Autism More Likely to be Diagnosed in Boys Than in Girls.

CDC Reports

The Centers for Disease Control and Prevention (CDC) report that 4.5 times as many boys as girls are diagnosed with autism every year. Boys thus seem to be far more susceptible to the condition – but there is some evidence this may not be the case.

According to Dr. Louis Kraus, a psychiatrist who specializes in autism at Chicago’s Rush University Medical Center, girls with autism are better at blending in, so their symptoms are often less obvious. While boys with autism are often loners, autistic girls still try to socialize and join groups, even if they feel awkward doing so.

Boys Higher Diagnosis Rate

Consequently, boys are more likely to be diagnosed with autism than girls, and they are also more likely to be diagnosed at an earlier age than are girls. Since girls’ symptoms are less noticeable, they often don’t get the needed early intervention to be successfully treated.

Diagnosed in Adulthood

Such was the case with Haley Wittenberg. The Los Angeles resident is the youngest of four siblings, and she was diagnosed with autism when she was 19, roughly a year ago. She found the diagnosis a relief, for it explained the differences she’d noticed in herself compared to her classmates or siblings. For example, she found it easier to play with little boys rather than other little girls, because the boys didn’t talk as much. They preferred to focus on their sports, and Haley found that easier than trying to talk to the girls.

Her mother, Lonnie Wittenberg, had also noted some oddities about Haley. As a baby, she never wanted to snuggle or cuddle, and she did not make eye contact. Haley had trouble being “spontaneous,” and she disliked crowded and noisy places like Disneyland. Lonnie, however, considered these to be harmless “quirks.” As she put it, “Nothing screamed autism.”

Social Camouflaging in Girls with Autism

Development Evaluations Determine Diagnosis

Autism, more formally known as autism spectrum disorder or ASD, is a developmental disorder. Common symptoms include a lack of interest in socializing with others, difficulty making and maintaining eye contact with other people, and compulsive, repetitive actions. Since there are no medical tests for diagnosing autism, doctors need to evaluate a child’s development and behavior in order to diagnose them.

High-Functioning Girls

Haley, as it turns out, is fairly typical of a high-functioning girl with autism. According to Amanda Gulsrud, the clinical director of the Child and Adult Neurodevelopmental Clinic at University of California, Los Angeles, high-functioning girls are often adept at “social camouflaging.” That’s a fancy way of saying they can more readily pass for normal than can boys with autism.

Programs Developed for Children with Autism

Gulsrud helps schools develop programs for autistic children. Those programs are partly based on the results of research performed by some of Gulsrud’s colleagues at UCLA. The researchers studied the differences in how boys and girls with autism interacted with other children during recess. According to Gulsrud, the boys were very obviously different from their peers: They did not join the other boys in their games, but stayed off by themselves and remained at the periphery of the playground.

By contrast, the autistic girls were less noticeable. They stayed close enough to the other girls to make it look as if they were interacting with them, even though they really weren’t.

Gender Differences Between Autistic Girls and Boys

Survey Study of Clinicians

Marisela Huerta, a psychologist at the Weill Medical College, explained that girls with autism tend to be quiet and behave more appropriately than their male counterparts. She and some colleagues conducted a survey of clinicians who specialize in treating autism. The survey asked the clinicians to compare the girls’ symptoms to the boys’. Seventy percent of the respondents reported distinct differences between girls and boys. Boys with autism were more likely to display fixated interests and repetitive behaviors. They were also less social than girls with autism, who also tended to be more verbal. Consequently, parents and teachers were less likely to notice the girls’ symptoms or refer them for evaluation.

Compulsive Behavior

Compulsive behavior is another symptom of autism, and there are again differences in how this manifests in boys and girls. Again, boys with compulsive behavior linked to autism show more obviously abnormal behavior. For example, they might get obsessed with objects like rocks and endlessly talk about them. They might also carry their whole rock collection around in a backpack. Girls, by contrast, tend to fixate on things like seashells that normal people find more appealing and acceptable.

Examining Brain Function, Behavior, and Genes

Kevin Pelphrey has two children with autism. He is also a child psychologist and the director of the Autism and Neurodevelopmental Disorders Institute at George Washington University, where he is leading a study funded by the NIH. The researchers will be studying girls with autism, and they will be examining brain function, behavior, and genes.

So far, the researchers have found that the brains of autistic girls differ from those of autistic boys. For example, brain imaging shows girls apparently have less of a disruption in the brain region that handles social information. As a result, girls with autism are more likely to understand how they are expected to behave in social situations.

Helping Girls with Autism

Delayed in Treatment

Social camouflaging causes problems for girls with autism, for it, delays both the diagnosis and the treatment. Dr. Kraus pointed out that children who are diagnosed and treated early generally enjoy better outcomes than those who are diagnosed late. He states that falling behind in social development is significantly more serious than falling behind in academics.

Programs for Teens and Young Adults

There is now an increasing number of programs designed to help teens and young adults get caught up socially. Haley Wittenberg has joined PEERS, a program at UCLA that has been teaching her to approach groups, make and keep friends, and participate in conversations. She reports that social situations have become less stressful and exhausting, and she finds it easier to talk to people.