Autism: It’s Different for Girls

apara autism center

Autism within Girls

apara autism center

  • One in 68 kids across the U.S. is affected by autism, but recent research indicates that the current diagnosis methods don’t consider girls, which means that more children could be at risk of being diagnosed as having autism.
  • The preliminary findings from neuroimaging and behavioral studies indicate that autism manifests differently for girls. In particular, girls who have autism may be more similar to men who normally develop their social capabilities than typical girls or boys with autism.
  • Girls with autism might be more difficult to recognize due to many reasons, such as specific criteria that are geared towards males as well as diagnoses that are overlapping like obsessive-compulsive disorder and anorexia.

When Frances was a newborn she was a bit late to talk, walk, and talk. She was just three years old when she was able to recognize her self-name. 

While there were signs of something unusual in her growth, the only thing parents believed was that she had autism. “She was extremely social and was a very joyful and easy child,” says Kevin Pelphrey the father of Frances.

Pelphrey is an eminent research scientist in Yale’s renowned Child Study Center. He was also the only one to identify the disorder for his daughter until she was diagnosed around five years old. 

Today, Frances is a slim 12 year old with lightly freckled skin and her father’s warm brown eyes. As with many girls of her age, she’s not very confident, but she has opinions on what she wants and doesn’t wish to do. 

When lunchtime rolls around she and her sister, Lowell have a blast engaging in typical sibling squabbling–“Mom I’m being kicked by him!”

Lowell seven-year-old, Lowell, was given an autism diagnosis earlier, around 16 months. Their mother, Page, can recall how different the diagnosis process took place for both of her kids. For Lowell it was quick. 

For Frances she says she went from doctor to doctor and were instructed to just wait and watch or there could be a variety of physical causes for her delay for example, not seeing clearly due to the eye condition known as Strabismus, which would require surgery at the age of 20 months. “We received a variety of various diagnostics” the woman recalls. “They were always saying”Oh, you’re a girl. It’s not autism.'”

In reality, the criteria used to diagnose Autism spectrum disorders (ASD)–a disorder of development that is defined by communication and social problems and rigid, repetitive behaviors–are built on research that comes mostly from studies conducted on boys. 

The standards, Pelphrey and other researchers believe, are not encompassing many girls and women due to their symptoms being distinct. 

The disorder was once a common occurrence, and is thought to affect 1 of every 68 children within the U.S., was thought to be at the very least four times more prevalent in boys than girls. 

Experts believed that children who had autism were generally much more severely affected and had more severe signs like intellectual disabilities. Recent research suggests that both of these assumptions could be incorrect.

A lot of girls, just like Frances get diagnosed later due to the fact that autism may have distinct symptoms for females. 

Others may go undiagnosed or be given diagnoses such as attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD) and even, some researchers believe, anorexia. 

Researchers are studying the way this disorder manifests in girls, they are facing results that may challenge their assumptions not just regarding autism but also sex and how it affects physically and socially impacts various aspects of development. 

Researchers are beginning to identify ways to cater to the particular requirements of women and girls with autism.

apara autism center

This is different for GIRLS

Researchers in recent years have examined a myriad of reasons for the skewed gender ratio in autism. 

Through this, they have identified personal and social factors that can aid females in coping or masking for the signs of ASD better than males and also biological reasons that might hinder the development of the disorder in the first place . 

refer to “The The Protected Sexuality” belowbelow. The research has also revealed an unjustified bias in how ASD is diagnosed.

A study from 2012 conducted led by cognitive scientist Francesca Happ of King’s College London with her colleagues looked at the frequency of autism traits and the formal diagnosis of autism within a group comprising greater than 15,000 twins. 

They discovered that if both girls and boys had similar degree of characteristics, the girls had to have more issues with their behavior or an intellectual disabilities or both in order to be classified. 

This suggests that doctors are not recognizing numerous girls that are in the less severe part of the spectrum of autism which was previously referred to as Asperger’s syndrome.

In 2014, psychologist Thomas Frazier of the Cleveland Clinic and his team of researchers evaluated 248 autistic children, with 304 of them being girls. They also discovered that girls diagnosed with autism are more likely be diagnosed with low IQs and severe behavioral issues. 

They also showed fewer (or more likely, less apparent) indicators of “restricted interests”–intense focus on specific subjects like dinosaurs and Disney films. 

These types of interests are usually the most important factor in diagnosing the milder part of the spectrum however, the criteria used in diagnostics often have stereotyped “male” interest like train timetables or numbers. 

Also, Frazier discovered additional evidence that girls are overlooked. In 2013, a study revealed that, similar to Frances girls, girls generally get diagnosed with autism more late than boys.

Pelphrey is part of a growing number of researchers seeking to know the biological implications of gender and sexual roles can reveal about autism and the reverse. 

