The Female/'Internalised' Presentation of Autism

• Autistic girls often appear shy. Their shyness, however, is often a strategy used to avoid or approach social interactions with caution due to (their social communication difficulties) being unsure how to engage and/or behave.

• Autistic girls have also been described as 'intense', quiet, mute, or even that talk too much. They may appear to be bossy, or rude or take on the teacher or custodian role telling others what to do. Girls are likely to avoid demands, have an intense focus and determination and have a high sense of social justice and concern about the 'rules', (often too rule-bound) and be too interested in what others are doing.

• Autistic girls can be highly sensitive, anxious and may get upset easily, in addition, tend to over-apologise and, over-react, taking on characteristics of others (by mimicking), have perfectionistic traits and be extremely strong-willed.

• Autistic girls have been observed to internalise their thoughts, be compliant and well-behaved and therefore overlooked. When they get home however or feel safe, they tend to release their valve. They often respond or present themselves in a passive-aggressive manner and insist that everything has to be done 'their way'.

• Autistic girls can be highly sensitive, anxious and may get upset easily, in addition, tend to over-apologise and, over-react, taking on characteristics of others (by mimicking), have perfectionistic traits and be extremely strong-willed.

• Autistic girls have been observed to internalise their thoughts, be compliant and well-behaved and therefore overlooked. When they get home however or feel safe, they tend to release their valve. They often respond or present themselves in a passive-aggressive manner and insist that everything has to be done 'their way'.

• Girls generally lack reciprocity in social play and find back and forth conversation challenging and tend to flitter between groups or people or may have one best friend (female or male) that they find difficult to share.

• Girls struggle socialising in large groups due to the number of social cues, body language and tone of voices that need to be decoded to understand the social interaction (and possibly sensory challenges that need to be managed/drowned out). Some girls prefer the company of older or younger peers.

• Girls watch and observe others using their intelligence to understand social situations, mimicking the behaviour of those around them, use 'compensatory strategies' from an early age often showing their peers, imitating peer behaviour to initiate social contact.

• As socialisation becomes more sophisticated (usually around the age of nine/ten) the gap between their social understanding, mimicking etc tends not to work anymore resulting in higher than usual social anxiety, sleep disturbances and/or school refusal.

• Girls at school tend to spend playtime alone, walking around in the library, or looking for opportunities to help others rather than socialise with peers. She may position herself as the class helper, and called 'the teacher's pet', or spend a lot of time following or being with teachers, as mentioned above, preferring the company of older people.

• Girls are known to be exceptional 'social blenders' camouflaging into the background ensuring they get no attention, so more likely to be ignored or overlooked. This is also referred to as 'social masking' and can have significant and detrimental long-term mental health side effects.

• Girls' 'special interests' are similar to their peers, but more intense.

• Their interests are considered more socially acceptable, meaning they tend to be more mainstream than that of boys, like, animals, fashion, historical facts or age-appropriate trends e.g. playing Minecraft.

• Their interests might also be to collect information on people instead of things.

• Girls may have imaginary animals or friends who are very real; often very imaginative and creative; 'off in their own world'.

• Girls/females appear to have less repetitive and restricted behaviours compared to boys but could also just have behaviours that go unrecognised.

• Sadly, girls who show these traits are more likely to be ignored or misunderstood rather than diagnosed and treated.

• Girls can get very good grades, have no academic or learning difficulties or can be cognitively gifted.

• Their social challenges are attributed to being 'too bright' for their peers.

Families of Autistic girls/females report on how frustrating and difficult a proper diagnosis is to gain due to the lack of information amongst health professionals and mental health practitioners on the presentation of Autistic girls/women and therefore fail to identify their traits correctly.