Autism in girls: recognising the different signs

Why autism can look different in girls

Girls are often better at copying social behaviours they see in others. They may have fewer obvious repetitive behaviours, or their special interests may seem more “socially acceptable” (for example, animals, books or celebrities rather than trains or numbers). These differences can make autism less visible to teachers or healthcare professionals.

Common signs of autism in girls

• Social interaction: Girls may appear friendly but struggle with the “hidden rules” of friendships. They may prefer one close friend rather than group play, or feel exhausted after socialising.  Sometimes these difficulties only become apparent as girls get older and the complexity of social relationships increases. 

• Communication differences: While sometimes having advanced vocabulary or delayed speech, their challenges lie in subtle difficulties with back-and-forth conversation, turn-taking, tone of voice or interpreting body language. In addition, literal interpretations, struggling to understand jokes, idioms and sarcasm and a preference for deeper, meaningful conversations over small talk, is common,

• Special interests: Intense focus on a topic but within an area considered typical for girls (such as horses, books, make-up, dolls, TV shows).

• Masking and camouflaging: Copying others’ behaviours or scripts to “fit in”, which can hide their challenges but lead to anxiety or burnout.  Many girls are keen to please adults such as teachers at school which leads to them not ‘standing out’ in the classroom.  Perfectionism tendencies are also common and often driven by the need for social approval, fear of making mistakes and drawing attention. 
• Sensory sensitivities: Being very sensitive to sounds, textures or smells, which can show up as picky eating, clothing discomfort or avoiding noisy environments.

• Repetitive behaviours: While boys may display more overt repetitive behaviours, in autistic girls can be more subtle and less noticeable to others. These subtle behaviours may include hair twirling, skin picking, obsessive organising or self-talk. These behaviours often serve as a way to cope with sensory overload, anxiety, or emotional distress.

Why early recognition matters

Spotting autism early helps families access support or adjustments at school in a timely fashion.  Diagnosis can also be empowering for girls and women and help them to view their own strengths and needs through a positive lens. Assessment isn’t about labelling – it’s about understanding and supporting your child’s needs.

Supporting autistic girls

• Validate feelings and encourage self-expression: Let your child know it’s okay to feel different or need breaks from socialising. Help your child communicate their needs and feelings in a way that is suitable and comfortable for them, for example using various methods, including symbols, drawings, music and creative arts.
• Create safe routines: Predictability can reduce stress.  Whenever there is an unpredictable change, take time to explain the reasons why and provide extra time to process it. Providing opportunities to be themselves by allowing time for them to follow their interests is also important.
• Reduce anxiety: Support your child to understand what makes them feel anxious and identify together strategies to help them to recharge and feel calm. Avoid giving too many instructions at once and rushing them. Be aware of sensory differences and how the environment can affect your child. Using earbuds or fidgets such as fidget rings can help tolerate busy and noisy places.
• Seek specialist advice: Speech and language therapy, occupational therapy and school support plans can all help.
• Look after mental health: Girls who mask may be at higher risk of anxiety or depression. Encourage open conversations and, if needed, professional help.

Next steps

If you have any questions about your child’s development or would like to speak with us, you can book an appointment or get in touch with the Childhealthy team.

Our autism assessments are designed with your child in mind:

• Multidisciplinary approach – input from a range of highly skilled professionals who have extensive experience in working with girls and young women with autism and neurodiversity. 

• Tailored to each child – because one approach does not suit all children.

• Individualised recommendations – practical guidance to support your child’s next steps.

We’re here to help you understand your child’s needs and access the right support at the right time. 

For additional information, please see the NHS website and The National Autistic Society.

(This article is for general information only and is not a substitute for individual medical advice. If you have concerns about your child’s development, please speak to a qualified healthcare professional.)