Hull et al. (2017) tried to conceptualize a model of camouflage, and their work reflects emerging qualitative features that may not be transferrable to all females with autism. However, it is a beginning to something more qualifiable when it comes to an understanding of the needs of females with high-functioning autism since autism is a spectrum disorder, and so can the variance of HFA presentation in females. If one has possible indicators, early intervention can reduce the symptoms of autism and improve the long-term prognosis of the individual. Females with HF-ASD can present with having a close friend and have interests in friendship with others, but early signs of autism can include the presence of anxiety coupled with having social difficulties such as making and keeping friendships viable (Tierney, Burns, & Kilbey (2016).
When a female presents with shyness or is more aloof, this can be a subtle indicator of ASD, but these signs can be camouflaged by social conditioning instead of recognizing such behaviour as having considerable difficulties with social communication. While being alone is a typical behaviour demonstrated by males with autism, aloneness can be a by-product of female social rejection due to an individual’s lagging and lacking social skills necessary for relating and communicating with others effectively. The adverse outcomes of aloneness not only generate feelings of anxiety, and worry, but increases the risk for developing depression that stems from being a ‘social misfit’ (Honeybourne, 2015).
Parents may also observe limited social interactions of their daughters with females who are neuro-typical outside of school. This can take the form of restricted phone calls and texts, along with having limited invites to participate in social outings with others that are common with adolescents (Auger, R., 2013). Their children may be subjected to situations that involve more rejection resulting in them engaging in more solitary activities with limited group participation due to inadequate social interactions. Witnessing monologued, one-sided conversations, having trouble initiating and sustaining conversation, and sharing information that does not ‘fit’ the topic of conversation are also potential indicators of social communication challenges (Madenmitz, Sing, Shic, & Koeng, 2017).
Additionally, parents may observe changes in their daughter’s self-care skills whereby their appearance and hygiene practices may be significantly different from other same-aged females, along with wearing clothes that are ‘quirky and odd’ resulting in choices that are not appropriate to those choices of the peer group (Madenmitz, Sing, Shic, & Koeng, 2017).
Having an awareness of possible red flags not only improves the opportunity for earlier diagnosis, but the result is better outcomes with timely access to appropriate interventions and supports at home, in the community, and at school. These interventions are fortified when they are group-based to help with socialization opportunities and enriched when these same group activities allow for females with ASD to interact with NT females.
The more intricate social interactions become, there is an increased demand for processing and having time to respond to the face-paced social communication with peers. These demands increase the complexity of negotiating social relationships, having dramatic impact on increased social isolation, developing depression, and anxiety because these females ‘just do not quite fit in’ (Madenmitz, Sing, Shic, & Koeng, 2017) because the NT females help mentor social skills development and self-care improves through such modeling and interaction for what pro-social. Net gains are improved social-emotional wellbeing and self-confidence.
Tierney, Burns, & Kilbey (2016) postulated that caregivers and educators should look carefully at why social situations are stressful for an individual to sustain so that appropriate evidence-based supports can be used to help a female with HFA increase their accessibility to social relationships with neurotypical female peers. In a school environment, this can look like being on the periphery and social isolation during breaks, which are informal social opportunities for the student. Also, difficulties with group work can elucidate an individual’s core impairment, given their inability to interact socially; use their social skills; compromise, and use self-advocacy skills.