'Underdiagnosed' Girls With Autism Struggle to Fit In

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Myles believes these social skills are not as ingrained in boys as they are in girls. "It's more appropriate, if you will, for a boy to have a tantrum and major meltdown than a girl," Myles said.

When girls do melt down -- as Kaede does at home -- it's often dismissed as nothing serious, precisely because they are female. "People roll their eyes and say 'drama queen,' even me," said Kristi Sakai.

Some researchers and psychologists believe that symptoms of autism in girls might therefore be more mild, or more easily explained away as something else. In addition, girls are typically more developed in certain social and conversational skills, further masking possible indications of autism.

According to Shana Nichols, a psychologist at the Fay J. Lindner Center for Autism, a girl's autism might even pass unnoticed if a test for conversational ability is kept short enough.

"You might be able to engage in a back-and-forth conversation with a girl to a greater degree than with the boys," said Nichols. "In a one-to-one, five-minute conversation in passing, they could greet you and answer a couple of questions back and forth. But when you go beyond that, then you begin to see the hole or the gaps in her social understanding."

Girls Being Targeted

Nichols regularly holds an informal support group for teenage girls with autism, meeting with them in Bethpage, New York.

Many of the girls she sits down with can hold a conversation quite well and appear to have a sort of high-functioning autism. But all have stories about being picked on mercilessly because they were odd somehow -- literally disabled when it came to surviving the more sophisticated social complex of teenage female society.

Victoria Roma is a teenager who attends special education classes in New Jersey and intends to become a marine biologist. Roma has superb language skills and is highly motivated, but she has difficulty picking up subtle social skills and therefore struggles to fit in.

"It's a challenge for me to be aware of everything," explained Roma. "Am I flapping? Was that a joke I just heard? Should I be laughing? Should I not be laughing? Should I be serious at this time? Can I be a little silly at this time?"

Brenda Myles, the autism researcher, believes girls with autism might struggle to fit in with their peers even more than boys with autism, because of these missed social cues.

"There's no doubt that girls are being targeted," said Myles. "And because they don't understand those social cues, and in many cases they are not interested in those typical girl behaviors, they don't understand sarcasm, they are often left alone or targeted."

The Sakais don't want Kaede to be targeted or left alone, which is why she is getting lessons on how to make friends with a special education teacher she spends time with at school. While her teacher takes her diagnosis seriously and understands the challenges she faces, not everyone in her regular elementary school does.

"Nightline" recently followed Kaede around school and met a faculty member who was skeptical, suggesting that the children's challenges had to do with the way they were parented. Myles said that kind of reaction is "heartbreaking, and indicates a gross misunderstanding of autism spectrum disorders. And I'm not blaming that indiviudual staff member, but he or she doesn't understand."

Of course, autism is something none of us really understand. Even the determination of whether "girl autism" is different from "boy autism" is an unanswered question. But one that is worth asking.

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