Sunday, October 2, 2022

Autism Spectrum In Women

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Extreme Male Brain Theory

Girls and Women with Autism Spectrum Disorder

Simon Baron-Cohen’s extreme male brain theory states that autistic males have higher doses of prenatal testosterone and on average have a more systemising brain, as opposed to the more empathising female brain. He suggests that autistic brains show an exaggeration of the features associated with male brains. These are mainly size and connectivity, with males generally having a larger brain, which is seen in an exaggerated form in those with ASD. Individuals with ASD were found to have widespread abnormalities in interconnectivity in specific brain regions. This could explain the different results on empathy tests between men and women as well as the deficiencies in empathy seen in ASD, as empathy requires several brain regions to be activated which need information from many different areas of the brain. Baron-Cohen therefore argues that genetic factors play a role in autism prevalence and that children with technically minded parents are more likely to be diagnosed with autism.

Autistic Girls Pass At Least For A While

Another reason girls may not be diagnosed is because theyre able to pass.

Girls tend to get by, Dr. Epstein says. They might not understand whats going on but theyll try to just go along and imitate what they see. And they may get away with it to third grade or fifth grade, but once they get to junior high and high school, it shows as a problem.

This has been the case for Lisa, now 13. Melissa says of her daughter, She is less mature than her typical peers, and girls are so intricate in how they behave socially. Its very difficult for her to maintain friendships because of this and, let me tell you, 13-year-old girls are not very accepting of someone different.

Understanding Autism In Women

Autism is rarer in females than in males. In fact, one major researcher in the field, Simon Baron-Cohen, wrote that autism is a manifestation of the extreme male brain.

There does seem to be a real difference in the number of females who are actually diagnosed with autism versus the number of males. But this so-called “female protective effect” is still being explored.

In recent years, it has become clear that autism is underdiagnosed in females. There are a number of reasons for this:

  • Girls are more likely to internalize anxiety related to autism instead of behaving aggressively, they are more likely to become depressed or anti-social.
  • Most cultures make it acceptable for girls to be “shy” whereas shyness is less acceptable in boys.
  • When girls with autism focus exclusively on a particular interest, they are more likely than boys to choose a socially acceptable fascination such as unicorns or dolls.

Because fewer females have autism, fewer females with autism have been included in studies. More attention is now being paid to how autism manifests in females.

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Adhd Vs Autism: Similarities And Differences

Autistic women and women with ADHD can share the following traits:

ADHD is diagnosed when a patient has symptoms of inattentiveness, hyperactivity, and/or impulsivity. For an ASD diagnosis, however, the patient must have clinically significant difficulty with social interaction or communication, and unusually restricted or repetitive patterns of behavior or interests. In fact, many autistic people have a special interest a topic or subject that they are heavily invested in and are more knowledgeable about than most.

Autistic individuals are also more likely to have sensory processing disorder, discomfort making/maintaining eye contact, and hyper-logical methods of thinking, with a tendency to be extremely literal.

The Developmental Profile Of Girls And Women With Autism

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Early Childhood

Clinical experience and parental reports indicate that girls who have autism have greater social motivation and engagement than their male peers. However, a characteristic of the girl with autism when playing with her peers is a tendency to be overly dominant and controlling or to be attracted to other girls with strong personalities who tell her what to do . Parents often report that she is indiscriminate and excessive when expressing affection or extremely reticent or uncomfortable expressing affection, even with family members. Parents also describe extreme emotional meltdowns in particular situations, such as having to cope with a change in expectations or in response to specific sensory experiences . The despair and agitation are intense, and parents are often unable to distract or console the child.

In contrast, some girls avidly observe other girls playing and socializing and may copy or clone themselves after other girls, borrowing their gestures and phrases to achieve the social abilities needed when playing with peers . The child may imitate gestures, facial expressions, and phrases, which are reenacted and rehearsed when she is alone. Parents may notice that she is more animated when imitating and engaging with her peers than when engaged with family members.

Early School Years

High School Years

The Adult Years

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Autism Symptoms In Women

Autism Spectrum Disorder is observed differently in women compared to men. Although there is a lack of scientific research in this area, it is known that this is the case in practice. Thats why its important to know what these differences are. You can understand better when there is a woman with autism around you. Although it is a complex subject, it is useful to know.

Although men and women seem to be equal in many aspects of life, unfortunately, the situation is not the same when it comes to body and health. It can even cause great grievances if it is seen as equal. For this reason, male and female bodies should not be considered equal in terms of health. Autism is exactly one of these disorders. It would be misleading to think that men and women should be observed equally.

Appropriate Support Throughout Schooling

Ideally, Sophie would have been diagnosed as a child. She could have benefited from specialised support throughout her schooling, as is legally required in France and other countries. This support would have made her less vulnerable, giving her the tools to defend herself from bullying in the schoolyard and helping her learn with teaching methods adapted to her way of thinking. Upon leaving school, her diagnosis would have opened up access to labour rights, such as disabled worker status, which would have helped her find an adapted employment. Sophies life would have been simpler and she would be more at peace with herself.

