Mental Health and Autism in Girls: Autism Acceptance Month and Identification in Schools

During Autism Acceptance Month, there is increased emphasis on recognising the diverse presentations of autism, including the often-overlooked profile seen in girls. Autism in females is frequently under identified due to subtler social differences, masking behaviours, and diagnostic frameworks historically based on male presentations.

In school settings, autistic girls may appear socially competent but often experience significant internal distress. Masking—through imitation of peers, rehearsed interactions, and suppression of autistic traits—can make difficulties less visible to educators. However, this coping strategy is associated with adverse mental health outcomes, including anxiety, depression, emotional exhaustion, and reduced sense of identity.

Educators and school staff play a key role in early identification. Signs of autism in girls may include:

• Social fatigue or withdrawal after sustained interaction

• Intense but socially typical interests (e.g. books, animals, celebrities)

• Perfectionism and heightened anxiety around performance

• Difficulty maintaining friendships despite apparent social motivation

• Sensory sensitivities (e.g. noise, textures)

• Emotional dysregulation in safe environments (e.g. after school)

  
  

These presentations are often misinterpreted as shyness, anxiety, or behavioural issues, leading to missed or delayed diagnosis.

Autism Acceptance Month provides an opportunity for schools to adopt more inclusive and informed practices. This includes staff training on gender differences in autism, creating environments that reduce pressure to mask, and promoting neurodiversity-affirming approaches.

Improving awareness of how autism presents in girls is essential for both accurate identification and the prevention of secondary mental health difficulties. Schools are a critical setting for recognising early signs and supporting positive outcomes.

Here at Montrose we can support schools to recognise these behaviours by implemntng training and support for SENCO's and teachers as well as providing guidance around assessment refferal pathways.