Autism in Girls
Understanding and Supporting Through Child-Centred Play Therapy
When we think of autism, the typical characteristics that come to mind, such as difficulty with social interactions, repetitive behaviours, and sensory sensitivities; are often based on research and diagnostic criteria that were originally developed with boys in mind. As a result, many autistic girls go undiagnosed or are misdiagnosed, leading to years of misunderstanding and unmet support needs.
In my work as a child-centred play therapist at Inspiring Play: Child & Family Play Therapy Sunshine Coast, I see firsthand how autism presents uniquely in girls and how play therapy can be a powerful, affirming way to support their emotional well-being, self-expression and social development.
Autism in Girls: What Makes It Different?
Many autistic girls exhibit characteristics that differ from those typically seen in boys, often leading to underdiagnosis or late diagnosis. Some of these include:
Social Camouflaging and Masking
Autistic girls often work hard to "blend in" with their peers by mimicking social behaviours, learning scripts for conversations or observing and copying others' facial expressions and gestures. This is known as masking, and while it can help them navigate social settings, it is exhausting and can lead to anxiety, burnout, and identity struggles.
Deep, Intense Interests That May Align with Peers’ Interests
While autistic boys may have highly specialised interests (for example, trains, numbers, dinosaurs or mechanics), autistic girls may develop intense interests in areas that seem more socially typical, such as animals, fashion, fantasy worlds, books, or friendships. Because these interests align with what other girls their age enjoy, they are less likely to be flagged as a sign of autism.
Strong Imaginative Play, But With Rigid Patterns
Autistic girls may engage in pretend play but in highly structured or repetitive ways. They may create elaborate fantasy worlds, act out the same scenario repeatedly or insist on controlling all aspects of the play. While this looks different from the more obviously repetitive play of some autistic boys, it serves the same regulatory function.
Sensory Sensitivities
Many autistic girls have strong sensory preferences, often being highly sensitive to clothing textures, noise levels, bright lights, smells or food textures. However, they may not always express distress outwardly and instead internalise their discomfort, leading to emotional regulation challenges.
Emotional Sensitivity and Internalising Difficulties
Rather than externalising distress (e.g., through meltdowns or aggression), autistic girls often internalise their struggles, leading to high levels of anxiety, perfectionism, depression and social withdrawal. They may be seen as "shy," "highly sensitive," or "overly emotional" rather than being recognised as autistic.
The Challenges Faced by Autistic Girls
Because autism in girls is often misunderstood or overlooked, they face unique challenges, including:
Late Diagnosis or Misdiagnosis – Many autistic girls are diagnosed much later than boys or misdiagnosed with anxiety, ADHD, or even personality disorders in adolescence.
Exhaustion from Masking – Constantly suppressing autistic traits to fit in can lead to significant emotional burnout and mental health struggles.
Social Difficulties and Friendship Struggles – Despite a strong desire for friendships, autistic girls often experience social misunderstandings, feel left out or struggle with the unpredictability of peer relationships.
Emotional Regulation Challenges – Due to sensory sensitivities, masking, and internalised anxiety, many autistic girls experience high emotional distress and difficulty managing big feelings.
How Child-Centred Play Therapy Supports Autistic Girls
Child-Centred Play Therapy (CCPT), based on the work of Virginia Axline and developed further by Dr. Garry Landreth, provides a safe, affirming space where autistic girls can express themselves freely, process their experiences, and build self-awareness. Unlike structured therapies that focus on teaching neurotypical social skills, CCPT honours the child’s individual way of being and supports their unique strengths and challenges.
A Space to Unmask and Be Their Authentic Selves
In the playroom, there is no pressure to "perform" or conform to social expectations. Autistic girls can explore their inner world without fear of judgment, allowing them to express themselves in ways that feel safe and authentic.
Emotional Regulation Through Play
Play provides a natural way for children to process emotions and experiences. Autistic girls, who may struggle with verbalising their feelings, can use play as an outlet to work through anxieties, sensory sensitivities or social challenges.
Building Self-Understanding and Self-Compassion
Through play therapy, autistic girls can develop a greater awareness of their emotions, needs, and sensory preferences. By experiencing acceptance and validation in the playroom, they learn that their way of experiencing the world is okay, just as it is.
Reducing Anxiety and Supporting Sensory Needs
The child-centred approach allows for sensory-based play, helping autistic girls regulate their nervous systems. Whether through sand play, movement, or repetitive play patterns, therapy provides a calming space that honours their unique sensory needs.
Strengthening Social-Emotional Skills Without Forcing Compliance
Rather than teaching social "rules" that prioritise masking, CCPT supports social-emotional growth organically. Autistic girls can explore relationships, experiment with different ways of interacting, and develop their own comfortable way of connecting with others.
Embracing Neurodiversity: Supporting Autistic Girls with Compassion
Understanding autism in girls requires a shift from viewing it as a set of deficits to recognising it as a different way of experiencing the world. Child-centred play therapy embraces this perspective by providing a nurturing, validating space where autistic girls can thrive, just as they are.
At Inspiring Play: Child & Family Play Therapy Sunshine Coast, I am passionate about supporting neurodivergent children in a way that honours their authenticity, strengths, and needs. If you are looking for compassionate, neuroaffirming support for your child, I’d love to connect.
Get in Touch
If you’d like to learn more about how play therapy can support your child, visit www.inspiringplay.com.au or reach out to book a session.
Let’s create a world where autistic girls feel seen, supported, and celebrated.