Back to episodes


How to Know If Your Child Has Autism? – S3 E7

Boys are four times more likely o be diagnosed with autism than girls according o data from the CDC. That’s because the traditional  signs of autism are often difficult  to detect depending on the gender a child is assigned at birth. Our guest explains the signs parents  should look for and what to do if  they think their little one  may be showing signs of autism.

Jessica speaks with Dr. Christopher J. Smith, Southwest Autism Research & Resource Center’s Chief Science Officer, to learn more about the different ways autism can present in children.

Podcast Resources:
Southwest Autism Research & Resource Center: Resources and Guides
Arizona Early Intervention Program
The Parenting Brief: Early Intervention for Autism
Strong Families AZ
Host: Jessica Stewart-Gonzalez
Guest: Christopher J. Smith, Ph.D.
Podcast Credits:

host Host: Jessica Stewart-Gonzalez is the Chief of the Office of Children’s Health at the Arizona Department of Health Services. She is married, has two young children, and loves reading (anything except parenting books!) and watching movies and TV. She loves to spend time with her kids (when they aren’t driving her crazy) and celebrating all of their little, and big, accomplishments. Jessica has been in the field of family and child development for over 20 years, working towards normalizing the hard work of parenting and making it easier to ask the hard questions.

host Guest: Dr. Christopher J. Smith, Southwest Autism Research & Resource Center's Chief Science Officer


Jessica Stewart-Gonzalez: [00:00:00] Welcome to the Parenting Brief. I’m your host, Jessica Stewart-Gonzalez, an Arizona [00:00:10] working mom and Chief of the Office of Children’s Health at the Arizona Department of Health Services. There’s no one size fits all solution when it comes to parenting a little one. Taking it day by day [00:00:20] and paying attention to what helps your little one thrive makes those elephant sized challenges a little bit smaller. And that’s why we’re here, with tips and advice from experts to help make the [00:00:30] journey of parenthood a great one.

Jessica Stewart-Gonzalez: Thank you for joining me on [00:00:40] this episode of the Parenting Brief. In season one, we covered the early signs of autism among children. But we didn’t get to talk about how it presents differently based on [00:00:50] assigned gender at birth. According to the CDC, boys are four times more likely to be diagnosed with autism than girls. When girls aren’t diagnosed early, they miss out on [00:01:00] key support systems that can help build life skills. Our guest explains what parents need to know up next.[00:01:10]

Jessica Stewart-Gonzalez: We’re welcoming back Dr. Chris Smith, the Chief Science Officer at the Southwest Autism Research and Resource Center. Back in season one, Dr. Smith [00:01:20] explained the early signs of autism parents should look out for. Today, we’re focusing on how autism presents in girls. Thanks for coming back on the show, Dr. Smith.

Dr. Christopher J. Smith: You’re [00:01:30] welcome. Thanks for having me.

Jessica Stewart-Gonzalez: So in that previous episode, there was a lot of response to that information [00:01:40] and you know, what that looked like and really information that, you know, parents are clearly after. And I know personally that what that looks like [00:01:50] in girls versus boys can be very different. And a lot of the information that we have is very specific to kind of what that looks like or presents in [00:02:00] boys and especially in young children. So can you explain why autism is more commonly diagnosed among boys than girls? [00:02:10]

Dr. Christopher J. Smith: You know, one way to think about that is if I was to give two people the same textbook and I was to say this person go into this room and [00:02:20] study this textbook an hour a day in a quiet environment with no distractions and I give the same textbook to another person and have them go and study the [00:02:30] same material, but I told him to have the TV on and the phone with them. So they’re constantly getting interrupted.

Dr. Christopher J. Smith: In a month’s time, who is going to have [00:02:40] better skills in whatever the topic of that textbook is trying to teach? Certainly it’s the person that doesn’t have the interruptions while they’re trying to learn the material, right? [00:02:50] So, similarly with autism, if something is interrupting that learning process from the environment, then their development in a given topic, in [00:03:00] this case it’s social communication, is going to happen more slowly than it would happen if they didn’t have those interruptions.

Dr. Christopher J. Smith: Now, for whatever reason, [00:03:10] we do know that there are differences in how girls will acquire skills related to social communication than boys will when [00:03:20] they’re very young, right? We’re talking about babies and toddlers here. Girls will tend to develop social skills more quickly or more efficiently than boys [00:03:30] and when that girl has that interruption to the learning process, they have a stronger propensity to develop social [00:03:40] communication skills. But it happens on a slightly different trajectory.

Dr. Christopher J. Smith: Now that can manifest itself in a number of ways, but because they have that kind of [00:03:50] social advantage very early on, right? So we’re talking again about toddlers, and as kids age, that kind of evens out very quickly. But as toddlers, they have a [00:04:00] more distinct social advantage. The signs of autism, things that we’re used to seeing in boys, can be much harder to detect in girls [00:04:10] because they have some interest in socialization and their social skills generally look better than boys. But that doesn’t mean that that [00:04:20] learning process isn’t interrupted.

