Autistic girls 'dodging diagnosis', academics warn

Autistic females are passing “under the radar” because they are so effective at camouflaging their behaviours, academics have warned.

Around one in every 100 people are on the autism spectrum and there are around 700,000 autistic adults and children in the UK, according to figures from the National Autistic Society.

However, for every four males who are diagnosed at an earlier age, there is just one female diagnosis and a new study suggests that this is because young girls are adept at hiding their autistic traits in order to “fit in”.

It has been termed “camouflaging” and it means many autistic young girls dodge an official diagnosis and therefore do not get access to support they may need.

The study has been published in the Journal of Autism and Developmental Disorders by researchers from the Centre for Innovation in Mental Health at the University of Southampton, Liverpool Hope University, and University College London (Wood-Downie et al, 2020).

Some of the typical behaviours among children with autism include not responding to their name, avoiding eye contact, repeating certain phrases, struggling to understand what others are thinking and feeling, adopting strict routines, and making repetitive movements, such as flapping hands, flicking fingers or rocking the body.

The study, however, shows that when it comes to “social reciprocal behaviours”, such as taking turns, following someone else’s initiative and being flexible, autistic females have more advanced “social presentation” than males.

The study involved a group of 84 participants, aged between eight and 14, and including autistic and non-autistic male and female children and adolescents.

The researchers say that, on the whole, autistic girls may be quieter, hide their feelings, and may appear to cope better in social situations, meaning they may not display the stereotypical behaviours associated with autism.

Co-author of the research, Dr Henry Wood-Downie, a research fellow at Southampton Education School at the University of Southampton, says that a better awareness of camouflaging could lead to increased support for those who might otherwise slip the net.

He said: “We need to raise awareness of camouflaging in general, in terms of educating school staff, GPs and other practitioners, because there seems to be a lot of autistic females flying under the radar as things currently stand.

“And we want to raise this awareness so that girls who need it can access support at the earliest stage possible – because early intervention is usually key in promoting positive outcomes.”
Dr Julie Hadwin, of Liverpool Hope University’s School of Education Studies, who contributed to the research, added: “Camouflaging itself is something that can lead to difficulties. It’s a stressful, effortful thing to do. Girls describe camouflaging as constantly having to be something they’re not. And, of course, that’s a really difficult thing to maintain.

“Females can have an identity crisis, as they’re trying not to be themselves while at the same time engaging in camouflaging strategies that take a lot of effort. This leaves little in the way of spare capacity to engage in other things, like doing school work.”

Dr Wood-Downie added: “There is research to suggest autistic females only get picked up once they hit crisis point – i.e. they only receive an autism diagnosis once they’ve been referred to other mental health services for things like depression, anxiety and eating disorders.”

  • Wood-Downie et al: Sex/gender differences in camouflaging in children and adolescents with autism, Journal of Autism and Developmental Disorders, July 2020: