Are Girls Disadvantaged by Current ASD Testing Methods?

According to current statistics, autism spectrum disorders are between four and five times more likely to affect boys than girls: the Centers for Disease Control states that 1 in 42 boys in the U.S. has ASD, compared with 1 in 189 girls. But a few experts are beginning to wonder if current diagnostic methods may be at least partially responsible for such a significant imbalance.

Some experts who specialize in working with girls with autism, such as psychologist Dr. Lori Ernsperger, claim that current testing methods for autism spectrum disorders may be inadequate for diagnosing girls, because the tests primarily concentrate on signs and characteristics that are more typically associated with male behavior. Contrary to widely held views within the health profession, Dr. Ernsperger and others believe that ASD can and does present differently in girls than in boys, and that in focusing too closely on the more severe or obvious signs of ASD, clinicians can overlook, or even dismiss, some of the subtler indicators that are more likely to be displayed by girls. It is therefore possible that the true number of girls with ASD is underestimated, and that many girls on the autism spectrum are not receiving the treatment and support that they need because no one is aware of their condition.

An important focus for Dr. Ernsperger, therefore, is how to adapt current diagnostic questionnaires in order to more accurately assess and diagnose girls with ASD. Instead of rewriting them, a possible first step is simply to implement different scoring levels for boys and girls; for example, with a diagnostic checklist of 20 questions, boys would need to score 18, but girls would need to score 16, in order to receive secondary testing. For an article about Dr. Ernsperger’s work in this area, see here.