03 Feb Autism or ASD and Anxiety in Girls (including non-binary and transgender individuals)

---

What is the difference between boys and girls and ASD presentations? 

Autism, also known as autism spectrum disorder (ASD), affects individuals regardless of gender. However, girls with ASD may present differently than boys and have historically gone underdiagnosed or misdiagnosed. This is due to many factors, including gender biases in diagnostic processes, as most of the initial research into ASD used data from boys and men. Autism underdiagnosed in females is a significant concern in autism diagnosis Australia.

It is important to engage with a professional who can help you identify the difference between autism and social anxiety. Common misdiagnoses in girls and women with ASD include social anxiety disorder, general anxiety disorder, borderline personality disorder, and ADHD. These are seen more commonly as some of the symptoms overlap with ASD, and girls tend to be less ‘overt’ in their presentation, making it harder for professionals to distinguish autism in female adults from any of the other diagnoses above.

What are some common traits of girls with ASD that may be less seen in boys?

1. Strong verbal skills and an ability to mimic social behaviours.
2. Better at ‘masking’ or concealing their difficulties or discomfort in social situations.
3. A tendency to be overly compliant, which can make these individuals vulnerable.
4. High levels of anxiety and depression.
5. Sensory sensitivities (girls are seen to be more sensory avoiding, such as disliking loud noises and certain textures, than sensory seeking, however, this is dependent on the individual and can be seen in boys too).
6. Boys with autism are more likely to have more obvious repetitive behaviours (or stims), while girls with autism are more likely to have restrictive interests and less obvious stims, contributing to difficulties in diagnosing girls.
   

What do research findings show about the common traits of girls with ASD that may be less seen in boys?

There have been studies in more recent years into different presentations of autism in female adults, and now more girls are being diagnosed at an earlier age, and adult women are being diagnosed later in life. This research has also led to a wider knowledge of ASD and how it presents as a whole, and studies have found some boys, gender non-conforming people, and trans people also present in a way typically seen in ‘girls’. This new research and changes in autism diagnosis Australia have created a need for support for individuals with ASD that present differently from what we commonly see. One of the biggest challenges girls with ASD face is anxiety. Girls with ASD can experience anxiety for a variety of reasons, which we explore below.

Why do people with autism experience anxiety?

1. Difficulty understanding and navigating social situations, social cues, and social expectations. This can be challenging for girls with ASD and lead to social anxiety.
2. Sensory sensitivities, including overwhelming sensory experiences that can trigger anxiety.
3. Difficulty managing change and unpredictability, as individuals with autism may experience fear and anxiety when faced with unexpected change.
4. Fear of failure or negative evaluation, as individuals with ASD may be particularly sensitive to negative evaluation or getting things ‘wrong,’ leading to anxiety in performance situations, or things like work avoidance in school-aged children.
5. Co-occurring conditions such as ADHD or OCD may also contribute to anxiety.
   

What supports are available for girls diagnosed with autism and how can psychology help?

There is no single ‘treatment’ for autism, as it is a multifaceted condition that affects individuals in different ways. There are also common comorbidities that may come with ASD, including OCD, anxiety, depression, language delays, and other medical conditions, which will change the way the individual will be supported and treated. Often individuals with autism engage with a multidisciplinary team of occupational therapists (OTs), speech pathologists, and psychologists.

What are common interventions psychologists use to support girls with ASD?

1. Cognitive Behavioural Therapy (CBT) supports individuals to manage symptoms of anxiety, depression, and social anxiety, which is a common presentation in girls with ASD. This can also help support coping with negative evaluation and reduce avoidance behaviours associated with anxiety.
2. Social skills training and support navigating social situations to support girls who may not understand social cues and boundaries, teach them self-advocacy, and support them in building meaningful relationships with others.
3. Parent coaching using a positive behaviour support approach is used to support parents in understanding their child’s individual needs and develop strategies to reduce any behaviours of concern.
4. Individuals may also engage with an OT to understand and manage sensory needs or a speech pathologist to explore communication and any language delays.

What about support with an assessment and diagnosis?

Should an assessment be required, the benefits and need for this can also be explored in a session with one of our warm and compassionate psychologists at Positive Wellbeing Psychology. We recommend starting with a session to discuss your needs as the first step. Our psychologist autism assessment process ensures you receive an accurate evaluation and the necessary support.

How can a Psychologist help you?

At Positive Wellbeing Psychology, we match you with a psychologist experienced in addressing your specific needs and therapy goals. Each of our psychologists has a special interest in particular areas and undergoes ongoing professional development to ensure up-to-date expertise.

Our clinic director carefully reviews each enquiry to ensure you are matched with the right psychologist for your concerns. You can feel confident knowing your psychologist will understand your challenges, address your needs, and highlight your strengths.