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 âfemale protective effectâ 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 âshyâ 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.
Autism In Females Often Flies Under The Radar
The diagnostic criteria for autism are the same for males and females.
However, the knowledge and conceptualization of autistic traits were largely derived from male samples, which can lead to a skewed understanding of the autism spectrum.
Compared to males, females with autism tend to have:
- Lower likelihood of externalizing behaviors like breaking rules, disrupting activities, or interrupting others
- Higher social motivation, which means their social experiences can sometimes be more similar to individuals without autism than males with autism
- A greater capacity for traditional friendships
- Lower measures of repetitive behavior
- Better non-verbal communication
In other words, females may express their autism differently and fail to meet the diagnostic criteria. This might explain why autism is underdiagnosed in females and is more likely to be identified late, mislabelled, or missed entirely.
Where Can I Find Support
Given that women tend to be better at masking their symptoms, being an autistic woman can feel particularly isolating. For many women, its an emotional process that involves revisiting childhood behavior and social problems.
Consider reaching out to other autistic women. The Autistic Women and Nonbinary Network is a nonprofit organization dedicated to supporting women and gender-nonconforming autistic people.
Even if youre not ready to interact with someone, you can find blog posts, first-person stories, and doctor recommendations online.
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What Are The Benefits Of Being Diagnosed With Autism Spectrum Disorder As An Adult
If someone has lived with symptoms of autism their whole life into adulthood, and were never diagnosed, should they pursue diagnosis? Is it too late? What is the point of being diagnosed?
People with mild ASD are often very good at masking their symptoms. If they are undiagnosed, they may struggle with feeling different, misunderstood, or be confused by others behavior. This can cause serious problems and isolate them from their loved ones in ways they dont even realize.
Obtaining a diagnosis is a personal choice each individual adult must decide for themselves. For some, it is information they rather not have. For others, it changes their lives for the better.
It is important to note that adults diagnosed with ASD also had it in childhood. Just because it wasnt diagnosed till later in life, doesnt mean it didnt exist. Therefore much of the current research applies in retrospect.
Symptoms Of Autism In Children
Symptoms of autism in children fall into two major categories: communication challenges and restricted and repetitive behaviors. Children may also experience sensory issues and might find themselves overstimulated or understimulated by sounds, light, smells, or pain.
Communication Challenges
This is a symptom that is common in children and adults. For example, autistic people might struggle to speak, maintain eye contact, control their facial expressions, or repeat gestures.
These are some of the other ways communication challenges might reveal themselves in people with this condition:
- They may not respect peoples personal space.
- They don’t respond to their name when its called, especially at a really young age.
- They have a hard time playing with children of the same age.
- They find it difficult to understand other peoples emotions and, in some cases, don’t know theyve hurt someone elses feelings.
- They often get distracted in between conversations.
- They might sometimes speak in a tone that is different from their regular tone of voice and keep this going for a while.
- They may find it difficult to understand non-verbal cues.
Restricted and Repetitive Behaviors
Autistic children might engage in certain behaviors that might seem atypical if you arent familiar with them. They could also repeat these behaviors very often.
Some restricted and repetitive behaviors autistic children exhibit include:
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Potential Benefits Of Living With An Autism Diagnosis
Receiving an ASD diagnosis as an adult could mean a greater understanding of yourself and how you relate to the world. And it can help you learn how to better work with your strengths and strengthen areas of your life that are impacted.
Getting diagnosed can help you gain a different perspective on your childhood. It can also help those around you to understand and empathize more with your unique characteristics.
A better understanding of your own situation can help you find new and inventive ways to work with your strengths and qualities. You can also work with your clinician and your loved ones to seek supports that may be right for you.
Common Signs Of Autism In Adults Include:
- finding it hard to understand what others are thinking or feeling
- getting very anxious about social situations
- finding it hard to make friends or preferring to be on your own
- seeming blunt, rude or not interested in others without meaning to
- finding it hard to say how you feel
- taking things very literally for example, you may not understand sarcasm or phrases like break a leg
- having the same routine every day and getting very anxious if it changes
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In The 2010s And Through Today
A new version of The Diagnostic and Statistical Manual of Mental Disorders was published in 2013. This is the reference that providers use today to diagnose autism.
