Don’t overlook autistic girls


Close your eyes, and conjure up an image of an autistic kid. What springs to mind?

If I had to guess, I’d say it’s probably a socially awkward boy who’s obsessed with gaming.

But the time has come to challenge that assumption. A new study in the Journal of Autism and Developmental Disorders, released Jan. 4, reinforces something I’ve known innately for years, having myself been an undiagnosed autistic girl: It is easy to overlook us.

According to the Centers for Disease Control and Prevention, autism affects one in 68 children but is four and a half times more prevalent in boys than girls. But that still means there are an awful lot of autistic girls.

The study, led by the Children’s National Health System, found that autistic girls are often flying under the radar, undiagnosed and untreated, because their symptoms are different. Specifically, girls tend to camouflage their social deficits better than boys. They can be more aware of what social interaction should look like. They often strain to fake it, to appear “normal.”

Hence, many are never referred for testing, although they are equally in need.”

This could mean that girls who meet the same clinical criteria as boys actually are more severely affected by ongoing social and adaptive skill deficits that we don’t capture in current clinical measures,” said the study’s lead author, Dr. Allison Ratto, a clinical psychologist within the Center for Autism Spectrum Disorders at Children’s National.

Girls with autism are less “different” or “disruptive.” They may mask their symptoms and be more adept at learning to blend in. They watch, carefully, and study social interaction until they are ready to try to engage.

Unfortunately, this doesn’t always work, and it can, in fact, lead to internalized stress. This may even be at the root of many other mental health issues prevalent among girls, such as eating disorders and depression.

I remember back when reports on the different symptoms of heart attack in women first came in. We realized as a society that all those cardiology studies done exclusively with men were misleading us about women’s different symptoms, and making us overlook many women at risk.

We are standing at the same spot now with autism. There are likely many undiagnosed women and girls, some of who could benefit from earlier intervention and support.

Early intervention would have helped me navigate the world with more ease, understanding and clarity. Autism awareness was practically nonexistent when I was growing up — but thankfully, times are different now.

I hope this new research will help us to re-picture what autism looks like, in our girls as well as our boys, so that we may support all young people in accessing resources for their optimal mental health.

Sally J. Pla is the author of “The Someday Birds,” which recently won the Dolly Gray Children’s Literature Award. Her second novel, “Stanley Will Probably Be Fine,” will be released in February.

Progressive Media Project