Post 9: Autism and girls

Welcome to week 9.

This week will explore autism in girls: how it presents itself and some of the explanations why prevalence rates for females is so much lower than for males.

The National Autistic Society (NAS) state that 5 times as many males are diagnosed as being on the autism spectrum than females (this is supported by a range of research - have a look at the section on Autism and gender here). But why is this the case?

A good way to introduce this topic is to look at this short video featuring pupils from Limpsfield Grange, the only school for girls with autism in the UK, which gives an insight into the difficulties faced by girls on the autism spectrum.

Many experts in the field believe that girls are able to mask the difficulties associated with autism, that they are able to mimic the behaviour of their peers. Generally in society there is a higher expectation on girls to be more social than boys and research has shown that many girls on the autism spectrum are more socially inclined than boys - they get involved in social play (but are not usually the ones to initiate it).  They may have one special friend. However, they tend not to engage in social 'chit-chat' as many females do.

Rosanna Rosetti - for more images click here.

While boys may have distinctive special interests, girls interests are often similar to other girls, for example, animals, soaps, celebrities or classical literature.  The difference is that they may be obsessively focused on these.


Diagnosis

So, why are there more boys diagnosed with being on the autism spectrum? Research by Tony Attwood, Lorna Wing and others theorize that girls and women are often just not referred for diagnosis, even though they need support just as much.  Some personal reports state that this is because girls are seen to cope.

Many believe that the diagnostic criteria is heavily biased towards how boys and men present, for example, their behavioural characteristics.  This has led to many experts in the field calling for the diagnostic questions to be altered so that girls and women on the autism spectrum are not missed.  You can listen to Dr Judith Gould discuss late diagnosis and mis-diagnosis in women from BBC Radio 4's Women's Hour here (scroll down to 'Aspergers late diagnosis).

Other experts in the field, such as Simon Baron-Cohen, have proposed an 'extreme male brain theory'.  To find out more about this, click here.


Mental health issues in girls on the autism spectrum
Many practitioners state that mental health issues arise as many girls feel that they need to repress their autism as a way of fitting in.  This can result in depression or eating disorders.

"The fact that girls with undiagnosed autism are painstakingly copying some behaviour is not being picked up on and therefore any social and communication problems they may be having are also overlooked.  This effort of mimicking and repressing their autistic behaviour is exhausting, perhaps resulting in the high statistics of women with mental health problems" (Dale Yaull-Smith, NAS, 2008)

Research by Simon Baron-Cohen in 2013 goes some way in demonstrating that girls with anorexia have 'elevated autistic traits' (you can read about the research here).


Personal accounts

As I have said throughout these blog posts, the best way of understanding the autism spectrum is to listen to or read personal accounts, those 'lived experiences'. One of the most well-know women on the autism spectrum is Temple Grandin, who was born in the 1940's and diagnosed with autism as a child.  She was one of the first to write an 'insider' narrative about living with autism in 'Emergence: Labelled autistic' (available in the University library here).   Have a look at her TEDtalk 'The world needs all kind of minds' below.

More recently in the media there have been a number of articles written by or about women diagnosed with autism.  Have a look at this article in the Guardian by Nicola Clark who was diagnosed in her 40's. Another interesting article, which focuses on mothers who have been diagnosed themselves after their children gave received a diagnosis, is available here.

Useful resources

To find out more about the UK's only school for girls with autism, have a look at this article in the SEN section of  Guardian.


If you sign up for a free trial of Audible you can get access to a great book called 'Aspergers & girls' by Tony Atwood, Temple Grandin and other experts in the field.

Another book which I have mentioned before and found really interesting is by Laura James who was diagnosed recently with autism aged 40+.  It's called 'Odd girl out: An autistic woman in a neurotypical world' (again, with a Audible trial you can get this for free).

Finally for this week, to find out more about the experiences of Temple Grandin you can watch the feature film about her life.  

Contact

If you have any queries or concerns you can contact me directly at lesley.english@cumbria.ac.uk 

For general queries relating to the peer mentoring scheme contact peermentoring@cumbria.ac.uk