Asperger’s syndrome is no longer a diagnosis in the DSM-5. Instead, the manual provides one diagnosis for all people with autism symptoms: autism spectrum disorder .
People with ASD have challenges with social communication, usually resist changes in their routine, and can be hypersensitive to noise, smell, touch, and other sensory experiences. These symptoms can range from mild to severe.
Today, people with mild symptoms as well as those with severe speech delays or sensory issues are all diagnosed with ASD.
The DSM-5 identifies the level of support an autistic person may need by using functioning levels. The levels range from 1 to 3 and are based on the severity of an autistic person’s symptoms, with 1 describing people who need the least support because their symptoms are mild.
However, few people outside of the medical community use the term “level 1 autism.” Often, the terms Asperger’s syndrome or mild autism are still used, though they are controversial within the autistic community.
What To Do If You Suspect Youre Living With Adult Autism
The symptoms of ASD listed above are not an exhaustive list, and an autism spectrum disorder diagnosis must be made by a licensed medical professional, such as a psychologist or psychiatrist.
For some adults, an ASD diagnosis can provide comfort, relief, and a clearer path forward. You may also want to speak with a therapist who specializes in autism spectrum disorder.
While autism spectrum disorder is a life-long condition, some therapeutic treatmentsincluding applied behavioral analysis, cognitive behavioral therapy , and certain medicationscan help manage symptoms.
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Difficulty Picking Up On Small Social Cues
Deciphering nonverbal, subtle social cues can be hard for adults with autism spectrum disorder, so they may feel lost in conversation.
Adults on the autism spectrum typically may interpret nonverbal communicationincluding facial expressions, eye-rolling, and hand gesturesdifferently than neurotypical people.
Referral To Autism Sa By A Healthcare Professional
A referral to Autism SA from a medical or allied health professional is sometimes the first step in the assessment process. This could be your General Practitioner , a specialist, or another healthcare professional.
It is, however, important to understand that GPs are not qualified to undertake an autism test, nor to diagnose autism. Nevertheless, they may ask you questions about your development, or undertake screening and observations, in order to determine whether an assessment for autism is appropriate, or to help them rule out other possible issues.
If a healthcare professional decides to refer you to Autism SA, they will be required to complete a Diagnostic Assessment Referral form, and so will likely need your assistance with some of the background information the form requests.
Please note that if you are not satisfied or disagree with the outcome of a screening test or informal assessment conducted by your GP or another healthcare professional, you can still proceed with a self referral to Autism SA.
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Who Can Make A Diagnosis
Many autism centers are primarily child-focused, so as you age out of them and move into adulthood especially if you have deficits that werent caught as a child finding support can become a huge issue, Dr. Ferrari says.
Try finding an adult psychiatrist or psychologist in your area who works with people who have autism. But if you cant find one , Dr. Ferrari recommends reaching out to a pediatric psychiatrist or psychologist to ask if theyre comfortable assessing for and diagnosing ASD in adults.
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What Are The Dsm
In 2013, the American Psychiatric Association released the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders .
The DSM-5 is now the standard reference that healthcare providers use to diagnose mental and behavioral conditions, including autism.
By special permission of the American Psychiatric Association, you can read the full-text of the new diagnostic criteria for autism spectrum disorder and the related diagnosis of social communication disorder below.
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Mild Autism In Adults: Can You Really Be Mildly Autistic
Growing up Megan struggled with her relationship with her father. He was loving, hard working, and a musical genius. As far as relationships though, things were as complicated as the intricate melodies he composed.
In order to have a productive conversation, it was as if she had to enter the all encompassing bubble he lived in. Their connection was contingent upon his interests and knowledge base, which though extensive, often didnt interest her. He often struggled to reciprocate, and join her in the rest of the world.
One day, while doing research for her college psych class, Megan stumbled upon an article about mild autism in adults. Suddenly her fathers life made complete sense! Megan set out on a quest to find out as much as she could to better understand autism spectrum disorders. In the process she learned what I want to share with you today.
Treating Autism With Educational/behavioral Interventions
Behavioral therapy is the mainstay treatment for children with autism. Even when a childs behavior is good, this type of therapy can help to teach her new skills, and improve her language and social abilities. Social skills training, for example, can teach individuals with autism how to interpret gestures, eye contact, tone of voice, humor, and sarcasm. Cognitive behavioral therapy can help to manage obsessive behavior and anxiety. Ongoing behavioral therapy is linked with better long-term health outcomes, even when symptoms of ASD are mild.
