Determining Eligibility for Autism in Girls

Autism diagnoses are becoming more prevalent in recent years. However, much of the research about what Autism “looks” like stems from young Caucasian males. In this post, we will discuss how Autism is currently evaluated (specifically in schools), and the differences between Autism in girls and boys.

Girl stacking blocks with adult woman helping.
Autism in girls can be different than boys.

Autism Spectrum Disorder in Girls

People traditionally think of a person with Autism exhibiting limited eye contact, restricted interests, stereotypical movements (i.e. hand flapping) and either sensory-seeking or sensory-avoidant.

Recent studies have shown that while these “symptoms” can still be present in girls with Autism, it may look a little bit different. Girls are typically better at imitating others’ social behaviors, and traditional “girl” play (i.e. house, dolls…etc.) lends itself to girls learning the rules of social engagement faster than boys.

Often, girls’ restricted interests can be something that is either age or gender appropriate. For example, one of my past student’s restricted interest was mascara, and Evie the Explorer’s restricted interest is Dora the Explorer- both of which were appropriate for their age.

The difference between “normal girl stuff” and “restricted interest” can be subtle, so it’s important to look at the intensity with which they show interest in these topics.

Because some of the symptoms of Autism Spectrum Disorder can be missed, girls often have other behavioral or emotional difficulties that interfere with their daily lives. All of this can lead to a later diagnosis, therefore leading to missed opportunities for interventions.

Evaluations to Determine Eligibility

WISE TIP: It is important to clarify that schools cannot diagnose ASD, but rather can determine if ASD symptoms may be affecting the student’s school experience.

Evaluating for Autism eligibility can vary by state, school district and even from school to school. For some general tips on how to get started with social/ emotional evaluations- check out this post.

There are also a wide variety of assessments available, so it’s best to check with your district about which assessments are used. Here are three of the common assessments our district uses to assess for autism in girls (and boys):

Childhood Autism Rating Scales (CARS)

The Childhood Autism Rating Scales (CARS, 2nd Edition) is one of my most commonly used assessments for Autism. The CARS assessment is more of an interview format than some of the other assessments.

The interview format can be nice to complete as a team (i.e. general education teacher, specials/ elective teacher, other service providers…etc. all completing it together). If there are discrepancies in the answers, this can help open up discussions about what specific people are observing and in what setting.

However, the interview format is also much more subjective than some of the other formats. Because of this, I have most commonly used this assessment when there is an outside diagnosis and the school needs to confirm that the symptoms are seen at both home and school.

Autism Spectrum Rating Scales (ASRS)

The Autism Spectrum Rating Scales (ASRS) assessment is a good assessment for determining the symptoms of ASD. The results are broken down into various types of communication (e.g. peer socialization, adult socialization…etc.) as well as other categories that match the DSM-5 eligibility criterion.

The results can help to understand the strengths and areas of need for each individual. The ASRS can also be helpful for teasing out other communication, sensory and self-regulation difficulties.

However, as with other assessments, the ASRS doesn’t account for other contributing factors. For example, I had a student with known in utero alcohol exposure, whose symptoms presented like ASD. However, with the complete body of evidence, she did not qualify and would not have met criteria for an outside diagnosis of ASD.

Social Responsiveness Scale (SRS)

The Social Responsiveness Scale (SRS, 2nd edition) is similar to the ASRS in the way that it breaks down different aspects of ASD.

The key difference in this assessment is that it measures “social motivation”- in other words, how much a student wants to have friends/ be social. For me, this aspect has been helpful in determining Autism qualifications for girls especially.

While I use this assessment a lot, I have also found that parent and teacher reports generally vary greatly and it can be difficult to develop a full picture for the student.

No matter what assessment is used, there should always be a body of evidence when making a determination for eligibility.

Check back soon for a post about some interventions that can be implemented at school for students with Autism.

Additional Resources for Autism in Girls

How Autism Manifests Differently in Girls: What families need to know

The Missing Autistic Girls

Not Just for Boys: When Autism Spectrum Disorders Affect Girls

Are Girls With Autism Hiding in Plain Sight?

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