Gender Disparities in the Identification of Special Educational Needs: Evidence, Diagnostic Bias, and Implications for Inclusive Education

Authors

Keywords:

Diagnostic Bias, Gender Disparities, Inclusive Education, Neurodevelopmental Conditions, Referral, Special Educational Needs

Abstract

Boys are identified with special educational needs more often than girls across several diagnostic categories. Yet these recorded differences cannot be assumed to represent equivalent differences in underlying prevalence. This structured narrative review draws on research published between 2016 and 2026 to examine gender patterns in the identification of ADHD, autism, specific learning disorders, developmental language disorder, intellectual disability, and emotional and behavioural difficulties. It considers prevalence estimates alongside evidence from referral practices, clinical assessment, school identification, and first-person accounts of delayed diagnosis. The findings vary across conditions, but a recurring pattern is evident. Difficulties that disrupt classroom activity or produce conspicuous academic failure are more likely to prompt assessment, whereas inattention, anxiety, social withdrawal, compensatory effort, and camouflaging can remain unnoticed. This may increase the visibility of some boys while delaying recognition and support for some girls. At the same time, biological vulnerability and genuine variation in developmental outcomes cannot be excluded, particularly in specific diagnostic groups. The evidence therefore does not support a single explanation for gender disparities or the construction of uniform “male” and “female” profiles. More equitable identification requires developmental history, information from several settings, direct assessment, and attention to the effort learners expend to maintain apparently adequate performance. Educational support should ultimately be guided by functional need rather than by how closely a learner resembles a familiar diagnostic prototype

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

Arnett, A. B., Pennington, B. F., Peterson, R. L., Willcutt, E. G., DeFries, J. C., & Olson, R. K. (2017). Explaining the sex difference in dyslexia. Journal of Child Psychology and Psychiatry, 58(6), 719–727. https://doi.org/10.1111/jcpp.12691

Baethge, C., Goldbeck-Wood, S., & Mertens, S. (2019). SANRA—a scale for the quality assessment of narrative review articles. Research Integrity and Peer Review, 4, Article 5. https://doi.org/10.1186/s41073-019-0064-8

Bargiela, S., Steward, R., & Mandy, W. (2016). The experiences of late-diagnosed women with autism spectrum conditions: An investigation of the female autism phenotype. Journal of Autism and Developmental Disorders, 46(10), 3281–3294. https://doi.org/10.1007/s10803-016-2872-8

Belcher, H. L., Uglik-Marucha, N., Vitoratou, S., Ford, R. M., & Morein-Zamir, S. (2023). Gender bias in autism screening: Measurement invariance of different model frameworks of the Autism Spectrum Quotient. BJPsych Open, 9(5), Article e173. https://doi.org/10.1192/bjo.2023.562

Bishop, D. V. M., Snowling, M. J., Thompson, P. A., Greenhalgh, T., & the CATALISE-2 Consortium. (2017). Phase 2 of CATALISE: A multinational and multidisciplinary Delphi consensus study of problems with language development: Terminology. Journal of Child Psychology and Psychiatry, 58(10), 1068–1080. https://doi.org/10.1111/jcpp.12721

Cage, E., & Troxell-Whitman, Z. (2019). Understanding the reasons, contexts and costs of camouflaging for autistic adults. Journal of Autism and Developmental Disorders, 49(5), 1899–1911. https://doi.org/10.1007/s10803-018-03878-x

Centers for Disease Control and Prevention. (2024). Youth Risk Behavior Survey data summary & trends report: 2013–2023. U.S. Department of Health and Human Services. https://www.cdc.gov/yrbs/dstr/index.html

Centers for Disease Control and Prevention. (2026a, August 20). Data and statistics on children’s mental health. https://www.cdc.gov/children-mental-health/data-research/index.html

Centers for Disease Control and Prevention. (2026b, July 8). Data on ADHD in children. https://www.cdc.gov/adhd/data/index.html

Cook, J., Hull, L., Crane, L., & Mandy, W. (2021). Camouflaging in autism: A systematic review. Clinical Psychology Review, 89, Article 102080. https://doi.org/10.1016/j.cpr.2021.102080

Dean, M., Harwood, R., & Kasari, C. (2017). The art of camouflage: Gender differences in the social behaviors of girls and boys with autism spectrum disorder. Autism, 21(6), 678–689. https://doi.org/10.1177/1362361316671845

