Autism spectrum disorders are usually recognized in boys but much less in girls. The rate of autism is 4
times greater for boys than for girls. Because boys outnumber girls with autism, comparatively little research
has focused on girls. The reason why there are more males than females with autism is not known.
However this high ratio of boys to girls is found in a number of disorders involving language and learning
Girls with autism face unique challenges not just because they are girls, but because the disorder itself
presents differently in them than it does in boys. Lack of knowledge about autism in females may add to the
difficulty it causes. The unique challenges faced by girls with autism may also influence the way in which
the disorder is presented.
Girls with autism are less likely to have an obsessive lifelong interest in collecting facts, as boys with autism
often do. For instance, autistic boys seem to focus on certain interests like trains, science, weather, etc.
Girls with autism are interested in art, music, relationships and feelings. Autistic girls are more likely to have
obsession interests centered on people and relationships. Some girls on the autistic spectrum often focus on
diet or calorie control, which may become their obsession. Research shows that about one in five women
with an eating disorder is thought to be on the autistic spectrum.
Research on Autism and Girls
To date, there are few autism studies on girls with autism and the existing studies have focused on 2 forms
of autism, PDD and Rett disorder. Rett Syndrome is a rare but serious developmental disorder that primarily
afflicts girls. Because it shares some traits with autism, some experts say it is on the autism spectrum. PDD
and PDD/NOS cases are at the less severe end of the spectrum, where sufferers may have limited or no
speech problems and can have high IQs.
Studies comparing girls to boys with autism indicate that when girls are identified as having disabilities, they
were likely to have more significant challenges and extreme educational needs than their male peers. Girls
with autism obtain IQ scores that average approximately 5 points lower than those of autistic boys. These
girls on the autism spectrum may suffer as well by being placed in specialized educational programs, where
they will be surrounded by boys and further isolated from female social contacts.
A study from York University (measured by the Vineland Adaptive Behavior Scales) found that girls with
autism really do seem different than autistic boys in symptoms such as adaptive functioning and visual skills.
However, girls with autism did not demonstrate higher socialization scores than boys. Autistic girls have
been noted to have stronger pretend-play skills. Girls with autism also have stronger communication skills or
communicative behaviors such as pointing and gaze following. Other behaviors like language deficits,
tantrums, and aggression are all less common in girls than boys in the general autistic population.
Autistic Girls and Adolescence
During adolescence, social interactions and relationships are normally more complex and challenging for
females with autism. Autistic girls have more trouble with social interaction because peers are aggressive in
more discreet indirect ways which are hurtful toward another girl. Typical girls may bully girls with autism
by spreading rumors, gossiping, exclusion, and nonverbal behaviors such as giggling and eye-rolling. While
lacking the social interaction skills, girls with autism spectrum disorders, often mask their disorder through
silence or imitation of others.
Girls with autism ages 8-12 years old may start puberty such as menstruation, development of breast and
hormonal changes. As girls approach adolescence, they may show trouble coping with puberty like
accepting the changes in body shape. During these stages of life interventions should address sex
differences in communication, social behaviors, expectations, self-esteem, mental health, and adaptive skills
associated with puberty. Girls ages 13-15 years old early teens may have to worry about self- care and
personal hygiene, hair growth and decisions on shaving, wearing deodorant and acne some girls with autism
may be overwhelmed.
Autistic girls may not be concerned with fashion or dating. With girls on the autism spectrum, parents and
professionals need to consider how hormonal changes connected with the menstrual cycle influence
behavior, and how best to structure the environment and frustration during menstruation. One reason is
changes which may require new or modified hygiene task (ex. frequency of showering, putting on
deodorant, using maxi pads and shaving). Autistic girls who dislike change in general may try to avoid these
Girls on the Spectrum and Behavioral Problems
Other difficulties in girls with autism are fine-motor deficits and problems with coordination and sensory
issues. Parents of girls with autism often struggle with severe problem behaviors for years. With females,
issues related to menstruation can be difficult for families, teachers, and other caregivers to handle. For
example, sensory sensitivities and dislike of changes in routine may lead to resistance or refusal to use
sanitary napkins. Some girls and women with autism might not recognize that they have their periods or may
not have the communication skills to inform their caregivers.
Occasionally, some girls with autism become fascinated with the sensory qualities of the menstrual blood.
Additional, learning to change sanitary napkins and dispose of the used ones requires individualized and
private instruction for many adolescents with autism. Some girls with autism may experience premenstrual
distress that negatively affects their mood and behavior, yet they may not be able to communicate the nature
of their discomfort. Another aspect of skill development that is important for adolescent females with autism
is learning to put on and wear a bra.
When girls with autism are younger, behavior problems seem easier to deal with. However, once her size
increases and she becomes a teenager strategies used to correct childhood behavior no longer work.
Problem behaviors can often be decreased by using visual supports and exercising new strategies and
techniques. For additional help with problem behaviors, it is advisable to work with a behavioral therapist.
Finally, some girls with autism may engage in disruptive behaviors for purposes of social interaction. These
functions tended to be for gaining caregiver attention or avoiding certain demands from parents and
caregivers. You have just begun a long journey, and there will be many curve balls along the way. You will
hear many opinions, receive a lot of advice, and have to sort through conflicting information.
The most important things to remember: You are the expert on your own child - you know your child and