Signs of Autism in Girls: Why New Research Shows Girls Are Being Diagnosed Later
What if the signs of autism in girls have been there all along, but we have been looking for the wrong things?
Imagine a young girl who earns good grades, follows classroom rules, and enjoys spending time with friends. Her teachers describe her as quiet, cooperative, and bright. Yet, at home, her parents notice that she struggles with unexpected changes, becomes overwhelmed after social interactions, and has difficulty expressing her emotions.
Despite these challenges, no one has suggested an autism evaluation.
For many families, this experience raises an important question: Why are signs of autism in girls sometimes overlooked?
New research published in 2026 suggests that autism diagnoses among girls and women are increasing, potentially reflecting greater recognition of individuals whose developmental differences were previously missed.
Understanding how autism can present differently across children is essential for parents, educators, speech-language pathologists, and healthcare professionals.
What Does New Research Reveal About Autism Diagnoses in Girls?
A July 2026 study published in JAMA Network Open, titled Autism Spectrum Disorder Incidence by Age and Sex in a US Health Care System, 2016 to 2024, examined diagnostic trends among more than 171,000 individuals.
Researchers identified several significant findings:
Autism diagnoses among females increased substantially after 2020.
Among adolescent girls ages 10–18, newly recorded autism diagnoses increased at an average annual rate of 22.3% between 2020 and 2024.
Females received an autism diagnosis approximately 3.4 years later than males, on average.
Diagnostic trends among males remained relatively stable or declined during the study period.
These findings suggest that increased recognition of autism among previously underidentified females may help explain rising diagnosis rates. However, the study examined records from one healthcare system and does not establish that all increases were caused by improved detection.
The findings also complement discussions about autism identification featured in The ASHA Leader.
What Are the Signs of Autism in Girls?
The signs of autism in girls can vary significantly. Some girls demonstrate characteristics commonly associated with autism, while others display differences that are less readily recognized.
Potential characteristics include:
Difficulty navigating friendships or interpreting social expectations
Rehearsing conversations or imitating peers during social interactions
Strong interests that may appear typical for their age but are unusually intense
Sensitivity to sounds, clothing textures, lighting, or crowded environments
Difficulty adjusting to changes in routines or expectations
Challenges understanding sarcasm, implied meanings, or subtle social cues
Emotional exhaustion following school or social activities
Difficulty maintaining reciprocal conversations despite strong vocabulary skills
These characteristics are not exclusive to girls and do not independently establish an autism diagnosis.
Importantly, a child can demonstrate strong language abilities, maintain friendships, and perform well academically while still experiencing autism-related differences.
Why Is Autism Sometimes Diagnosed Later in Girls Than Boys?
Historically, autism research and diagnostic practices have been influenced heavily by studies involving boys.
As a result, certain developmental characteristics associated with autistic girls may be less readily recognized.
A 2024 review, Improving Diagnostic Procedures in Autism for Girls and Women, highlighted the importance of recognizing camouflaging behaviors, co-occurring conditions, and differences in how autism may present.
Social Masking May Hide Autism Characteristics
Some autistic girls use strategies commonly referred to as social masking or camouflaging.
These strategies may involve copying peers' behavior, preparing conversational responses, suppressing repetitive movements, or working intentionally to blend into social environments.
For example, a student may observe how classmates interact during lunch and imitate those behaviors to participate.
Although she appears socially engaged, the experience may require significant cognitive and emotional effort.
Masking can make developmental differences less noticeable to teachers, caregivers, and healthcare providers.
Strong Verbal Skills Can Make Social Communication Challenges Less Obvious
Some autistic girls have well-developed vocabularies, strong reading skills, and advanced verbal abilities.
However, the ability to communicate verbally does not necessarily mean that social communication is effortless.
A child may struggle with conversational reciprocity, understanding multiple perspectives, recognizing nonverbal communication, or interpreting abstract language.
These differences may become more noticeable as social expectations increase during adolescence.
Anxiety and Attention Difficulties May Complicate Identification
Some autistic girls also experience anxiety, attention difficulties, or emotional regulation challenges.
When these concerns become the primary focus of an evaluation, broader developmental differences may receive less attention.
A comprehensive assessment should consider the child's developmental history, communication skills, sensory experiences, social participation, and emotional well-being.
What Does Current Autism Research Tell Us?
The 2026 findings build upon a growing body of research examining differences in autism identification.
Research published in 2024 found that the proportion of girls receiving autism diagnoses increased over time, although girls continued to be diagnosed later than boys.
The Centers for Disease Control and Prevention (CDC) also reports that approximately 1 in 31 eight-year-old children in participating U.S. communities was identified with autism in 2022.
Although autism was identified more frequently among boys, these differences warrant continued investigation.
