Representative Image
Representative Image

Unmasking autism in girls

Behaviours that might raise concerns in boys can be overlooked in girls because they align with gendered expectations and societal norms.

HYDERABAD : Autistic Spectrum Disorder [ASD] is a neurological and developmental disorder that affects how a child interacts, communicates, learns, and behaves. While diagnosed in both boys and girls, many studies show that autism diagnoses skewed heavily toward males, with a ratio of 4 boys diagnosed for every 1 girl. This raises the question, why are girls with ASD seemingly going underdiagnosed? There are several factors to this discrepancy, including biological, social, and diagnostic biases.

Autism disorders are diagnosed primarily by observing behavioural patterns. However, these patterns can vary significantly from one child to another, making diagnosis a complex process, particularly when someone’s presentation falls outside the stereotypical image of ASD.

Dr Suman Saraf, Autism expert, Clinical psychologist, and Special Educator states, “In my experience with over 30,000 cases, I’ve never seen two cases exactly similar. Every child with autism is unique in their presentation but, there are certain developmental milestones children typically reach. If a child is not showing these milestones, it is important to seek evaluation to determine if there might be an underlying issue.”

Societal gender norms and several stereotypical reasons also play a crucial role in the diagnosis. Behaviours that might raise concerns in boys can be overlooked in girls because they align with gendered expectations and societal norms. “Many Indian families still believe that sons, being the primary breadwinners of the family and becomes more concern about their well-being. On the other hand, fearing that seeking help will hinder their daughters’ chances of finding a good match, families often hesitate to disclose, neglecting their daughters’ needs,” says Dr Suman Saraf.

Boys with this disorder tend to isolate themselves more readily. In contrast, girls, who are often seen as naturally more social, may mimic their neurotypical peers to fit in with groups. This social adaptation can make their autistic symptoms less noticeable. This phenomenon aligns with the concept of social camouflaging, where individuals mask their autism symptoms by mimicking neurotypical social behaviour. This effective masking can lead to underdiagnosis of autism in girls, says Dr Madhavi Adimulam Founder, Director of Ananya, and RCI Certified Autism Specialist

Dr Madhavi emphasises, girls are often diagnosed with autism later in life than boys, which can have significant negative consequences, leading to mental health problems like anxiety and depression, as well as difficulties in social and academic settings, lack of understanding and support from healthcare professionals, and strained family environment.

They also have a stronger emotional regulation ability, allowing them to handle the challenges and frustrations of therapy with more tolerance. Dr Suman adds that during treatment, girls show generally higher tolerance levels (with some exceptions) and are more likely to listen to feedback compared to boys but still the recovery rate in boys and girls are almost the same. While there is currently no cure for autism spectrum disorder (ASD), early diagnosis and intervention can significantly improve a child’s development and quality of life. Effective therapies can help manage symptoms and improve communication, social skills, and behaviour. Early intervention both in boys and girl ideally before the age of 3, offers the best chance for maximizing a child’s potential.

The New Indian Express