October 19, 2026
Ratna Fitry/Pixabay
For many women with autism, certain parts of motherhood can be especially challenging, experts say.
Autism spectrum disorder is a developmental and neurological condition that affects how a person interacts and communicates with others. Health experts have a better understanding of the ways autism manifests than they did 30 years ago, but its impact on motherhood remains understudied.
For many women with autism, certain parts of motherhood — like coordinating children's activities or the sensory overload that comes with a busy household — can be especially challenging. And mothers who have never received a proper diagnosis may feel particularly alone in their struggles.
Though the World Health Organization estimates that 1 in 127 people are autistic, women with autistic characteristics often fall through the cracks. The ratio of men to women who receive an autism diagnosis ranges between 3:1 and 4:1. And when women are diagnosed, it is often in adulthood.
A 2024 study found that only 12% of men with autism were diagnosed as adults compared with 25% of women. Another study found women are more likely to be misdiagnosed, because their symptoms often are different than men's and they have a higher rate of medical conditions like anxiety and depression.
Megan Graham, a speech-language pathologist at Boston University, has worked for years with women who received autism diagnoses later in life and notes that autism particularly impacts their relationships with their children. In her book, "When Your Mom Is Autistic: A Guide to Understanding, Accepting, and Appreciating Your Autistic Mother," she writes that her goal is to help adult children better understand their autistic mothers.
Many children grow up knowing that their mother is a little different from other mothers, she writes, but not knowing exactly how or why. Or they might question their mother's love for them because she wasn't as physically affectionate as they needed her to be while growing up.
Graham, as well as Bari Keller, executive director of The Center for Autism, and Melanie Levitt, senior psychologist at The Center for Autism, spoke with PhillyVoice recently about how the ways women experience autism differ from men.
When diagnosing autism, they explained, there are three main areas that healthcare professionals examine: social interactions, communication and restrictive or repetitive behaviors. Challenges in these areas must be experienced throughout the person's life. Autism is not an acquired condition.
Difficulties with social interactions include struggling to maintain typical back-and-forth in conversations or a failure to adjust behavior or language to different social contexts. A person with autism also may have difficulty using or understanding facial expressions and body language.
Repetitive behaviors include strict daily routines involving the same activities and meals, repetitive motor movements like lining objects up in order or rocking back and forth, and distress when small changes occur. Some people with autism also have sensory issues like heightened sensitivity to noises and light.
Keller emphasized that not every person with autism looks the same. Popular media portrayals of people with autism — like in the television show "The Big Bang Theory" and the film "Rain Man" — offer only a glimpse and not a full picture. Autism is truly a spectrum.
Though some people may need a lot of support, others need very little. There is no one-size-fits-all.
"It is a very nuanced diagnosis," Keller said. "We should not categorize all people with autism in one box. Sometimes people think that autistic people don't have an innate desire for communication. They do — they just express it differently."
Added Levitt: "The differences can be subtle. Like they interact with people, but they interact the same way with everyone, or they only like reading on one topic. Inflexibility can be a subtle red flag."
Subtler symptoms can lead to a later diagnosis in men and women, but they occur more frequently in women.
With women, Keller said, sometimes a repetitive interest is in a topic considered neurotypical — like mental health — and so it might not be picked up on.
Keller and Levitt said they often see parents come in for a diagnosis after their children are diagnosed, recognizing some of the same patterns or behaviors in themselves.
"Most research is rooted in male presentation, which tends to be outward, so it can easily be missed in females," Graham said. "Also, females tend to learn early how to mask their autistic characteristics, so it is not as apparent. They may parallel play and look like other girls but just not engage in the same way."
Masking allows them to more easily blend into neurotypical society, and women tend to do this more than men — often without realizing they are doing it, research shows.
"There is more awareness in doctors today of the gender differences, and more females are being diagnosed at a younger age," Graham said, "but there are still older women today who didn't receive a diagnosis until adulthood."
The women she works with at the speech-language clinic at Boston University are ages 30 to 60. They all were diagnosed with autism later in life.
Many children of mothers with autism describe their moms as loving, but often overwhelmed, Graham said.
People with autism can have difficulty accessing the executive functioning skills needed for planning, time management and the ability to quickly switch tasks — all of which are especially important in motherhood, she said.
Think about the planning needed to get kids ready to return to school in the fall. Or the steps needed to make dinner each night for the family: choosing a recipe, making a list of ingredients and, of course, the shopping and cooking.
For a mother with autism, these tasks can take more energy to perform.
Another role of motherhood is scheduling activities and playdates. But when large groups of people and busy environments drain one's social battery quickly, it can be hard to keep up with all the social expectations of mothers, Graham said.
Masking constantly can be physically and mentally taxing and can lead to stress, anxiety and burnout.
Levitt said there can be added stress to parenthood when living with autism. When women often experience sensory overload and need time and space to recover, they may feel guilty.
In her book, Graham focuses on helping adult children better understand their autistic mothers.
"Leading with curiosity seems so basic, but it's true. We often misunderstand people through our own lens," she said. "We need to ask ourselves, why is my way of communicating the best way?"
But how can people start that conversation with their mothers?
"In my experience with autistic people, they are direct communicators," Graham said. "I would say, 'I've been reading a lot about the presentation of autism in women. Do you know much about this?'"
Keller said there needs to be some readiness for the conversation and that there must be no fear of retribution.
"The approach needs to be specific to each family," Keller said. "It is complicated. There is no one right approach. Their upbringing and their relationship with their family are all factors."
If someone recognizes autistic behaviors or patterns in their mother, but she has never been diagnosed with autism, it is easy to wonder whether she should be encouraged to get evaluated. But it is important to remember that seeking a diagnosis is a personal choice, the experts said. For some women, it can help with their identities and offer a sense of community. Others may not need it.
If people who are looking to better understand their mother's experience of motherhood and how it might differ from the memories of their childhood, Graham offered several strategies:
• Use "both/and" thinking to validate your own feelings about childhood and your mother. For example, your mother may love you very much, but at the same time you might have felt a lack of love growing up, because she wasn't always physically affectionate. Both can be true.
• Recognize that communication is a two-way street and that both people are responsible for finding a better way to communicate with each other. For instance, people may not realize that their mothers express love through acts of service than physical touch until asking.
• If your mom is uncomfortable in large, noisy crowds because of sensory overload, try to find ways to spend time with her in settings that are comfortable for everyone. If you know your mom won't be comfortable at a large family gathering, plan on spending time with her one-on-one instead.
Some of the communication and sensory issues that people with autism experience are not exclusive to autism, the experts said. Mothers and children with personality mismatches or different love languages can have similar disconnects — and can benefit from open conversations, too.
