Working with and raising boys is different than with girls. That’s a fact. I have only boys at my house (down to the dog!) but also have a wonderful set of nieces to balance out the group. As a psychologist, I spend a huge portion of my time with boys of all ages, as they are more likely to be referred for assessment and consultation at my office. I don’t have any hard numbers (having never crunched them), but I would ballpark that only 25% of my patients are female. This means that on “girl days” at my office, I get to change things up, which is a refreshing experience. Even when they present with disabilities, girls are different and require their own individualized approach. This can make the process of fully conceptualize these young women and their needs challenging. This is not a research paper, so I am going to use some basics to outline facts, not necessarily all the hard numbers. Most findings suggest that when autism spectrum disorders are considered, boys are more likely to outnumber girls by 3 or 4 times. There are more girls on the autism spectrum who are also intellectually disabled. This means that a small portion of the autism spectrum disordered population is female and with cognitive functions that are average or higher than that. Neuroscience findings have noted differences between boys and girls on the autism spectrum with typical intellectual functions in the genes involved, differences in brain volume, and brain structures/communication. This suggests that high functioning forms of an autism spectrum disorder (ASD) really are different for girls. This means that for those diagnosing, treating, and parenting this young ladies takes some extra TLC.
Interestingly, girls with high functioning ASD are more likely to have functionally effective social skills in elementary school. This is part of the reason that they are usually older when receiving a diagnosis (which is true for lots of kids on the high functioning end of the autism spectrum). Research suggests that girls with high functioning ASD (or what used to be called Asperger’s Syndrome; this diagnosis no longer exists and has been combined with all presentations on the autism spectrum) are more likely to blend in during elementary school and maybe even early middle school. However, when those brutal middle school years require them to be more socially flexible, intuitive, and to mesh with one or more cliques, they start to flounder, and social functions decline hugely and rapidly. Psychologists studying the small number of girls with high functioning ASD (there is FAR less than for boys) have found that they struggle more with depression (which is true for women in general in comparison with men). So, the sequence suggests that the super complex social requirements of being a middle school girl are the precursor for a cascade of events for preteens and teens on the autism spectrum. First, their lack of social skills development leads to a lack of success when they try to use the skills that they DO have. Middle schoolers are hard on each other on a good day, but can be downright vicious at times when things go wrong. For girls on the high functioning end of the autism spectrum, this series of social failures often leads to social anxiety, which can be pronounced enough that they step out of the social experience almost completely.
Although persons on the autism spectrum LOOK like they are away from the group and are content with that, most have a very strong desire to connect with others and just don’t have the skills to do so comfortably and effectively. This can lead to progressively depressed mood and even more pronounced withdrawal from the world around them. Research that has been conducted with girls on the high functioning end of the autism spectrum suggests that they are much less likely to marry or create a family, are more likely to live at home with parents or extended family members as adults, and are less likely to be employed at a level matching their cognitive skills. If all of these things are noted in research, this suggests that a strong focus on early and consistent support for girls on the autism spectrum is needed. But, finding a way for these girls to connect socially can be tricky. Lots of social skills groups exist out there for pre-teens and teens on the autism spectrum. Unfortunately, there are so few girls diagnosed with high functioning ASD in comparison with boys, many will be in a grouping of all boys, which may not be particularly helpful when working on “girl” social skills. In Dallas, there are some wonderful groups and organizations that provide services for children, teens, and young adults on the autism spectrum. Assuming they don’t mind a little free advertising, I have included links and info below. Most of these will offer largely local services, but some may be able to help with virtual or home-based supports as well. I have also included some books and links for a broader approach to the process of helping these girls get the services they need.
Dallas area ASD providers
Center for Brain Health Charisma Program is a virtual social skills program developed at University of Texas at Dallas. This offers a guided format for addressing social anxiety and social skills deficits in children, teens, and adults with social anxiety disorders and/or ASD. (Charisma)
Spectra Therapies and Evaluation specialize in diagnosis and treating children on the autism spectrum age 4 and up and provide supports up through late adulthood. They offer social skills groups for all ages (Spectra Social Skills Groups).
United Through Hope is a local non-profit group specializing in social skills development in persons on the autism spectrum. They offer a range of social skills groups from elementary school into adulthood. (United Through Hope Social Skills Groups for elementary, teens including a group just for girls, and adults).
The Social Communication Connection is a team headed by a brilliant speech therapist with specialty in social communication. They specialize in much younger children (up to age 5), allowing opportunities to support social skills and communication deficits early (often before diagnosis is established). They offer groups just for pre-k girls).
Especially for women with ASD nationwide
Felicity House (Manhattan, NY) https://felicity-house.org/our-mission/
Links, sites, and educational information
Asperger/Autism Network- women and girls https://www.aane.org/women-asperger-profiles/
Aspect Autism Spectrum Australia https://www.autismspectrum.org.au/uploads/documents/Fact%20Sheets/Aspect-Research-girls-and-women-on-the-autism-spectrum.pdf
Autism Speaks https://www.autismspeaks.org/blog/women-autism-spectrum-stress
Child Mind Institute https://childmind.org/article/autistic-girls-overlooked-undiagnosed-autism/
Autism.org https://www.autism.org.uk/about/what-is/gender.aspx
SPARK for Autism https://sparkforautism.org/discover_article/are-girls-with-autism-hiding-in-plain-sight/
The Art of Autism https://the-art-of-autism.com/females-and-aspergers-a-checklist/
TED Talk https://www.youtube.com/watch?v=QY2ctCuTWPw&list=PLv63NTmutBE8iAeUcGzkus9So35UaJp6E&index=317
Books

Asperger’s and Girls featuring Tony Atwood and Temple Grandin

Parenting Girls on the Autism Spectrum by Eileen Riley-Hall


Girls Growing Up on the Autism Spectrum by Shauna Nichols


The Autism Friendly Guide to Periods by Robyn Steward

The Spectrum Girl’s Survival Guide by Siena Castellon

The Autism Playbook for Teens by Irene McHenry and Carol Moog

The Social Skills Picture Book for High School and Beyond by Jed Baker

Life on the Spectrum: A Guide for Girls and omen by Karen

Asperger’s in Pink by Julie Clark

The Care and Keeping of You 2: The Body Book for Older Girls by Cara Natterson
