A survey of assessment practices among health professionals diagnosing females with autism.
Most diagnosticians skip girl-specific autism tools—so verify your assessor before you refer.
01Research in Context
What this study did
Diemer et al. (2023) asked 133 Australian health workers how they test girls for autism.
The team used an online survey. Doctors, psychologists, and speech therapists replied.
They listed the tools they use and any training they got on girls’ signs.
What they found
Only one in six said they use checklists made for girls.
Most admitted they had zero training on how autism looks different in females.
Many still rely on the same forms built for boys.
How this fits with other research
Beaulieu et al. (2019) found the same gap in cultural training: most BCBAs want it, few get it.
Topaz et al. (2026) looks like a clash but isn’t. They show AFAB autistic teens later hit barriers to gender care. C et al. show the first barrier—missed diagnosis—so the two papers trace one pipeline of care gaps.
Wang et al. (2020) add a world view: China also leans on male-normed DSM lists, not gold tools. The problem crosses borders.
Why it matters
If you refer families for autism testing, ask the assessor, “Do you use female-specific tools?” If the answer is no, keep shopping. Early, accurate labels open doors to ABA, peer groups, and self-understanding. Push your state board to add gender-difference modules to licensure courses. One email from a BCBA can start that change.
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02At a glance
03Original abstract
BACKGROUND: Emerging research suggests there may be a distinct female autism phenotype, although females are still diagnosed at a much lower rate than males. To date, no research has examined the assessment practices of health professionals when assessing females for autism. AIMS: This study aimed to identify the training received, level of confidence, and assessment practices specific to assessing females for autism. METHODS AND PROCEDURE: An online survey was completed by 126 health professionals (34 paediatricians, 40 psychologists and 52 speech pathologists) working across Australia. OUTCOMES AND RESULTS: The majority of health professionals received no training that addressed gender differences when assessing for autism, even when controlling for number of years since they completed their studies. Most health professionals reported using similar assessment practices when assessing and diagnosing males and females for autism; only 18.2 % reported using female-specific assessment measures. CONCLUSIONS AND IMPLICATIONS: Suggestions for the lack of difference in assessment measures used across genders are discussed. Potential for including measures that may be more sensitive to the presentation of autism in females in health professional's assessment practices is identified. The high proportion of health professionals engaging in professional development following their clinical training highlights the importance of training opportunities to enhance practitioner understanding and confidence when undertaking assessments for autism in females.
Research in developmental disabilities, 2023 · doi:10.1016/j.ridd.2023.104445