Autism Is Not Gender Specific – Our Society Is….

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The labeling of  Women who do not fit neatly within the confines of society, as being ‘nutty’, ‘weird’, ‘batty’, ‘anti-social’, ‘loners’, ‘reclusive introverts’ or ‘eccentric’, when they may indeed be experiencing undiagnosed Female Autism, creates the kind of life long harm that ensnares Undiagnosed Autistic Women forever, within the confines of an artificially imposed, yet personally experienced prison, of societies making.

It’s high time that  the name calling, isolation and double standards that lead to the abandonment and  misdiagnosis of Women with undiagnosed Autism stopped.

It should no longer be considered acceptable for our society to be encouraged to acknowledge only those presentations of  Autism that fit within the confines of Male Autism.

Autism is not a Male only condition.

Yet still today, if a male exhibits peculiar behaviors, or behaviors that are viewed as being out of the norm for males, they are automatically considered for an assessment of Autism. 

Their behaviors are both attributed too, and understood as being part and parcel of  the presentation of Male Autism, even before that assessment takes place.

As such, Autistic behaviors in males are considered excusable, simply because it’s perceived that they may be on the Autism spectrum.

Yet, when a Female exhibits similar sets of peculiar behaviors, or behaviors that are viewed as being out of the norm for females,  she’s considered by others to be ‘weird’,’ unruly’, ‘unfeminine’,”highly strung’,’ intentionally disruptive’, ‘rude’, ‘bossy’ or ‘deliberately seeking attention’.

The one thing  Women’s behaviors  never seem to be automatically considered for, is an Assessment for Autism.

As a result, most Females on the Spectrum (either diagnosed or undiagnosed)  are often punished socially, emotionally, economically and psychologically,  for behaviors that they themselves may have no idea are unwelcome or are breaching social expectations.

Many girls and women are not even aware that they are on the Autism Spectrum until much later in life.

Nor unfortunately, are the people who often surround them in their daily lives.

Even their families, friends and peers often fall into the trap of  re-attributing or reconstructing,  the traits of Autism in  Women, as personal behaviors that arise due to a perceived lack of self-discipline, ambition, sociability, maturity and in many cases, even sanity.

In short, when it comes to Women and Autism, it still seems that the overwhelming propensity amongst many in society is to perceive Female Autistic traits as evidence, not of Autism as they do in Males, but as evidence of some kind of personal female weakness, fault or issue.

This results in the re-labeling of Female Autistic behavior as being anything but…Autistic.

It seems that it is still far easier for those within our society to re-label Autistic Women with any number of demeaning personal faults, than it is to open their eyes to the possibility that the rates of Autism amongst Women, particularly older women, are much higher than anyone dared previously imagine.

Autism is not Gender Specific and therefore, nor should our understandings of it be.

Asperger’s Syndrome in Females – A biased perception.

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Tony Attwood (2006) observed that parents and teachers often send boys for evaluation at the point when their aggressive behaviour becomes a significant problem at home or school. The practice of making referrals based on acting out behaviour, means that overall, more boys will be evaluated, and the perception that aggressive behaviour is significant in AS may mean that parents and teachers overlook children who do not display disruptive behaviour (Attwood, 2006; Wagner, 2006). Girls, for example, may not have tantrums or meltdowns at school, but may instead, refuse to respond to requests or participate in activities (Wilkinson, 2008).

An often present feature in Asperger syndrome is an intense interest in one or more areas (Beteta, 2009), and long, encyclopaedic monologues, often on obscure subjects, are usually recognized as indicating a possible AS diagnosis in boys (Attwood, 2006). Findings suggest, though, that girls tend to have more age-appropriate interests, that generally reflect those of their peers, e.g., horses, or creative pursuits (Attwood, 2006; Beteta, 2009).

Attwood (2006) emphasizes, however, that the dominant role these interests play in the life of a girl with AS is qualitatively different from the role that the same interests play in the lives of her female peers. Attwood (2006) stresses further that a girl’s intense interests can extend well beyond an appropriate age,  and that this can help to determine abnormal intensity and focus.

Overall, these observations suggest that increased insight into how these interests function differently for girls with AS, may help to clarify diagnosis.

