Autism: Understanding the difference between girls and boys
Autism Spectrum Condition (ASC) is a neurodevelopmental disorder that affects communication skills, social interactions, forming relationships and behaviour. As well as this, those with ASC tend to have issues processing sensory input, an overwhelming need for routine and the presence of repetitive and restrictive behaviours. It’s already a complex condition but it presents differently in boys and girls too, which is why understanding these differences is crucial for caregivers so they can offer the right support.
Research generally shows that autism is more prevalent in boys than girls, with the most up-to-date studies estimating a 3:1 ratio. However, recent studies suggest that autism may be underdiagnosed in girls, as their symptoms and the way they express themselves differ to that of autistic boys.
Studies conducted on children with autism have also shown boys and girls differ in their clinical and neurobiological characteristics. Care givers, including foster parents, need to understand these differences so they can provide the right support for their autistic children, helping them to live happy, fulfilling lives.
Putting on the mask – autism in girls
Research suggests the main reason that girls stay undetected and therefore are underrepresented in autism statistics, is because they’re more capable of imitating their peers and mimicking social norms to fit in. This is called masking, and it takes a big toll on mental and physical health. Unfortunately, this survival mechanism means they often evade treatment and support, leading to further problems in adolescence and adulthood.
6 ways autism is different between girls and boys
Diagnostic criteria
One of the most significant reasons why we’re only recently understanding the differences between signs of autism in boys and girls is the diagnostic criteria. The criteria include difficulties in social communication, social interaction, and repetitive behaviour, but they were developed based on studies of predominantly males. This gender bias is likely the reason why there’s an under-diagnosis of autism in females, because their behavioural characteristics differ from the original criteria used to diagnose ASC.
Social communication
Girls with autism tend to have better social communication skills than boys, making it harder to detect the condition in females. As girls are more likely to mask their difficulties in social situations, they’re able to blend in better with their peers. Research also shows that girls with autism are more likely to develop coping mechanisms to hide their social difficulties, such as mimicking their peers' social behaviours. They may also have a better ability to adapt to social situations, which makes it difficult for others to recognise their internal challenges. For example, girls with autism may learn how to make eye contact during conversation, even though they may not understand its social significance, or they might use rehearsed scripts and responses to get by in social situations.
Social interaction
Social interaction difficulties in autistic girls can be more subtle than in boys. Boys with autism tend to have more noticeable deficits in social interaction and communication, such as difficulty initiating and maintaining conversations, lack of eye contact, and limited interest in socialising with others.
However, while autistic girls may have difficulty initiating and maintaining friendships, they tend to have more of a desire to be socially involved. However, despite being more motivated to engage socially, they can still struggle with the nuances of social cues such as sarcasm, facial expressions or reading when people are being untruthful. This vulnerability can sadly lead to them being taken advantage of by classmates or family members.
Repetitive behaviour
Repetitive and restrictive behaviours (RRBs) are a core symptom of autism. They have important implications for diagnosis and intervention, but the differences in RRBs between autistic girls and boys can be subtle. Some of the key differences between girls and boys in terms of repetitive behaviours include the types of behaviours, the frequency and the social implications.
Types
Boys with autism tend to display more stereotypical and overt repetitive behaviours, such as flapping their hands or spinning objects. In contrast, autistic girls may exhibit more subtle repetitive behaviours. This could be picking at their skin, obsessively organising objects, engaging in more repetitive self-talk or perseverative thinking, and repeating certain words or phrases in their head. To the outside world, these aren’t immediately noticeable.
Frequency
Another reason why autistic girls often fly under the radar is because they’re more able to suppress their repetitive behaviours, leading to an underestimation of the prevalance in RRBs in girls. For example, girls are more likely to engage in repetitive behaviours in private, such as when they’re alone in their room, rather than in public settings where others might observe them. This may make it more difficult for parents or caregivers to recognise the presence and frequency of these behaviours.
Social implications
Girls with ASC may be more aware of social expectations and norms than boys, which can cause them to suppress or modify their repetitive behaviours in order to fit in with their peers. An autistic girl who engages in hand flapping may be more likely to suppress this behaviour in public than a boy who displays the same behaviour. This makes it more difficult for healthcare professionals and caregivers to recognise the presence and severity of repetitive behaviours in girls, which can lead to under-diagnosis or misdiagnosis.
Comorbidities
Comorbidities are other conditions that occur in addition to the primary diagnosis. Research has shown that autistic girls are more likely than boys to have comorbidities such as anxiety, depression, and eating disorders. This could be because girls with ASC have more difficulty coping with the social demands of adolescence, leading to higher rates of anxiety and depression. They’re also more likely to develop eating disorders, such as anorexia nervosa or bulimia, as a result of their sensory issues and rigidity around food.
Misdiagnosis
The differences in how autism presents in boys and girls can not only lead to females staying undiagnosed, but also being misdiagnosed. Healthcare professionals may not recognise the subtle traits of autism in females, so they may diagnose anxiety, depression, borderline personality disorder (BPD, which is now known as emotionally unstable personality disorder, EUPD) or attention-deficit/hyperactivity disorder (ADHD) instead. What’s crucial to note though is that these conditions can also coexist with autism, so a person may have autism and ADHD, autism and EUPD or perhaps all three, making diagnosis quite complex.
Autism Support Pack for Foster Parents
Download the FCA’s Autism Support Pack. Learn more about the common misconceptions made about children with ASD and how to adapt your home and surroundings to children with autism.
Other signs of autism in girls and boys
Signs of autism in boys
- More likely to have repetitive and restricted play behaviours.
- More likely to struggle with social communication in early life.
- More likely to have challenging or disruptive behaviour to obtain items.
- More likely to have perseverative interests in things like statistics and schedules.
- More likely to be hyperactive or prone to distraction.
Signs of autism in girls
- More likely to mask in order to fit into social settings. Boys can do this too but it’s less common.
- More likely to be able to respond to non-verbal communication cues.
- More likely to have challenging or disruptive behaviour to gain attention.
- More likely to have perseverative interests that appear socially ‘typical’, like music.
- More likely to be passive and withdrawn.
Fostering a child with autism
Every person with autism is entirely unique, which is what makes being a foster parent to an autistic child such a wonderful and rewarding role. Being separated from their birth family is hugely distressing for any child, but for those with ASC, the confusion and changes to their routine and environment can be exacerbated. They need the love and support of a caring foster parent, who has the time, patience and compassion to help them during such a difficult period in their lives.
Fostering an autistic child won’t always be easy, but becoming a foster parent could be the best decision you ever make. And when you foster with FCA, you’ll have a huge network of support there for you whenever you need it. From social work support and therapy services to first-class training and a 24/7 helpline, you’re never on your own.
To find out more about fostering, please get in touch with us today using our online enquiry form. Or download our Beginner’s Guide to Fostering a Child to discover everything you need to know about being a foster parent.