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Autism First Signs: A Checklist For Girls and Women
While it is clear that the number of boys in Australia who are diagnosed with autism is higher than the number of girls, the reasons for this are not necessarily as obvious.
Why are girls less frequently diagnosed with autism?
The ratio of male:female autism diagnoses is thought to be about 4-3:1, although this likely does not reflect the true gender ratio of autism. It is also generally the case that when girls are diagnosed, it is later on than males.
Research suggests there may be a number of different reasons as to why girls are diagnosed with autism less frequently:
- A bias towards males in the diagnosis process, with the specific needs of girls on the spectrum not sufficiently researched
- When boys display characteristics of autism, these are more likely to be recognised by parents, carers, teachers or health professionals
- Girls are thought to use masking or camouflaging more frequently than males, and are more reluctant to draw attention to themselves
- Girls tend to be diagnosed as being on the spectrum at a significantly later age than boys.
Girls are generally diagnosed later than boys.
Signs of autism in girls
Everyone’s lived experience of being on the spectrum is unique, but there are many characteristics of autism that are shared by both boys and girls, men and women alike.
However, there are also some signs of autism that are more commonly observed in girls and women, and which may account for the lower incidence of autism diagnoses in females. These can include:
- Masking or camouflaging the challenges presented by the characteristics of autism through a range of strategies
- Avoiding or not seeking social interaction
- Being seen by others as excessively shy, or preferring not to engage with others
- Can be seen as extrovert when it comes to their interests and hobbies
- An ability to keep emotions under control in social scenarios, but prone to becoming upset or distressed at home as a means of release
- Seen by others as quirky, or a day dreamer
- Copying or mimicking others’ speech and actions in social situations
- Having a very limited number of close friendships
- A tendency to become very intense and possessive in friendships, which can also end very suddenly
- Having a tendency to get ‘mothered’ by peers at primary school
- A well developed sense of justice that means they may stand up for others
- Language skills that may appear to be advanced for their age
- A range of non-verbal communication skills
- A highly developed imagination and enjoyment of fiction, pretend and fantasy play
- Play can be one-sided, or overly controlled
- Repetitive behaviours, such as hair twirling
- Intense interests, which may be focussed on culture, art, people, music or animals. These interests may stem from a desire to match those of their peers, or to fit in with others of the same age
- Interests that are advanced for their age
- Being considered an overly fussy eater.
Some characteristics of autism can lead girls on the spectrum to lack self-confidence and have poor levels of self-esteem. This can lead to anxiety and the development of co-morbid mental health issues, particularly if autism has not been formally diagnosed.
Some characteristics of autism can lead girls on the spectrum to lack self-confidence and have poor levels of self-esteem.
Signs of autism in women
Some of the characteristics that adult women with an autism diagnosis commonly report, include:
- Being able to camouflage or mask the signs of autism
- Mimicking others’ behaviours as a means of gaining acceptance and blending in
- Imitating the gestures, expressions and body language of others
- Forcing themselves to make and maintain eye contact in social interactions
- Preparing expressions, phrases and jokes in advance to use in conversations with others.
It is important to remember that the information above is simply a list of some of the common signs and characteristics of autism. It is unlikely that a girl or woman will display all of these characteristics.
To be diagnosed with an Autism Spectrum Disorder an individual does not need to display all of these signs, but rather must meet a specific combination of criteria across the two domains of communication and social interaction and behaviours.
It is also important to keep in mind that this is just a short summary and only trained accredited specialists can make an autism diagnosis.
Getting an autism assessment
If you, your daughter, or someone you know is displaying some of the signs and characteristics associated with autism as described above, reaching out to a qualified health care professional is advised. The health care professional may refer for an autism assessment to be conducted by trained and qualified specialists in diagnostics.
The highly experienced Diagnostic Team at Autism SA provides autism assessments for people of all ages and genders and there are a number of ways in which you can arrange an assessment for yourself or for someone in your care.
Self-referral to Autism SA
You can self-refer to Autism SA, meaning that you make the arrangements to have an assessment directly, rather than through your doctor or another healthcare professional.
You can do this either for yourself or for someone in your care, and there is no upper age limit for seeking an autism assessment. All referrals are required to be in writing.
You can make a self referral in a number of ways:
Referral to Autism SA by a healthcare professional
A referral can be made to Autism SA from a medical or allied health professional, such as your General Practitioner (GP) or a family health nurse, for instance.
It is important to understand that GPs are generally not qualified to undertake an autism test, nor to diagnose autism. Nevertheless, they will ask you questions about your child’s development (or your own, in the case of an adult), and may undertake screening and observations to determine whether an assessment for autism is appropriate, or to help them rule out other possible health or developmental issues.
If your GP or another healthcare professional decides to make a referral to Autism SA on your behalf, they will be required to complete a Diagnostic Assessment Referral form, and so will likely need your assistance with some of the background information the form requires.