If you were asked to describe a typical student with autism, what would you say? I’m almost certain that your description would include ‘male’. Think about all the examples of people with autism (or ‘Autistic Spectrum Conditions’, ASC) that are in our consciousness: ‘Rainman’, ‘The Curious Incident of the Dog in the Night-time’, ‘A Beautiful Mind’, Roy Cropper in Coronation Street, ‘Schtum’; I’m sure there are more. What do these all have in common? The person or character with ASC is male. I challenge you to think of an example where the character with ASC is female (if you can, please let me know as I would love to widen my list!).
Why the imbalance?
This is one of the reasons that nasen’s miniguide ‘Girls and Autism’ is subtitled ‘Flying under the Radar’: it is becoming more and more widely understood that there may well be as many girls and women with autism as there are boys and men, but their needs are not always being identified. Why is this?
As ‘Girls and Autism’ points out, there could be a gender bias in screening and referral processes; perhaps females with autism use protective and compensatory behaviours; and there are probably gender-specific ASC profiles. These factors go some way to explaining the 1:10 ratio of females to males in the sub-group of ASC students without learning difficulties (the ratio is 1:2 in those with moderate to severe learning difficulties).
How do females with ASC present?
They tend to have better social integration skills than males with ASC, although these are not intuitive as in the neuro-typical population, but are based on analytical thinking. Some females with ASC will rote-learn conversational phrases and follow ‘social scripts’, which will enable them to mask some of their innate ASC behaviours.
Females with ASC often have the ‘special interests’ observed in males, but they tend to be more similar to those of their peers, such as a boy band, or horses. These do not fit the ‘typical’ (expected) range of ‘ASC’ interests, which might include trains, electricity pylons, dinosaurs etc. However, the quality and intensity of their interests differentiates girls with ASC from their neuro-typical peers.
The repetitive, ritualistic behaviours (such as flapping, tremor etc) commonly seen in males with ASC do not seem be as prevalent in females.
However, one of the most overwhelming aspects of ASC in females is pervasive anxiety. As Carrie Grant (mother of three girls with ASC) says, “Their daily minefield of worries takes up a large portion of their headspace, and the concentration required to keep everything hidden takes up anything that is left! With all capacity used up, they are prevented from listening properly or learning effectively.” So not only are these females suffering from potentially crippling anxiety, they may also be struggling to learn. And it is not surprising that there is often an overlap with mental health disorders such as eating, obsessive-compulsive and depressive disorders.
How can schools help?
The most important thing that schools can do is be aware of the possibility of an ASC diagnosis for girls as well as boys. Make sure all your staff have this understanding; using the nasen booklet would be a good way to start: it contains case studies as well as further information on research, and a particularly useful section from Sarah Wild, Headteacher at Limpsfield Grange School for girls with autism, containing advice for senior leaders, mainstream teachers and TAs.
Look out for the girl in class who is very quiet and well behaved but seems to have some friendship issues, and may not laugh at your jokes; if you look carefully, you may also see the signs of anxiety in her perfectionism and reluctance to answer questions. There may also be other learning difficulties, including dyslexia and ADHD, which can overshadow an ASC profile as they are easier to identify. A school refuser or persistent truant might be struggling with the social pressures as much as the academic ones; could she have ASC? Keep an open mind and consider the possibility of ASC.
Enabling school environments
If your school is ‘autism friendly’ (or ‘communication friendly’), then you are going a long way to supporting all pupils, whether diagnosed or not, boys and girls. This includes using multi-sensory teaching methods, lots of visual support, routine and consistency, acceptance of difference, the use of specific praise and a careful use of language (the most important teaching tool that we have).
If you would like to download the booklet, please visit the resources section of our website (www.nasen.org.uk) or use http://www.nasen.org.uk/resources/?tag=miniguides. And keep ASC in mind for girls as well as boys!
nasen Education Development Officer
I have recently started working as an Education Development Officer for nasen, after a 24 year career covering mainstream teaching, SENCO, running Dyslexia and SLI resource bases, Reading Recovery teacher leader, special schools teaching and outreach work and lots of delivery of CPD in SEND.