The art of camouflage: Gender differences in the social behaviors of girls and boys with autism spectrum disorder

Abstract

This study examined the extent to which gender-related social behaviors help girls with autism spectrum disorder to seemingly mask their symptoms. Using concurrent mixed methods, we examined the social behaviors of 96 elementary school children during recess (autism spectrum disorder = 24 girls and 24 boys, typically developing = 24 girls and 24 boys). Children with autism spectrum disorder had average intelligence (IQ ⩾ 70), a confirmed diagnosis, and were educated in the general education classroom. Typically developing children were matched by sex, age, and city of residence to children with autism spectrum disorder. The results indicate that the female social landscape supports the camouflage hypothesis; girls with autism spectrum disorder used compensatory behaviors, such as staying in close proximately to peers and weaving in and out of activities, which appeared to mask their social challenges. Comparatively, the male landscape made it easier to detect the social challenges of boys with autism spectrum disorder. Typically developing boys tended to play organized games; boys with autism spectrum disorder tended to play alone. The results highlight a male bias in our perception of autism spectrum disorder. If practitioners look for social isolation on the playground when identifying children with social challenges, then our findings suggest that girls with autism spectrum disorder will continue to be left unidentified.

Protective Effect or Missed Diagnosis? Females with Autism Spectrum Disorder

“…This final section will explore reasons why autistic females of all ages may not be identified despite changing perceptions of ASD presentation, and look at the ways in which females with ASD may come to clinical attention for other conditions. autistic girls have been found to fit in better to school social settings such as the playground by appearing to have typical friendships and interactions at first glance, whereas boys are more obviously identified as struggling socially [63]. However, closer examination reveals autistic girls may have significant difficulties maintaining friendships and dealing with conflict, and therefore are not functioning socially to the same extent as their typically developing peers [56].…”

“…Simultaneously, several self-reported anecdotes and a few newly emerging studies have identified camouflaging techniques used by autistic females to mask and distract from their ASD difficulties, and to present a more socially competent self than they actually feel [61,62]. These strategies, which are used both to cope with ASD difficulties and minimise others' awareness of them, may result in under-identification of females who are struggling with their ASD, as the outward portrayal to teachers or clinicians is of someone who is developing typically [59,63]. This behavioural technique may also explain why increasing numbers of females receive their ASD diagnosis in adolescence or adulthood, when either the effort of maintaining camouflaging strategies or the ASD itself becomes overwhelming, and so brings the individual to clinical attention [62].…”

Understanding Friendship Sex Heterophily and Relational Characteristics to Optimize the Selection of Peer Models for Children with Autism Spectrum Disorder

“…These data suggest that the social networks of children with ASD may be sex dependent. Recent research also shows that ASD may present differently in males and females such that males with ASD may have more overt behaviors and be more conspicuous among their peers, whereas females with ASD may be more camouflaged among or masked with their peers (Dean et al 2014, 2017). This, in addition to previous studies of peer social networks of children with ASD and typical peer models (Locke et al 2012; Garrison-Harrell et al 1997), indicate that identification and selection of peer models should take into account children’s sex.…”

Towards sex- and gender-informed autism research

“…Nevertheless, the extent of camouflaging varies substantially in both male and female groups in their study. Beyond individual characteristics, Dean et al (2017) make another point of fundamental importance that camouflaging reflects features not just of the individual but also of the environment. They point out that 'the female social landscape', characterised by fluid social groupings, provides a social milieu for girl's camouflaging.…”

“…Further evidence for important sex and gender differences in social functioning comes from a methodologically innovative, ground-breaking study by Dean et al (2017), investigating behaviour in the school playground. Using a sophisticated and rigorous mixed-methods approach, this research demonstrated that the social difficulties of autistic girls were more 'camouflaged' than those of autistic boys.…”