Autism diagnosis delayed in girls due to “social camouflage”
Girls with autism struggle more than boys when it comes to routine tasks such as getting dressed or making small talk, a study has revealed.
These results occurred even when the study group was normalised to meet similar basic clinical diagnostic criteria across sexes.
This adds to a pool of growing evidence that girls with autism may display symptoms differently to boys, and that some of their social difficulties may be masked during clinical assessments.
Dr. Allison Ratto, lead author of the US study published in the Journal of Autism and Developmental Disorders, said that based on their research criteria, parents reported that girls have a more difficult time with day-to-day skills than boys.
She added: “This could mean that girls who meet the same clinical criteria as boys actually are more severely affected by ongoing social and adaptive skill deficits that we don’t capture in current clinical measures.
“Autistic girls, in general, may be camouflaging these types of autism deficits during direct assessments.”
The study used an age and IQ-matched sample of school children diagnosed with ASD in order to assess sex difference according to the standard clinical tests, as well as parent-reported autistic traits and adaptive skills.
Dr. Laura Kenworthy, study contributor, said: “This study is one of the first to eliminate many of the variables that obscure how sex impacts presentation of autism traits and symptoms.
“Though today’s clinical tools do a really good job of capturing boys with a wide range of symptom severity at a young age, they do it less effectively for girls.
“This is a crucial issue considering how much we know about the success of early interventions on long-term outcomes.
“We have to find better ways to identify girls with autism so we can ensure the best approaches reach all who need them as early as possible.”
Specific evidence of women more effectively masking or camouflaging social and communication deficits is limited.
However, autistic self-advocates have pushed the theory that that the unique social pressures and demands on girls at a young age may teach them to “blend in” and “get by”, including maintaining successful, brief social interactions.
The Center for Autism Spectrum Disorders will continue investigations into sex differences, and aims to develop self-reporting measures for adolescents and adults that better capture additional populations, including females and non-cisgender males.
Dr. Ratto said: “We hope the ACE studies will help us better understand the diversity of the autism spectrum by allowing us to focus on the ways in which differences in sex and gender identity might influence the expression of autistic traits, thereby enabling us to make more accurate diagnoses.”