Autism is quickly becoming one of the most diagnosed disorders among children. According to the Center for Disease Control, in 2014 approximately 1 in 59 children was diagnosed with Autism, and that statistic is projected to increase.
In recent years, researchers have been putting more emphasis on breaking down the differences between autism in boys versus autism in girls. To date, fewer girls get diagnosed with autism than boys, with a ratio of 4.2 boys for every girl, and this is, potentially, because autism presents much differently in girls than it does in boys.
It is crucial to know the differences in order to catch autism early in both boys and girls, giving them an equal chance at early intervention, and early intervention is the best place to start on your child’s journey to success.
What is Autism
For those of you who are not confident in your understanding of autism, here’s a quick rundown.
The Diagnostic and Statistical Manual of Mental Disorders (DSM), the book doctors use to diagnose disorders such as depression or anxiety, recently merged the autism and Asperger diagnoses into one overarching diagnosis called Autism Spectrum Disorder (ASD).
You may also like:
There are two different patterns to the emergence of symptoms. The first is early onset where the child begins to display symptoms at a young age. The second is a regressive course where a child begins to develop typically, but regresses linguistically and socially between their first and second year. Luckily, most children tend to present with the early onset pattern, making early intervention is possible.
Requirements for Diagnosis
The DSM (the diagnostic book) has an exhaustive list of requirements that a child must meet in order to be diagnosed with Autism:
- Persistent deficits in social communication and interaction
- difficulty with back-and-forth conversation
- failure to initiate social interaction
- inability to make or maintain eye contact
- Specific and repetitive behaviors, interests, or activities
- flapping hands
- lining up toys
- inflexible adherence to routines
- highly focused interest on unusual objects or topics
- Symptoms must be present during early development
- Symptoms cause clinically significant impairment in important areas of functioning
A comprehensive analysis of autism’s sex ratio, conducted in 2017, found that approximately 4.2 boys were diagnosed for every 1 girl. It has been suggested that the ratio is inflated by factors like the notion that autism is primarily found in boys (bit of a self-fulfilling prophecy on that one), and the fact that autism may present differently in boys than in girls.
However, researchers have found a 1 in 3 ratio when following children from infancy and repeatedly screening them, suggesting that the higher rate in boys holds.
Despite the ratio holding, there are still differences between autism in boys and girls.
Symptoms of Autism
Autism is a social and behavioral disorder, meaning it affects one’s ability to socialize and behave typically. The list of symptoms is long, but it is important to be aware of them all, as no person with ASD has the same set of symptoms.
On top of the social and behavioral symptoms, there are also a few physical symptoms like delays in gross and fine motor skills. Some children with autism may be delayed in their ability to crawl or walk. Others will master those skills as usual, but will struggle with fine motor skills like pinching, gripping, or forming word sounds with their mouths. The delay in forming their mouths properly is what leads to a speech delay. Again, all children with autism are different, so some may have difficulties with all, some with none, and still some with anything in-between.
Autism in Girls
In the past few years, there has been an explosion of research looking into the claim that autism presents differently in boys than in girls. As it turns out, this claim has a bit of weight behind it.
Studies have found that autism presentation in girls depends on their IQ level. Compared to boys, girls on the lower end of the spectrum tend to have more social communication difficulties and lower cognitive abilities. Girls on the higher end also seem to have fewer restricted interests than boys. While boys with ASD tend to focus on one or two very specific topics, girls with ASD mirror the interests of their female peers, but with more intense focus than their neurotypical peers.
It has also been found that more genetic mutations are needed for girls to have autism. Which potentially contributes to the lower diagnosis rate, but, when they are diagnosed, they often receive diagnoses much lower on the autism functioning spectrum.
Girls with autism show more signs of externalizing behaviors than boys with the diagnosis, which is a surprise considering girls are often thought to internalize.
As with mirroring social interests, girls with ASD have also been found to mirror other behaviors as well. This is referred to as “camouflaging.” This means that girls will do things like force themselves to make and maintain eye contact, rehearse conversations beforehand, and become more proficient at mimicking the social behaviors of those around them.
While both boys and girls with ASD can camouflage, it is seen more often in girls than in boys.
It is important to note that many of the studies conducted on the sex differences in ASD have been small, meaning the results may not be entirely accurate. The largest study into the differences has found that compared to boys, girls with autism have:
- fewer restricted interests
- difficulty adapting
- trouble interacting
- social difficulties
- externalizing behaviors like aggression
- emotional problems
- cognitive and linguistic issues
Early Intervention is Key
When diagnosed and treated at an early age, children with ASD have a better chance of mitigating problem behaviors and functioning more successfully in life. In order to accomplish this, parents must be aware of the signs of ASD and, more importantly, advocate for their child to professionals.
Unfortunately, doctors can sometimes tell parents that they are simply feeding into the autism hype and what they’re seeing isn’t actually a problem. You are the parent! You spend the most time with your child and you know your child best! If something seems wrong, keep pushing until you are satisfied. Don’t be afraid to get a second, or even third, opinion.
If your child does in fact have autism, getting them into an early intervention program, and getting in-home services to help teach you as a parent, is crucial.
The longer a child goes undiagnosed, the longer their problem behaviors have to become set ways. The older a child gets, the more difficult it is to change and shape behavior.
I don’t say this to scare you, but rather to motivate. Trust your gut and advocate for your child. Never stop doing what you think is best, no matter what anyone says.