Dubai Autism Center highlights delayed diagnosis of girls with autism due to social camouflage

The Dubai Autism Center warns that girls with autism are often diagnosed later than boys because their symptoms can look different and may be masked, highlighting the need for earlier, more nuanced assessments.

Autism in girls is often missed or recognised later than in boys because the condition can look different in females, the Dubai Autism Center has said, warning that lower diagnosis rates do not necessarily mean fewer girls are affected. The centre said many girls meet the criteria for autism spectrum disorder but remain unidentified for longer because their difficulties are less obvious in everyday settings.

Researchers and clinicians have increasingly pointed to what they describe as social camouflage, or compensating for social difficulties by copying others, memorising conversation patterns or rehearsing responses. That can make a girl appear to be coping well at school or at home even when socialising is draining and confusing. The centre said a systematic review of diagnosis barriers in girls and young women identified several reasons for delay, including differences in presentation, the ability to mask symptoms, limited awareness among adults and bias during assessment.

The issue is not limited to one local centre’s experience. A 2023 US study cited by the Dubai Autism Center found that females received their first autism diagnosis about 14 months later on average than males. Duke University researchers have also reported that girls are more likely to be diagnosed first with anxiety or depression, which can blur the picture and postpone recognition of autism. Earlier studies have suggested that existing diagnostic tools may be better at catching the more visible patterns often associated with boys, such as pronounced repetitive behaviour.

Mohammed Al Emadi, director-general and board member of the Dubai Autism Center, said diagnosis should not depend on a single outward sign. He said clinicians need to look at a child’s wider developmental history, communication, social interaction, interests and sensory or repetitive behaviours, while Dr Nicholas Orland, the centre’s executive director of educational and therapeutic programmes, said assessments should draw on information from families, schools and multiple settings. The centre said earlier identification matters because it opens the way to support before academic and social pressures build, and it called for greater awareness, professional training and screening to close the diagnostic gap.