What Is The Cost Of A Misdiagnosis
Autism can be misdiagnosed as another neuro developmental disorder, like ADHD or a mental health disorder, like borderline personality disorder. This can mean that autistic women and girls can end up having therapies or treatments that are not appropriate for their needs. This can be confusing and harmful in the long term as they struggle to get the right support they need at the right time and can also end up with them feeling misunderstood and potentially traumatised by having the wrong kind of help. The costs of a missed diagnosis are many.
An autism diagnosis can be life changing. It can explain years of feeling different and help unlock educational and employment support. Without a diagnosis autistic people will go through their lives unable to understand who they are and why they seem to struggle with things others seem to take for granted. This can lead to mental health problems such as depression, anxiety or eating disorders.
Why Does Autism Seem More Common In Males
Being female does appear to protect the brain from many developmental disabilities, not just autism. There is emerging evidence that girls with autism need more extreme genetic mutations than boys to develop autism.
However, there is a growing body of work that indicates that autism just presents differently in girls and therefore often goes unrecognised, especially in verbally fluent girls with normal intelligence. Girls with autism also appear to be better at âcamouflagingâ their symptoms in order to fit in.
With the diagnostic criteria for ASD based largely in how autism presents in males, girls can often âslip under the radarâ or get misdiagnosed. Girls with ASD seem to have less restricted and repetitive behaviours than boys, but itâs also possible that some of these behaviours go unrecognised â for example, an obsessive interest in collecting dolls may be misinterpreted as pretend play.
Recognising Autism In Girls
Historically it was thought that women and girls were less likely to be autistic because the research indicated that the numbers of females affected was lower than the number of males when looking at population samples. However, our understanding of autism, as a broader spectrum of strengths and difficulties, has meant that we have become better at recognising autism in women and girls.
Recent research has highlighted the challenges in identifying autism in women and girls. Its now recognised from research, clinical practice and anecdotal reports that many autistic females and other people who demonstrate less obvious autistic traits, often miss out on an autism diagnosis or can be misdiagnosed with other conditions.
The difference is mainly down to the more subtle presentation of autism in women and girls. On average, autistic women and girls tend to be more interested in the social world than autistic boys and men. Some autistic women and girls can feel that they are masking their autism to try and hide the fact that they feel different. They may copy the behaviour of those around them and can be exhausted by the constant effort to fit in. Some may be unaware that they are masking in the first place. This more subtle presentation of autism is also a major barrier to clinicians and other professionals recognising that a girl might need an autism assessment.
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Autistic Women And Girls
More men and boys are currently diagnosed as autistic than women and girls. This is changing slowly but surely, as more women and girls are being diagnosed as autistic.
Attitudes towards autism and gender are changing, although we still have a long way to go. Many autistic women and girls are still struggling to get the support they need.
Here, we explain more about the gender diagnosis gap, share stories from autistic women and girls, and share some theories on why more men and boys are being diagnosed as autistic.
You can also visit our gender page here, where we look at autism and gender identity in more detail.
Awesome Autism Gift Ideas For Christmas
I can think of hundreds of reasons why gift shopping for someone with autism is enough to make you want to call quits on the whole Christmas malarkey. However, given that you have clicked on this article looking for autism gift ideas, its fairly safe to say that you probably have a hundred more.
So instead of giving you the spiel about what makes autism gift buying so difficult, today I thought I would dive straight in at the deep end with my list of 8 great gift ideas, to buy for someone on the spectrum.
Links to the autism gifts featured can be found by clicking the bold titles or any of the text in red.
Starting off todays post is the gift that keeps on giving sensory boxes by My Sensory Crate is a monthly subscription service which brings a variety of new sensory friendly toys straight to your door, each month.
With everything from slime monsters to educational musical instruments, this autism gift is intended for people on the spectrum considered to need a lot of support but from what I have seen online, I believe there is something here to please everyone. Additionally, 10% of all purchases go to the National Autistic Society, so you can feel good whilst giving something great.
Moon Girl and Devil Dinosaur is an all-ages comic book series which, in recent years, has become a favourite of mine. Set in the Marvel universe MG + DD follows Lunella Lafayette, a 10-year-old genius who doesnt understand social norms and struggles to make friends .
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A Difficult Disorder To Pin Down
Autism is not the easiest condition to diagnose.
Unlike some physical health difficulties, we dont have a biomarker for autism, Mandy told Healthline. We dont have blood tests or brain scans. We cant actually see autism itself, so instead we do what people do in all mental health disorders, pretty much. We diagnose it not by looking at the thing itself, but by looking at its manifestation, its size, and its symptoms.