Ebbels, S. H., McCartney, E., Slonims, V., Dockrell, J. E., & Norbury, C. F. (2019). Evidence-based pathways to intervention for children with language disorders. International Journal of Language & Communication Disorders, 54(1), 3–19. https://doi.org/10.1111/1460-6984.12387

Giofrè, D., Allen, K., Toffalini, E., Mammarella, I. C., & Caviola, S. (2022). Decoding gender differences: Intellectual profiles of children with specific learning disabilities. Intelligence, 90, Article 101615. https://doi.org/10.1016/j.intell.2021.101615

Holthe, M. E. G., & Langvik, E. (2017). The strives, struggles, and successes of women diagnosed with ADHD as adults. SAGE Open, 7(1), 1–12. https://doi.org/10.1177/2158244017701799

Hull, L., Petrides, K. V., & Mandy, W. (2020). The female autism phenotype and camouflaging: A narrative review. Review Journal of Autism and Developmental Disorders, 7(4), 306–317. https://doi.org/10.1007/s40489-020-00197-9

Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M.-C., & Mandy, W. (2017). “Putting on my best normal”: Social camouflaging in adults with autism spectrum conditions. Journal of Autism and Developmental Disorders, 47(8), 2519–2534. https://doi.org/10.1007/s10803-017-3166-5

Lai, M.-C., Lombardo, M. V., Ruigrok, A. N. V., Chakrabarti, B., Auyeung, B., Szatmari, P., Happé, F., Baron-Cohen, S., & the MRC AIMS Consortium. (2017). Quantifying and exploring camouflaging in men and women with autism. Autism, 21(6), 690–702. https://doi.org/10.1177/1362361316671012

Lockwood Estrin, G., Milner, V., Spain, D., Happé, F., & Colvert, E. (2021). Barriers to autism spectrum disorder diagnosis for young women and girls: A systematic review. Review Journal of Autism and Developmental Disorders, 8(4), 454–470. https://doi.org/10.1007/s40489-020-00225-8

Loomes, R., Hull, L., & Mandy, W. P. L. (2017). What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 56(6), 466–474. https://doi.org/10.1016/j.jaac.2017.03.013

McGregor, K. K. (2020). How we fail children with developmental language disorder. Language, Speech, and Hearing Services in Schools, 51(4), 981–992. https://doi.org/10.1044/2020_LSHSS-20-00003

McKenzie, K., Milton, M., Smith, G., & Ouellette-Kuntz, H. (2016). Systematic review of the prevalence and incidence of intellectual disabilities: Current trends and issues. Current Developmental Disorders Reports, 3(2), 104–115. https://doi.org/10.1007/s40474-016-0085-7

Mowlem, F. D., Rosenqvist, M. A., Martin, J., Lichtenstein, P., Asherson, P., & Larsson, H. (2019). Sex differences in predicting ADHD clinical diagnosis and pharmacological treatment. European Child & Adolescent Psychiatry, 28(4), 481–489. https://doi.org/10.1007/s00787-018-1213-3

National Center for Education Statistics. (2024). Students with disabilities. Condition of Education. U.S. Department of Education, Institute of Education Sciences. https://nces.ed.gov/programs/coe/indicator/cgg/students-disabilities

Norbury, C. F., Gooch, D., Wray, C., Baird, G., Charman, T., Simonoff, E., Vamvakas, G., & Pickles, A. (2016). The impact of nonverbal ability on prevalence and clinical presentation of language disorder: Evidence from a population study. Journal of Child Psychology and Psychiatry, 57(11), 1247–1257. https://doi.org/10.1111/jcpp.12573

Patton, G. C., Sawyer, S. M., Santelli, J. S., Ross, D. A., Afifi, R., Allen, N. B., Arora, M., Azzopardi, P., Baldwin, W., Bonell, C., Kakuma, R., Kennedy, E., Mahon, J., McGovern, T., Mokdad, A. H., Patel, V., Petroni, S., Reavley, N., Taiwo, K., … Viner, R. M. (2016). Our future: A Lancet commission on adolescent health and wellbeing. The Lancet, 387(10036), 2423–2478. https://doi.org/10.1016/S0140-6736(16)00579-1

