Autism in Girls: Signs, Symptoms and Underdiagnosis

Autism in Girls May Look Different From Autism in Boys

Autism in girls may look different than in boys. Sometimes, caregivers and even healthcare providers may doubt that a female child is autistic because they do not have the "typical" autism symptoms that are more often seen in boys.

Signs and symptoms of autism in females, particularly those on the high-functioning end of the spectrum, include:

  • Relying on other people to guide or speak for them
  • Having unusual sensitivity to sensory challenges
  • Having passionate but limited interests
  • Difficulty making and keeping friends
  • Having conversations that are restricted to limited topics of interest
  • Difficulty with social communication (which increases with age)
  • Appearing to be shy, quiet, or unusually passive
  • Having depression, anxiety, or other mental health symptoms
  • Difficulty controlling emotion
  • Having epileptic seizures

It's true that the signs of autism in girls and women are not always the same as the signs of autism in boys and men. This means that females may not get an autism diagnosis until much later in life—if ever.

This article will go over how autism is different in girls. You'll learn about the signs and symptoms of autism in girls and women, as well as how the differences in autism between girls and boys can delay diagnosis.

autism in girls
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Signs of Autism in Girls

While there is no single sign or symptom that diagnoses autism in anyone, regardless of their sex at birth or gender identity, there are some characteristics of autism that can help providers make the diagnosis.

That said, autistic girls may not show some of the "classic" autism signs that are more often seen in boys. Sometimes, autistic girls learn how to hide these behaviors or overcompensate for them.

Whether you are female and think you might be autistic or you are caring for a child who might be on the autism spectrum, there are some experiences that are shared and resonate with many autistic girls and women.

An autistic girl may:

  • Rely on other children to guide and speak for her during the school day.
  • Have passionate but limited interests. The list of things that interest her is very narrow and restricted. For example, an autistic child may talk endlessly about a TV show's characters, locations, props, or actors, but know little or nothing about the show itself (e.g., the plot).
  • Have conversations that are limited to her topics of interest. She may share her focus on a specific interest with you but cares little for another person's response. This may interfere with her ability to join groups or make friends.
  • Be unusually sensitive to sensory challenges such as loud noises, bright lights, and strong smells (a symptom that's as common in many autistic people regardless of sex).
  • Have a low frustration level and find it hard to manage feelings when she is frustrated. She may have inappropriate "tantrums" for her age—which are really autistic meltdowns. The behavior can become disruptive at school, and may lead to detentions or even suspension.
  • Have depression, anxiety, or other mental health symptoms. Autistic people of all ages often have co-occurring mental health conditions, including obsessive-compulsive disorder (OCD) and eating disorders.

Some autism symptoms can be perceived as being part of a young girl's personality, or just "quirks" in how she connects with others.

In fact, these can be subtle but missed signs of autism in girls:

  • She has a hard time making or keeping friends. She may seem oblivious to nonverbal social cues and even somewhat clueless about how the girls around her behave—for example, not understanding or being interested in their hair and fashion choices.
  • She is called "quiet" or "shy" in school and other social situations. Autistic people have varied language skills, but having these challenges can make it hard for a child to jump into talks with friends, raise their hand in class, or respond quickly in social settings.
  • She is unusually passive. Being passive can be a sign that she's unsure what to do or say in a situation and has decided the safest option is to do nothing. Some autistic people are actually quite assertive, but young girls may learn that being passive is more likely to be accepted or rewarded, especially at school.
  • She developed typically as a child but starts to find social communication increasingly difficult as she enters her teen years. Autistic girls often find ways to mask and cope with their differences early on. However, once social expectations become more complex in the early teenage years, her challenges become a lot more clear and harder to manage (or hide).
  • She has epileptic seizures. Some research has suggested that epilepsy could be more common in autistic girls than boys.

Why Autistic Girls Go Undiagnosed

Some girls have clear autism symptoms like self-stimulating behaviors (stims), or extreme speech and language difficulty.

If challenges with social communication or cognitive tasks are obvious, girls are usually referred for help and diagnosed at a young age. However, for girls with subtle symptoms and those who have learned to mask, autism may not be diagnosed—or even discussed—until they are pre-teens, teens, or adults.

Cultural beliefs (and misbeliefs) also contribute to missed autism diagnoses. Many girls are expected to behave in quieter and less assertive ways than boys. A girl who seems shy and withdrawn might be seen as "feminine," while a boy with the same characteristics would get intervention because they are not exhibiting more outward, "typical "boy" behavior.

