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Autism In Girls: Checklist

Updated: Jul 4

"Because our diagnostic systems and stereotypes of ASD are based on males, we just don’t know how many girls with very high autistic traits are out there, unrecognized. We need to know, and we need to know if they are suffering in silence or managing to compensate." Francesca Happé, King’s College London

All the characteristics need not be present in the child but a significant number of checks warrant an assessment. Visit a speech-language pathologist today. Only trained specialists can make the autism diagnosis.

Early Years

Separation anxiety from parent or caregiver

• Seeks and/or prefers the company of adults throughout the day

• Intense emotions are often observed in crying

• Sense of justice, adherence to rules, telling on others (or herself), described as bossy

• Can make friends but may have difficulty maintaining more than one friendship. It is the quality of the social interactions, as compared to her peers, that is the key indicator

• May be clingy to one peer

• Often has an advanced reading ability

• Correcting the teaching or others

• May be observed by herself and/or wandering around alone

• Teachers may view her as the odd one out, “odd” or “different”

• Passive and/or resistant to contributing to class group work/discussion and/or lack of

interest in classroom activities

• May be viewed as the “teacher’s pet”

The key social diagnostic characteristics include:

A. PLAY: may not be motivated to play with female peers. May play with boys or alone.

B. IMITATION: using copying and mimicking to imitate and attempt to fit into the social world. This helps them cope with their social confusion.

C. INTEREST: a lack of interest in what their female peers are interested in or their typical play.

A tendency to role-play adult roles. A tendency to spend the majority of the time “setting up” the scene rather than playing with it. Their interests are often similar to their peers, but it is the “intensity” of the interest that is the difference. There are differences in the areas of play, friendship, and social situation abilities and interests.

These may change in intensity depending on environmental/ social/health context. They will not all be present in one individual, but a significant number of ticks would suggest a referral for assessment might be helpful.

"Girls are diagnosed later than boys."


  • Lacks best friend/has just one or two intense friendships/fixates on one person/controlling or domineering/on the edge of things socially/imaginary friend/teased or bullied by peers /shy/timid/passive/flitting from group to group

  • May struggle with group work.

  • May obsess about the possibility of a relationship particularly a love interest or a feasible new friendship.

Strengths: May be very loyal


  • Different to peers; sometimes immature – may have a special object for comfort e.g. teddy bear – may play with younger children - or older children

Strengths: Sometimes very mature

Intense interests

  • That is very specific and restricted [may be similar to most girls e.g. books/animals/dolls/celebrities/fashion but more passionate, intense and repetitive, and less imaginative]- likes to talk about one particular topic but may be very factual

  • May have rich fantasy life – may be misinterpreted as psychosis

Strengths: Specialist in-depth knowledge which gives huge pleasure

School work

  • Difficulty with starting work in lessons or with stopping work that is unfinished –lack of interest in lessons - issues with homework.

  • Difficulty with change and or transitions

  • Forgetful – disorganized

  • Wanting things to be certain

  • High standards/perfectionist/may spend a long time on work -horror of failure = mental burnout

Strengths: Maybe a model student

May produce work of the very high caliber

Misunderstanding social norms

  • Failure to recognize status/authority – rude to teachers;

  • Correcting adults and their peers; may not know how to be a ‘child’, rejecting play with other girls preferring boys

Strengths: Different take on what really matters – sometimes refreshing!


  • May have been referred for Speech and Language therapy;

  • Struggling with following verbal instructions; poor at chit-chat; difficulty with open questions;

  • Overuse of stock phrases; taking things literally; selective mutism; may be exhausted by social interaction; not initiating conversations; reluctant to answer questions in class

  • Difficulties with appropriate facial expressions and responses - may laugh inappropriately –infrequent use of gesture

Strengths: May be able to learn ‘scripts’ successfully

Some girls with autism have exceptionally good expressive language.

Different behavior from home to school

  • e.g. anxious at home but ‘fine’ at school

  • Find it very difficult to get up in the morning and ‘face the world’; trying hard to fit in at school but this comes at a cost: exhausted and emotional when safely at home

High levels of anxiety

  • May be misdiagnosed with mental illness – but may also develop mental health problems [ e.g. depression, self-harm, OCD, demand avoidance];

  • Emotionally upset for apparently trivial reasons; catastrophizing; ‘meltdowns’[shouting, aggressive] or ‘shutdowns’ [ silent, head on the desk, avoiding interaction, unable to communicate, a blank stare, looking into space, withdrawn]

  • Obsessive – organizing things endlessly, doing the same thing repeatedly e.g. line up toys [rather than play imaginatively with them]

Strengths: Ability to persist with something

Lack of sense of personal identity

  • e.g. not sure how to describe themselves beyond physical appearance

  • Over apologetic – appeasing others

Strengths: Freedom from social constraints

Gender may lack certainty about gender;

  • May reject ‘feminine’ clothing preferring comfortable practical clothes;

  • No interest in hair or make-up; Tomboy type; desire to present as male

Strengths: Freedom from social constraints

Sensory processing differences [noise/touch/light…]

  • e.g. dislike having hair brushed or washed, dislike hand dryers, sensitive to clothes, resistant to hugs and kisses, need warning that someone is going to touch

  • Flicks fingernails, pick skin, rubs hands, paces, clears throat

  • Eating issues: limited diet; eating disorder

  • Poor personal hygiene

Strengths: May find great pleasure in certain sensory experiences


  • It May come across as opinionated; strong need to be right,

Strengths: Strong sense of justice

Copying others

  • Studying people-watching in the playground or on films/videos [repeatedly] and acting out what she has seen; practicing what she is going to say, play may be about practicing rather than having fun;

  • Lacking in spontaneity

  • Observe and copy behavior – may use repeated script when meeting people - mask the autism

  • Analytical rather than intuitive

Strengths: Observant

Sounderic provides online speech therapy sessions for Autism. We would love to help you. Get in touch with us on WhatsApp at +919644466635 or schedule a consultation with us at

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How to deal with Autism in girls?

  • Early Identification and Diagnosis: Girls with autism are often diagnosed later than boys, as their symptoms may present differently or be masked by coping mechanisms. Early diagnosis allows for early intervention and support.

  • Understanding Individual Needs: Each girl with autism is unique, so understanding her strengths, challenges, sensory sensitivities, and communication preferences is crucial.

  • Supportive Environment: Create a supportive and structured environment that accommodates sensory sensitivities and provides clear routines and expectations.

  • Social Skills Development: Many girls with autism struggle with social interactions. Teach social skills explicitly through therapy, role-playing, and social stories. Encourage participation in structured social activities.

  • Communication Support: Use visual supports, assistive technology, and alternative communication methods as needed to facilitate effective communication.

  • Educational Accommodations: Work with educators to implement accommodations and modifications in the school setting, such as extended time for tasks, quiet spaces, and sensory breaks.

How can Speech therapy help girls with autism?

How can occupational therapy benefit girls with autism?

Can a Child Be Diagnosed with Autism and Downs Syndrome?

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