Unmasking autism: gender differences in diagnostic practices and challenges in Norway’s mental healthcare services for children and youth

Gender plays a critical role in the recognition, diagnosis, and support of children with Autism Spectrum Disorder (ASD). This qualitative study explores the perspectives of special education professionals, who are involved in both diagnosing and following up children with Autism, on how ASD manifest...

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Main Authors: Katrine Lyngvær Fredriksen, Alexander G. Page, Celina Lindhardt, Sobh Chahboun
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Education
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Online Access:https://www.frontiersin.org/articles/10.3389/feduc.2025.1552943/full
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author Katrine Lyngvær Fredriksen
Katrine Lyngvær Fredriksen
Alexander G. Page
Celina Lindhardt
Celina Lindhardt
Sobh Chahboun
author_facet Katrine Lyngvær Fredriksen
Katrine Lyngvær Fredriksen
Alexander G. Page
Celina Lindhardt
Celina Lindhardt
Sobh Chahboun
author_sort Katrine Lyngvær Fredriksen
collection DOAJ
description Gender plays a critical role in the recognition, diagnosis, and support of children with Autism Spectrum Disorder (ASD). This qualitative study explores the perspectives of special education professionals, who are involved in both diagnosing and following up children with Autism, on how ASD manifests in girls and the diagnostic challenges that arise. Although boys are more frequently diagnosed—and often at younger ages—emerging research and clinical experience suggest that girls may exhibit more nuanced and socially adaptive traits that fall outside traditional diagnostic expectations. Girls with ASD often use compensatory behaviors such as social mimicry, masking of difficulties, and scripting in social situations to conform to neurotypical norms. This study is based on semi structured interviews with three special educators from the Child and Adolescent Psychiatric Services. While these strategies can temporarily obscure core challenges in communication and social reciprocity, they frequently contribute to delayed identification and are associated with long-term psychological consequences, including fatigue, anxiety, and depression. Participants noted that girls are typically referred for evaluation later in adolescence, often in connection with internalizing symptoms such as eating disorders or mood-related concerns, rather than overt behavioral issues. Findings highlight the limitations of diagnostic frameworks that are largely based on male-typical presentations of ASD and emphasize the need for gender-informed assessment practices. This study underscores the importance of developing diagnostic tools and support strategies that account for the diverse ways ASD may present in girls, thereby enhancing early identification, reducing misdiagnosis, and promoting more equitable support within education and mental health services.
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spelling doaj-art-5932639ec2d84c16a59ff75f4366c8852025-08-20T03:24:52ZengFrontiers Media S.A.Frontiers in Education2504-284X2025-06-011010.3389/feduc.2025.15529431552943Unmasking autism: gender differences in diagnostic practices and challenges in Norway’s mental healthcare services for children and youthKatrine Lyngvær Fredriksen0Katrine Lyngvær Fredriksen1Alexander G. Page2Celina Lindhardt3Celina Lindhardt4Sobh Chahboun5Institute for Pedagogy, Queen Maud University College, Trondheim, NorwayMental Healthcare for Children and Adolescents’ Services, Kristiansund, NorwayDepartment of Social Work, Norwegian University of Science and Technology, Trondheim, NorwayInstitute for Pedagogy, Queen Maud University College, Trondheim, NorwayÅsveien School, Trondheim, NorwayInstitute for Pedagogy, Queen Maud University College, Trondheim, NorwayGender plays a critical role in the recognition, diagnosis, and support of children with Autism Spectrum Disorder (ASD). This qualitative study explores the perspectives of special education professionals, who are involved in both diagnosing and following up children with Autism, on how ASD manifests in girls and the diagnostic challenges that arise. Although boys are more frequently diagnosed—and often at younger ages—emerging research and clinical experience suggest that girls may exhibit more nuanced and socially adaptive traits that fall outside traditional diagnostic expectations. Girls with ASD often use compensatory behaviors such as social mimicry, masking of difficulties, and scripting in social situations to conform to neurotypical norms. This study is based on semi structured interviews with three special educators from the Child and Adolescent Psychiatric Services. While these strategies can temporarily obscure core challenges in communication and social reciprocity, they frequently contribute to delayed identification and are associated with long-term psychological consequences, including fatigue, anxiety, and depression. Participants noted that girls are typically referred for evaluation later in adolescence, often in connection with internalizing symptoms such as eating disorders or mood-related concerns, rather than overt behavioral issues. Findings highlight the limitations of diagnostic frameworks that are largely based on male-typical presentations of ASD and emphasize the need for gender-informed assessment practices. This study underscores the importance of developing diagnostic tools and support strategies that account for the diverse ways ASD may present in girls, thereby enhancing early identification, reducing misdiagnosis, and promoting more equitable support within education and mental health services.https://www.frontiersin.org/articles/10.3389/feduc.2025.1552943/fullautism spectrum disorder (ASD)gender differencesdiagnostic practicesfemale autism phenotypecompensatory behaviormental health services
spellingShingle Katrine Lyngvær Fredriksen
Katrine Lyngvær Fredriksen
Alexander G. Page
Celina Lindhardt
Celina Lindhardt
Sobh Chahboun
Unmasking autism: gender differences in diagnostic practices and challenges in Norway’s mental healthcare services for children and youth
Frontiers in Education
autism spectrum disorder (ASD)
gender differences
diagnostic practices
female autism phenotype
compensatory behavior
mental health services
title Unmasking autism: gender differences in diagnostic practices and challenges in Norway’s mental healthcare services for children and youth
title_full Unmasking autism: gender differences in diagnostic practices and challenges in Norway’s mental healthcare services for children and youth
title_fullStr Unmasking autism: gender differences in diagnostic practices and challenges in Norway’s mental healthcare services for children and youth
title_full_unstemmed Unmasking autism: gender differences in diagnostic practices and challenges in Norway’s mental healthcare services for children and youth
title_short Unmasking autism: gender differences in diagnostic practices and challenges in Norway’s mental healthcare services for children and youth
title_sort unmasking autism gender differences in diagnostic practices and challenges in norway s mental healthcare services for children and youth
topic autism spectrum disorder (ASD)
gender differences
diagnostic practices
female autism phenotype
compensatory behavior
mental health services
url https://www.frontiersin.org/articles/10.3389/feduc.2025.1552943/full
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