Ratto, A. B., Kenworthy, L., Yerys, B. E., Bascom, J., Wieckowski, A. T., White, S. W., Wallace, G. L., Pugliese, C., Schultz, R. T., Ollendick, T. H., Scarpa, A., Seese, S., Register-Brown, K., Martin, A., & Anthony, L. G. (2018). What about the girls? Sex-based differences in autistic traits and adaptive skills. Journal of Autism and Developmental Disorders, 48(5), 1698–1711. https://doi.org/10.1007/s10803-017-3413-9

Rynkiewicz, A., Schuller, B., Marchi, E., Piana, S., Camurri, A., Lassalle, A., & Baron-Cohen, S. (2016). An investigation of the “female camouflage effect” in autism using a computerized ADOS-2 and a test of sex/gender differences. Molecular Autism, 7, Article 10. https://doi.org/10.1186/s13229-016-0073-0

Shaw, K. A., Williams, S., Patrick, M. E., Valencia-Prado, M., Durkin, M. S., Howerton, E. M., Ladd-Acosta, C. M., Pas, E. T., Bakian, A. V., Bartholomew, P., Nieves-Muñoz, N., Sidwell, K., Alford, A., Bilder, D. A., DiRienzo, M., Fitzgerald, R. T., Furnier, S. M., Hudson, A. E., Pokoski, O. M., … Maenner, M. J. (2025). Prevalence and early identification of autism spectrum disorder among children aged 4 and 8 years—Autism and Developmental Disabilities Monitoring Network, 16 sites, United States, 2022. MMWR Surveillance Summaries, 74(2), 1–22. https://doi.org/10.15585/mmwr.ss7402a1

Simcoe, S. M., Gilmour, J., Garnett, M. S., Attwood, T., Donovan, C., & Kelly, A. B. (2023). Are there gender-based variations in the presentation of autism amongst female and male children? Journal of Autism and Developmental Disorders, 53(9), 3627–3635. https://doi.org/10.1007/s10803-022-05552-9

Snowling, M. J., Hulme, C., & Nation, K. (2020). Defining and understanding dyslexia: Past, present and future. Oxford Review of Education, 46(4), 501–513. https://doi.org/10.1080/03054985.2020.1765756

Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research, 104, 333–339. https://doi.org/10.1016/j.jbusres.2019.07.039

Tubío-Fungueiriño, M., Cruz, S., Sampaio, A., Carracedo, Á., & Fernández-Prieto, M. (2021). Social camouflaging in females with autism spectrum disorder: A systematic review. Journal of Autism and Developmental Disorders, 51(7), 2190–2199. https://doi.org/10.1007/s10803-020-04695-x

Vasileiou, I. (2026). Enhancing executive functions to improve academic achievement in school-aged children: A systematic review of educational, cognitive, and digital interventions. Journal of Education and Practice, 17(6). https://doi.org/10.7176/JEP/17-6-01

Wood-Downie, H., Wong, B., Kovshoff, H., Mandy, W., Hull, L., & Hadwin, J. A. (2021). Sex/gender differences in camouflaging in children and adolescents with autism. Journal of Autism and Developmental Disorders, 51(4), 1353–1364. https://doi.org/10.1007/s10803-020-04615-z

World Health Organization. (2022). International classification of diseases for mortality and morbidity statistics (11th rev.). https://icd.who.int/

World Health Organization. (2025, September 1). Mental health of adolescents. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health

Young, S., Adamo, N., Ásgeirsdóttir, B. B., Branney, P., Beckett, M., Colley, W., Cubbin, S., Deeley, Q., Farrag, E., Gudjonsson, G., Hill, P., Hollingdale, J., Kilic, O., Lloyd, T., Mason, P., Paliokosta, E., Perecherla, S., Sedgwick, J., Skirrow, C., … Woodhouse, E. (2020). Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/hyperactivity disorder in girls and women. BMC Psychiatry, 20, Article 404. https://doi.org/10.1186/s12888-020-02707-9

Zablotsky, B., Ng, A. E., Black, L. I., & Blumberg, S. J. (2023). Diagnosed developmental disabilities in children aged 3–17 years: United States, 2019–2021. NCHS Data Brief, 473, 1–8. https://www.cdc.gov/nchs/products/databriefs/db473.htm

Downloads

Published

2026-10-09

How to Cite

Gender Disparities in the Identification of Special Educational Needs: Evidence, Diagnostic Bias, and Implications for Inclusive Education. (2026). Journal of Gender, Youth and Social Inclusion, 1(1), 11-27. https://journals.e-palli.com/home/index.php/jgysi/article/view/8630