I’ve read a number of articles about Sesame Street’s groundbreaking introduction of Julia, a Muppet with autism. As the mother of an incredible young woman on the autism spectrum, I think what’s most groundbreaking is that Sesame Street’s new character is a girl.
Current statistics show that of the 1 in 68 children in the US challenged by autism, boys are diagnosed five times more often than girls. It’s not that girls don’t have autism, they do. It’s that, for a variety of reasons, girls are often misdiagnosed.
The criteria for diagnosing Autism Spectrum Disorder (a developmental condition marked by social and communication difficulties, repetitive/ inflexible patterns of behavior, and restricted interests/ intense fixations) are based on data derived almost entirely from studies of boys.
It can be difficult to identify girls on the spectrum. On a measure of friendship quality and empathy, research shows that girls with autism scored as high as typically developing boys of the same age – but lower than typically developing girls (Head, McGillivray, & Stokes, 2014).
Girls on the spectrum can show a much higher interest in socialization than boys, which can make them more adept socially, but also makes social exclusion (which becomes inevitable during adolescence) especially painful.
Social life does not come naturally. Girls may painstakingly study people to imitate them, developing a greater ability to hide their symptoms – yet another reason girls with autism may be hiding in plain sight.
In addition, the criteria for an autism diagnosis in girls is often masked by overlapping diagnoses. Autism and ADHD frequently occur together – and because people diagnosed with ADHD tend to have higher levels of autism traits then typical people do – girls who seem easily distracted or hyperactive may get the ADHD label, even when autism is more appropriate.
A misdiagnosis for girls on the spectrum can be particularly difficult, especially as they enter adolescence. Meeting the “mean girls” of junior and senior high school (and trying to decipher this new behavioral code) can be incredibly painful. Moreover, puberty involves unpredictable changes (horrifying to those with autism) that include breast development, mood swings, and menstruation.
The world is more dangerous for girls with autism as they develop sexually. Their tendency to take things literally, their social isolation, and their deep desire to connect and to belong, can make girls and women easy prey for sexual exploitation.
People with autism who do not seem interested in social life may not obsess about what they are missing – but those who want to connect socially and cannot are tormented by loneliness. In this way, autism may be much more painful for girls – and for women. 71% of adult women with Asperger’s reported suicidal thoughts; more than 10 times higher than the general population (Cassidy, et al., 2014).
Stacy Gordon, the puppeteer who plays Julia, was quoted as saying, “As the parent of a child with autism, I wished that [Julia] had come out years before, when my own child was at the Sesame Street age,” she said.
About the Author: Roberta Scherf is the parent of a young adult with autism, and the creator of MeMoves. See Roberta’s work at: www.thinkingmoves.com
Head, AM, McGillivray, JA, & Stokes, MA. Gender differences in emotionality and sociability in children with autism spectrum disorders. Molecular Autism. 2014; 5; 19.
Cassidy S, Bradley P, Robinson J, Allison C, McHugh M, Baron-Cohen S. Suicidal ideation and suicide plans or attempts in adults with Asperger’s syndrome attending a specialist diagnostic clinic: a clinical cohort study, The Lancet, Volume 1, No. 2p142–147, July 2014.