Table 9.

Features in females with autism spectrum disorder according to ICD-11.

Males are four times more likely than females to be diagnosed with ASD. Those females who are diagnosed with ASD are more frequently diagnosed with co-occurring disorders of intellectual development, suggesting that less severe presentations may go undetected compared to males. Females tend to demonstrate fewer restricted, repetitive interests and behaviors than males. Some individuals with ASD are capable of functioning adequately by making an exceptional effort to compensate for their symptoms during childhood, adolescence, or adulthood. Such sustained effort, which may be more typical of affected females, can have a deleterious impact on mental health and well-being. During middle-childhood, boys may act out with reactive aggression or other behavioral symptoms when challenged or frustrated, while girls tend to withdraw socially and react with emotional changes to their social adjustment difficulties.