By Lisa Jo Rudyx
Could your daughter have autism?
The answer may not be as obvious as it would be if you had a son. That’s because signs of autism in girls and women are not the same as those in boys and men. More importantly, perhaps, they can be easy to miss, particularly in cases of high functioning autism.
Why girls may be underdiagnosed
Girls who have overt symptoms such as obvious self-stimulating behaviors (stims), extreme difficulties with speech and language, severe difficulties with social communication, or significant cognitive challenges, are usually referred for evaluation and diagnosed at a young age.
But girls whose symptoms are subtle, or whose intelligence level allows them to mask symptoms, may only be diagnosed as pre-teens or teens. Our culture may be to blame for some missed diagnoses in girls. Girls are generally expected to be quieter and less assertive than boys.
A girl who appears shy and withdrawn may be seen as acceptably “feminine,” while a boy with the same behaviors is considered to be atypical. Similarly, a girl who seems “spacey” and unengaged is often described as “dreamy,” while a boy with similar behaviors may attract negative attention.
Limiting daily function
No single symptom is enough to suggest autism. In addition, while some symptoms may become increasingly obvious to you as your daughter gets older, you should be able to look back and realize that they have been present since her toddler years. Her symptoms should also be severe enough to limit daily function. In other words, if your daughter has one or two of the symptoms of autism but is well-adjusted and successful in other ways it’s unlikely that she’s autistic.
What to watch for
• Your daughter relies on other children (usually girls) to guide them and speak for them throughout the school day.
• Your daughter has “passionate” and limited interests that are very specific and restricted. For example, while many girls may be fans of a particular TV show, a girl with autism may collect information and talk endlessly about the characters, locations, props, or actors, but know little or nothing about the plot or genre of the show.
• Your daughter is unusually sensitive to sensory challenges such as loud noise, bright lights, or strong smells. (This symptom is as common among boys as among girls.) Sensory challenges are not unique to autism, but they are one symptom of the disorder.
• Your daughter’s conversation is restricted to her topics of interest. She may share her areas of specific and restricted fascination, but have no interest in hearing another person’s response. This may interfere with her ability to join groups or make friends.
• Your daughter has a low frustration level and finds it difficult to moderate her feelings when she is frustrated. She may have age-inappropriate “meltdowns.” This may interfere with her relationships with teachers, or lead to behavioral interventions such as detentions or even suspension from school.
• Your daughter experiences an unusual degree of depression, anxiety, or moodiness. Again, these symptoms are by no means unique to autism, but autism is associated with both mood disorders and obsessive-compulsive disorder.
Anyone who hasn’t made a mistake hasn’t tried something new.Albert Einstein
• Your daughter has a difficult time making or keeping friends; she may seem “clueless” when it comes to non-verbal social cues (other people turning away, facial expressions, etc.). She may also have a difficult time imitating other girls’ behaviours, fashion choices, or hairstyles even though she may want to “fit in.”
• Your daughter is usually described as “quiet” or “shy” in school and other challenging social situations. Being quiet or shy isn’t in itself a symptom of autism, but often difficulty with receptive and/or expressive language can make it difficult to jump into conversations, raise your hand, or respond quickly to social situations.
• Your daughter is unusually passive. While some people with autism are quite assertive, passive behaviors (while socially acceptable in school) can be a sign that your daughter isn’t quite sure what to do or say, and has chosen the safe route of doing or saying as little as possible.
• Your daughter appeared to be developing fairly typically as a young girl but finds social communication to be increasingly difficult as she enters her teen years. (Studies suggest that girls with high functioning autism may find ways to cope with and mask difficulties with social interaction, often by allowing others to speak for them. This strategy works well until social expectations become more complex and demanding in the early teenage years.)
• Your daughter has epileptic seizures (epilepsy has been found, in one study, to be more common among girls with autism than among boys). If you see several of these issues, they seem to be prevalent over time, and they interfere with your daughter’s ability to function successfully, you might wish to consider having your daughter screened or evaluated by a professional team of autism experts.
A word from the author
If you feel that these criteria describe your daughter, and you decide to seek an evaluation, be sure to find an evaluator or team that has specific experience working with girls on the spectrum. As mentioned, it can be tough to diagnose high functioning autism in a girl who has learned how to work around her challenges.
If you do discover that your daughter has autism, it’s important to know that there are a wide range of treatments available. In addition, depending on her needs and challenges, you may decide to consider a variety of educational options.
Individualized special needs plans can help at public school; you may also decide to consider private or charter options as autistic girls often do better in smaller settings.
Reprinted with permission from verywellhealth.com. Lisa Jo Rudy, MDiv, is a writer, advocate, author and consultant specializing in the field of autism. This article was medically reviewed by Aron Janssen, MD.