'Underdiagnosed' Girls With Autism Struggle to Fit In

Socialization and conversational skills could mask symptoms of autism.

ByABC News
January 23, 2008, 12:17 PM

Jan. 23, 2008— -- At first glance, 8-year-old Kaede Sakai is a typical first grader. She's a smart student, and most of the time she is kind and cordial in class. But recess is an exercise in frustration for her because no matter how hard she tries to fit in, she just doesn't click with the other kids.

It's heartbreaking to see, especially for her mom.

"[She's] been very sad lately, because a lot of the kids have their play as a set group," said her mother, Kristi Sakai.

There's something about how Kaede approaches play that turns off a lot of kids. "She's inflexible and has difficulty engaging properly with other peers," said her mom. "She needs them to do things her way, period. And kids aren't able to do that."

And while Kaede might appear like nothing more than a little girl having a bad day, it takes someone who has seen a lot of autistic children to recognize that Kaede has autism.

Brenda Myles, one of the lead researchers specializing in the quite narrow field of girls with autism, said autism can be more difficult to detect in girls.

"Almost all the research is on boys," said Myles. "Well, first of all there are more boys than girls with autism spectrum disorders, but second of all, girls are underdiagnosed."

For a while, the Sakais dealt with the consequences of this narrow field. Kristi Sakai sensed something was wrong when Kaede was very young, but she struggled with a diagnosis.

"I had a really hard time getting her diagnosed," she said. "The early intervention people would not recognize the things that I was seeing even though they were identical behaviors as the boys."

The Sakais also have two sons touched by autism. The family lives in a rural area of Oregon, not far from Eugene. It's the kind of place where everybody tends to watch out for everybody else. And in Kaede's family, that's important.

Kaede's brothers, Tom and Kito, have many issues, including an inability to give and take in conversation, and intolerance of various physical stimuli, like certain kinds of clothing.

"[Kito] would pull at the feet of his pajamas and scream until we would take them off," said Kristi Sakai.