In short, diagnosing autism isnt quite an exact science. The criteria for diagnosing autism includes a group of observable characteristics and behaviors that the medical community has come to a consensus on as representing autism.
Generally speaking, these characteristics come down to difficulties in the realm of social communication and flexibility when it comes to things like switching activities and focus. Other autistic characteristics include sensitivity to outside stimuli like bright lights or loud noises.
Why Are Girls Often Under
There are a number of theories that might explain why more men and boys than women and girls get an autism diagnosis.
These include research that suggests that they present differently, that they are less interested in the stereotypical autistic subjects like trains, maths or tech. Their particular interests for instance being devoted fans of a celebrity or band can easily be taken to be that of any other girl.
This research suggests there is a female autism phenotype, which doesnt fit with the profile usually associated with men and boys on which assessment tools are usually based leading to under diagnosis in women and girls.
Other studies suggest that women and girls are better at masking or camouflaging their difficulties and that autism traits in girls are under-reported by teachers, who are often key to identifying girls at an early stage and referring them on for diagnosis.
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The Cost Of A Missed Diagnosis
Dr. Epstein says undiagnosed autistic girls end up wondering whats wrong with them, which can lead to depression, anxiety and loss of self-esteem. They work so hard to fit in that it wears them out. Thats the thing about imitating, she says. You dont necessarily get it so youre just trying to do what people do. If youre just trying to mimic and you dont really understand, it makes it pretty rough.
Dr. Nash says less severe autism in girls is often first flagged because of these social issues, or the depression they generate. In people we call mildly autistic, there are adolescent social problems or theyre seeming hyperfocused on a topic and not participating in school to their potential or abilities, she says. Depression can be more common among high-functioning kids on the spectrum. So theyll come in for something like depression or poor school performance. Then it becomes more clear to me that they have a restricted interest and social communication issues.
Another cost of being overlooked is missing out on early support for skill-building. We talk about early intervention, Dr. Epstein says. When the girls are identified late, theyve missed out on a lot of social interventions that are much harder later. Thats the danger for anybody who gets a late diagnosis.
What Does Autism Look Like In Girls
Although every child with autism is different, here are some common characteristics in girls with autism:
- A special interest in animals, music, art, and literature
- A strong imagination
- A desire to arrange and organise objects
- Not wanting to play cooperatively with female peers
- A tendency to âmimicâ others in social situations in order to blend in
- An ability to hold their emotions in check at school, but be prone to meltdowns or explosive behaviour at home
- Strong sensory sensitivities, especially to sounds and touch .
For autistic girls to thrive, itâs important they have access to a timely and accurate diagnosis, and the informed supports that come with it. A delayed or missed diagnosis can impede their education and development, as well as their social and community participation.
While boys with autism are more likely to have outwardly challenging behaviours, girls with autism are more vulnerable to internalising problems.
As our understanding of how autism affects females is still emerging, it is important parents and professionals alike stay updated on the best ways to specifically support girls and women on the spectrum.
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Sex Differences On Gold
Overall, approximately 90% of females and 94% of males in this sample met Autism Spectrum cutoff criteria on the ADOS/ADOS-2, using the ADOS-2 diagnostic algorithm . Consistent with our hypotheses, there were no significant sex differences in the ADOS-2 Comparison Score , indicating similar levels of overall autistic traits across sexes. Similarly, there were no significant differences in likelihood of meeting ASD criteria on the ADI-R by sex , with 72.63% of females and 75.51% of males meeting criteria. Performance on gold-standard measures was further explored through item-level analyses of the ADOS. Consistent with our hypotheses, females showed less evidence of RRBs, as evidenced by lower scores on the Excessive Interests item of the ADOS , with a small effect size . Contrary to hypotheses, no significant sex differences were found in play skills or conversation skills on the ADOS. Females were less likely to direct a range of facial expressions towards the examiner during the ADOS , with a small effect size . At the trend level, females out-performed males in identifying and sharing emotions with others , with a small effect size , and showed lower rates of hyperactivity , with a small effect size . However, none of these findings survived corrections for multiple comparisons, indicating that overall, performance on the ADOS was similar between males and females.
So If You Want To Look Into A Diagnosis Where To Next
Remember, autism is complex, and even though you might be thinking these symptoms ring true of yourself or your child, there are many factors such as your environment and personality which shape who you are. Also, other conditions may have similar signs.
If you do want to explore a diagnosis for your child, the first step is to talk to your GP or paediatrician. If you are an adult, check out our blog on receiving an autism diagnosis as an adult.
