Autism in Girls vs Boys | Early Signs of Autism

For many years, autism research and diagnostic tools were developed around patterns typically seen in boys. Not surprisingly, boys are diagnosed with autism about three times more often than girls (CDC, 2025). As our understanding of autism grows, researchers and clinicians are learning that girls on the autism spectrum often present differently—differences that can lead to delayed or missed diagnoses. Recognizing these patterns is critical for caregivers, educators, and clinicians, especially during early developmental years when intervention has the greatest impact.

Many of the screening tools and diagnostic criteria used to identify autism were developed using predominantly male research samples (Cruz et al., 2024). As a result, girls whose traits fall outside of these traditional patterns may not meet the “classic” diagnostic thresholds.

Some girls consciously or unconsciously engage in what is known as social camouflaging—imitating social behaviors, mimicking peers, or following learned social scripts. While this can help them blend in, it often masks underlying social challenges and makes autism more difficult to detect (Dean et al., 2017).

In other cases, girls who struggle socially may be labeled as “shy,” “quiet,” or “anxious.” These labels can lead to their social difficulties being misattributed rather than recognized as potential signs of autism (Wood-Downie et al., 2020).

Research has identified several autism traits that may present differently in girls.

• Girls may work extremely hard to “fit in,” even when they feel confused by social cues or find it difficult to form friendships (Neighmond & Greenhalgh, 2017).
• Even when language skills appear strong, girls may struggle with the unwritten social rules of conversation, such as sarcasm, humor, or subtle social cues.
• Repetitive behaviors may be less visible, as girls are often more effective at hiding or suppressing them (Arky, 2025).

It’s important to note that autism presents uniquely in every child. However, research has identified some common patterns that tend to differ between young girls and boys on the spectrum.

Girls with autism often remain physically close to peers and may move in and out of group play rather than withdrawing completely. This can give the appearance of social engagement, even when meaningful connection is difficult (Dean et al., 2017; Neighmond & Greenhalgh, 2017).

Boys with autism, on the other hand, may be more likely to play alone or appear socially withdrawn. Girls may also expend significant effort trying to blend in socially, even when interactions feel confusing or stressful.

Girls often use more eye contact, expressive gestures, and socially appropriate language than boys with autism, which can mask communication difficulties (Rynkiewicz et al., 2016).

Some girls engage in “linguistic camouflage,” using filler words or conversational phrasing that sounds typical, even when deeper social understanding is limited (Parish-Morris et al., 2017). Despite advanced vocabulary, challenges with sarcasm, humor, and conversational reciprocity often remain.

Research suggests girls with autism may be more aware of social expectations and how others perceive them (Mattern et al., 2023). While this awareness can help them navigate social situations, it often comes at a cost—leading to exhaustion, anxiety, and emotional stress from constantly “passing” socially.

Boys with autism often display more overt repetitive behaviors and interests that are less socially typical, such as maps or train schedules (Neighmond & Greenhalgh, 2017; Digitale, 2015).

Girls’ interests are often more socially accepted—such as animals, stories, or favorite characters—but the intensity can be just as strong. Girls may also be more skilled at hiding repetitive behaviors, making them less noticeable during evaluations (Arky, 2025).

Because autism can present differently in girls, many are misdiagnosed or missed altogether. When autism goes unrecognized, girls lose valuable opportunities for early intervention during critical developmental periods. Early identification—particularly for girls who camouflage their challenges—can reduce emotional burnout, lower stress, and support healthy social and emotional development. Understanding these differences allows caregivers, educators, and clinicians to provide the support children with autism need to thrive.

• CDC (2025). Centers for Disease Control and Prevention. “Data & Statistics on Autism Spectrum Disorder.”
• Cruz, L., et al. (2024). Gender differences in autism diagnostic tools. Journal of Developmental Disorders.
• Dean, M., et al. (2017). Social camouflaging in girls with autism spectrum disorder. Journal of Autism and Developmental Disorders.
• Wood-Downie, H., et al. (2020). Understanding gender differences in autism diagnosis. Molecular Autism.
• Neighmond, P., & Greenhalgh, L. (2017). How girls with autism engage in play and social interaction.
• Rynkiewicz, A., et al. (2016). Sex differences in early autism presentation. Journal of Autism Research.
• Parish-Morris, J., et al. (2017). Linguistic camouflage in girls with autism. Journal of Child Psychology and Psychiatry.
• Mattern, C., et al. (2023). Social-emotional awareness in girls with autism. Autism Research Journal.
• Digitale, S. (2015). Repetitive behaviors in boys vs. girls with autism.
• Arky, B. (2025). Hiding repetitive behaviors in girls with autism. Child Development Perspectives.