The interest he has for autism research is personal and professional. Of his three kids the middle one is typical. Kenneth, Pelphrey jokes, is a classic “middle-child syndrome” and is adamant the fact that his children “get free of murder since they can attribute it to his autism.”

Pelphrey is currently working with researchers from Harvard University, the University of California, Los Angeles and at the University of Washington to conduct an important study of women and girls who suffer from autism.

The study will follow the participants through the period of their childhood until the early years of adulthood. The researchers are seeking “every piece of clinical data we can find since we don’t know what to be seeking,” Pelphrey says. 

Therefore, they are soliciting family members and participants to suggest areas for investigation because they are aware of the most useful and what is the most troublesome.

The study’s participants will be compared to boys with autism as well as typical growing children from both genders through the brain scanning method, as well as genetic tests as well as other tests. 

These comparisons will aid researchers in determining what developmental differences can be attributed to autism, and not to sexuality, as well as the extent to which autism can affect gender differences in the brain , and how biological and social factors influence gender-typical behaviours.

Already, Pelphrey is noticing amazing differences between autistic girls as he conducts his preliminary study. “The most interesting thing we’ve found is that all that we believed we knew about functional brain development isn’t accurate,” he says. 

“Everything we believed to be relevant to people with autism may only be the case in the case of boys.” For instance there are numerous studies that show how the brain of boys who has autism typically processes social signals like gestures and eye movements using distinct brain areas than the typical boy’s brain. 

“That’s been an amazing discovery for Autism,” Pelphrey says. However, it doesn’t hold on in girls, at least according to the unpublished data that his team has compiled to date.

Pelphrey has discovered that children who have autism are different from girls with autism in the way their brains process social data. However, they’re not as different as boys who have autism. The brain of each girl is similar to that of a normal boy at the same age, but with less activities in the areas that are typically connected with socialization. 

“They’re nonetheless less than generally developing girl,” Pelphrey says, however the brain-activity measurements that they provide would not be classified as “autistic” for a boy. 

“Everything we’re examining, cognitively, seems to be following the same trend,” he adds. In short the girl’s brain suffering from autism might be more similar to that of a normal boy than the brain of a child with autism.

A brief study conducted of Jane McGillivray and her colleagues at Deakin University in Australia, released in 2014, offers proof of this theory. McGillivray and her coworkers studied 25 autistic boys and 25 girls who had the same number of normally developing children. 

In a test of friendship quality and empathy autistic girls scored nearly as high as normally developing boys of similar to their age, but less than girls typically developing.

Pelphrey is discovering that autism can also highlight normal differences in development between boys and girls. Sex hormones, according to him, “affect just about every structure you could be interested in, and nearly every other procedure you’re keen on.”

Even though boys tend to grow up earlier than girls do but the differences in brain development seem to be substantial, far more than the differences in behavior.

MASKING AUTORISM

Jennifer O’Toole, an author and the founder of the Asperkids web site and company was diagnosed just the time her husband son, and daughter were identified as being in the autism spectrum. From the outside, she appeared almost exactly like autistic. 

In Brown University, she was an athlete and a sorority girl, whose boyfriend was head of the fraternity he was a part of.

But on the inside, it was quite different. Social activities wasn’t something that came easily for her. O’Toole utilized her innate intellect to become a great actor and mimic, and the effort required often left her exhausted. 

From the moment she began reading at age three and continued to read throughout her early years in gifted schools, she was a student of people in the same way that others might do math. 

She then imitated them, learning what people absorb on the playground, only through intense novel reading , and the repercussions of embarrassing mistakes.

The story of O’Toole demonstrates the ability of a person to make up for a impairment and also hints at a reason that females with autism could be difficult to spot. 

Girls might have a higher capability to conceal their signs. “If you judged by the appearance of their behaviour, you may not be aware of any difference in this individual,” says University of Cambridge the developmental psychopathologist Simon Baron Cohen. 

“It is more about being able to penetrate the layers and observing their experiences and not on how they appear before the public.”

O’Toole’s obsession with studying and identifying the rules and patterns in social situations is more typical of girls that have autism than those who do not, as clinical evidence suggests. 

Boys with autism may not care if they are socialized with or they do. Indeed, certain diagnostic guidelines suggest a lack of interest in socializing. However, autistic girls are more likely to exhibit a greater need to make connections.

Additionally the boys and girls who have autism behave differently. 

Research has found that girls with autism show less repetitive behavior than boys and, as the 2014 findings of Frazier and his coworkers suggest, children who are autistic often don’t possess the same hobbies as stereotypical autistic males. However, their interests and activities are more like those of other girls.

Frances Pelphrey’s fascination of Disney cartoon characters as well as American Girl dolls might seem normal, not autistic for instance. 