Recent research suggests that changes in diagnostic practices, public awareness, access to evaluations, and recognition of diverse autism presentations may contribute to changing identification patterns.
These findings highlight the importance of considering developmental differences across genders, cultures, and communication profiles.
How Can Speech-Language Pathologists Help Identify Communication Differences?
Speech-language pathologists (SLPs) play an important role in evaluating children's communication strengths and needs.
When families express concerns about social communication, an SLP may examine several areas, including:
Social communication and conversational reciprocity
Receptive and expressive language development
Understanding of figurative and nonliteral language
Narrative language and conversational organization
Functional communication across environments
Communication skills needed for participation in everyday activities
For children who demonstrate strong verbal abilities, comprehensive assessment is especially important.
Standardized language testing alone may not fully capture the communication demands a child experiences in daily life.
Clinical observations, caregiver interviews, teacher input, and functional communication assessments provide additional insight.
Speech-language pathologists can also collaborate with other qualified professionals when a comprehensive autism evaluation is indicated.
A speech-language evaluation does not automatically determine whether a child has autism, but it can identify communication needs and help guide appropriate referrals and support.
When Should Parents Seek an Autism Evaluation for Their Daughter?
Parents should consider discussing developmental concerns with their child's pediatrician or another qualified professional when challenges persist or interfere with daily participation.
Examples include ongoing difficulties with friendships, frequent overwhelm in social environments, communication breakdowns, sensory differences, or significant distress related to changes in routines.
Parents do not need to wait until academic performance declines or behavioral concerns become severe.
Early identification of developmental and communication needs can support access to appropriate strategies, accommodations, and services. Even when an autism diagnosis is not established, an evaluation may identify areas where additional support would benefit the child.
Supporting Girls With Autism at Home and School
Support should be individualized, strengths-based, and responsive to the child's experiences.
Families and educators can create more inclusive environments by:
Listening to children when they describe social or sensory challenges.
Providing predictable routines and advance notice of changes.
Supporting communication without requiring children to mask their differences.
Offering sensory accommodations and opportunities for regulation.
Teaching self-advocacy skills and respecting individual communication preferences.
These approaches can support meaningful participation while recognizing each child's unique strengths.
Every Child Deserves to Be Seen, Heard, and Understood
The growing recognition of autism among girls challenges us to reconsider longstanding assumptions about developmental differences.
A child should not have to struggle visibly before adults recognize that she may need support.
At BMS Pediatric Therapy Group, we believe comprehensive, culturally responsive, and family-centered speech-language services can help children build communication skills and participate more confidently in everyday activities.
Our approach recognizes that communication differences do not look the same in every child.
Take the Next Step: Schedule a Speech-Language Consultation
Are you concerned about your child's social communication, language development, or ability to navigate everyday interactions?BMS Pediatric Therapy Group provides pediatric speech-language services for families in Chicago and surrounding communities. Our team works collaboratively with families to understand each child's communication strengths, identify areas of need, and develop individualized recommendations.
Contact BMS Pediatric Therapy Group today to learn more about our speech-language evaluation and therapy services.
Because every child deserves to be understood—not overlooked.
Frequently Asked Questions About Autism in Girls
Can a girl have autism and still make eye contact?
Yes. Some autistic girls make eye contact, maintain friendships, and demonstrate strong verbal communication skills. Eye contact alone cannot confirm or rule out autism.
At what age is autism usually diagnosed in girls?
Autism may be identified in early childhood, but some girls receive diagnoses during adolescence or adulthood. A 2026 study found that females were diagnosed approximately 3.4 years later than males, on average, within the healthcare system studied.
What is masking in girls with autism?
Masking involves consciously or unconsciously adapting behaviors to meet social expectations, such as imitating peers or rehearsing conversational responses. Masking is not unique to girls.
Can speech therapy help autistic girls?
Yes. Speech-language therapy can support functional communication, language comprehension, conversational skills, self-advocacy, and other individualized communication goals. Therapy should respect neurodiversity and prioritize meaningful participation rather than forcing social conformity.
Where can I find pediatric speech-language services in Chicago?
BMS Pediatric Therapy Group offers pediatric speech-language evaluation and therapy services in Chicago and surrounding communities. Families can contact the practice to discuss service options.
Research and Sources
Messias, E., et al. (2026). Autism Spectrum Disorder Incidence by Age and Sex in a US Health Care System, 2016 to 2024. JAMA Network Open.
Improving Diagnostic Procedures in Autism for Girls and Women: A Narrative Review. (2024).
Are the Diagnostic Rates of Autistic Females Increasing? An Examination of State-Wide Trends. (2024).
Centers for Disease Control and Prevention. (2025). Data and Statistics on Autism Spectrum Disorder.
The ASHA Leader. (2026). Research on Autism Diagnosis.
