Schedule A Consultation!
Call Now: 877-77-ARTTX

Underdiagnosed: Girls With ASD Miss Out On Early Intervention

Published on 08/16/2023
underdiagnosed girls with asd miss out on early intervention

Children with autism spectrum disorder (ASD) require particular understanding and support to facilitate their success at home, school, and in the social realm. Unfortunately, girls with autism are significantly underdiagnosed, resulting in an unfair lack of the support systems they need to thrive.

Without an accurate diagnosis, girls with ASD miss out on early intervention therapies, programs, and treatments. But, equally important, their parents and caregivers miss out on the early intervention and training that supports household harmony and the resources they need to promote their child's - and household's - well-being. 

Girls With Autism: Overlooked And Undiagnosed

According to the CDC, studies show that one girl is diagnosed with ASD for every four boys with the same assessment. As a result, autism has largely been considered "a boy's disease." However, current research indicates this isn't the case at all. Most researchers now agree that the 

While there are some genetic differences causing males to be more prone to ASD, researchers and clinicians now believe the misdiagnosis of girls and women is due to diagnostic bias and because females with autism may present differently than their male counterparts.

Females With ASD May Present Differently

First, let's review some of the most common symptoms indicating a child may be on the autism spectrum. These ASD symptoms largely revolve around two of the most typical behaviors associated with autism: lack of communication/social skills and restricted/repetitive behaviors.

Children with ASD typically display the following symptoms:

  • Speech delay or being mostly nonverbal (apraxia) 
  • Inability to read/interpret emotions in others
  • More stoic facial expression 
  • Lack of gestures or body language to communicate
  • Lack of empathy for others
  • Rigid attachment to specific routines or orders of things
  • Obsessive or repetitive behaviors (often called stimming)
  • Extreme sensory sensitivities
  • Other developmental delays

However, there are ways in which girls may present slightly differently from their male counterparts, which may delay accurate diagnosis, treatment, or referrals to specialists.

Girls may do a better job at navigating social situations

In many cases, girls with ASD seem to navigate the social realm with less strife than boys with ASD. Even non-verbal girls may still read the facial expressions and emotional spectrum, which keeps them off parents' and teachers' ASD radar for longer. 

Repetitive behaviors look different for females

Researchers also noticed that hindsight reveals things that in-the-moment assessments do not. For example, the obsessive qualities a boy may show about area train schedules or a particular set of data outside the age-related norms, girls are prone to obsessing about unicorns, kittens, or princesses - and these are considered more normal age/gender appropriate. 

This is one of the reasons why girls with ASD are often referred to as "hidden in plain sight." 

Differences in the brain help girls hide their behaviors

Behavior analysis between girls and boys with ASD highlights some other interesting findings:

  • Girls are more apt to recognize they're different and then hide or control their behaviors in public.
  • They tend to make eye contact and smile more than boys with ASD (often part of the learned behavior to fit in).
  • A Stanford study showed physiological differences in brain structure make boys more prone to certain repetitive behaviors, like hand flapping, than girls.
  • Girls with autism may be better at faking it during the school day but then explode once they get home. This is called The 4:00 explosion. 

Like boys, a girl's ASD symptoms typically show up during their toddler years, but girls are better able to make one or two close friends, which may cause a teacher or pediatrics specialists to rule out ASD as a potential issue.

Another observation worth mentioning is how females are more programmed to please and mimic others. Also, this tendency or ability towards imitation means they're more likely to present as if they have high-functioning ASD when, in fact, they don't.

Emotional distress hides the root cause

Another difference between females and males with autism is that girls with undiagnosed ASD tend to be more emotionally affected by social issues than children who've had the benefits of accurate information, therapy, and other early intervention programs. 

As a result, an adolescent or teen girl with ASD has higher rates of depression, anxiety, and poor self-esteem. However, while the root cause of this is the emotional pain from lack of social integration and difficulty fitting in, clinicians are more apt to see it as a normal part of female puberty and the teen mental health spectrum. 

This misdiagnosis (see below) leads to extended missed opportunities for the changes required to support the whole child.

Think Your Daughter May Have ASD?

If you suspect your daughter has ASD, don't let school officials or your pediatrician tell you otherwise from a single visit or assessment. They may be operating from a well-meaning but outdated paradigm.

Instead, contact your child's school district psychologist, health insurance provider, and local agencies that provide applied behavioral analysis (ABA) to learn more about your options. Autism disorders show up differently for different children, and a parent's gut instincts are always a powerful sign.

Benefits of an autism diagnosis

There are multiple benefits to getting an official, accurate ASD diagnosis. These include:

Access to free and low-cost therapy

Children with ASD benefit from multiple therapies and interventions, including:

  • Occupational therapy
  • Speech therapy
  • Individual and group sessions focused on communication skills
  • Other helpful and supportive intervention services

Therapists also work with children and families to create an environment that proactively supports and prevents some of the most challenging behaviors and effects associated with ASD.

Goal setting and collaborative behavior strategies

Once you have an official diagnosis, we can create age- and ASD symptom-related goals - and collaborative strategies - that support positive family outcomes. Evaluations are an ongoing part of the steps taken to support individuals and families with autism, and the results of these evaluations form our personalized behavioral plans.

Access to reasonable accommodations

ASD is viewed as a learning disability like dyslexia, ADHD, and other learning/behavioral/developmental disabilities. Once schools and teachers know about the diagnosis, they'll provide teaching and instruction accommodations to meet your child's specific needs and learning styles. In addition, your child will eventually have access to reasonable work accommodations as needed.

Accurate mental health support

Unfortunately, those with undiagnosed ASD have a higher risk of inaccurate mental health diagnoses, which can mean taking medications for nothing. Working with a doctor takes the time and care to look beyond

Schedule An ABA For Your Daughter

Do you suspect your daughter may have ASD? Don't let her slip into the "lost girls" category. The earlier you have an accurate diagnosis, the sooner she'll have access to an intervention program that turns her "problems" into opportunities for learning and developing the best approach to fostering her success at home, at school, and with her peers.

Have questions? Contact us here at Autism Response Team. Our organization works with people of all ages with ASD, from toddlers to adults. Through our carefully crafted treatment plan, our BCBAs identify your child's individual needs and provide treatment in center-based, home-based, educational- and community-based settings.

Join Our Mailing List

linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram