Towards understanding the under-recognition of girls and women on the autism spectrum

It is only in recent years that research has begun to focus on gender differences in males and females on the autism spectrum. There is now an increasing awareness that we are missing women and girls on the autism spectrum and the assumption has been that there are more males with autism or Asperger syndrome. The questions needing to be asked are as follows: (1) Does autism present differently in females?; (2) Do females mask the symptoms better than males?; and (3) Are professionals less likely to diagnose females even when symptoms and behaviour are evident? Three of the papers in this special edition of "Autism" attempt to address these questions. This commentary discusses the studies by Dean et al., Lai et al., and Duvekot et al. presented in this issue of "Autism." In both the papers of Dean et al. (2017) and Lai et al. (2017), it is pointed out that the heightened tendency to camouflage difficulties in females in both social interaction and social communication may not be picked up by teachers, primary care workers or unenlightened diagnosticians, making an autism spectrum disorder (ASD) diagnosis less likely. A very important finding of Duvekot et al.'s study was that girls were less likely to receive an ASD diagnosis based on the standardised diagnostic instruments. [For Dean et al.'s "The Art of Camouflage: Gender Differences in the Social Behaviors of Girls and Boys with Autism Spectrum Disorder," see EJ1149803. For Lai et al.'s "Quantifying and Exploring Camouflaging in Men and Women with Autism," see EJ1149809. For Duvekot et al.'s "Factors Influencing the Probability of a Diagnosis of Autism Spectrum Disorder in Girls versus Boys," see EJ1149813.]