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Why are Girls Diagnosed Less with ASD?



In autism spectrum disorder (ASD), more boys are diagnosed than girls, some reports say ten times more. This imbalance in diagnosis may be due to difficulties in identifying girls with ASD than boys with ASD. Girls are better at camouflaging, or masking, their symptoms, such as repetitive behaviors, to adapt to social settings. Moreover, boys are more likely to show restricted interests to unusual ideas such as train schedules or taxis, as opposed to girls, whose interests align more with stereotypic items like stuffed animals or dolls. In earlier ages, students socialize in playgrounds during recess, and sex becomes a powerful indicator of children’s social organization. Boys are more involved in team games and physical activities are more essential whereas girls’ value social conversation more. Because boys show more visible hyperactivity and inattention, it is easier for teachers to refer them to get help. For example, boys tend to be more isolated during playtime and easier to pinpoint than girls who blend in together with normally developing girls. Girls can copy and mimic social behaviors to mask their symptoms to hide from teachers spotting them, but because of their disadvantaged sensory processing, it is more difficult for them to identify more subtle social cues like eye rolls and smirks. The lack of ability to realize mistakes make girls with ASD more susceptible to exclusion and aggression. Because girls are less likely to receive an intervention, they might suffer more from emotional distress.

This phenomenon of low detection in girls with ASD stems from perceiving ASD symptoms from a gender-biased view. Gender difference is evident in socializing in normally developing children, and inclusive diagnosis and intervention should be implemented. It is common for girls to be in a social skill intervention program with more boys, and the skills required for two groups are different. Girls would benefit more from learning how to interpret social cues since they use subtler cues to communicate. It is especially important for the development of a more specified intervention for girls because the cost of camouflaging might impact girls negatively. They put a tremendous amount of work to fit in and not having control over their emotions can be highly taxing, leading to disruptive mental states. Further research on developing intervention for girls should be conducted in order to support them with better communication skills. Of course, many differences in autism diagnosis rates can be attributed to what some scientists called a, “female protective factor” that is hypothesized to have a protective gene against autism on the X chromosome. Seeing the true proportion of girls diagnosed with autism can give us insight on both social and genetic effects of autism.


If interested: Check out this link of a girl with ASD explaining the differences in symptoms between boys and girls.


References:

Dean, M., Harwood, R., & Kasari, C. (2016). The art of camouflage: Gender differences in the social behaviors of girls and boys with autism spectrum disorder. Autism, 21(6), 678-689. doi:10.1177/1362361316671845


Russo, F. (2020, August 06). The costs of camouflaging autism. From https://www.spectrumnews.org/features/deep-dive/costs-camouflaging-autism/

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