red-woman-girl-brown

Autism—It’s Different in Girls

Research suggests the disorder often looks different in females, many of whom are being misdiagnosed and missing out on the support they need.

It’s different for girls. We learn to blend in until we cannot blend in any more. The pressure becomes too much and we fall apart. Passing for neurotypical is something that many Aspie women learn – causing anxiety, low self esteem, and more.

Having to “pass” as a neurotypical person says “you are not good enough as you are.” It takes up a lot of energy when our energy is already limited. Things will not change until the world knows we exist.

I can take no credit for the information below – please check out the AMAZING full article on Scientific American by Maia Szalavitz here.

One in 68 children in the U.S. is affected by autism—but new research suggests that current diagnostic methods overlook girls, meaning even more kids may be on the spectrum.

Girls with autism may be harder to diagnose for several reasons, including criteria developed specifically around males and overlapping diagnoses such as obsessive-compulsive disorder or anorexia.

In 2014 psychologist Thomas Frazier of the Cleveland Clinic and his colleagues assessed 2,418 autistic children, 304 of them girls. They, too, found that girls with the diagnosis were more likely to have low IQs and extreme behavior problems. The girls also had fewer (or perhaps less obvious) signs of “restricted interests”—intense fixations on a particular subject such as dinosaurs or Disney films. These interests are often a key diagnostic factor on the less severe end of the spectrum, but the examples used in diagnosis often involve stereotypically “male” interests, such as train timetables and numbers. In other words, Frazier had found further evidence that girls are being missed. And a 2013 study showed that, like Frances, girls typically receive their autism diagnoses later than boys do.

Girls may have a greater ability to hide their symptoms. “If you were just judging on the basis of external behavior, you might not really notice that there’s anything different about this person,” says University of Cambridge developmental psychopathologist Simon Baron-Cohen. “It relies much more on getting under the surface and listening to the experiences they’re having rather than how they present themselves to the world.”

 

Lots more GREAT information in the full article here.

 

Related post on AnonymouslyAutistic.net Anonymously Autistic – One of Many Invisible Women on The Spectrum about my own personal experience as an Autistic woman here.

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41 thoughts on “Autism—It’s Different in Girls”

  1. I don’t know. I felt like the research was kind of biased…

    But I’m trying really hard to not write an essay on your comment section explaining why I feel that way. lol!

    The short version is… the study ignores the fact that society naturally provides support for girls who have autistic symptoms in childhood, and does so in ways that an autistic individual can understand (i.e, telling her blatantly to her face how she should behave in order to conform to society’s expectations and often providing support to help her achieve it if she can’t figure it out on her own… e.g., Witness the “makeover” phenomenon…). Or rather, it seems to be portraying this as a problem, rather than an aspect of society that is actually helping these women.

    Men don’t get that because society values men for their ability to be leaders, etc. No one is trying to help boys to conform because that is antithetical to what society wants from boys.

    Just imagine how many times as a woman that strangers explicitly tell you to smile in a given day. (At least, where I live…) Then realize that men /never receive that kind of feedback/. Certainly not from anyone but their mothers or maybe a big sister.

    It’s no wonder that men with autism would have a harder time figuring out what they’re doing wrong, even if they’re actively aware of the issue and are trying to cope. The cues that men need to follow are WAY more subtle.

    Basically, I think the study comes at it from the wrong direction. Instead of looking at why women don’t as often get diagnosed with high-functioning autism, perhaps they ought to be looking at why men /are/ and figure out how society is failing those men.

    But I don’t know. I also kind of feel like the idea that calling a passion for something a clinical symptom is inherently flawed, in the first place.

    But maybe that’s just my opinion. I have a lot of dumb ideas so this might be one of them. 🙂 It’s just my initial reaction.

    Liked by 1 person

    1. Thank you so much for sharing your thoughts. Always happy to have good discussions.regardless of the reasons why – the important thing is that we figure out how to identify these girls earlier because many of us suffer alone wondering why we can’t naturally fit in. We learn to pass in society as normal but “passing” is not healthy. We don’t need to try to make Autistic kids look like normal kids. . . It’s like telling a fish he is stupid because he can’t easily run on land. We are almost our own species.

