Autism is diagnosed much less frequently in females than males, with ratios often cited around 3:1 or 4:1 (males to females), but this is believed to be due to underdiagnosis in girls who mask symptoms, suggesting the true prevalence might be closer to equal numbers, with many females remaining undiagnosed into adulthood. Girls often display autism differently, focusing on social masking and intense interests, leading to misdiagnosis as anxiety or mood disorders, and historically, diagnostic criteria have been boy-centric.
The ratio of males to females with ASD is generally quoted as 4:1, though it is believed that there are biases preventing females from being diagnosed and that the true ratio is lower. These biases have not been clearly identified or quantified.
Around 90% of autism cases are attributed to genetic factors, meaning autism is highly heritable, with many different genes contributing, rather than a single cause, often interacting with environmental influences during early brain development, though specific environmental factors don't cause it but can increase risk. Twin studies show strong genetic links, with concordance rates between 60-90% in identical twins, and research points to complex interactions of many genes and prenatal/perinatal factors.
In the U.S., about 4 in 100 boys and 1 in 100 girls have autism. Boys are nearly 4 times more likely to be diagnosed with autism than girls.
In my book, I explore the difficulties in securing a diagnosis and coming to terms with having autism.
The "6-second rule" for autism is a communication strategy where a speaker pauses for about six seconds after asking a question or giving information, giving the autistic person extra time to process it without feeling rushed, which helps reduce anxiety and allows for a more thoughtful response, reducing frustration for both parties. Instead of repeating or rephrasing, which can be confusing, you wait, and if needed, repeat the exact same words after the pause.
Restricted interests and repetitive behaviors: Like their male counterparts, women with high functioning autism often exhibit intense and specific interests. These interests may be highly focused and bring them great joy and fulfillment. They may also engage in repetitive behaviors or routines.
Below, we describe signs of autism to look for in autistic girls: She may show lower information processing speed for social and emotional information. The girl takes slightly longer to answer in social situations, may avoid answering questions in class and/or may avoid speaking in groups.
Changes in the diagnostic criteria and increased screening at wellness visits seem to be the main contributors.
The behavioral symptoms of autism spectrum disorder (ASD) often appear early in development. Many children show symptoms of autism by 12 months to 18 months of age or earlier. Some early signs of autism include: Problems with eye contact.
A: Both parents can carry genes associated with autism, even if they don't show any signs themselves. These genes can be passed down to children through either the mother, the father, or both.
Understanding the 6 stages of an autism meltdown can help parents, caregivers, and educators respond with empathy and support.
We reviewed 36 studies examining maternal diet and autism spectrum disorder (ASD) and found that prenatal vitamin/multivitamin use and adequate intake of folic acid and vitamin D were each associated with lower likelihood of having a child with ASD.
Top 10 Calming Strategies for Autism
Background and Aims: Persons with combined sensory and intellectual disabilities are more sensitive to stress than people without disabilities, especially when they have an Autism Spectrum Disorder (ASD). Reversely, stress can also trigger ASD symptoms.
Autistic girls may be extremely sociable or chatty, or very shy and isolative. It is common for them to have one or two strong friendships, but struggle socialising in groups. This may not be obvious though, as they may have learned to mask their difficulties well.
Why is autism on the rise? Autism prevalence has risen due to increased awareness of autism, broader diagnostic criteria for autism, improved screening tools and standardized screening processes. These factors have led to earlier detection and more diagnoses.
The three main symptom areas for Autism Spectrum Disorder (ASD) are persistent difficulties with social communication and interaction, restricted or repetitive patterns of behavior, interests, or activities, and often, different ways of learning, moving, or paying attention, all of which impact daily functioning. These core characteristics vary greatly but center on social connection challenges, rigid routines or repetitive actions, and sensory sensitivities.
Furthermore, individuals with Autism generally succumb to health complications approximately 15 to 20 years earlier than the general population. Longitudinal studies that followed people with Autism for over 20 years found that the average life expectancy ranges between 39 years and 58 years.
Females tend to mask signs of autism
Females with autism learn or mimic socially acceptable behavior by watching television shows, movies and the people around them. They may copy the facial expressions of others to hide social communication challenges. Those efforts can cause mental exhaustion, stress and anxiety.
Reaching to one's own forehead in response to a marked mirror image has traditionally been conceptualized as an important, initial measure of self awareness (the mirror self recognition test, or MSR, e.g. Gallup, 1970) and it typically emerges between the ages of 18 and 24 months (Bertenthal and Fischer, 1978).
A number of studies have reported data on the timing of regression ranging anywhere from the second year of life to 81 months [19]. A recent meta-analysis found that across 28 studies, the average reported age of regression was around 20 months of age [20].
One common expression of anger in high-functioning autism is intense emotional outbursts such as tantrums, verbal aggression, and even physical aggression. These episodes can include shouting, name-calling, hitting, slapping, or destroying objects.
Girls are often more socially observant and may quietly copy others to fit in. Because they don't always match traditional stereotypes, their struggles can go unnoticed. Many are misdiagnosed with anxiety, depression or ADHD long before autism is even considered.