An autism assessor has shared the five most common signs of autism in women and girls, who are often undiagnosed due to them being subtle and easily missed

A specialist occupational therapist outlined the most common autism indicators he’s observed in women and girls(Image: OR Images via Getty Images)

Conor McDonagh, owner and director of Caerus Therapies and a specialist occupational therapist, has shared his top five most frequent indicators of autism in women and girls. His firm delivers autism health evaluations and assistance, and he regularly posts guidance on his TikTok profile, discussing everything from sensory processing difficulties to helping an autistic youngster.

In one clip, Conor outlined the most common indicators he’s observed in women and girls. He explained: “Research has shown that signs of autism in women and girls with autism are more subtle and difficult to identify, for example they are often very good at ‘camouflaging’ or hiding signs.”

He told Surrey Live: “Here are five very common signs of autism in women and girls from the point of view of an autism assessor. But before I do, it’s worth noting that up to 80% of women and girls with autism are undiagnosed. I will speak about the reasons for this in other videos.”

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Top five frequent signs of autism in women and girls

Finding it hard to cope without routine

Conor described: “So the first of these signs is when a woman or a girl will really struggle with a lack of structure. So they may be used to a certain routine, and whether it be at work or school, where these routines change, they can become quite anxious and often very flustered. This may not be very obvious to others, but women and girls can often internalise these difficulties”.

Problems with motor abilities

The expert continued: “Secondly, a woman or a girl may have poor fine and gross motor skills. The fine motor skills are the skills that we use in our fingers and our hands to do things like handwriting, fascinating buttons and manipulating tips.

“Gross motor skills are the bigger movements that we use to catch a ball, to swim, to ride a bike, etcetera.”

Limited diets

Conor added: “Thirdly, a woman or a girl may have a limited diet, and this often relates back to difficulties with processing sensory information. So they may be over sensitive to strong tastes and smells.

“They may be very uncomfortable with how certain food feels in their mouth or they may have poor oral motor skills, so they have difficulties with manipulating food in their mouth to break it down, and whether may have been difficulties with this, it can have a lasting impact on them.”

Struggling with social situations

He noted: “Fourthly, a woman or a girl may be quite awkward in social situations, so they have the ability possibly to develop superficial relationships. They lack the skills and the confidence to build stronger relationships.”

Poor attention and focus

When discussing attention issues, he explained: “And finally, a woman or a girl may have difficulties with poor attention and focus, so they’re often distractible. They have difficulties with following conversations. They struggle to concentrate on tasks for long periods.”

What does the NHS say?

The NHS has stated that historically, many girls with autism have gone undiagnosed due to mental health problems often being the primary diagnosis, potentially masking the underlying autism.

This can lead to a lack of appropriate support, resulting in loneliness, depression, social isolation, increased vulnerability in terms of emotional well-being, such as self-harm and eating disorders, lowered grades and reduced future opportunities.

The National Autistic Society also notes that while numerous theories have been proposed to explain the gap in diagnosis, none have been definitively proven.

Some of these theories include:

  • A potential ‘female autism phenotype’ – in other words, autistic women and girls have characteristics that don’t fit with the traditional profile of autism
  • Autism assessments are less sensitive to autistic traits more commonly found in women and girls
  • Women and girls are more likely to ‘mask’ or camouflage their differences
  • Autistic traits in girls are under-reported by teachers
  • A range of biological and environmental factors may mean men and boys have a higher prevalence of autism
  • The ‘extreme male brain’ theory of autism, which focuses on the effects of foetal testosterone on brain development

It is important to remember that research and knowledge about autism changes constantly. Some of these theories may not reflect how we think about autism today.

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