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      1. Well, that’s understandable. And I definitely feel like people need to learn to understand themselves, and that’s difficult to do if you don’t see yourself reflected in any of the people around you… (This being especially true for children.)

        But currently, I haven’t seen a lot of evidence that psychiatry does any better at handling people with high-functioning autism than social support systems do. It seems to me that what they do is slap a label on them that stigmatizes them and makes them feel “other” and then they just kind of… shrug and say “Now what?” 😛

        Maybe they should look inward at themselves and their research processes before they look for even more people to diagnose. (And I say this as someone with an inside perspective on how psychiatric research is carried out. It is mostly deeply problematic for so, so many reasons.)

        Personally, I think we should start looking at the society that feels like you have to have a label for what you are before it is deemed worth of respect and belief. Perhaps if people just believed other people when they describe their experiences, things would be a lot easier for everyone.

        Liked by 1 person

        1. Thanks again for your insight. You mentioned that psychologists label kids as “other” or different and this is harmful. There is something that most Autistics agree on – without being labeled or even diagnosed we almost ALWAYS feel like we are difficult or other than the rest of the world. We wonder why we are always confused in social situations. We realize that we have problems with working memory and executive functioning and think that we are defective because we don’t know that there are others like us in the world. We often feel lost and alone until we discovered that all of these things are not weird IF you are an Aspie.

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          1. Haha, personally I think we need to stop teaching children that “weird” is an insult. 🙂 But I get where you’re coming from on the “feeling like an outsider” thing.

            When I was a kid, my aunt once asked me which character in Animorphs that I would want to be. I told her Tobias, and she got the most stricken look, and replied, “Oh sweetie, that’s so sad.” 😄 She meant well, but totally missed what was going on with me entirely. lol!

            I think the theory of psychiatry is wonderful. People should be able to get help when they need it and I’m super stoked for anyone who finds help there. I think I’m just jaded because they failed me so catastrophically. 🙂

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        2. I agree that Autism should not be pathologized the way it is BUT there are almost always comorbids that need to be addressed – like sensory processing disorder. My disabilities are almost all invisible but Autism also is at the root of all my strengths.

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  2. Most studies of diagnosis seem heavily “male orientated.” Females to me always seem extroverted and like they have it together, lets face it MEN the ladies are masters of keeping things “looking under control,” when shi/ finally goes down though, watch out!

    Personally I think its in the beauty of ladies, they look beautiful and usually hold themselves up quite well, with that, it is difficult to spot the statistic in the room.

    Liked by 1 person

  3. Thanks so much for the follow Anna! Your blog is interesting too! I hope you enjoy reading my posts. And let’s be honest… We’re all a bit autistic! 🙂 x

    Liked by 1 person

  4. You talked about our medical system being flawed. I think it is for anyone without mainstream abilities. Many doctors will tell someone whose child is Deaf the news like it’s bad news, and the same for any different ability set. This is why we have to work toward educating those who deliver our diagnoses first. They are the first point of contact. If their message is doom and gloom, parents are less likely to embrace their child’s individuality. Doctors, hospitals, clinics, etc. need to be held accountable, and further educated to have greater awareness about the intersection between society and ability.

    This article you discussed was very interesting. I kept wondering if the differences might stem from how a woman’s brain works, usually, which is making more connections between different parts of the brain.

    Not saying one way of brain processing is superior to the other, because there is value in different ways of approaching thought processes.

    This Psychology Today article discusses it more in detail: https://www.psychologytoday.com/blog/hope-relationships/201402/brain-differences-between-genders

    I’ve guessed this has to do with having children, since it’s traditionally been more important for women to multi-task with small children around.

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  5. My perspective on this is a bit different in that I am a Parent of someone on the Spectrum who was diagnosed as “PDD-NOS” (Pervasive Developmental Disorder Not Otherwise Specified, aka “atypical autism”) and we got such a “label” for our son when he was still a preschooler. He also had many other issues that were primarily medical in nature and during key points of his life these medical needs really took preeminence (2 open heart surgeries, brain tumor, liver transplant, etc).

