Autism in girls

[mamaandme21]

Hello,

We suspect our daughter (4) may be neurodivergent. We have had a niggle about it for a couple of years (since around 2) but when we've looked into autism in particular, speech delay was the symptom that made us dismiss it, as she has been the opposite - i.e. she started talking early and speaks elaborately now, in long sentences and in quite a lot of detail. Only recently I stumbled across an article (which led to lots of articles!) about girls and autism and how advanced speech can actually be a sign in girls. I wondered if anyone has a daughter who has received a diagnosis with similar signs. For her, they are:

• Advanced speech
• Copying, mimicking: We first noticed this in the nursery when she would sound/act almost exactly like her favourite friend (from the tone of his voice to a few mannerisms). She has always been a ‘follower’ rather than a ‘leader’.
• Observant: In playgrounds, she would often approach things methodically and observe or assess her surroundings, before getting involved.
• Chewing / Sensory: Since very young she never liked having things like sand, pen, paint, glue, or food on her hands. Chewing-wise, in the last 6 months or so she started chewing her hair, clothes, etc.
• Being particular: e.g. if I put something back in a shop in the wrong place, she will put it back in the right place (the place I picked it up from).
• Meltdowns: Quite intense and very different to tantrums - never as a result of not getting something. More due to something unexpected where she seems very overwhelmed.
• Memory: From around 2 years, she was able to recite books word for word and from around 3 years whole picture books. She also memorised the train line stations from around 2 years old.
• Reading: She can sit and be read to for hours and has a keen interest in books.
• Rule-keeping: She is very interested in signs and what they mean, often asking us to tell her. She will quickly point out when someone isn't following them.

There's more but these are the main ones! We have no concerns over her speech or socially (she tends to have a few really good friends at one time and shows a selection of people particular interest). But there are many niggles which make us wonder. I'd love to hear any thoughts and learn if anyone else has experienced anything similar...

Thank you so much in advance!

Hi there

Currently going through the assessment process with my DD who has just turned 5. She hasn’t been diagnosed yet but all signs indicate she will receive a diagnosis of ASD.

You have listed a few potential red-flag behaviours which would need to be discussed with a medical professional however my understanding of ASD is that you must have social communication difficulties and have repetitive and restrictive behaviours (bound by routines and rituals, as DD’s SLT described it to me.)

How is your daughter socially, would you say she is shy, timid? Does she have any rigid interests, routines or rituals she must adhere to? How does she converse, does she ask you questions, does she talk about things that aren’t just of interest to her or about her, does she tell you about her day? Does she often repeat phrases? Have school mentioned any concerns to you?

My daughter shows many typical traits but also makes eye contact with those close to her and engages in some pretend play however her paediatrician has said this is not unusual for ASD in girls.

DD’s main traits (off the top of my head) are:

• sensory - extreme loud noise aversion (covers ears often and gets distressed), doesn’t like flickering lights, occasionally stims (particularly when anxious/excited/overwhelmed), walks on tiptoes occasionally, gets distressed at face and hair being washed, hates getting her nails cut, hums while she eats
• Very fussy eater - mostly beige, dry diet
• Won’t look into a camera for a picture
• follows routines and rituals - watches the same programs, plays the same games, unusual attachment to certain items of clothes, needs advanced notice of any changes or transitions, repetitive play, can get very distressed at changes or transitions
• Socially - severe social problems, extremely shy and timid, observes peers from the periphery, unable to engage with peers at all without significant and constant adult support, mimics actions of peers, struggles with sharing and taking turns, always seeks out adults in social situations, hates crowds
• speech and language - speech unclear, late talker, some unusual speech patterns, speech is tangential, used echolalia a lot (repetitive phrases), talks only of her own interests and wants and needs, doesn’t as “why” questions, has difficulty understanding comprehension, needs longer to process information, needs instructions and information broken down into smaller chunks for her to understand, needs visual aids and choice boards etc for school
• issues with fine and gross motor skills

As I say my daughter presents quite typically and a diagnosis is expected. Do you recognise any of your DD’s traits in the above list? The list is not exhaustive it’s just what I can think of now and each child on the spectrum presents differently however my DD’s traits may help you identify some with your own DD that you had not recognised yet but as always if you have any concerns regarding your child’s development the best plan of action is to discuss with a health professional I.e. health visitor or gp who will be able to guide you and arrange for a referral if they feel it is necessary.

