Earlier this year, the Centers for Disease Control and Prevention announced a new estimate of the number of children living in the United States with autism spectrum disorder, a condition that affects many aspects of development. There isn’t any one test to diagnose autism, but a person with autism may exhibit marked communication differences, such as a lack of eye contact, as well as repetitive behaviors and sensory problems. Autism spectrum disorder is diagnosed after careful evaluation by a trained professional, such as those on staff at Neurobehavioral Associates — and it is increasingly common.

While the CDC reported in 2016 that 1 in 59 children were estimated to have the condition, the center’s updated report estimates that 1 in 68 children have autism. While this is a noteworthy increase, the big question that experts are asking now is if autism is actually becoming more common, or if the new numbers are simply due to the fact that we’ve become much more skilled at both identifying and diagnosing autism.

One of the major areas where professionals have struggled is in the diagnosis of women and girls with autism. While the disorder is still considered to be nearly 5 times more common in boys than in girls, extensive bodies of research has shown that girls are not only diagnosed with autism at significantly later ages than their male counterparts, but they are also less likely to be diagnosed at all.

Why are Girls Less Likely to be Diagnosed with Autism?

There are several factors that cause the gap between the diagnosis of boys with autism and the diagnosis of girls. An earlier study, released in 2015, found that there is an obvious difference both in symptoms, and in the presentation of symptoms in girls with autism.  Researchers have noted differences in the brain scans and genes of girls with autism when compared to boys. It’s also important to note that, because of the lower rate in girls, much of the study and research around autism has been conducted with male participants, as opposed to female.

When it comes to symptoms, girls have been found to be more likely to experience difficulty with social skills. They tend to have problems centering around language and communication, such as appropriately interpreting social cues. Girls are often quiet and exhibit less of the repetitive behaviors that are found to be more pronounced in boys, such as hand-flapping. Nevertheless, girls who do manage to be diagnosed at an early age usually present with much more severe symptoms and lower IQ scores than boys of the same age with autism. Girls who don’t show severe traits, or who have higher IQ scores — perhaps, suggests research, the majority — are the ones diagnosed later in life, or not at all.  It seems that girls on the spectrum are underdiagnosed both because of their differences in symptom presentation, and due to the very social constructs within which these girls struggle.

Camouflaging Autism: Girls are More Likely to Try to Blend In

As researchers have learned more about autism rates among the genders, they have found that girls and women tend to cover up their autism symptoms during social situations, and they do this at a significantly higher rate than boys.4 The research is strong enough that this discovery is thought to explain a great deal of the disparity between boys and girls on the spectrum. Researchers who have observed the two genders at play have noticed that girls with autism are typically found among other girls, looking as though they are having a positive interaction, even as they are not. Boys, meanwhile, play by themselves, and seem more okay with the isolation.

Girls are more likely to attempt to hide their own desire for repetitive behaviors, such as flapping hands or spinning, in an attempt to please others, while boys are more likely to show these behaviors, and to appear overactive. While boys are most often obsessed with obscure topics, like coins or presidents, girls become obsessed with things their peers also enjoy, such as celebrities. This laundry list of differences means that the questions being asked during standard autism evaluations are leaving girls unnoticed, while their male peers are being diagnosed.

What Does it Mean to Camouflage Autism?

While most every child and adult can relate to the desire to ‘fit in’ socially, girls who camouflage their autistic traits bring on a completely different set of problems. These individuals hide their autism in an effort to achieve greater success at work or in their relationships. This decision is extremely difficult, as consistently hiding a condition like autism is exhausting. People who camouflage their autism may develop anxiety or depression, and experience an overall lower level of life satisfaction. It is through social masking that many girls are not even diagnosed with autism spectrum disorder until they reach adulthood, preventing them from receiving the services and resources that could actually make autism easier to manage.

Still, the issue isn’t as simple as recognizing and diagnosing autism in girls at the same early age as boys. Some women have shared with researchers their concern about being labeled and the negative reactions from others to that label. However, the majority of women expressed that knowing there was a word for their social difference would have allowed them the ability to better understand themselves, as well as to access those tools and supports that could have aided them before adulthood.

Tools to Succeed

For many reasons, from the difference in symptoms to the intense social camouflage that girls often undertake, autism spectrum disorder is underdiagnosed in women and girls. This underdiagnosis keeps girls from receiving valuable assistance that can help them have more successful relationships and careers without the pain associated with masking their autism.

Neurobehavioral Associates provides comprehensive neuropsychological services that can help confirm autism. Our evaluations will look at many different aspects of  development, including attention, verbal skills, memory, executive function, and social/emotional functioning. We will offer you a wealth of resources and referral options to get you or your child on a healthy path to success.