    Our seemingly biggest challenge overall was in getting the educational system to even pretend to address his Actual Needs. We had years of frustration where they absolutely refused to acknowledge his autism diagnosis (in fact they never officially Did recognize that he was on the Spectrum, though his last Special Ed Case Manager did admit the obviousness of his Autism in private conversations with me). The school system was extremely derelict in its legally mandated duties to my son and we dealt with significant frustrations in this arena for the duration of his public schooling, K-12 (ironically special ed preschool did a Great Job with him, so our frustration was mightily increased by the torments that followed).

    One extremely important aspect of special education law (in the US) involves Transition Planning & Services that are required to begin no later than the year the student is to turn 16. These services are to be tailored to the individual needs of the student and should be designed to facilitate their Transition from public school to Independent Living, Post-Secondary Education, and Employment. The ideals of this approach are laid out in detail in US law (IDEA, the Individuals with Disabilities Education Act & its later “improvement”), but our experience, and likely that of many others, reveals how far short of the legal mandates/standard things are…let alone compared to what should be “ideal” (as in identifying and addressing All areas of known or suspected disability, regardless of diagnostic “labeling”)…My son was “graduated” from high school not even possessing 3rd grade math skills and his now denied Michigan’s through age 26 special education because he “graduated”. I have a cousin with two autistic sons in Arkansas and her older son also “graduated” but struggled so significantly in college that she got him tested and discovered that his reading was only at grade school level even though he had a “diploma”. I don’t know how much she fought for him educationally but I know to what incredible lengths I went to over the years all to virtually no avail…

    My son’s Primary Care Doctor, who has a practice devoted to complex special needs kids & families, including a significant cohort on the Autism Spectrum shared a chilling perspective. She said that the “high-functioning” autistic kids, like my son is now (he’s been significantly lower functioning when younger) are not coming close to having their needs met here in Michigan. If they are high enough functioning to be included in regular academic settings then often their “independent living” or functional “life skills” needs often go unaddressed. Once they get out of high school they discover that “the adult services industry” is woefully inadequately prepared to address so many of their needs. Also, because the many systems are so poorly managed and financially irresponsible and/or overburdened many times kids with significant needs do not come close to getting their needs met at any point…

    Given that the “higher functioning” autistic kids are probably the ones most likely to be able to “handle it” to some degree in the regular/normal/neuro-typical world it would certainly seem in society’s best interest to help give them the tools and support necessary to foster their highest level of independence while young and thereby ensure a likely increasing percentage of such kids will grow into (nearly) independent adults. This would mean the possibility of significant resource allocation during the earlier years developmentally but should hopefully result in many more of these kids not needing nearly so much public support as they likely would otherwise had such intervention not have been provided. The arguments for early and intensive intervention for Autistic Spectrum kids have surely now made that perspective widely accepted and hopefully there has been sufficient time for data gathering to bolster this view “scientifically”.

    In our family’s case, we spent many years and uncountable mental, emotional, spiritual, and financial capital attempting to get our local school system to DO THEIR LEGALLY MANDATED JOB…and these requests were based on data, diagnoses, and clear evidence of myriad needs (many in keeping with autism spectrum issues)…however the real bottom line was that my son got virtually Only what the school felt like offering whether it directly addressed his needs or not. And since they absolutely refused to acknowledge or address his Autism Spectrum issues (which were known as early as 2000 and had written behavioral pediatrician’s orders) he was significantly negatively impacted by not having received these necessary (and technically IDEA mandated) services.

