Are there really more Autistic boys than girls or does the diagnostic criteria for Autism Spectrum Disorder (ASD) hold a male-based gender bias leaving many girls missing the criteria and therefore not receiving a clinical diagnosis?
Well yes, currently but maybe not. Once assumed predominantly a male diagnosis, Autism is now commonly diagnosed in females as well. Research that once said the male-to-female ratio was 4:1, is now suggesting it's closer to 3:1. As more research is produced and we continue to understand Autism in females, the male to female ratio may shift even further.
Clinical understanding of Autism and how it presents has been based primarily on male observations, leading to the diagnostic criteria holding gender bias. As a result, some girls don’t meet the ‘typical’ criteria and therefore have gone undiagnosed or misdiagnosed. In fact, many girls are not diagnosed until they reach mid to late teens or adulthood. Sadly this can result in adverse impacts on mental health, overall wellbeing, education, and employment.
Autistic females have many of the same core autistic traits, but due to their ability to internalise their difficulties and do what is called “masking”, their autism is often missed when compared to their male counterparts. There are many traits associated with females and autism, here is a list of some of the more common ones:
As seen above Autism in females presents in many different ways and no two Autistic females are alike. It's important to keep this in mind in clinical practice and focus on treating your client as an individual, finding and addressing the underlying root cause/causes, and using a holistic approach. This means supporting them Nutritionally but also emphasising the importance of lifestyle support, stress and anxiety reduction, self-regulation, self-acceptance, and referrals to other health practitioners where necessary.
From a Nutritional perspective, there is a lot we can do to support Autistic females. Below are a few examples.
Firstly identifying and removing any possible food allergies or intolerances because these can contribute to intestinal permeability and chronic gut inflammation. This can negatively impact the immune system and create digestive upset, mood imbalances, and behavioural issues.
Dairy (Casen), gluten, and soy can sometimes be the worst culprits here, but not always (remember everyone is different!). Removing these foods particularly the gluten and dairy for 6-8 weeks alongside additional gut support may help reduce symptoms.
Understanding which Nutritional deficiencies are present is an important step for ascertaining what may be causing or exacerbating mood disorders, appetite, food habits, general behaviours, and sleep difficulties.
Deficiencies may be evident from physical examinations, the patients presenting signs and symptoms and tests such as hair tissue mineral analysis or in some cases pathology or urine testing.
Some common deficiencies include:
Diet can be challenging for some Autistic females. Some may have a limited variety of foods in their diet due to sensory or textural difficulties or food neophobia. In these cases nutritional supplementation may help to bridge the gap between nutritional deficiencies.
Top foods for supporting Autistic females
The good news is that as Autism in girls is becoming more recognized, support systems are being established to help Autistic girls and women, wherever they are in their journey.
How does nutrition affect our overall wellbeing? Find out more through our Bachelor of Health Science (Nutritional and Dietetic Medicine) and range of Nutrition Short Courses.
Margo is an Endeavour College of Natural Health alumni and completed her Bachelor of Health Science (Nutritional and Dietetic Medicine) in March 2021. Since graduating, Margo has been mentoring Endeavour students to prepare them emotionally, mentally, and practically for clinical subjects. Margo also runs her own clinic Whole Body Nutrition where she is the lead Nutritionist.
Margo's Nutrition journey began after the birth of her two children, who have inspired her towards healthy eating and cooking with wholefoods. When it comes to healing, Margo takes a whole-body approach. This encompasses not just food and diet, but the whole person including physical, mental and emotional health. Margo believes that food can be used as medicine to gently nourish, strengthen and support overall health and wellbeing.
Margo has a special interest in student mentoring, anxiety and stress management, fatigue, nutrition for teenagers and children, digestive health, skin health and women's health.