Historically there has been a strong gender bias of more males diagnosed with ASD than females. As a result, professionals are less likely to diagnose girls/women even when symptoms and behaviours are evident.

Girls with an ASD are often undiagnosed, because original diagnostic criteria have a boy bias. The criteria were created by examining mainly boys, and girls can be very different. I think we all know ‘neuro-typical’ boys and girls are very different in their social, communication and behaviour.

Autism Spectrum Disorder in Females

Social Understanding

• Girls are more able to follow social actions by delayed imitation. They observe children and copy them, masking symptoms
• They are on the periphery of social activities
• Girls are more aware and feel a need to interact socially
• When involved in social play, girls are often led by peers rather than initiating contact
• Girls are more socially immature and passive than typically developing peers
• In primary school more likely to be ‘mothered’ by other girls but bullied in secondary school
• Parents often ‘engineer’ or ‘organise’ friendships
• Girls more often more socially inclined than boys and may have one special friend

Social Communication

• Little difference in acquiring speech in girls and boys
• Girls generally have superior linguistic abilities to boys of a similar cognitive level
• In society, girls are expected to be social in their communication but they do not do social chit-chat or make meaningless comments to facilitate social communication
• Little idea of social hierarchy and how to communicate with people of different status

Social Imagination

• Girls have better imagination and more pretend play
• Many have a rich and elaborate fantasy world with imaginary friends but have difficulty separating reality from fantasy
• Girls escape into fiction and some live in another world
• When involved in solitary doll play they have a ‘script’ and may reproduce a real event or a scene from a book or film
• There is a lack of reciprocity in their social play and they can be controlling or domineering
• Social imagination does not relate only to pretence or symbolic activities – it is the ability to use imagination in a social sense

Special Interests and Routines

• The male stereotype of autism has clouded the issue in diagnosis
• Boys are more hyperactive and aggressive and have interests in technical hobbies and facts
• Girls are more passive and collect information on people rather than things
• The interests of girls in the spectrum are similar to those of other girls – animals, soaps, celebrities, fashion
• Perfectionism is frequently seen in girls
• It is not the special interests that differentiate them from their peers but it is the quality and intensityof these interests

 There are many characteristics that are very similar to boys with an ASD but here is a list of the main differences to girls with an ASD.

Ten Ways Girls with an ASD differ to Boys with an ASD

1. 1. Their special interests are usually animals, music, art, literature.
   2. They often have a very good imagination which includes imaginary friends, games, being animals or taking on persona of other girls.
   3. They often see speech therapists for their speech and may be diagnosed with specific language disorders, however there is something different about this girl no one can quite put their finger on.
   4. They often play with older children or much younger children. This play is sometimes unusual for example ‘Mums and Dads’ but she will want to play the same role and game every time. She usually wants to be the pet or baby, whereas most girls want to be the Mum or Dad.
   5. They often have hyperlexia – the ability to read but comprehension does not always match their reading skills. They are often the class book worm or write stories but they write the same story over and over changing a few characters. Many have a special interest in literature.
   6. They have unusual sensory processing, like the boys, however bigger fluctuations often going from one extreme to the other.
   7. They get anxious like boys, however their anxiety is rarely physical or disruptive. In fact, many have great coping mechanisms at school however the family see a very different child at home where the anxiety can explode.
   8. Often their difficulties with social skills are called ‘shy’, ‘quiet’, ‘solitary’.
   9. They often like to organize and arrange objects. Example: one little girl spends hours seemingly playing “My Little Ponies” however on closer examination she was just arranging and re-arranging the horses over and over.
   10. The main difference is there are MANY more undiagnosed girls/women than boys/men