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AUSTIN (KXAN) – The prevalence of autism spectrum disorder (ASD) has grown rapidly over the past two decades. Although the number of girls diagnosed with the developmental disorder has risen along with the overall numbers, doctors say diagnosing girls with ASD is more challenging than diagnosing boys.
ASD is a developmental disability characterized by persistent difficulties in social interaction and repetitive behaviors, interests, or activities that make it difficult to communicate and participate in daily activities, according to the CDC.
The CDC began tracking autism in children in Atlanta in 1996. In 2000, it established the Autism and Developmental Disabilities Monitoring (ADDM) Network, which expanded screening to nine more US metropolitan regions.
Since then, the prevalence of autism in children has increased markedly. In 2000, the network found that around one in 150 children had ASD. 18 years later, this number has jumped to around one in 44.
And since 2018, it has increased even more. The CDC reported last month that one in 36 children in 2020 had autism, according to its data. And for the first time since the CDC began tracking autism, the prevalence of ASD in girls in 2020 exceeded 1%. The rate for children is around 4%.
“We are beginning to understand that autism is not just a condition of boys and that there are many girls who have often been overlooked, until they are teenagers or adults when they begin to realize, ‘Oh my gosh, maybe that’s why I always I’ve felt different,’” said Dr. Audrey Brumback, an assistant professor of neurology at the UT Austin Dell School of Medicine.
Why have autism diagnoses skyrocketed?
Brumback said that when scientists started talking about autism, the condition was blamed on “refrigerator moms,” meaning mothers who weren’t overly nurturing. She said the theory was later thrown out as scientists began to understand that there was a biological component to the disorder.
The prevalence in recent decades has increased mainly because doctors are better at diagnosing children with autism, Brumback said. Many people in the past were labeled with other conditions, such as mental retardation, and now would likely be diagnosed with autism.
In the new CDC report, the ratio of children diagnosed with autism is around 4 to 1 male to female. Brumback said there’s a biological component that partially explains why boys are more likely to be diagnosed with autism than girls, but also why girls tend to be more difficult to diagnose.
Why are girls more difficult to diagnose?
“It’s easier for women to go under the radar,” Brumback said.
This happens for a few reasons.
“Girls tend to be quietly autistic, where they don’t stand out by making all these things visible to outside observers. And so, they’re just quietly having challenges.”
He also said that girls are largely better than boys at picking up on the behaviors of others.
“Girls are good at copying and pasting other people’s behavior onto themselves,” Brumback said. For example, a girl may see a classmate who is socially popular with a large group of friends and think of ways to imitate that classmate’s behavior to try to achieve what she has.
Brumback said that while it remains more difficult to diagnose girls with autism than boys, “we’re starting to close that gap,” he said.
Signs to look out for
Many girls with autism may have problems at home but not at school.
“Basically, they are using every energy molecule they have to imitate their neurotypical friends and appear neurotypical. We call it masking,” she said. “The teachers think that everything is fine, they have a group of friends and they are doing very well in their class work.”
But in these situations, when the child gets home to a safe place, he may break down.
“If you have a teenager who comes to see you swooning after school, hit the pause button and ask yourself, could this person have autism?”
And if a person discovers that they might be on the autism spectrum later in life, Brumback said self-acceptance is paramount.
“Just understand that there is nothing wrong with you. It’s just that you’re wired differently,” Brumback said.
