Why autism in girls is so often missed
Why Autism in Girls Is Often Missed
Autism is currently diagnosed four times more often in boys than in girls. While biological differences may play a role, we now understand that diagnostic bias is also a major factor. Most autism research has focused on boys. As a result, many of the tools and criteria we use today are less sensitive to how autism shows up in girls.
Autistic girls tend to show fewer outward signs of difference. They are often more socially motivated than boys. They may go to great lengths to mask their difficulties by mimicking others, following scripts, or staying quiet in social settings to avoid making mistakes. Over time, this effort can come at a high emotional cost.
Signs of Autism in Girls
Every autistic person is different, but here are some common traits that may show up in girls:
1. Strong desire to fit in
Many autistic girls work hard to be liked and accepted. They often observe others closely and copy social behaviours to blend in, even if they don’t fully understand the interactions.
2. Masking and mimicking
Girls may smile, nod, and make eye contact, even if it feels uncomfortable because they have learned that is what is expected. This can make their underlying struggles less visible to teachers and professionals.
3. Perfectionism and high anxiety
Wanting to get things “just right” can be an early sign of autistic traits. Many girls become overwhelmed when they can’t meet their own high standards, especially in social situations.
4. Different special interests
Autistic girls often have deep, passionate interests, but these may centre around animals, fantasy characters, celebrities, or books, which can seem more 'typical' and, therefore, be overlooked.
5. Exhaustion after social situations
While they may seem to cope at school, many girls “hold it together” only to have meltdowns or shutdowns once they’re home and in a more secure environment.
The Hidden Toll of Masking
Masking is when autistic individuals hide or suppress their natural behaviours to fit in. For girls, this can start early and become automatic.
But masking is exhausting. It can lead to confusion around identity, reduced self-esteem, and a greater risk of anxiety, depression, and burnout. It can also delay or complicate diagnosis, as girls may struggle to explain what they are experiencing, even when they desperately want help.
Repetitive Behaviours May Look Different, Too
While some autistic girls do engage in obvious stimming, such as hand-flapping or rocking, others may stim in more subtle ways, like tapping, twirling hair, or quietly scripting. Their need for sameness and structure may come across as inflexibility or anxiety rather than a sign of autism.
Girls’ special interests may also appear socially appropriate and even encouraged, such as an intense focus on animals or storytelling, making them less likely to raise red flags.
Supporting Autistic Girls: What Helps
Know the signs
Learn how autism presents differently in girls and challenge outdated stereotypes. Early recognition helps girls develop self-understanding and avoid years of missed support.
Be curious, not dismissive
If a girl is anxious, overwhelmed, or having meltdowns after school, dig deeper. Don’t assume that “coping in the classroom” means she isn’t struggling.
Prioritise emotional regulation
Girls are often taught to “be good” and may not feel allowed to express strong emotions. Teach and model healthy ways to notice, name, and manage feelings.
Offer structure and routine
Predictable routines can help reduce anxiety and support transitions. Even small changes can be overwhelming for neurodivergent kids.
Support executive functioning
Scaffold tasks, use visual schedules, and provide support for planning, organisation, and time management.
Talk about autism in strengths-based language
Help your child understand their brain, and that being autistic is not something to fix, but a different way of experiencing the world.
For Clinicians: Look Beyond the Checklist
If you’re assessing a girl for autism, slow down. Observe carefully. Ask questions about her inner experience, not just her observable behaviours. Pay attention to the social cost of keeping up appearances. Screen for co-occurring conditions like ADHD, anxiety, and learning differences, which often overlap and can mask one another.
Final Thoughts
Autistic girls have always been here. What’s changing is our ability to recognise and understand them.
If you are a parent wondering whether your daughter might be autistic, or if something just does not feel right, trust your instincts. Early support can make a world of difference, and at The Neurodevelopment Clinic, we are here to listen.
We offer neuroaffirming assessments designed to look beyond the surface and truly understand your child. If that sounds like what you’re looking for, please get in touch here.
