Delving into a diagnostic dilemma: The effect of gender on autism identification in children

Evidence is building which suggests girls could be just as likely to be on the Autism spectrum, as boys. Yet their symptoms may present differently. Dr Katja Osswald is Service Lead for The Retreat’s Autism and ADHD Service. Here she explores some of the evidence around this research.

Here at The Retreat, we have a long history of using innovative approaches to tackle mental health issues.

When the organisation was first conceived more then 200 years ago, the focus was on thinking differently about the symptoms, diagnosis and treatment of mental health conditions – and that philosophy is still very much alive today.

In our children and young people’s autism service for example, we’re currently starting to re-think the way we assess children on the spectrum based on whether they are boys or girls.

Up until recently, the general perception has tended to be that boys are more likely to develop some form of autism than girls. However, an increasing amount or research, including important work by the National Autistic Society, points to something a bit more complex.

An evidence base is building which suggests that in actual fact, girls could be just as likely to be on the spectrum as boys but their symptoms may present differently which can be challenging to always recognise for parents, teachers and even therapy professionals.

There are a number of potential reasons for this.

The first is that today’s autism assessment tools have largely been developed using male characteristics due to early research into the condition predominantly being carried out on male study groups.

Added to this phenomenon is an emerging school of thought that the female social landscape provides better opportunities for ‘camouflage’ or ‘masking’. Girls have often been observed to weave in and out of group situations in order to mask any social challenges they might have, whereas the male landscape, which tends to involve more organised games, allows boys on the spectrum (who often prefer to play alone) to be more easily identified.

It may still be the case that boys are in some way more prone to autism because of biological factors such as genetics and sex chromosomes – and research is ongoing in these areas – but it is almost certainly the case that a large number of girls on the spectrum are not being identified and given the help that they need.

The Retreat’s therapy teams are constantly looking at the latest research findings to ensure that our diagnostic and assessment practices are as effective and evidence-based as they can be.

If you have any concerns about your child and would like to find out more, you can speak to the children and young people’s team on 01904 426023. Alternatively you can make an online enquiry via our website

Dr Katja Osswald is Service Lead for The Retreat’s Autism and ADHD Service