But Sophies problems are twofold. Not only is she autistic, but shes also a woman. If getting a diagnosis is already tricky for men, its even more difficult for women. Originally, autism was thought to only rarely affect women. This erroneous idea, which emerged from a 1943 study conducted by Léo Kanner , has been reinforced by the long-dominant psychoanalytical approach. The criteria defining autistic symptoms were based on observations in boys.

Later, when science replaced psychoanalysis as the dominant model, studies were largely conducted on male children, thus reducing the chances of recognising autism as its manifested in females. This phenomenon, also present in other areas of science and medicine, has far-reaching implications today.

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Acting Submissive In Social Situations

This is a behavior that women in general are socialized to exhibit, but for those who have trouble figuring out how to behave in social situations, it may actually serve a dual purpose as a compensatory strategy.

“Being shy and averting your eye gaze when someone speaks to you is more acceptable for females than males in our society,” says Oswald. “At the end of the day, its OK to be shy and polite because youre a girl, and so the potential autism traits get missed.”

What Does The Care Continuum Look Like For Girls

Understanding the Lived Experiences of Women with Autism

The care continuum is a concept that illustrates how treatment, intervention and other types of care dont end when a person leaves a clinical space. Care for an individual must persist beyond the therapists walls and work effectively to turn all spaces into safe spaces.

The continuity of care is necessary across all environments to make sure that youre able to support the individual in all settings that theyre participating, Johnson said.

Everyone benefits when more people are informed about the autism community that means including and understanding the needs of women and girls on the spectrum. It starts with educating a community, which includes the following:

  • Immediate and extended family
  • Parents of friends and neighbors
  • Teachers and advocates at school
  • Colleagues and employers
  • Law enforcement and social authorities

For example, Johnson described a high school student with ASD who was keenly interested in romantic comedies and would perform the same behaviors she saw in those movies, namely writing love letters to boys at school. The crucial component to this intervention was educating classmates about how to respond in a nurturing way. Some students did not want to hurt her feelings, so I think they inadvertently kind of reinforced some of it, Johnson said.

Johnson used the A-B-C intervention method to extend the care continuum to others in the community, such as a school setting:

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Behavioral Traits Of Girls With Autism

According to the Simons Foundation Powering Autism Research for Knowledge , girls may present similar ASD-related traits as their male counterparts, but because of societal and gender norms, people may overlook these characteristics in girls or feel less of a need to begin a behavioral intervention.

Some of those traits include the following:

  • Shyness
  • Likely to mimic others in social situations
  • Appearing calmer in school or social situations than at home

Its important to look at the whole person and make sure that youre going back to a qualified professional who is able to diagnose that for you,said Kristy Johnson, an adjunct faculty member at Simmons University who works in a public school district as a behavior analyst for students.

Autism In Women: Why Its Different And What To Look Out For

In many areas of life, and particularly healthcare, men are seen as the standard and women suffer as a result as it is assumed female bodies function in the same way. We know that heart attacks and strokes, for example, present differently in women than they do men and this gap in knowledge can have devastating consequences for women.

Autism or Autism Spectrum Disorder is similar in that many studies have shown that autism presents differently in women than it does men. Sadly, as with many womens issues, there is a stark lack of scientific research in this area. However, we think it is important to outline what we do know about autism in females so that youre better able to spot signs of autism either in yourself or others. This is an extremely nuanced and complex topic and we encourage further research on everything we will briefly mention in this introductory article.

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Autistic Women And Autistic Girls

In recent years, questions have been raised about the ratio of males to females diagnosed as having an autism spectrum disorder . Overall the most recent studies suggest that the prevalence of autism spectrum disorder is about one in 100, but what of the male/female ratio?

There is no hard evidence of numbers. Various studies, together with anecdotal evidence, have come up with male/female ratios ranging from 2:1 to 16:1. Whatever the true ratio, clinical referrals to a specialist diagnostic centre have seen a steady increase in the number of girls and women referred. Because of the male gender bias, girls are less likely to be identified with ASD, even when their symptoms are equally severe. Many girls are never referred for diagnosis and are missed from the statistics. Emphasis is placed on the different manifestations of behaviour in autism spectrum conditions as seen in girls and women compared with boys and men.

The different way in which girls and women present under the following headings have been identified below social understanding, social communication, social imagination which is highly associated with routines, rituals and special interests. Some examples are:

The presence of repetitive behaviour and special interests is part of the diagnostic criteria for an autism spectrum disorder. This is a crucial area in which the male stereotype of autism has clouded the issue in diagnosing girls and women.

