Optimizing ABA Therapy for Girls and Women with Autism: Understanding Unique Challenges and Tailoring Support

Autism spectrum disorder (ASD) affects people of all genders, but it often presents differently in girls and women. This can lead to frequent misdiagnosis or late diagnosis for those assigned female at birth. While the ratio of diagnosed boys to girls with autism is about 4:1, researchers believe the actual ratio is closer to 3:1.

The difference in ratios points to systemic issues in recognizing and diagnosing autism in girls and women. But with the right support and therapy, girls and women on the spectrum can thrive.

Optimizing ABA Therapy for Girls and Women with Autism
Optimizing ABA Therapy for Girls and Women with Autism

Unique Challenges for Females with ASD

Several factors contribute to the disparity in autism diagnosis between males and females:

Camouflaging and Masking

  • Girls tend to be better at camouflaging or masking autistic traits. They may:
    • Mimic neurotypical facial expressions, vocal tones, and body language
    • Learn social rules by studying peers and media
    • Force themselves to make eye contact
    • Suppress stimming and other autistic behaviors
  • Camouflaging takes considerable effort and can lead to exhaustion and burnout.

Gender Bias

  • Diagnostic criteria are skewed toward traits more common in boys.
  • Girls’ restricted interests often align with social norms (e.g. dolls, unicorns).
  • Girls tend to internalize their difficulties rather than act out.
  • Shyness and social difficulties are more accepted in girls.

Barriers to Diagnosis

  • Professional diagnosis is time-consuming and expensive.
  • Minority groups face discrimination in healthcare.
  • Many adults are self-diagnosed due to lack of accessibility.

Recognizing Signs of Autism in Girls and Women

Knowing what signs to look for can help identify autism earlier in girls and women:

Social Communication Differences

  • One-sided conversations focused on special interests
  • Inability to distinguish platonic and romantic interactions
  • Speaking excessively in groups
  • Difficulty reading humor, sarcasm, and tone

Repetitive Behaviors

  • Intense emotional reactions and meltdowns
  • Rigid thinking and difficulty with change
  • Soothing behaviors like rocking, pacing, or hand-flapping

Sensory Issues

  • Sensitivity to textures, sounds, lights, clothing
  • Fascination with sensory stimuli like smells or textures
  • Picky eating or food restrictions

Emotional Difficulties

  • Anxiety, depression, and emotional dysregulation
  • Low self-esteem and poor self-image
  • Lack of impulse control

Tailoring ABA Therapy for Females

Applied Behavior Analysis (ABA) is a common therapy for autism, but it has drawbacks. Traditional ABA often focuses on changing autistic behaviors to appear “normal.”

Instead, ABA for girls and women should aim to:

  • Build confidence and self-esteem
  • Develop healthy coping strategies
  • Foster acceptance of autistic traits
  • Create sensory-friendly environments
  • Teach social skills without forcing masking
  • Accommodate special interests
  • Prevent burnout and manage meltdowns

An occupational therapist can also help girls develop self-care skills like getting dressed, brushing teeth, and managing hygiene during periods.

Accessing Support and Finding Community

Getting the right support is key for girls and women to manage challenges that come with autism. Here are some recommendations:

  • Get evaluated early if signs are present. Don’t write off symptoms as just shyness or anxiety.
  • Find an experienced diagnostician. Look for someone who specializes in female autism presentations.
  • Connect with other autistic girls and women. Online groups provide community and allow for sharing experiences.
  • Work with autism-affirming providers. Seek therapists who embrace neurodiversity and won’t push masking.
  • Practice self-care. Make time for special interests, alone time, and sensory needs.
  • Educate loved ones. Help family and friends understand autism and how to provide support.
  • Know your rights. Understand your rights under the Americans with Disabilities Act and other laws.
  • Seek accommodations. Request accommodations at school or work like sensory breaks and adjustments to workload.
  • Learn coping strategies. Therapists can teach healthy emotional regulation and self-soothing techniques.
  • Join a support group. Local and online groups provide safe spaces to share challenges and successes.

Access World-Class ABA Therapy in Maryland

If you’re seeking ABA therapy for an autistic girl or woman in Maryland, Jade ABA Therapy provides personalized in-home services centered around your child’s unique needs.

Our experienced therapists help each child thrive through positive reinforcement, building life skills, and developing healthy behaviors. We partner with families to create individualized treatment plans that focus on your child’s growth and happiness.

To get started with top-rated, compassionate ABA therapy in Maryland, call Jade ABA Therapy today at (410) 616-0901 or email us at info@jadeaba.org. Our team is ready to help your daughter build confidence and success on her own terms.


[1] Hull L, Petrides KV, Mandy W. The female autism phenotype and camouflaging: a narrative review. Rev J Autism Dev Disord. 2020;7(3):306-317. https://doi.org/10.1007/s40489-020-00197-9

[2] Milner V, McIntosh H, Colvert E, Happé F. A qualitative exploration of the female experience of autism spectrum disorder (ASD). J Autism Dev Disord. 2019;49(6):2389-2402. https://doi.org/10.1007/s10803-019-03906-4

[3] Mandy W, Pellicano L, St Pourcain B, Skuse D, Heron J. The development of autistic social traits across childhood and adolescence in males and females. J Child Psychol Psychiatry. 2018;59(11):1143-1151. https://doi.org/10.1111/jcpp.12913

[4] Parish-Morris J, Liberman MY, Cieri C, et al. Linguistic camouflage in girls with autism spectrum disorder. Molecular Autism. 2017;8, 51. https://doi.org/10.1186/s13229-017-0164-6

[5] Ratto AB, Kenworthy L, Yerys BE, et al. What About the Girls? Sex-Based Differences in Autistic Traits and Adaptive Skills. J Autism Dev Disord. 2018;48(5):1698–1711. https://doi.org/10.1007/s10803-017-3413-9

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