Have you ever known a young woman, a classmate, a student or a friend, who was painfully “out of step” with the rest of the social group or just uncomfortably “quirky”? There is a chance that the young woman has autism.
In the past, we might have thought of her as a free or independent spirit. Today we are more aware of the increased prevalence of autism, as well as the benefits of interventions and supports.
The term autism can be applied to a spectrum of neurological disorders characterized by challenges in social interactions, difficulty communicating and repetitive behaviors. Individuals with autism may also have intellectual disabilities, motor skill and attention deficits or other health-related challenges. The Center for Disease Control reports that the current prevalence rate of autism spectrum disorders (ASDs) is 1 in 88 children. Boys are five times more likely than girls to be identified as having an autistic disorder (2012).
Parents, teachers, research scientists, advocates and others have come to question the screening process for ASDs. Why do experienced teachers and clinicians usually spot a young boy who has autism with a fair degree of accuracy- but not girls? What are their “gut feelings” telling them about the boys that are not picking up on for the girls?
As a parent of a child who has autism, a teacher and research scientist, I have come to join some of my colleagues in suspecting that the 5:1 male to female ratio for individuals with autism is skewed and that some girls who have ASDs are not getting diagnosed. I believe we are hampered from recognizing girls who have ASDs by two problems: one is the inability of families, educators and other face-to-face service providers to recognize autism in females because it presents somewhat differently than in boys. The second problem is the diagnostic tools that are currently available are not working to correctly identify females who are referred for screening.
Why does this matter?
Intervention is so important! The earlier a child receives the intervention and support services they need, the greater the gains they will make in the long run. Naturally, the process of screening children and providing the appropriate supports and services can be quite challenging. However, I believe it is worth the effort. Children with autism experience significant social challenges and often suffer years of social isolation, peer rejection, depression, anxiety or other mental health challenges and are at an increased risk for a variety of poor academic outcomes (Wilkinson, 2008). Developing social skills is quite similar to developing a large vocabulary. The more opportunities children have to learn and practice the needed skills, the better they tend to be at them.
Why is it so hard to recognize the warning signs of autism in females?
Poor social skills are one of the defining features of autism. While the debate is still open if girls are born more social than boys or if our society conditions girls to be more social then boys, most of us would still agree that, for the most part, girls are more social than boys. In addition, we seem to be more tolerant of girls who are shy, less aggressive and more physically awkward than boys. For whatever reason, as a society, we are less concerned when girls do not keep up with their age-level peers than boys. The real question then becomes…
What’s the harm in letting girls progress “at their own pace”?
If you think about it, there are so many benefits that we derive from having strong social skills. From infancy onward: (a) others interact with you more often, increasing your opportunity to practice and learn more things, (b) increased friendships reduces your vulnerability to bullying, (c) you can accomplish more tasks because others enjoy playing/working with you, (d) others advocate for your inclusion, etc. In short, when you have strong social skills, you are more likely to be a positive person with a strong sense of self-worth and the supports necessary to succeed academically and in life. After all, it takes two to play on the teeter-totter, to play catch, to receive feedback on a speech, to be hired, to sell a product, to build a relationship with, and to support each other.
What can you do about it?
You are the first, best chance that all of the women in your life will receive the supports and services they need to be successful. Be a good advocate by following these few simple guidelines:
- Know the signs of autism.
- When evaluating your impressions, compare the person to other females their age not males.
Brief Checklist for Some of the Signs of Autism
- Challenges in social interactions
- Unusual or challenges in communication
- Perseveration including intense or ritualized behavior (Perseveration is response repetition in inappropriate situations)
- Sensory challenges
This list is not extensive. If you suspect that a child may be exhibiting symptoms of autism, the best course of action is to have the child screened by a pediatrician or autism specialist. Early diagnosis leads to early intervention and better outcomes.
Do you have an insight on or experience with autism in girls? Please leave a comment.
Haidee Copeland, Ph.D.
Associate Research Scientist / Adjunct Special Education Professor / Parent of a Child with Autism