Good luck! 🤞🏻

Thank you so much for coming back to me - this is all very helpful indeed and I really appreciate you taking the time to share your experience here.

From the research I've done, it seems that girls present very differently to boys so we had up until recently dismissed it as a possibility at all. Her speech is pretty advanced and at times, she comes across as being quite serious and mature. She's always seemed like an old soul. She can be quite social, but from what I have read this can actually be the case with girls (when masking)? She seems to be missing a few social cues - for example, she said to me yesterday that we should only say goodbye once, when a friend said goodbye multiple times. I found this list quite helpful too. https://eastsidespeech.com.au/girls-and-autism/#:~:text=Girls%20may%20also%20present%20with,a%20child%20of%20their%20age)

There are a few things I've seen in the signs you've listed too - hair being washed / nails being cut / attachment to clothing / watching the same programmes again and again. It's a niggle that we haven't been able to shift in two years... it's different with our son and we haven't had the same hunch at all with him! I just hope we can get some answers to support her as she needs

Oh yes I absolutely agree @mamaandme21 that girls can present very differently with ASD than boys, my DD’s paed confirmed this. IF your DD is on the spectrum she definitely sounds high-functioning, my DD’s needs are a bit more significant (she also has suspected moderate learning disability in addition to ASD and has been referred for genetic testing too.) She is still the sweetest little girl in the whole world and we wouldn’t change her for anything but just want to make sure she receives all the support she needs to help her flourish.

You know your DD better than anyone and I say always trust your instinct as a mother, it’s rarely wrong. If you have concerns about her development (especially in comparison to a sibling) definitely follow it up. We have a younger DD who is developing very typically and the stark difference between their development is remarkable.

My DD’s paed told me that the age that girls with ASD really start to struggle is around 7/8 years when social dynamics in friendship groups change so much better that support is in place before then x

Hello, I know this isn't super recent but thought I could help...
My DD is 4.5 and recently received a diagnosis. Her language is also very advanced and never been an issue. There were no red flags at her 2 year review. She had us puzzled for quite some time. She doesn't at all fit the stereotype or a lot of the assessment screening questionnaires (which are built around boys). Main issues:
-sensory issues mainly with noise
-high anxiety at nursery and with larger groups of children from around age 3. This resulted in a lot of hitting behaviour for a time, now it is more shouting or appearing very excited but slightly out of control
-very particular, wants rules to be followed by everyone
-controlling behaviour which can result in meltdowns if things aren't done the way she wants
-some instances of extreme meltdowns, which is really panic or overwhelm

She had no obvious repetitive behaviour and can seem fairly flexible when it comes going out and doing things, however she notices every tiny detail when something is different from usual. She doesn't seem upset by it, but she notices it, and I think it can feed into low level anxiety. She also has an amazing memory and can recite books. She will correct me if I put a word wrong.

We also didn't recognize any communication problems at first as her language was so good, but when she's very stressed or anxious, her language regresses and she uses noises or pointing/gestures in a cross way, instead of speaking. She can also have some level of situational mutism if put under pressure by an adult she doesn't know well.

She is not at all shy, quite the opposite, and appears to have social skills in terms of holding conversations and playing but there is some level of lack of understanding which is difficult to explain. I fear that may become more obvious as she gets older. She can be controlling in her play, and prefers to socialize with older children.

I feel very lucky to have her diagnosed so early when she is not a "classic case" which is thanks to her wonderful nursery. I would say, trust your instincts, and if possible seek a diagnosis so that you have it early if it's necessary. It will make her life and understanding of herself a lot easier, and you can also seek out support for yourself. Best of luck x

I have three autistic girls with vastly differing presentations and I'm also autistic myself. My just turned 4 year old sounds a bit like your dd, OP - she doesn't have a diagnosis yet but I've asked for her to be referred to paediatrics because I do think she's autistic with PDA profile.

The thing that initially held me back from thinking she's autistic was how social she appears to be on the surface. She also has very advanced speech for her age and uses words like 'technique' and 'impressive' and she can already read and write. She's definitely autistic imo.

Hi
how’s your dd doing now ? ☺️