The core characteristics of autism spectrum disorder include difficulties (or differences from children without autism or other diagnoses) in the areas of social skills and communication skills as well as making and maintaining relationships. Research has explored how these ASD traits can differ in males versus females with autism. There are some similarities between both males and females with ASD; however, there are some things that make the experience of having autism different for both boys and girls.
Males Diagnosed with ASD More Often Than Females
Autism spectrum disorder (or ASD) is diagnosed four times more often in males than in females (American Psychiatric Association). Some research suggests that it could be because of the way ASD is diagnosed. Specifically, the symptoms that are included in the assessment for obtaining an autism spectrum disorder diagnosis might be more applicable to the ways males behave as opposed to females. On the other hand, it could be true that males do indeed experience autism more often than females (Halladay, Bishop, Constantino, et. al., 2015).
Symptoms of ASD in Boys and Girls
Research that has been done in exploring ASD in males versus females has shown that the symptoms of ASD sometimes look different in girls as compared to how they look in boys.
One reason for this, that some researchers suggest, is that it is possible that females mask their symptoms more effectively than males. Either by the way that females are conditioned in society or by their natural way of interacting with others, females tend to be able to “put on a mask” to cover up or hide autistic traits. Males are less likely to control their behavior, or maybe they have less inclination to “fit in”.
Also, females are often able to learn to imitate their peers to try to fit in. Although some females with ASD have more noticeable behaviors, research shows that many females with ASD are quiet and reserved therefore others don’t notice them much.
Impact of IQ
When females are diagnosed with autism spectrum disorder, it's likely because they have behavioral issues or developmental delays. Females with higher IQs are often undiagnosed.
Females with high IQ, who don’t show behavioral issues, often don’t stand out -- and, therefore, don’t get diagnosed as often with ASD. Many of them who have average or above-average IQ use their intelligence level to observe and assess their surroundings and then they develop coping mechanisms to get by in their daily life. They also learn the process of how to imitate others even if it doesn’t align with their true nature. For instance, they learn to fake small talk when they feel that this behavior is expected of them or they smile and nod to show that they are listening even if it makes them uncomfortable. They also learn to get through life by putting in extra effort to manage day-to-day responsibilities, social interactions, and so on.
Girls who are “higher functioning” can often pass through school and other situations, even get through many years of childhood at home, without having an adult suspect that they might have ASD. This prevents proper diagnosing of autism in females.
Females Display More “Socially Acceptable” Behaviors
Many females with ASD engage in activities that don’t bother other people or that don’t make them stand out. For example, a female who has autism might have a special interest in reading or doing academic activities, which may not appear as a behavior that is too odd in the eyes of teachers or parents. And, this interest, might be seen as the child being “a good kid” although it could be a symptom of their autism.
Some girls with autism may be seen as shy or introverted which is often more acceptable in many cultures as compared to this type of personality being less acceptable when seen in males. Males are often more likely to be expected to be extroverted, aggressive, and social. When girls aren’t as social as society thinks they “should be,” they are simply thought of as being shy and quiet.
Motor Skills and Communication Skills in Boys and Girls
A research study explored the gender differences as related to symptoms of autism and developmental functioning. This study focused on children between 17 to 37 months who met the criteria for a diagnosis of autism spectrum disorder (Matheis, Matson, Hong, et. al. 2019).
In this study, gender differences were not found as they related to the severity of symptoms. What this study did find was that the young girls (toddler-aged females) had more motor skill deficits, but fewer communication skill deficits compared to the boys in the study.
Restrictive or Repetitive Behaviors
Some research suggests that females display fewer restricted and repetitive behaviors (RRBs) or at least less noticeable RRBs as compared to males. For example, girls who have a repetitive behavior of lining items up or organizing toy items, such as with dolls or other typical toys of early childhood, might just look like she is playing. However, with closer observation, it can be noticed that she is not playing with the toys in a similar fashion as her peers.
This is not to say that boys with autism don’t experience these types of restricted or repetitive behaviors. However, a male’s behaviors are often more noticeable by adults. For instance, they might wave their arms excessively or make loud sounds or have a special interest that they talk about a lot which interferes with their conversations with others.
Boys and Girls with Autism - Differences & Similarities
In a study (Boorse, et. al., 2019), the researchers looked at how girls and boys with autism spectrum disorder used certain kinds of words during storytelling. They found that girls used more “cognitive process” words such as “think” and “know” as compared to boys. Another interesting thing about that study was that they found that both girls and boys with autism used more nouns than non-autistic peers to describe the story. The researchers suggested that this means that children with autism use more object-focused storytelling. They focus on the tangible and observable stimuli in their environment or in the story.
Boys and girls with autism spectrum disorder might display some of the same behaviors and they may have some of the same internal experiences; however, there are some differences that can be seen, as well. Males are more often diagnosed with autism. Many females have struggles but adults don’t realize that their struggles could be due to autism. Females also might be misdiagnosed (such as being told they have anxiety or depression instead of autism).
Everyone who has autism experiences ASD in their own way. No matter how boys or girls express or experience traits of autism, it is important to validate and support them fully. Accept each child for who they are while encouraging them to grow and develop in ways that support their quality of life and their sense of self.
American Psychological Association. (n.d.). Autism and autism spectrum disorders. American Psychological Association. Retrieved March 18, 2022, from https://www.apa.org/topics/autism-spectrum-disorder
Boorse, J., Cola, M., Plate, S. et al. Linguistic markers of autism in girls: evidence of a “blended phenotype” during storytelling. Molecular Autism 10, 14 (2019). https://doi.org/10.1186/s13229-019-0268-2
Halladay, A.K., Bishop, S., Constantino, J.N. et al. Sex and gender differences in autism spectrum disorder: summarizing evidence gaps and identifying emerging areas of priority. Molecular Autism 6, 36 (2015) doi:10.1186/s13229-015-0019-y
Matheis, M., Matson, J.L., Hong, E. et al. J Autism Dev Disord (2019) 49: 1219. https://doi.org/10.1007/s10803-018-3819-z