Why Neurodivergent Girls and Women Fly Under the Radar
The fact that ASD and ADHD are often diagnosed much later in girls and women has been receiving increasing attention. And for a good reason. Not knowing why you’re struggling so much with things that girls are supposed to be good at or seem to enjoy, as well as not receiving interventions early on that help with social skills and school, can cause a lot of anxiety and other mental health problems and has even been linked to increased self-harm and suicide rates. Unfortunately, many women are only diagnosed after seeking mental health care when responsibilities mount higher than they handle, like moving away for the first time or after having kids.
Diagnosis tends to happen later for three main reasons, and they are all connected.
Societal expectations lead to masking, which makes it harder to see that they’re struggling.
Girls are expected to be good at understanding their emotions and needs and understand other people’s emotions and needs through their words, actions, and body language. That’s a core symptom of autism. So, girls on the spectrum learn to compensate early on by copying the “normal” way to respond in different situations.
They are also expected to be good at sitting still, waiting their turn, and organizing their own (and later on other’s) lives. Those are all executive functioning skills impacted by ADHD.
Masking takes a lot of energy, but the negative messages they hear early on make it seem like it’s worth it. But because of all that masking, girls and women who are undiagnosed tend to fall apart at the end of the day and not be able to participate in social activities and hobbies that are healthy for mental health.
Diagnostic screening tools and criteria don’t capture differences in how symptoms appear that are harder to detect.
When you think of ADHD or autism, you think of the stereotypical boy bouncing off the walls or stimming (repetitive motion).
Girls are more likely to have the inattentive subtype of ADHD. Even when they have the combined type, their hyperactivity is more likely to show up as excessive talking.
Girls with autism tend to have fewer problems with verbal communication than boys and have more socially acceptable special interests.
Because of these differences and masking, there isn’t enough research on how to best screen for ASD and ADHD in girls and women. As a result, diagnostic criteria and assessments (created mainly by men) don’t always detect them.
There is a general lack of awareness among educators and clinicians, resulting in misdiagnosis and inappropriate treatment.
Because diagnostic criteria and screening tools don’t detect girls and women with ASD, clinicians aren’t trained on the differences in how symptoms look. They often misdiagnose and recommend the wrong treatment. As a result, girls and women, their parents, and educators also aren’t aware. This creates a loop because fewer girls and women are diagnosed, so there’s less interest in research on how to change diagnostic and screening tools and differences in intervention needs.
So, what can we do?
If you haven’t been diagnosed yet, do it! I recommend filling out a checklist of symptoms specifically made for women and girls and bringing it to your appointment. Here’s a great one for girls and women with ADHD. Here’s a great one for girls with autism. Here’s a great one for women with autism.
Educate your friends, family, teachers, and doctors on how ADHD and autism look different in girls and women.
Be open about how it impacts you and advocate for your needs. But always ask yourself if it’s in your and other’s best interest before disclosing.
Advocate for policies that make it easier to get diagnosed and treated.
Get involved in research about differences in how these conditions look and treatment needs.
Support the amazing girls and women spreading awareness on social media.
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