Similarly, a girl who seems "spacey" and unengaged is often called a "dreamer" in a positive way, but the same behaviors might be viewed as disruptive in boys and, again, would lead to intervention.

Healthcare providers and mental health professionals can miss autism in girls, too. The diagnostic criteria for autism spectrum disorder (ASD) were put together based on available research, which has long been primarily in boys and men.

Strides are being made to help make the criteria more inclusive for autistic people who are not male, but there is still a long way to go.

Summary

Autistic girls and women may not get diagnosed as early as boys and men—if they are diagnosed at all. The "classic" signs of autism do not always show up in girls, and some girls learn how to cover up the symptoms at a young age.

There are many factors that contribute to the missed and misdiagnosis of autism in girls, and some of them have to do with cultural expectations. Not only does this make it harder for autistic girls to get diagnosed, but it also means they go longer without the support they need to thrive.

A Word From Verywell

If you care for an autistic girl, it's key to support her at home and advocate for her needs to be met at school. Regardless of birth sex or gender identity, every autistic child benefits from a treatment plan that is tailored to their needs.

If you are not sure if your child is autistic, but you have noticed some signs of autism, talk to your pediatrician and look into what resources are available at your child's school. If a young girl in your life is autistic, the best thing you can do for her is help her get diagnosed and make sure she gets the support she needs to thrive.

Frequently Asked Questions

  • Are girls less likely to be autistic than boys?

    Autism is diagnosed more often in boys because they tend to show more of the "classic" signs. While autism is recognized more easily in boys and men, it does not necessarily mean that girls and women are less likely to be autistic.

  • How is autism different in girls?

    Autistic girls and women may not show all the "typical" signs that boys and men do. In many cases, autistic girls do experience these symptoms but learn how to cover them up or overcompensate for them early in life. While this might help them "blend in," it also makes it harder for them to get diagnosed.

  • Can adult women be autistic?

    It's not uncommon for an adult woman to learn she is autistic. When an adult woman is diagnosed with autism, she often experiences a lot of clarity about what her life has been like. She may look back at her childhood and teen years and realize that certain "quirks" or experiences that she had were clear signs of autism that were missed by the adults in her life.

    As she became a teen and young adult, she may have sought help from healthcare providers or mental health providers only to be diagnosed with another mental health condition (or even a physical medical condition) rather than autism.

  • Is the treatment for autism different for girls?

    Treatment and support for autism should be tailored to each individual. That said, an autistic girl can benefit from many of the same treatments that an autistic boy would, such as speech therapy and occupational therapy.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Werling DM, Geschwind DH. Sex differences in autism spectrum disorders. Curr Opin Neurol. 2013;26(2):146-53. doi:10.1097/WCO.0b013e32835ee548

  3. Nichols, Shana. A Girl's-Eye View: Detecting and Understanding Autism Spectrum Disorders in Females. Interactive Autism Network at Kennedy Krieger Institute.

  4. DeWeerdt, S. Autism characteristics differ by gender, studies find. Simons Foundation.

  5. Navot N, Jorgenson AG, Webb SJ. Maternal experience raising girls with autism spectrum disorder: a qualitative study. Child Care Health Dev. 2017;43(4):536-545. doi:10.1111/cch.12470

  6. El Achkar CM, Spence SJ. Clinical characteristics of children and young adults with co-occurring autism spectrum disorder and epilepsyEpilepsy Behav. 2015;47:183-190. doi:10.1016/j.yebeh.2014.12.022

  7. Green RM, Travers AM, Howe Y, Mcdougle CJ. Women and Autism Spectrum Disorder: Diagnosis and Implications for Treatment of Adolescents and Adults. Curr Psychiatry Rep. 2019;21(4):22. doi:10.1007/s11920-019-1006-3

  8. Sarris, M. Not Just for Boys: When Autism Spectrum Disorders Affect Girls. Interactive Autism Network at Kennedy Krieger Institute.

  9. Child Mind Institute. Why many autistic girls are overlooked.

  10. Autism Network. Asperger and Autism Spectrum: Women and Girls.

  11. Simmons University. Interventions for Girls and Women on the Autism Spectrum.

Additional Reading

By Lisa Jo Rudy
Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism.