ADHD News & Research

New Study: Autism — Like ADHD — Diagnosed Later in Girls

Research shows that symptoms of autism spectrum disorders (ASD) show up differently in girls, which may mean physicians overlook the condition for longer.

April 29, 2015

Like ADHD, autism spectrum disorders look different in girls and in boys — and that disparity may be delaying diagnosis for some girls with the condition.

This is the finding reported in a new study by the Kennedy Krieger Institute, and presented at the Pediatrics Academic Societies’ Annual Meeting in San Diego. This research suggests that girls’ symptoms are misunderstood, ignored, and/or undiagnosed for longer than are boys’ symptoms, partially explaining the fact that four boys are diagnosed with ASD for every one girl identified as on the spectrum.

The researchers analyzed data for 50,000 people with ASD. The numbers showed that girls are diagnosed later than are boys with pervasive developmental disorder and with Asperger’s syndrome — both forms of ASD. Additionally, the symptoms that led to the diagnosis varied by gender. Young girls more commonly had trouble with social cues, while boys exhibited repetitive behavior like hand flapping. In older children, boys had more social issues than did girls ages 10-15. The findings suggest that ASD symptoms in girls may be more nuanced and difficult to notice, leading to delayed — or completely missed — diagnosis.

The same is often true when it comes to recognizing and diagnosing ADHD symptoms in girls.

Even today, most people consider ADHD an adolescent boy’s condition. This is simply not true. In fact, the highest rates of recent diagnosis are among adult women. Though the condition is equally prevalent in both genders, for every three boys diagnosed with ADHD, only one girl is similarly identified. The reason for the disparity is that ADHD manifests, or is described, differently in girls and women, which means physicians often mistake it for another condition or miss it entirely.

Girls with ADHD are more likely to be inattentive rather than physically hyperactive. Since they are not disrupting the classroom by jumping around, their daydreaming may not lead to an ADHD evaluation. Even when girls are hyperactive, this manifests as chattiness or a subtle movement like foot fidgeting or finger tapping. Additionally, girls more commonly develop strategies to compensate for their ADHD difficulties because of social pressure to behave and perform well in school. In other cases, a coexisting condition like anxiety or self-esteem problems can camouflage the inattentive ADHD that underlies — and could be causing — the secondary condition.

Long-held gender biases cause too many girls’ ADHD symptoms to be disregarded as “ditzy” behavior. The stigma of an unrecognized condition can mean years of low self-confidence, shame, and psychological damage from feeling flawed, not good enough, or simply unable to keep up with peers. Learning to recognize unique symptoms of ASD and ADHD in females, is the first step toward helping them manage their conditions and lead a successful life.

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