UNDERSTANDING GIRLS WITH AUTISM
Autism is characterised by social, sensory processing and communication differences, as well as rigid and repetitive behaviours, and sometimes special interests that engage the person for hours. Sensory perception differences may be apparent in the person’s hyper- or hypo-sensitivity to certain or loud noise, tactile sensations, aromas, tastes, light, or, reduced sensitivity to pain and/or temperature. Autism is thought to affect around one in one hundred people. Many people with autism have either normal or superior intelligence. This form of autism is generally referred to as high-functioning autism (formerly known as Asperger’s syndrome). The majority of individuals referred for a diagnostic assessment for Asperger’s syndrome are males. Nevertheless, we know that a substantial proportion, approximately 50 per cent of individuals on the autism spectrum, are females who tend to be missed in the diagnostic process.
Recognising Autism in Girls: Flying Under the Radar
Many girls with autism remain undiagnosed because the signs are less obvious than they are with boys. Girls are more motivated to conform and to fit in socially and so girls with autism are likely to be well behaved, less disruptive and so less likely to be noticed. They may have learned that if they are good, they will be left alone and if they are quiet, no one will see them, making it less likely they will come to the attention of their teachers. Rather than intuitively understanding what to do socially like their neurotypical peers, girls with autism will closely observe and analyse the social world around them before making the first step. Often they will use better coping and camouflaging mechanisms, including imitation and acting to be able to conceal their confusion when socialising with their peers.
What to Know about Girls with Autism
Every girl on the autism spectrum is unique and her needs will be reflected differently. Schools should be cautious not to run the risk of overgeneralising, as students with autism can be as different from each other as any other students.
Unlike most boys with autism, girls are more likely to be able to accurately interpret and answer questions about social interactions, social situations and friendship. However slower information processing speed and a reliance on intellect rather than intuition, means their responses may not come naturally or as quickly, making it difficult to keep up in group settings or with chatty friends. They may find males as more like-minded friends as thought patterns may be similar and friendship dynamics may be perceived as being easier to understand.
Girls with autism are likely to strictly adhere to rules and routine. From an early age, girls with autism have commonly applied their cognitive skills to analyse social interactions and so they are much more likely than males with Asperger’s syndrome to discuss the inconsistencies of social conventions or be enforcers of social justice (e.g. fairness). Their willingness to abide by the rules as well as their tendency to be shy, naïve and unassuming means they are easily missed in a classroom of boisterous children. Girls will also be very hesitant to ask for help for fear of drawing attention, strong perfectionism, as she doesn’t want to get things wrong, or be seen as silly by teachers or peers.
Because girls may focus much of their intellectual energy on learning about their social world, special interest topics may have more of a social or nurturing focus, such as animals, horses or celebrities, literature and fantasy. It is not so much the topic that differs from neurotypical girls; rather it’s the intensity of their interests. Often they will have a rich imaginary world where they may engage in elaborate doll play using a script that may re-enact real events, which may help decode social situations. Their tendency to follow scripts (i.e. be rule abiding), and lack of social reciprocity in play may put them at odds with peers who may be unaware or not want to follow her script and find her too controlling. She will not easily read social cues to know what to do, or to know how to predict people’s behaviour. Thus, girls may have trouble recognising and managing conflict, affecting their ability to repair and maintain friendships.
Despite their frequently better coping mechanism and ability to camouflage their social difficulties, these social difficulties are very real and cause enormous stress and confusion for the girl on the autism spectrum. The social challenges and sensory difficulties experienced by girls with autism can have a significant impact on their wellbeing. Girls with autism quite often experience high levels of anxiety in the classroom and playground. When this occurs, girls may:
• become overwhelmed in social situations
• be reluctant to participate in class activities
• be unable to communicate verbally
• feel judged negatively by their peers
• withdraw from social interaction
However, quite often, because of their well-developed coping mechanism of camouflaging through observation and imitation, girls with Asperger’s syndrome can appear to be typical to those without Asperger’s syndrome and successfully ‘keep it together’ at school. In fact, a girl with autism may be able to do such a great job at wearing the mask and fitting in that nobody apart from her parents would believe she has autism. However, the toll that this effort takes to conceal their difficulties on their energy levels and emotions can be high. Girls will often come home feeling exhausted, irritable and overly emotional, following a day processing both the academic and social curriculum. It is not uncommon for parents to report that their daughter’s teacher or principal are sceptical when parents disclose their daughter’s diagnosis.
Below, we provide an outline some of the common difficulties girls with autism face at school and share suggestions for supporting the academic and social learning of girls with autism at school.
Tip sheet – Girls with an Autism Spectrum Condition
Difficulties girls with an ASC may experience at school:
• Slower information processing speed for social and emotional information
• Being ‘too quiet’ or ‘too good’ but internally struggling with enormous overload due to social confusion, sensory issues and executive functioning problems, and needing help
• Elective or selective mutism – indicating very high anxiety and inability, at the time, to self-regulate
• Difficulty reading the non-verbal communication (body language, facial expressions) of teachers and peers, and responding appropriately
• Alexithymia – difficulty verbally describing their thoughts and emotions, for example lack of an answer to a question about what she think or feels is likely to be confusions about what to say, rather than oppositional behaviour
• Difficulty expressing their wants and needs
• Executive function challenges (i.e. difficulties with planning, organising, prioritising and initiating)
• Sensory issues (bright lights, certain noise, odours such as perfume, aerosols)
• Problems of distractibility, exhaustion, shutdown and irritability, also being on a ‘short fuse’
• Easily triggered to very high levels of stress by transitions and change
• Unstructured nature of morning / lunch breaks.
• Social demands of school
• Bullying / social rejection
Helping girls with autism in class
While it may be difficult for educators to provide support for the social development of girls with autism, this is a critical aspect of their personal development.
She is likely to need assistance in understanding other people’s perspectives, intentions and expectations. It would also be helpful for her to have a number of allies at school, such as a counsellor, guidance officer who may be able to support her learning by:
• Explicitly teaching facial expressions, body language and personal boundaries
• Using videos, stories or roleplaying social scenarios or scripts to learn how to behave appropriately.
• Use Social Stories© and Comic Strip Conversations© to teach social skills (need to include references here)
• Modelling reciprocity by practicing sharing and turn-taking
• Finding caring and kind peers who are nurturing and supportive to model social behaviours
• Role-playing or creating social situations with alternative endings so they may develop more flexible thinking
• Teaching compromise and problem solving in the event of conflict with peers.
• Acknowledge and validate their feelings and offer reassurance
• Use visual supports to help her to identify her emotions
• Teach relaxation strategies when she is calm And rehearse in role play for situations that cause anxiety
Because she may likely feel a high level of anxiety about not wanting to stand out or be noticed as being different, where possible provide support with discretion, in moments before class starts, during break times or just after class ends for the day.
• Discuss with parents potential triggers (social and sensory) and specific fears
• Anxiety related to change and transition may be reduced by simply reminding them in advance of a coming change.
• Make learning concrete and provide context. Abstract concepts may be difficult to grasp.
• Auditory processing difficulties and a preference for visual learning means that where possible, presenting information in a visual way can help to encourage and support their communication, language development and ability to process information.
o Giving students a copy of instructions or information that their teacher writes on the board may also help
o Visual supports may be helpful using a visual timetable that shows what they’ll be doing will assist with adjustment to change and executive functioning difficulties.
• Their tendency to socially camouflage mean they are unlikely to ask for help – check their understanding consistently
Environmental accommodations such as allowing frequent “islands of solitude” during the day at school can be of enormous assistance in helping them manage a day filled with an equally important academic and social curriculum.