Tags: In This Issue, Pediatric Health, Special Needs
Girls Have Autism, Too
One in 88 children now falls on the autism spectrum, according to the Centers for Disease Control and Prevention. It's a familiar and unsettling statistic. The disorder is nearly five times more common among boys than girls, with one in 54 boys diagnosed with autism. Girls aren't out of the water as one in 252 are considered on the spectrum. Why such a discrepancy between the genders?
"We don't know," said Dr. Louis Escobar, pediatric genetics, neuro-developmental pediatrics and newborn follow-up with Peyton Manning Children's Hospital at St. Vincent. It could be due to genetic factors. It could be the environment. Maybe both. From an evolutionary perspective, boys are more susceptible to disease in general. There is no answer yet.
Noha Minshawi, Ph.D., clinical director of the Riley Hospital for Children Christian Sarkine Autism Treatment Center at Indiana University Health, agrees and says that there has not been a lot of research looking at gender differences in individuals with autism. "Because autism is so much more common in boys, the research we do have is more representative of males because that's who comes into research studies," she said. Minshawi does note that research has shown no real difference in how autism presents in boys versus girls.
So, does gender even matter when it comes to autism diagnosis and treatment? Possibly. If you ask area autism activist Jane Grimes, then the answer is absolutely. "Without question there needs to be substantially more research for girls who have autism to find out the underlying challenges [they face]," Grimes said. "Personally and professionally, I believe the rate for girls is higher than people think given the fact that the autism rates have soared – yet there's been little to no research done on girls," said Grimes.
It's a fair point. Without the data to show how autism affects girls, are some girls with autism flying under the radar and missing a much-needed diagnosis? Are those already diagnosed receiving the right interventions?
Consider that some young girls with high-functioning autism may display signs of a social deficit, yet their poor eye contact or awkward responses to physical touch may pass as little girl personality traits. They too may be less aggressive and disruptive than boys their age; therefore more easily overlooked.
Grimes believes early in life boys and girls diagnosed with autism can appear similar, but as they grow differences naturally emerge. Take puberty. There is a widespread perception that girls mature more quickly than boys. Grimes says this just isn't so with girls who have autism. "They are still very immature. Going through puberty is difficult for a typical girl, but even more so for a girl with autism," she said.
She says the depth of education a parent must go to in order to teach the fundamentals of things like wearing deodorant and dealing with menstruation is much more detailed and specific than what a typically developing child needs. Plus, many girls with autism also have heightened sensitivities that make puberty even more challenging.
Beyond physical development, core social dynamics of adolescence are different than those of childhood. In this stage girls seem to socialize in packs. Their conversations dart from topic to topic. Typical girls adapt to these new rules of engagement, but girls with autism fall behind.
Then there's the matter of boys – a whole other can of worms.
The point is that while the symptoms of autism in boys may be similar to the symptoms of girls, the experience between genders differs a great deal. So the question remains: does gender matter when it comes to autism? Are girls on the spectrum getting the proper diagnosis? Do these girls have a higher risk of developing depression, anxiety or eating disorders? It's worth consideration.
As autism unfolds, so too will answers to these questions. In the meantime, what is known is that early intervention is key. And, for parents of daughters on the spectrum, being willing to participate in research studies like those at Christian Sarkine Autism Treatment Center will help scientists better understand how autism affects girls.