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How Can We Better Support Women With Autism

More Adult Women Being Diagnosed With Autism

The lack of diagnosis and representation for women and girls with autism can prolong suffering and be confusing for many. Better support is needed for women with autism, both clinically and in their communities, Earl notes. Amplifying the voices of autistic girls and women is critical to understanding the female experience of autism and tailoring support and resources.

The most important thing we can do is to listen, respect, and believe girls and women. If she says, I think I might be autistic, I hope her doctor, therapist, family, or friends will take a moment to consider that, Marsh says. If you or a loved one seek resources dedicated to helping women with autism there are many options available. The Autistic Women and Nonbinary Network is an organization dedicated to providing support, community, and resources for women and gender-nonconforming with autism. There is also an abundance of literature available that offers insight in the experience of women with autism, like Women and Girls with Autism Spectrum Disorder and Thinking in Pictures: My Life with Autism.

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The Stages In Camouflaging Autism

Research and clinical experience suggest a three-stage model of the camouflaging process . In the first stage, there is motivation to be successful socially and to develop friendships. The second stage is to acquire the ability to camouflage social confusion, social immaturity, and a delay in social reasoning. This is achieved by masking and compensation strategies. The third stage is short- and long-term consequences, including delaying a diagnostic assessment, access to appropriate support and understanding, and subsequent mood and psychological disorders.

We now have a questionnaire to explore whether a person engages in camouflaging in social situations . The Camouflaging Autistic Traits Questionnaire was developed from discussing aspects of camouflaging with adults who have autism describing their experiences. Exploratory factor analysis suggests three factors with the questionnaire, namely compensation, masking, and assimilation.

Is There A Test For Autism In Women

Theres no medical test that can diagnose autism. It can be a difficult process that often requires visiting several types of doctors.

If you believe your child could be on the autism spectrum, make an appointment with their doctor. Depending on your childs symptoms, their doctor may refer them to a child psychologist or pediatric neurologist.

If you suspect that you may have undiagnosed autism, start by talking to your primary care doctor. A psychologist can also help you evaluate your symptoms and rule out other potential causes. Learn more about the process of working with a doctor to get an autism diagnosis.

Autism can be very hard to diagnose in adults. You may need to visit a few doctors before you find one who understands your symptoms and concerns.

If possible, try to ask close family members about any potential signs or symptoms you might have displayed as a child. This can help to give your doctor a better idea of your childhood development.

Throughout the process, remember that you are your most important advocate. If you feel your doctor isnt taking your concerns seriously, speak up or get a second opinion. Seeking a second opinion is common, and you shouldnt feel uncomfortable doing so.

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Autism Differences In Women

Because autism in women is so misunderstood, they often go years without being diagnosed or receive misdiagnoses like Bipolar Disorder.

This misdiagnosis means many women end up taking medication that does not help them, leaving them feeling frustrated and helpless.

Many of these women have always felt different, felt like theyve had to try extra hard in social situations, or avoided them altogether. They may be used to concealing their traits, and dont match the general stereotype of what people believe autism looks like.

Because of the societal expectations for girls and women, female teens with autism may have worked extra hard to adapt and be seen as normal, making diagnosis even more complicated. Growing up, they may have opted for solitude and focused on their hobbies, prioritized comfort over fashion, fantasizing or escaping from reality, were mute in certain situations, and had a special interest or aptitude for specific subjects.

Why Is This Blog About Autism In Women Important

Understanding Women and Girls on the Autism Spectrum

As we have discussed, autism in women is highly misunderstood so it is necessary to raise awareness about how women and girls get to experience autism and how we can put the stereotype of autism being thought to be more common in men and boys when it is important to take into consideration that autism in women goes undetected due to their ability to mask their difficulties.

Being a woman is already perceived as hard but being a woman and having autism is even harder so being more empathetic and sensitive about a girl or a woman suffering from autism can make a difference to them.

Please feel free to comment in the comments section below!

Side Note: I have tried and tested various products and services to help with my anxiety and depression. See my top recommendations here, as well as a full list of all products and services our team has tested for various mental health conditions and general wellness.

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What Causes Autism In Women

Experts arent sure what causes autism. Given the wide range of symptoms and severity, autism is likely caused by several factors, including genetics and environmental factors.

While theres no evidence that the exact cause of autism is different between the sexes, some experts suggest that boys are at a higher chance of developing it.

For example, investigators believe that girls might be born with genetic protective factors that reduce their chance of autism.

Theres also an emerging theory called the extreme male brain theory. Its based on the idea that fetal exposure to high levels of male hormones in the uterus might affect brain development.

As a result, a childs mind might focus more on understanding and categorizing objects, traits that are generally associated with the male brain. This is in contrast to empathizing and socializing, which are more often associated with female brains.

The effect of hormones on brain development isnt well known yet, giving this theory some major limitations. Still, its a start toward understanding how autism develops and why it appears more in boys than girls.

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