The use of social echolalia, i.e., mimicking others through imitation and modelling, exists almost exclusively in girls with Asperger syndrome  (Beteta, 2009; Wilkinson, 2008). In an effort to reduce their social and communication impairments, girls may copy the mannerisms, voice, persona, and behaviour of others, often quite successfully (Attwood, 2006).

However, Beteta (2009) points out that although girls may seem to benefit from the use of social echolalia, often they do not truly understand the contextual meanings of what they are mimicking.

Ryden and Bejolet (2008) found that adult females also seemed more successful at mimicking social behaviour than adult males, and for this reason, they rarely fit the original description of Asperger syndrome.

This suggests that the use of social echolalia may hinder the recognition and diagnosis of AS, and consequently, access to relevant support (Attwood, 2006), and that girls and women may experience increased stress in dealing with the consequences of mimicking behaviours that they may not quite understand.

Overall, a greater awareness of gender differences in phenotypic expression is vital so that girls will receive an accurate diagnosis, and access to services that could lessen the impact of AS, particularly beyond childhood.

Furthermore, as researchers discover the extent to which statistical gender differences translate into clinical significance, it is likely that support services will need modification to accommodate this new knowledge (Giarelli et al., 2010).

Differences in attitudes and behaviour towards females with Asperger Syndrome may also contribute to a delayed or missed diagnosis (Giarelli et al., 2010; Hartley & Sikora, 2009).

Attwood (2006) noticed that parents were more hesitant to seek a formal diagnosis if their daughters appeared to be functioning adequately, and that clinicians tended to hesitate in making a diagnosis unless the signs were quite conspicuous. This reinforces the observation made by Hully and Lamar (2006) that AS traits need to be exaggerated in females for a formal diagnosis.

In contrast to boys with AS, who are more often teased, ignored, or bullied by their male peers, girls more often experience support and even protection from some of their female peers, which could result in failure to recognize significant social impairments (Attwood, 2006). Beteta (2009) stresses that these friendships rely on the willingness of a girl’s peers, and accordingly, Rastam (2008) found that many girls with AS tended to have only one friendship that was usually tenuous in nature, and few peer relations overall.

In addition, the perception that many girls with Asperger syndrome seem to manage in social situations, can cause others to question the accuracy of diagnosis.

One result may be that when a girl exhibits behaviour common to AS, it is misunderstood as deliberate or wilful (Beteta, 2009), and she may not receive the necessary supports. Cooper and Hanstock (2009) found, for instance, that school staff continued to feel that Jane’s behaviour was “put on”, even after she received a diagnosis of Asperger syndrome.

Moreover, parents and teachers often connect social and functioning difficulties with intrinsic personality traits rather than to a developmental disorder like AS (Cooper & Hanstock, 2009). Specifically, they may misinterpret deficits in social skills, such as poor eye contact, as signs of shyness, embarrassment, or naivety (Wagner, 2006).

Girl’s social impairments, for example, are often misconstrued as stemming from their reserved natures, hence girls initially received an incorrect diagnosis of early onset anxiety disorder (Wilkinson, 2008).

In conclusion, there are a number of possible explanations for the 10:1 gender ratio in Asperger syndrome. Some think that the large number of diagnosed males accurately reflects natural sex differences in brain specialization, or points to sex-specific genetic susceptibility to AS (e.g., Baron-Cohen &Wheelwright, 2004; Jones et al., 2008).

Others believe that the current gender ratio misrepresents the incidence of AS in females (Thompson et al., 2003).

A biased perception of how AS presents may contribute to underdiagnosis (Attwood, 2006; Beteta, 2009), as many emphasize the overuse of a male prototype (e.g., Hully & Lamar, 2006; Thompson et al., 2003). Clinicians may attribute symptoms to psychiatric disorders more commonly seen in the general female population (Cooper & Hanstock, 2009; Rastam, 2008; Ryden & Bejolet, 2008), gender differences in phenotypic expression could mean that core impairments go unnoticed or are misinterpreted (Attwood, 2006; Beteta, 2009; Wilkinson, 2008), and the attitudes and behaviour of others towards females with AS may also contribute to underdiagnosis (Cooper & Hanstock, 2009; Wagner, 2006).

