- With children returning to school, autism experts outline how children having trouble at this time could be a sign of undiagnosed autism, especially for girls.
- The rate of children diagnosed with autism has doubled since 2010, with more than three boys for every girl diagnosed with autism.
- Autism is harder to diagnose in girls, and autistic girls might only begin showing clear signs of their condition as they approach their teens.
With millions of children across America returning to school over the past few weeks, many are settling into their new routines. However, some children might have found the return to school difficult, especially when moving to middle school or high school.
Most of these cases will be perfectly normal, since anyone can struggle in new environments, but in some cases, it might be a sign of undiagnosed autism. People with autism can find it more difficult to adapt to new routines than neurotypical people, and returning to school after summer vacation can be one of the most disruptive things a child will experience in childhood. This is especially so if a child has moved to a middle school or high school that has a different campus from their previous school.
This is why autism therapy experts at Autism 360 have compiled a guide for parents on how a difficult return to school could signify undiagnosed autism, why this might be more likely to be undiagnosed autism in their daughters, and what a diagnosis could mean for their children.
The general signs of autism and how prevalent it is in America
As many as 1 in 31 children were diagnosed with autism in 2022, up from 1 in 68 in 2010. In general, autistic children tend to be honest, have perfectionist tendencies, exhibit repetitive behaviors, have rigid routines, and may prefer their own company. They may have poor handwriting skills, may ignore advice, and can be withdrawn. Children with autism can also be more prone to depression than the general population. Autistic children also have special interests, which are highly focused topics someone is passionate about.
Autism presents differently in girls, leading to a diagnosis gap between girls and boys
More than three boys are diagnosed with autism for every girl, and this is partly because of the differences in how autism presents in girls and boys. Girls can exhibit fewer symptoms traditionally associated with autism due to historical autism research being focused on boys.
In general, autistic girls can socialize and fit in more easily than boys, and will attempt to do so far more than boys. Girls will also usually have at least one strong friendship and will attempt to make friends, while boys tend to be more solitary. This is because girls will tend to study how to behave in social settings, then use this to guide their interactions rather than relying on intuitive behavior.
These behaviors are commonly referred to as camouflaging or masking, and can manifest in girls as generally being more flexible and more likely to comfort others than boys, among other behaviors. Girls may also tend to apologize a lot, while boys can often be indifferent.
Autistic girls tend to have special interests that are more socially acceptable, such as animals, books, and art, while boys will favor things like vehicles or computers.
Girls with autism may be less demanding of attention and more empathetic than boys. Girls will tend to hide their emotions relative to neurotypical girls. Autistic boys, on the other hand, will generally display their emotions relative to other boys. This surfaces in mood swings, where girls are more likely to shut down and act in a passive manner, while boys are more likely to behave in aggressive or passive-aggressive manners. Girls with autism can be more prone to depression than boys in adolescence, too.
Why diagnosing autism in girls can be difficult, and why it may not present until adolescence
Many girls with autism tend to reach developmental milestones at the same times as their peers. This can be an issue with diagnosing autism, since these milestones are used in determining when a child is tested for autism. The ability of girls to mask their difficulties better than boys only adds to the difficulty of detecting and diagnosing autism in girls.
Boys tend to miss developmental milestones, so they may begin to be monitored for autism as toddlers. Girls, on the other hand, may not even begin to be monitored until they are much older.
These factors culminate in girls being diagnosed with autism later in life. One study found that girls were diagnosed an average of 3.4 years later than boys, with girls receiving a diagnosis at 15.7 years of age on average against 12.3 years for boys.
When and why autistic traits in girls become easier to identify
Autistic girls can find it difficult to grow into their teens. They may have been able to cope with social interactions as young children, but they can begin to struggle as interactions become more complex as they grow.
The first sign of underlying autism for girls could be the move to middle school and the disruption this may cause to their school routine, with research from the UK showing that people with autism may find the equivalent move up from elementary school more traumatic than neurotypical individuals.
Girls with autism often cling to the things that brought them comfort in childhood, such as their childhood best friend or the games, play, or fantasies they engaged in when younger. They may also have no interest in topics that other girls their age are beginning to obsess over, such as dating, fashion, or their appearance. However, they may feign interest to keep up with social norms.
Ash Bhattacharya, CEO and Cofounder of Autism 360, said:
“Autistic girls can easily slip through the cracks until much later in life. Our current diagnostic criteria are geared towards identifying autism in boys, and diagnosing autism gets even more complicated when autistic girls can generally navigate social interactions more easily than autistic boys can. Girls with autism are generally more interested in social interactions than boys, and they can use this to develop mechanisms and prepare reactions to mask their autism in social settings.
“It’s never too late to seek an autism diagnosis for your daughter. Sometimes, the first indication of autism in a girl can be her struggle with growing into her teens or transitioning to middle school. She may have always had a close friend who is now finding your daughter to be overly possessive or obsessed with childish things, or she may be having difficulty with the more complex social interactions that come with age. This frustration may make her become withdrawn or aggressive, so talk to your pediatrician if you are not seeing changes you might expect to see at her age.
“A diagnosis for autism can be life-changing, since it can help your daughter get the support she needs to thrive. It can help her understand why she might have been struggling with things that seem effortless to her peers, such as developing more mature interests and navigating more complex social interactions, plus it can show her what strategies she can use to make her life easier.”
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