Dubai: Differences between males and females in autism spectrum disorder (ASD) extend beyond prevalence rates and include how symptoms appear, are observed and interpreted, often resulting in delayed diagnosis among girls compared with boys, according to the Dubai Autism Center.The centre said lower diagnosis rates among girls do not necessarily indicate lower prevalence of autism, but may instead reflect differences in how symptoms present or the challenges involved in identifying them during the early stages.Citing scientific research, the centre noted that girls who meet the criteria for autism spectrum disorder are more likely to remain undiagnosed for longer periods.A systematic review examining barriers to autism diagnosis in girls and young women identified four key factors contributing to delays: differences in the behavioural and social presentation of autism in females, the ability of some girls to compensate for social difficulties, limited awareness of these differences, and unintentional bias during the diagnostic process.The centre also referred to a 2023 US study which found that females received their first autism diagnosis an average of 14 months later than males. Researchers found delays were more common in milder or atypical cases, particularly where language and cognitive abilities were preserved, repetitive behaviours were less pronounced or symptoms emerged later in development.Mohammed Al Emadi, Director-General and Board Member of the Dubai Autism CenterMohammed Al Emadi, Director-General and Board Member of the Dubai Autism Center, said the diagnostic gap between males and females deserves greater attention."Lower diagnosis rates among girls do not necessarily mean lower prevalence of the disorder, but may reflect differences in how it presents or in the ability to identify it during its early stages," he said.Al Emadi stressed the importance of moving beyond the traditional image associated with autism."Some girls may be more capable of adapting to social situations or imitating socially accepted behaviours, making their difficulties less apparent to parents, teachers and even specialists, particularly when language and cognitive abilities are strong," he said.He explained that diagnosis should be based on a comprehensive assessment of a child's developmental patterns, communication skills, social interactions, interests and sensory and repetitive behaviours rather than a single observable characteristic.Reducing the diagnostic gap, he said, requires cooperation among families, schools, healthcare providers and behavioural specialists, alongside greater professional understanding of how autism may present differently in girls.The centre reaffirmed its commitment to raising awareness about the importance of early identification and intervention, stressing that autism spectrum disorder can present differently from one child to another, including differences that may be observed between boys and girls.It also highlighted the role of awareness programmes, professional training, screening and assessments in helping identify children who may require further evaluation and support.Dr Nicholas Orland, Executive Director of Educational and Therapeutic Programmes at the Dubai Autism CenterDr Nicholas Orland, Executive Director of Educational and Therapeutic Programmes at the Dubai Autism Center, said one of the key challenges is that girls with autism do not always fit the traditional profile historically associated with the condition."Some girls may develop strategies to compensate for social difficulties, such as observing others and imitating their behaviour or memorising patterns of conversation and interaction," he said."From the outside, the child may appear capable of forming relationships and communicating effectively, while the process itself may be exhausting and require considerable effort."Orland said the concept of "social camouflage" has become increasingly important in understanding gender differences in autism diagnosis."The issue is not that the girl does not experience difficulties, but that some of those difficulties may be less visible within the environments where she is observed," he said.He explained that girls may speak fluently and participate in group activities while still facing significant challenges in understanding social relationships, adapting to change, processing sensory information and sustaining social interactions.According to Orland, assessments should not rely solely on first impressions or observations from a single session. Instead, they should incorporate developmental history, family and school feedback, direct observation, appropriate diagnostic tools and clinical expertise.He added that gathering information from multiple environments becomes increasingly important when signs are less obvious, as a child's behaviour may differ significantly between home and school and challenges may become more evident as social and academic expectations increase."Diagnosis is not simply about assigning a label," Orland said. "It is a gateway to understanding a child's needs and providing the appropriate support and interventions. Early identification increases opportunities to help children and families build the skills and strategies they need before social and academic pressures intensify."