It is clear that one explanation for the uneven gender ratio is not sufficient on its own. The reasons are multifaceted and complex, and it is likely that other possibilities will emerge with additional research.

However, a greater understanding of gender differences in Asperger syndrome will likely play a large role in balancing the 10:1 ratio, as more females will receive an accurate diagnosis.

Written by A. MacMillan

The Importance of Identifying Asperger’s Syndrome / High Functioning Autism in Adults

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“Growing up with undiagnosed Asperger’s Syndrome can be traumatic for many individuals.”

Many adults with undiagnosed Asperger’s Syndrome are usually keenly aware that they do not ‘fit in’, yet are unable to either express or understand exactly what it is that makes them feel differently to others.

For this reason many undiagnosed adults develop negative perceptions of themselves as “weird”, “crazy,” or “broken.”

Despite these negative self-images, many undiagnosed adults are able to hide their difficulties by developing coping mechanisms, such as mirroring or mimicking those around them in social settings.

They are therefore seen as being able to engage in the everyday routines of life such as working, having relationships, getting married and having children.

Yet though they have the ability to apply such coping mechanisms, many individuals with undiagnosed AS, are never able to shake off the underlying awareness of themselves as inherently ‘different’ to those around them.

Ironically, the very skill sets that adults with undiagnosed moderate to mild Asperger’s apply, in order to try and ‘fit in,’ have meant that they have flown “under the diagnostic radar”.

Other individuals with undiagnosed AS, who have not learnt such skill sets, may show greater signs of having social communication difficulties.

This can make them more susceptible to situations such as chronic unemployment and social isolation due to the fact that they may be mistakenly perceived as people who are deliberately anti-social, argumentative, objectionable or aloof loners who crave only their own company.

In reality, these people may be individuals who are displaying the lack of social skills required to communicate and act appropriately, that make up the characteristics or traits commonly described in Asperger’s Syndrome.

It is now well established that individual with AS may display varying degrees of some or all of the following characteristics:

A lack of social skills which manifest in inappropriate social approaches, responses or social awkwardness.

Difficulty recognizing the facial expressions or emotions of others.

Difficulties in considering or understanding others’ viewpoints.

Limited interest in friendships


Difficulties with being able to communicate their ideas, thoughts and emotions.

Difficulties in comprehending and following social reasoning and adhering to the status quo.

Difficulty with transitions and changes.

Hold a strong need for routines.

Narrow range of interests or idiosyncratic special interests.

Be overly sensitive to sounds, tastes, smells and sights.

Have motor coordination difficulties.

Experience difficulty managing their own negative feelings, especially anxiety, anger and depression

Adults with undiagnosed AS are susceptible to experiencing high degrees of stress, frustration, confusion and anxiety due to their awareness that they do not ]fit in’.

These additional difficulties have often been misinterpreted, misdiagnosed, misunderstood and mistreated, especially when their underlying AS is undiagnosed or not adequately understood.

Some of the most common additional difficulties include:

Angry outbursts (physical or verbal aggression, verbally threatening behavior)

Agitation and restlessness

Increase in obsessive or repetitive activities, thoughts, or speech

Low mood or depression

Apathy and inactivity

Unfortunately many professionals who are unfamiliar with AS often only focus on the surface symptoms and behaviors that an individual with undiagnosed AS may display.

This leaves individuals with undiagnosed AS at risk of being incorrectly diagnosed with conditions such as:

Personality Disorders

Psychosis

Bipolar Disorder

Obsessive Compulsive Disorder

Mood disorder

It is therefore essential, that in order to prevent individuals with undiagnosed Asperger’s Syndrome from being incorrectly diagnosed with conditions, treatment plans and medications that will not help them, that a thorough Autism assessment must be applied to adults who fall within this criteria.

A proper diagnosis of AS can better help adults put their difficulties into perspective and enable them to understand the underlying reasons for their lifelong struggles.

Correct diagnosis and effective treatment can help improve self-esteem, work performance and skills, educational attainment and social competencies.

More importantly a correct diagnosis can trigger both a journey of self-discovery and a healing process for the individuals concerned.