Autism Spectrum Disorder (ASD) is a common neurodevelopmental condition which our understanding of continues to grow. Where previous studies conceptualised autism as a disease to be cured, today most experts agree that ASD is a complex, lifelong condition that presents differently person-to-person.
One recent finding is how widely ASD presentations vary across sex and gender. Historically, boys were four times more likely than girls to receive an ASD diagnosis, but current estimates are now closer to two to one. While some biological factors influence this ratio, Shirene, one of our speech pathologists at The Benevolent Society, explains that girls are also underdiagnosed because they’re usually better at camouflaging, or “masking” their differences.
“Masking means they try to conform with their neurotypical peers. Young girls may change how they present, act, and respond to fit in, and so they tend to fly under the radar,” she says.
While mimicking the behaviours of others may result in a girl experiencing fewer instances of bullying or social tension, emotionally – it’s costly.
“It’s very natural for neurotypical children to respond to other people's feelings, to go up and ask, “are you ok?” and know what to say in response. But for children diagnosed with ASD, it's more like a script in the brain they must pull out. It takes more cognitive energy instead of being an innate ability, so socialising can be very tiring,” Shirene explains.
This means that girls who mask all day at school come home depleted, and parents may notice higher anxiety levels and emotional breakdowns.
Every child will experience ASD in their own way, but on average, boys tend to display more obvious signs of social and communication difficulties.
“These may include recognising emotions, regulating themselves, responding to others and participating in friendship groups. Of course, some girls are like this too; but others are hyperaware of how others are feeling. This can make them even more emotional and amplify their stress,” says Shirene.
Without early identification and intervention, the effects of such stress may show up as depression, anxiety or low self-esteem in adulthood.
If you’re a parent wondering whether your child may have brain that’s wired differently, Shirene emphasises there’s no definitive checklist, but describes some of the ‘quieter’ ASD traits* that can be overlooked:
- A particularly intense focus on a hobby or topic, known as a ‘special interest’. Narrow and highly-specific interests, such as coins, maps, or hurricanes, may be more noticeable than more “socially acceptable” interests such as gardening, reading, or animals.
- Difficulty adapting to change, including changes in routine, environment, or situations. E.g., not knowing how to greet or respond to a teacher if seen outside the school setting.
- Emotional regulation issues. A child may have trouble managing emotions, anxiety, or become easily overwhelmed in crowds and noisy places. They may respond to distress with self-soothing behaviours such as rocking, pacing, or fidgeting.
- Needing recovery time after social situations. A child may experience anxiety or overwhelm after spending time with others.
*Not a diagnostic tool. For a formal ASD assessment, speak to your doctor, paediatrician, or family physician.
The gift of early intervention
Recognising neurodivergence early is incredibly beneficial. Families can access our support services, begin learning about how their child’s brain works and find communities who understand the trials and triumphs associated with ASD.
Understanding each participant individually is a big part of Shirene's service, too. She must listen to every child attentively to learn about their level of self-awareness, strengths, struggles, desires, and needs.
“As a speech pathologist, I am always supporting my clients to build a voice for themselves. I help them learn how to advocate for themselves in different environments, such as in their friendship groups, at school, with their teachers and older adults,” she says.
Flora Ma, Shirene’s Team Leader, adds that Occupational Therapists often work in tandem with Speech Pathologists at The Benevolent Society to help a client with sensory issues, fine and gross motor skills and modifying the environment.
“We are basically providing multiple inputs for clients to enhance their skills. And we’re also sharing those strategies we’ve found in session with the family so they can help their child learn and grow,” she says.
Regardless of presentation or gender, the support journey should be inclusive and empowering.
“We want them to know that it’s OK to be themselves. And that if they’re feeling a certain way they can ask for a break or to go to a quiet space. If they find eye contact hard, they can say ‘I’m not looking at you, but I’m listening’” she says.
For support options, please call our Support Centre at 1800 236 762 or view our Services & Programs page.