    The cost to our family (we had four kids within four years) was/is truly incalculable. I’m not “blaming” the school for all the issues, but had they done their job there are so many things that would have gone differently. For instance my son required significant therapeutic intervention, especially when he was younger, so we would take him to PT (Physical Therapy), OT (Occupational Therapy), SLT (Speech & Language Therapy), Sensory Integration Therapy, Music Therapy (which I tried for years to get the school to provide to assist in re-mediating his Severe Learning Disability in Math), Art Therapy, Psychological Therapy, Visual Therapy, etc…We spent so much of what should have been family free time shuffling him to and from these visits and when I finally stepped back from it one year due to personal overload and burnout basically watched him deteriorate before my eyes. He should have had year round intensive intervention provided by the school but they absolutely refused to analyze or address his very real needs and declines. I actually ended up dragging all my kids to random Vacation Bible Schools over a few consecutive summers just to try to give my Special Needs Son some degree of educational structure (and all the other kids really came to resent this as they got to attend these nearby VBS’s along with their brother). There were a few years when being out of school got so upsetting for my son that he lost his toileting skills…but they immediately returned when school began. This level of distress did not concern school staff at all but it caused significant suffering for my son…and the rest of us.

    Well, this obviously went on Way Longer than I intended it to. I’m so glad you are putting your voice out there and speaking up on behalf of yourself and others who may not choose to speak but whose experiences and perspectives resonate with yours. My son has come such a long way from those virtually non-verbal and overwhelming sensory distress days to having discovered himself and continuing to refine his own unique voice. Although “movie quoting” and verbatim dialogue still punctuate much of his communication he can at least now speak as himself so much more freely now than ever before.

    Loving someone with autism and living with someone on the Spectrum can certainly be a challenge (and I won’t minimize the major hardships of our personal journey historically &/or presently) but it also presents a tremendous amount of joy as well. Our “special” son is really the heart of our family in so many ways. He is a constant source of entertainment and his humor is so random that it continues to surprise and amaze us all, which is a huge blessing and counterpoint to the stressors. However he also represents a personal bridge between this world and the Kingdom of God (he is a very strong & outspoken Christian)…he has seen the Face of God while undergoing his Liver Transplant and (similarly to his dad) can have a nearly conversational relationship with the Lord. I really believe that his “autism” facilitates this transparency. Just as he doesn’t know how to put a “mask” on in his human relationships, he is virtually incapable of having a barrier between himself and God. Witnessing his Christian Walk is both humbling & encouraging for those who live with him. If he struggles to talk with us earthlings there is no communication barrier with his Heavenly Father…and that is a gift that no “labeling” nor lack of supports could ever diminish!

    Blessings, thanks for all you shared, and thanks for letting me “wax eloquent” too here.

    Best Regards, Valerie Curren

    PS, I wrote more thoughts on your article at my blog here…I’d love to hear back from you on that, if you might be interested…

    https://specialconnections.wordpress.com/2016/10/11/commenting-on-autism-its-different-in-girls-so-is-adhd/

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  6. I just listened to a very interesting audiobook “Blink”, that discusses the accuracy of first impressions. In the second half of the book, the author describes how under pressure anyone can become a bit autistic. It describes cases of cops who shot innocent people because of wrong impressions that they had to judge in a split second. Whereas, it they took a little more time, they were more likely to make the right decision. Very interesting.

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    1. Frankly, I don’t link “Blink” and don’t think the author offers the best explanation for police shootings.

      I did some research and posted a blog on this several weeks ago (Crain’s Comments on WordPress). Concussions impact thinking and reflexes. In one recent police shooting, the victim was a concussion patient who simply couldn’t respond to orders as quickly as the cops wanted. However, cops also endure concussions on the job for which they may not be treated, and which can impair their reflexes and decision-making ability. In fact, the Seattle PD identified a concussion an officer had suffered as the reason for one shooting. The cop with a concussion can look at a suspect and mistake a book for a gun. That’s a problem. Departments need to be more rigorous with training and more aggressive in taking people off the street when they are hurt to allow adequate time for recovery. They don’t want to do that for budget and other reasons, but it just has to happen.

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  7. Oh surprise, yet another category of studies that show boys have something and girls don’t.
    PS, most girls are socialized out of showing that the have ADHD so obviously they don’t need meds, right? RIGHT? Because everything is just fine, right?

    Liked by 1 person

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