In early-intervention therapy, the entire family works with professionals to improve social, learning, and communication skills. Parent-training programs teach families how to best cope with autism, and teach parents how to administer therapy at home. Among the most highly trusted parent-training programs are Floortime , TEACCH autism program, the Lovaas Model ), and the Early Start Denver Model .
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Diagnosis In Young Children
Diagnosis in young children is often a two-stage process.
Stage 1: General Developmental Screening During Well-Child Checkups
Every child should receive well-child check-ups with a pediatrician or an early childhood health care provider. The American Academy of Pediatrics recommends that all children receive screening for developmental delays at their 9-, 18-, and 24- or 30-month well-child visits, with specific autism screenings at their 18- and 24-month well-child visits. A child may receive additional screening if they are at high risk for ASD or developmental problems. Children at high risk include those who have a family member with ASD, show some behaviors that are typical of ASD, have older parents, have certain genetic conditions, or who had a very low birth weight.
Considering caregivers experiences and concerns is an important part of the screening process for young children. The health care provider may ask questions about the childs behaviors and evaluate those answers in combination with information from ASD screening tools and clinical observations of the child. Read more about screening instruments on the Centers for Disease Control and Prevention website.
If a child shows developmental differences in behavior or functioning during this screening process, the health care provider may refer the child for additional evaluation.
Stage 2: Additional Diagnostic Evaluation
The diagnostic evaluation is likely to include:
What Causes Autism Spectrum Disorder
There is no clear-cut cause of ASD. Some causes that are supported by research include genetic and some environmental factors. Specific genetic causes can only be identified in 10% to 20% of cases. These cases include specific genetic syndromes associated with ASD and rare changes in the genetic code.
Risk factors include older parental age, low birth weight, prematurity and maternal use of valproic acid or thalidomide during pregnancy, among others. This field of study is an active one for research.
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Strict Adherence To A Routine
Autism spectrum disorder can manifest in a strict dependence on daily routines.
Individuals living with autism may become angry or upset when any detail of their daywhether it be a misplaced item or canceled activityis changed.
Stringent routines have some overlap with Obsessive-Compulsive Disorder tendencies, though ASD and OCD are two separate things.
Research is still ongoing on the overlap between the two disorders, but its thought that 17% of individuals living with ASD also have OCD.
A significant difference between ASD and OCD tendencies is that people suffering from OCD have a need to do a specific task, whereas people with autism spectrum disorder are more soothed by repetition than the specific task.
How To Diagnose Autism In Adults
A psychologist or psychiatrist will often interview you to learn about the history of your autistic traits and observe how you respond, Fisher says. They will ask about the way you communicate with others and whether you have any strong, specific interests, repetitive behaviors, or sensory issues. These questions will help them see if you fit the criteria for ASD.
Diagnostic tools like the Autism Diagnostic Observation Schedule which is considered the gold standard in diagnosing ASD in adults are often used to structure and guide the assessment, Fisher adds. This diagnostic test takes about 40 to 60 minutes to administer.
The diagnostician may also want to interview family members as well to get insight into your childhood experiences, Hanks says.
Ultimately, the decision to get diagnosed depends on you. If you are distressed about certain aspects of your behavior and you’re questioning whether you might have ASD, getting a diagnosis could lead to appropriate treatment, support, and services, Fisher says.
“Many adults who have been diagnosed with autism report it helps them to understand themselves and be more self-aware of their areas of challenge,” Hanks says.
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What Is It Like To Be Mildly Autistic
Being a mildly autistic person may mean that the majority of your symptoms revolve around social interactions. Common symptoms such as:
- communication difficulties
- others misunderstanding or not appreciating your sense of humor
Many autistic adults have carved out their own path. They may march to the beat of their own drum. Many autistic people who are on the more mild end of the spectrum are also highly intelligent, extremely talented, and may occasionally possess savant abilities.
Not knowing they are autistic may increase the likelihood of developing emotional or mental disorders. It can cause them to struggle in their socioeconomic groups, in relationships with family members, and their self esteem.
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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