Is autism under-diagnosed in girls?

Posted by on Jan 11, 2015 in Disorders, Featured | 0 comments

Is autism under-diagnosed in girls?

The short answer is: most probably. Autism is a highly stereotyped disorder whereby boys are four times more likely to be diagnosed with autism than girls are. Recent research, however, shows that girls are being overlooked or diagnosed with other disorders since they are better at masking their autistic traits. The lack of diagnosis, intervention and treatment for girls can hinder them in many ways and can even lead the development of other serious disorders, such as anorexia nervosa.


Boys with autism tend to receive clinical attention due to disruptive behaviour and language delay. Girls, however, exhibit other symptoms such as social withdrawal, anxiety and depression. These symptoms tend to present themselves later in life when social interactions become more complex and girls with autism find it difficult to cope. Even then girls with average IQ’s can find ways to compensate in social situations and hide their symptoms. When outside the home they give the appearance of simply being shy. Studies have found that girls with autism are able to recognise and interpret facial expressions of emotions but have difficulty in actually feeling the emotions. Therefore, many girls with autism may appear normal when dealing with the outside world but when they are home, they may have tantrums, exhibit aggressive behaviours and be irritable due to their pent up emotions finding release. As a result teachers or even clinicians may believe it is a parenting issue since at school they appear to be model children. The problem behaviours only seem to occur at home which implicate the parents.


Furthermore, many studies have found links between autism spectrum disorder and anorexia nervosa. Professor Gillberg from the National Centre of Autism Studies claimed that both girls with autism and those with anorexia tend to be withdrawn and uncommunicative. Moreover, they both develop fixations and ritualistic behaviour. For instance, calorie counting may be a manifestation of autism since it becomes an obsessive behaviour that girls with anorexia engage in.


According to Professor Simon Baron-Cohen, girls with anorexia have more autistic traits than girls without anorexia. These include the development of obsessions, rigid attitudes, inflexible thinking and behaviour patterns, detail oriented processing, lack of empathy and inward focus. Therefore, the symptom’s that are presented to clinicians appear to be that of anorexia. However, it is important to understand the underlying issue to develop effective interventions. If anorexia is a manifestation of autism, it is imperative that clinicians examine how to manage the autism by trying to move the obsession of calorie counting to something else or empathy and social skills training.


It is also necessary to move away from the male bias when dealing with autism and to develop tests that include more feminine aspects. Many tests focus on aspects such as obsessions with numbers or fascination with cars. This generally caters to male interests. According to David Skuse, professor of behavioural and brain sciences at University College London, girls tend to have more socially appropriate obsessions and are generally more interested in people. Therefore, tests need to be developed that take this into account in order to accurately diagnose children with autism and allow for early interventions to be put in place. As with all disorders, early intervention is key for success. Unfortunately with the current tests and diagnosis requirements, girls are being misdiagnosed, delayed and are at risk for developing serious disorders further compounding the problem and making it difficult to lead a normal life.



DeWeerdt, S. (March 27, 2014). Autism characteristics differ by gender, studies find. SFARI. Retrieved January 11, 2015. From

Girls’ autism ‘under-diagnosed.’ (June 28, 2005). BBC News. Retrieved January 11, 2015. From

Hammond, C (Writer). (June 17, 2014). Autism in Girls [Radio series episode]. All in the Mind. UK: BBC Radio 4.

Nordqvist, C. (August 10, 2013). Anorexia and autism- are they related? Medical News Today. Retrieved January 10, 2015. From

Image Credit: Atwood, M. (n.d.). A Sad Child. Glogster. Retrieved January 11, 2015. From


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