I recently attended an event organised by Autism Anglia, which included a couple of seminars on autism in girls. This is a topic that has interested me for a couple of years, but it is one that is still, unfortunately, shrouded in mystery.
When autism was first diagnosed, it was thought to be an almost exclusively male condition. As such, many of the diagnostic tools are skewed towards identifying males with autism. This has led to a huge number of females being undiagnosed and, therefore, left without support. In some cases, this has led to women with autism experiencing difficulties with their mental health, as a result of a lack of understanding as well as no access to support.
Even today myths are still perpetuated regarding female autism. Social and cultural influences mean that women with autism often present differently to men.
For example, because they have been biologically "hard-wired" to be better at non-verbal communication, autistic women may feel confident in making eye contact and may be more advanced at using language to build rapport with others, compared with males with autism. This means they could be starting with an "advantage", which allows them to unintentionally mask their differences. Girls are also less likely to demonstrate repetitive behaviours and their special interests are more likely to be seen as 'normal' – ponies, dolls and pop icons, for instance.
What difficulties are girls with autism facing?
It is important to recognise that girls with autism who are adept at mimicking neurotypical behaviour are incredibly vulnerable in many ways. It is easy for these young women to slip through the net, and never access the support that they need.
As a result, school can become a stressful and confusing environment and their academic performance can be negatively affected. High levels of stress can lead to self-injurious behaviours, such as scratching or picking the skin, pulling out hair or eyelashes (trichotillomania), or eating disorders.
However, there is plenty that can be done to support girls with autism. Here are some tips:
1. Help girls to manage emotions
There is a myth that people with autism lack empathy, but in many instances people with autism may, in fact, experience an overwhelming amount of emotion and not know how to process it. Access to cognitive behavioural therapy (CBT) may enable girls to take control of their emotions. Sensory toys such as tangle toys or stress balls may also help them to cope with overwhelming feelings.
2. Give positive feedback
Boosting self-esteem through positive feedback can help to bolster those girls who expend huge amounts of energy on just getting the basics right, day in, day out – successfully not standing out in any way. However, it is important that any praise you give is explicit, otherwise it might be difficult for the young person to ascertain what they are being praised for.
3. Teach communication skills
Communication and interaction skills will need to be taught explicitly, even with those girls who seem confident at communicating. Ideally, this will take place in a small group situation, although it is everyone's responsibility to gently point out what is and is not socially acceptable. Using social stories can be an impactful way of addressing some of the more sensitive challenges faced by young females with autism – for example, when discussing sexual consent or periods.
4. Assign a point of contact
Young people with autism should have a key person who they can speak to and who can advocate for them. In a busy school environment, it is easy to assume that everything is OK with young women with autism, as they may appear to be coping well and may even say that everything is fine when you ask them, whether that is true or not. However, it is important that a relationship is forged between learners with autism and a key person who can spend time listening to their concerns. It is also essential to not downplay or dismiss the young person’s worries, even if they seem trivial.
All school staff, and not just teachers, must become better informed about the presentation of autism in females. Increased awareness and understanding could prevent thousands of young women from suffering through their school years and not reaching their full academic potential.
Gemma Corby is Sendco at Hobart High School, Norfolk. Her Sendco column for Tes runs every second Tuesday during term time