Autism Spectrum Disorder and Some Differences Between Boys and Girls

By: Azlen Theobald, PsyD

Children and adolescents with Autism Spectrum Disorder (ASD) are increasing as a population with 1 in 44 children diagnosed with ASD nationwide according to a 2018 surveillance study published by the Centers for Disease Control (CDC) in 2021.

Studies suggest that ASD is 4.2 times as prevalent among boys as among girls. Recent research suggests that since girls may not present the typical signs of autism as early as boys (and their behavioral features are different), they may not be accurately represented by this statistic.

So what are the common differences?

  1. Boys with autism tend to have very repetitive and limited areas of play. Girls with autism tend to be less repetitive and have broader areas of play.
  2. Girls with autism are more likely than boys to be able to respond to non-verbal communication such as pointing or gaze following. They are also somewhat more focused and less prone to distraction.
  3. While boys’ social communication issues become challenging very early in their lives, girls may be able to manage the social demands of early childhood, but run into difficulties as they enter early adolescence.
  4. It is fairly common for girls with autism to appear socially competent during preschool and elementary school, but they may be neglected or rejected by peers upon approaching middle school age. This is thought to be a result of friendship groups/cliques forming and children developing more awareness of differences among their peers.
  5. Girls with autism are more likely than boys to experience anxiety and/or depression symptoms.
  6. Although girls with autism do have perseverative interests, they are more likely to develop interests (such as TV stars or music) that appear more typical than, for example, many boys’ perseverative interests, such as schedules, statistics, or transportation.
  7. Girls with autism are less likely to have aggressive behaviors and are more likely to be passive or withdrawn.

An issue in current research is the relatively low frequency of females represented in Autism studies.

Ultimately, as the sex and gender differences among children with ASD are more closely examined, many experts have observed that girls may be better at imitating socially appropriate behaviors and have fewer behavior concerns than boys. Given these findings, it is important that clinicians attend to milder presentations of Autism Spectrum-related behaviors among younger girls and provide the support and skill-building that girls also need to be successful in school, in relationships, and in life.


Maenner MJ, Shaw KA, Bakian AV, et al. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2018. MMWR Surveill Summ 2021;70(No. SS-11):1–16. DOI: http://dx.doi.org/10.15585/mmwr.ss7011a1

Frazier, TW, Georgiades, S, Bishop, SL, and Hardan, AY. Behavioral and cognitive characteristics of females and males with autism in the Simons Simplex Collection (2014). Journal of the American Academy of Child Adolescent Psychiatry, 53(3), 329-40.

Nordahl, CW, Andrews, DS, Dwyer, P, Waizbard-Bartov, E, Restrepo, B, Lee, JK, Amaral, DG. (2022). The Autism Phenome Project: Toward identifying clinically meaningful subgroups of Autism. Frontiers in Neuroscience, 15, 1-9.

Ruigrok A., Lai MC. (2020). Sex/gender differences in neurology and psychiatry: Autism. Handbook of Clinical Neurology. 175, 283-297.

NeurAbilities Healthcare is the premier provider of neurological, behavioral and neurodevelopmental services in New Jersey and Pennsylvania, offering comfort, hope and answers that transform the lives of individuals of all ages, and their families.

Our Mission

To transform the lives of patients through precision medicine, behavior sciences, and therapeutic treatments with compassion, dignity, and respect.

Our Vision

To provide hope and achieve positive outcomes for those we serve.

P: 856 346 0005 F: 855 266 6180

Our Core Values

  • Compassion
  • Collaboration
  • Integrity
  • Excellence
  • Joy

Notice of Privacy Practices

NOTICE: This website is for informational purposes only and is not intended as medical advice or as a substitute for a patient/physician relationship.

NeurAbilities is committed to creating a culturally diverse, inclusive and collaborative community for patients and their families, employees and associates where each person is celebrated and has a sense of equal belonging. See our DEI Statement Page for more information.

NeurAbilities Healthcare does not exclude, deny benefits to, or otherwise discriminate against any person on the grounds of race, color, or national origin, or on the basis of disability or age in admission to, participation in, or receipt of the services and benefits of any of its programs and activities or in employment therein. This statement is in accordance with the provisions of Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and Regulations of the U.S. Department of Health and Human Services issued pursuant to the Acts, Title 45 Code of Federal Regulations part 80, 84, and 91.

© NeurAbilities Healthcare. 2022. The NeurAbilities Logo is a registered trademark.