To start the process, your GP will usually refer you to a specialist. A diagnosis may involve seeing a number of specialists including a paediatrician, child psychiatrist or psychologist, speech pathologist, or occupational therapist.
Its not always easy to make an autism diagnosis as theres no lab test for it, although there are guidelines. Specialists will instead rely on watching your child play and interact, and also chat to you about what you see and experience day to day.
If you do receive a diagnosis of autism for your child, Early intervention has been found to be very helpful. Find out more about Early Childhood Intervention at Aruma.
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Masking: The Reason Girls Are Missed For Asd Diagnosis
Some research suggests the reason girls are typically under diagnosed for autism spectrum disorder is that the current diagnostic criteria does not meet the expression of autism in girls.
Current studies cite that at least three males receive an autism diagnosis for every one female. Two current arguments suggest an explanation the first argues the reason for this occurrence is that girls have an inherent trait that protects them from the likelihood of developing autism. While the second argument is that more girls are likely to develop autism than current data estimates, the limiting factor is that diagnostic bias and variations in the expression of autism in girls limit the positive diagnosis.
Out of these two arguments, the second is much more favored than the other. The main issue with the current diagnostic criteria is that behavioral maskers that are used as criteria for diagnosing autism are based on pre-existing conceptions of what autism looks like. These are predominantly based on male population samples previously diagnosed with autism.
Girls are often able to mask their autism traits and the behavioral maskers used as diagnosis criteria are therefore not so apparent but what does this mean?
How Does Autism Present In Girls And Women
In a 2009 study presented at the International Meeting for Autism Research, researchers explored gender differences in twins with ASD and found that many girls with highly autistic traits also had high IQs and social skills similar to boys without ASD.
Despite their presentations of autism, these particular girls were not diagnosed as often as girls with lower IQ scores.
A girl may be able to imitate what she sees in other people more, but it tends to be on the surface, Epstein said.
Common presentations of autistic traits are seen with both boys and girls, including repetitive behaviors and difficulties with socializing. However, social and cultural constructs related to gender and behavior can make it difficult to recognize signs of autism in girls. Unfortunately, when girls with ASD are diagnosed less frequently or later in life, they may spend much of their developmental years without the intervention or treatment they need.
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Autism In Girls And Women
Autism is a condition that affects both men and women. However, studies have shown that up to five times as many men are diagnosed with autism than women.
These differences have been dominant in research for many years, beginning with Hans Asperger in 1944 who originally thought that no women or girls at all were affected by the syndrome he described. Similarly, in 2009, a study by Brugha found that of the adults surveyed, 1.8% of the men had an Autistic Spectrum Disorder yet only 0.2% of women were affected. According to the National Autistic Society, in 2015 the number of men supported by their adult services exceeded women 3 to 1.
But why is this the case? Does autism really affect more men than women? Theres no straightforward answer and research is continually being done to find out more and to see if there really is a link between gender and autism.
What Research Is Being Done
The mission of the National Institute of Neurological Disorders and Stroke is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. The NINDS is a component of the National Institutes of Health , the leading supporter of biomedical research in the world. NINDS and several other NIH Institutes and Centers support research on autism spectrum disorder.
Nearly 20 years ago the NIH formed the Autism Coordinating Committee to enhance the quality, pace, and coordination of efforts at the NIH to find a cure for autism. The NIH/ACC has been instrumental in promoting research to understand and advance ASD. The NIH/ACC also participates in the broader Federal Interagency Autism Coordinating Committee , composed of representatives from various U.S. Department of Health and Human Services agencies, the Department of Education, and other governmental organizations, as well as public members, including individuals with ASD and representatives of patient advocacy organizations. One responsibility of the IACC is to develop a strategic plan for ASD research, which guides research programs supported by NIH and other participating organizations.
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What Are Some Common Signs Of Asd
Even as infants, children with ASD may seem different, especially when compared to other children their own age. They may become overly focused on certain objects, rarely make eye contact, and fail to engage in typical babbling with their parents. In other cases, children may develop normally until the second or even third year of life, but then start to withdraw and become indifferent to social engagement.
The severity of ASD can vary greatly and is based on the degree to which social communication, insistence of sameness of activities and surroundings, and repetitive patterns of behavior affect the daily functioning of the individual.
Social impairment and communication difficultiesMany people with ASD find social interactions difficult. The mutual give-and-take nature of typical communication and interaction is often particularly challenging. Children with ASD may fail to respond to their names, avoid eye contact with other people, and only interact with others to achieve specific goals. Often children with ASD do not understand how to play or engage with other children and may prefer to be alone. People with ASD may find it difficult to understand other peoples feelings or talk about their own feelings.