GIRLS OFTEN GO UNNOTICED
Why is it that we know a lot about the presentation of autism in boys, yet comparatively little about these conditions in girls? Although girls presenting with autism were noted by both Kanner and Asperger as far back as the 1940s, past research on autism has mostly focused on boys. Kopp (2010) has attributed this situation to the prevalence of developmental disorders in males coupled with a much higher rate of clinical referral in males. Could it also be that they weren’t being picked up because the presentation of autism in girls differs from that in boys?
The triad of impairment manifests more subtly in most girls on the spectrum and this may have contributed to many not getting their diagnosis of autism until they are teenagers. Not only does this mean that they and their families may have missed out on potential supports, it is also a particularly difficulty for them to receive a diagnosis at a time when they are having to cope with the challenges of adolescence.
Thankfully, awareness of girls with autism is increasing and this is reflected in a growth in recent publications. These works, along with autobiographical and anecdotal reports, suggest that we consider the following:
- girls with Autism often have a childlike quality to their tone of voice
- girls’ special interests may be of a socially acceptable type (e.g. horses or animals in general; Twilight series and other vampire-related things; Japanese Anime and Manga; fantasy stories and games; make up, hair and fashion)
- girls may be very quiet and appear shy or, alternatively, extremely ‘out there’. The former may result in their being overlooked; the latter in being labelled as having a conduct or behavioural disorder
- many girls on the spectrum may copy and mimic neurotypical females and may even adopt the persona of someone they perceive as socially successful. This may mask their difficulties until either the stress of keeping up the act overwhelms them or they are faced with a challenge they haven’t encountered before. Either way, they often inevitably crash
- if they are part of a female peer group, the other girls may support them and compensate for their difficulties
- those interested in fashion, make-up and hair styles may take it ‘too far’ (e.g. their fake tans may be more orange than others’; hairstyles higher or bigger and dress may be more extreme than their peers’
- their social and emotional naivety, can make them vulnerable to exploitation by others
- girls can be frequently bullied at school
- they frequently underachieve at school
- they often experience anxiety or depression
While there is commonality in terms of the triad of impairment, there is also much diversity in the presentation of autism in girls. The following case studies attempt to illustrate this range of difficulty as well as highlighting the girls’ wonderful abilities.