Autism: a boy’s disorder?
Autism awareness speaks through the blue color. As Uta Frith said in 1991 “It is fascinating to note that the autistic children we have seen are almost exclusively boys.” Autism Spectrum Disorder (hereinafter ASD) is widely thought of a boys’ condition since they outnumber girls with quite a margin. Current ratio is 4:1 which means that boys are four times more likely to have it. Margins get even wider when it comes to Asperger, also known as high-functioning autism, with a ratio that can go as high as 9:1. Encountering a female with ASD is exceedingly rare, but is this due to fewer females having it, or just fewer females being diagnosed?
Ratio has little to do with occurrence
Psychologists are know starting to coincide that they are several factors that lead to a misdiagnosis in girls and that play a major role in the numbers. One of them is the differences in profile. Symptoms in females often appear with a complete disparity to most people preconception of ASD, based on boys’ profiles.
ASD is a developmental disorder of variable severity that is characterized by difficulties in social interaction and communication and by restricted or repetitive patterns of thought and behaviour.
According to a 2016 article on sex differences in pre-diagnosis, girls with the disorder are better at socializing, decoding nonverbal cues and empathizing. Girls often have friendships, which usually takes them out of the radar. They are better at social communication skills, talking about their thoughts and emotions, and usually have an earlier language development. Females in the spectrum have less repetitive and routine patterns and have more self-regulation than boys. It is common that autistic girls mimic others in social situations in order to blend in and have different restricted behaviors. Therefore, it is common to see an autistic girl obssesed with makeup, for instance. A more socially accepted “restricted” interest that can be seen in neurotypical girls. Conclusions suggest that girls have the regular impairments of the condition, but have better skills and tools to hide them because of biology and experience.
These symptomatic differences lead autistic girls to misdiagnosis during their early years. ADHD, dyslexia and low IQ are the common words that psychologists use in their offices to misdiagnose most autistic girls. The ones who are actually identified with ASD are those who present extreme symptomatology, contributing to the widely spread scientific thought that says that females are more severely affected by autism than boys. Those who seem to have milder forms of the condition that do not resemble boys’ symptomatology (the majority) are the ones that remain hidden.
A minority within minorities
Scientists have tended to cull girls from studies because it is difficult to find sufficiently large numbers of them.
That same 2016 scientific article shed lights on how females are being diagnosed later than men. On average males are diagnosed from age 0 to 3; meanwhile, girls tend to be diagnosed during adulthood. Late diagnosis usually impacts the numbers since most studies are based on children samples. “Scientists have tended to cull girls from studies because it is difficult to find sufficiently large numbers of them,” The New York Times report.
This recent data makes it impossible to establish firm conclusions, but a number of scientists allege that there is a vicious cycle. The Interactive Autism Network demands that if few studies have females in their samples, the assesment tools to detect ASD will be based on boys’ symptoms, which is strictly linked to the misdiagnosis in females.
Whether some think that females are genetically protected against the condition or that they are being underdiagnosed, the girls that are affected are missing on oriented behavioral therapies to treat their specific symptoms in an understudied field where most researches try to ignore sex.