Jessica Stewart-Gonzalez: And does it present differently in girls than in boys?

Dr. Christopher J. Smith: In any kind of psychiatric [00:04:30] disorder, and autism is no different, in any kind of psychiatric disorder, there’s a mix between positive and negative symptoms. Positive symptoms are the things that [00:04:40] people will do that you wouldn’t expect them to do, right? What they are doing makes them look different.

Dr. Christopher J. Smith: And then there’s negative symptoms, where they are [00:04:50] not doing the things that people would expect them to do, right? So, when you’re talking about a toddler, you would expect a toddler to [00:05:00] seek attention from their parents pretty regularly. You would expect a toddler to use eye contact. You would expect them to be experimenting with language [00:05:10] throughout the day and progressing with language. And with autism, you might see some hints of what you would expect kids to do, [00:05:20] but primarily they’re not engaging in that behavior enough.

Dr. Christopher J. Smith: So they are kind of primarily negative symptoms, and [00:05:30] that’s what you’ll see generally when identifying girls. Or the very subtle signs in girls may appear to be more independent, to not need their [00:05:40] parents as much, to be able to play independently for long periods of time, to fuss when they get hurt or when they struggle with something or [00:05:50] trip over something, but not seek their parents’ attention or support when that’s happening.

Dr. Christopher J. Smith: So, you know, to sum all of that up, really, it’s [00:06:00] for girls, it’s kind of what we call the good baby syndrome, right? Oh yeah, she’s great. She’s totally independent. She can play by herself for an hour. [00:06:10] Well, I mean, that’s not really what you would expect from a typically developing toddler. They shouldn’t be able to play by themselves for an hour, they should be seeking parents [00:06:20] attention regularly throughout that hour. They should be craving parents’ attention or attention from other kids or looking to parents for guidance or having their needs [00:06:30] met. And, you know, I get most concerned when people tell me that their kids can play by themselves for long periods of time without any attention. That’s not typical. [00:06:40]

Jessica Stewart-Gonzalez: So if a parent does notice that their little girl may be showing signs of autism, what are their next steps? [00:06:50]

Dr. Christopher J. Smith: So, I mean, the very first thing that they want to do is bring it up to their pediatrician. And there’s a big variety [00:07:00] in pediatricians’ ability to guide parents to the appropriate next steps. Many times, that child is physically healthy. [00:07:10] So a pediatrician may not say, well, this is a road you want to go down. They may be a little bit hesitant to say that. Other pediatricians will say, [00:07:20] if you have concerns and you’re not seeing your child do these, the things that you want them to be doing or that you think you should be doing, then you should go and seek a developmental evaluation. [00:07:30]

Jessica Stewart-Gonzalez: Is there anything else on this specific topic that we haven’t covered that you think would be really important for parents to know?

Dr. Christopher J. Smith: One other thing [00:07:40] that I think is an important tip, right, if you are a parent and you’re noticing these differences in your child’s behavior or skill level or development, take [00:07:50] special care to note the details of that, because that’s going to be really critically important when you go for an evaluation. You’ll need to be able to [00:08:00] articulate what these differences are that you’re seeing. Right? Like, oh, I see that my child doing this and I don’t see other kids at their/his age doing that. Or I see [00:08:10] her, you know, engaging in this kind of behavior that seems like it’s a little bit too much for me. Like they need to be able to share those kinds of details.

Dr. Christopher J. Smith: And I think that that’s sometimes [00:08:20] really hard for parents because, particularly if they’re not trying to solve a major problem that’s interfering with their daily lives or that functional [00:08:30] impairment, right? I think what’s really critical is the parents kind of get over that hump of wanting to present their child in the best possible light, right? [00:08:40] So many times they’ll go and they’ll sit in front of this evaluator that they pursued, they want to get, and then they say, oh, my child’s really good at this and they’re really good at that. And they want to [00:08:50] present a holistic picture to that professional and they minimize the things that led them to that place in the first place.

Dr. Christopher J. Smith: And I like [00:09:00] to explain to parents, I draw another kind of analogy and I say, well, if you were if you had a spot on your forehead and you went to go see the dermatologist and [00:09:10] you pointed to that spot on your forehead and you said, I need you to look at this like this spot. Right? Like that’s the behavior that you would do. You wouldn’t go to a dermatologist and say, [00:09:20] well, everything else on this side of my forehead is really great skin. Oh, and by the way, I have this other little spot right here. Right. You wouldn’t do that. [00:09:30] You would say, this is what I am concerned about right now. This is why I’m coming to see you. And so it’s important that parents really pay attention to and be able to [00:09:40] articulate the details about the differences that they’re seeing. [00:09:50]

Jessica Stewart-Gonzalez: If you learned something new today, make sure to follow the Parenting Brief on this podcast player so you stay up to date with the latest tips and tricks to help your kiddo thrive. [00:10:00] And be sure to share this podcast with the parents or soon to be parents in your life. Until next time, this is Jessica. You’ve got this. [00:10:10]

Back to episodes