Skip to main content

Girls and Autism: Identifying barriers and understanding needs

Identifying barriers and understanding needs

The most up to date research suggests that the ratio of autistic males to females is 3:1 (Autistic women and girls (autism.org.uk)). The research suggests the ratio is more reflective of identification of need, rather than boys being any more prone to being autistic than girls.  

What is masking?

Everyone masks at times – but for an autistic person they may use strategies (consciously or subconsciously) to hide their autistic differences from other people. It is different to other forms of masking because of the effort involved and the impact it has for the autistic person doing the masking. Sometimes masking is also referred to as camouflaging, social chameleon, or compensation.

Masking in autism is a relatively current and evolving field of research. Research suggests that most autistic people mask their autism at some point. Some research suggests women mask more than men and to a higher degree (Sedgewick et al. Autism & Masking: How and why people do it, and the impact it can have).

Why do autistic people mask?

  • To fit in with others or in order to feel accepted
  • Previous experience, or fear, of negative feedback from others on character traits/ behaviour
  • To avoid stigmatising responses from others
  • A survival strategy to cope with the challenges in the sensory and social environment

What to look out for?

An autistic girl may:

  • Stop themselves from stimming or restrict their sensory responses
  • Put on a character; this could be real or imagined
  • Hide their true feelings i.e. putting on a fake smile
  • Copy the speech, tone or body movements of someone else
  • Use observation/ TV/ film/ books to learn social behaviours
  • Force eye contact
  • Practise facial expressions
  • Develop rules for conversation and scripts
  • Appear hypervigilant or have superb observational skills

Remember: It may not be easy to detect!

Home vs School presentation:

  • It is not uncommon for an autistic girl to present differently in their home environment compared to in school.
  • Home is often the young person’s safe place where they can be their true authentic self, including letting out any anxieties from the school day.
  • It is important for parents to feel listened to and heard so that schools can most effectively support an autistic girl in school.

What’s the impact?

  • Under-diagnosis: Masking can lead to autistic people not being diagnosed until much later in life, or at all – especially for girls.
  • It can be uncomfortable and exhausting masking differences.
  • Masking can lead to misunderstandings i.e. whereby it is assumed an autistic person understood something, when they did not.
  • There is often an offset whereby the pent-up emotions in the autistic person need to find a way out. This can lead to the differences being observed in home compared to school.
  • Long-term masking can impact an autistic person’s mental health, increasing the likelihood of anxiety and depression.

Friendships can be very important to autistic girls but also cause a great deal of anxiety at the same time. When asked about the perceived challenges autistic girls face at school, the most common responses were in terms of making friends and trying to fit in (Autistic Girl Network, Autism, Girls & Keeping it all inside’, 2022)

What to look out for?

  • Autistic girls are often socially motivated. They are typically very loyal in friendships and care deeply for their friends.
  • They may have a strong sense of social justice or moral compass.
  • Autistic girls often have passionate interests which are viewed as socially acceptable and help them to find friends with a similar interest. For example, animals and reading are common interests.
  • Trying to fit in can become a passionate interest on its own for some autistic girls. This is why masking is so common.
  • Autistic girls often have one or two strong friendships but may struggle socialising in groups. They may be very uncomfortable with conflict.
  • Feeling left out or bullied can be a common experience for autistic people, including autistic girls, at school.
  • May have a tendency to people please and give the answers they think others want to hear.
  • Autistic girls can experience a sense of ‘otherness’, feeling as though they do not fit into a friendship group.
  • Some autistic girls may form friendships with relative ease but struggle to maintain healthy friendships over time. They may have intense friendships vulnerable to falling out.
  • Autistic girls may struggle to socialise in unplanned situations, such as meeting a school friend in another context.
  • The use of inference can be problematic for some autistic girls; they may feel they do not understand a social conversation or interaction.
  • Some autistic girls observe those around them and may skilfully copy what they ‘should’ be doing. They often try hard to understand and learn social codes.
  • Autistic girls may need support to navigate social interactions, such as small talk in like with their social communication differences.

Autism is not a mental health problem, but 70-80% of autistic people experience or have experienced mental health problems in their lifetime (Ambitious about autism, 2017). Masking or internalising autistic traits can impact an autistic person’s mental health, confidence and self-esteem. Anxiety can become a major part of an autistic girl’s everyday life.

What to look out for?

  • Differences in presentation in one environment compared to another, i.e. releasing emotions through meltdowns, shutdowns or anxiety attacks at home.
  • Changes in physical symptoms, such as stomach aches, heart racing, tight chest.
  • Situational mutism (being unable to speak in situations which cause high anxiety or feel unsafe).
  • Anxiety around attending school.
  • Risk of emotionally based school avoidance.
  • Changes in diet and appetite.
  • Worries around friendships and social interactions.
  • Fears of being left out by friends.
  • Expressing feelings of being different from their peers.
  • Challenges developing a sense of their own identity.
  • Detrimental coping strategies, such as self-harm and disordered eating.
  • May appear ‘passive’ or ‘shy’ by masking their emotions.

Transitions can be challenging and disconcerting for autistic people. Transitions can range from micro-transitions (stopping an activity) to the larger transitions, such as moving from primary school to secondary school.

Transition to secondary school:

Transition to secondary school is a huge change for all children but especially so for autistic children. Sometimes, autistic girls may get by in primary school but find the transition to secondary school too overwhelming – the increase in sensory and cognitive input can become too much. Transitioning between classes may be very difficult, which is an increased expectation in secondary school. School practitioners need to be aware of the risks of anxiety-based absence that some autistic girls (and boys) may experience.

For primary aged students in Cambridgeshire, a referral for an autism assessment is made through Cambridgeshire Community Paediatrics:

The School SENDCO can complete a structured observation, observing the student’s social interactions in school: Social Communication Needs - Pupil Observation Form

School and parents can complete the following resources:

  • Gather the pupil’s voice, where appropriate, to understand their views of school and strategies which help: All About Me - Pupil Views
  • Parents can share early childhood development (i.e. did the young person reach their milestones with social interaction and communication?).

After a child receives an autism diagnosis, it can be a difficult time for the family and young person. The family and child may be coming to terms with a condition they know very little about, as well as trying to find new ways for everyone to feel supported within the family dynamic.