O’Toole recalls obsessively organizing herself Barbie dolls. In addition, while autism is typically characterized by a lack of play with pretend However, research suggests that this isn’t the case for girls.

In this way, they are able to disguise their signs. O’Toole’s actions could have appeared as if it was typical to her parents since she created Barbie weddings, just like the other children. 

However, rather than thinking her role as the wedding bride O’Toole actually was setting up visually static scenes and not stories.

In addition, as opposed to boys, the distinction between normal and autistic growth in girls could be less in the type of their pursuits than the intensity they display. 

Girls with autism may not want to discuss anything else or may not take the usual conversational turns. “The words that describe women with a spectrum are based on the word “too,”” O’Toole writes. “Too excessive insufferable and sensitive. Too this too this, too this, too that.”

She talks about how her sensory differences–she gets overwhelmed by crowds and annoyed by loud sounds and certain textures, as well as her social awkwardness caused her to stand out. 

Her life was defined by anxiety. When it comes to people who are on the spectrum, O’Toole says, “There isn’t a moment where we’re not experiencing an anxiety level that is usually triggered by social or sensory concerns.”

When she was a teenager and became autistic, O’Toole channeled her hyperfocus to another field in that culture often directs women in: body image and diets along with a dose of perfectionist. 

“I used to keep an excel sheet of the number of calories, and how many grams of this and another thing I could take inat any given time],” she says. The resultant anorexia was so severe that she needed to be admitted to hospital at the age of 25.

In the mid-2000s , researchers headed by psychologist Janet Treasure of King’s College London began to look into the possibility that anorexia could be one of the ways that autism manifests in females, which makes women less likely to get classified as autistic.

 “There are some striking similarities between the cognitive profilesof both,” claims Kate Tchanturia, an eating disorder researcher and a colleague with Treasure of King’s College London. 

People with autism and those suffering from anorexia are generally focused, solitary and stressed when they experience change.

Additionally, since many people who have autism find certain tastes and textures of food abrasive and therefore, often end up with diets that are severely restricted. 

Some research hints at the connection between anorexia and autism: in 2013 Baron-Cohen and his colleagues gave a group of 1,675 teen girls–66 of whom had anorexia–assessments measuring the degree to which they had various autism traits. The study found that those with anorexia exhibit greater levels of these traits than average women.

There is no evidence to suggest that all women who suffer from anorexia also suffer from autism. A 2015 meta-analysis conducted by Tchanturia and colleagues put the number at around 23 percent.

This is an amount of ASD significantly higher than found for the rest of us. What this all suggests is that certain among the “missing girls” with autism may be diagnosed with eating disorders instead.

Furthermore, as autism and ADHD frequently occur in tandem, and because those diagnosed with ADHD are more likely to exhibit more autism-related traits than normal people do, girls who are often distracted or hyperactive could receive this label regardless of whether autism is more suitable. 

OCD, rigidity as well as a fear of changing occur in people with autism as well as those who suffer from OCD and OCD, which suggests that females with autism could also be part of this group.

DOUBLE STANDARDS

Even when young women are comparatively “easy” to diagnose, they still face many challenges in the course of development–particularly social ones. 

This was certainly the case for Grainne. She was the daughter of Maggie Halliday, had lived in an extensive Irish family and could tell from the beginning she was pregnant with her 3rd child.

Grainne had a distinct personality. “I was aware from the time she was only a couple of months old that something was wrong,” Halliday says. “She did not like being hugged or held. She was able to make herself an unwieldy weight, and you could not take her off.”

While Grace’s IQ tests fall in the lower normal range but the results don’t accurately reflect her talents or her limitations very well. 

Today , the teen’s most ardent interests include boy bands and musical theatre. Although she is shy her stage presence is captivating and is a natural at singing. “The production she’s in, as they read the script within an entire week, she’s got everyone’s role memorized as well as every song from the script already memorized” Halliday explains.

Due to a genetic disorder, Grainne is short: 47 and a half inches she claims. While she’s not the most sociable and isn’t one to engage in conversation but she is also cheerful and is evidently eager to make connections. 

She considers what she says say carefully. For instance when asked if she believes that autistic girls have more interaction with others than males with autism Grainne responds, “Some might be,” not looking to generalize.

Of course, adolescence can be challenging for all kids and teens, but it’s especially difficult for girls with autism. A lot of them can handle the comparatively simple life of friendships in elementary school However, they have a hard time coping when it comes to those “mean girl” in junior high school and the subtilities of flirting and dating. 

Additionally, puberty brings unexpected changes like hormonal changes, breast growth and mood swings, as well as periods.

And there’s nothing autistic people dislike more than a change that happens without warning. “She would love to be able to have a partner, and that’s why she is a fan of boy groups,” says Halliday, noting that she believes Grainne may not know what a relationship could actually refer to.

Unfortunately, the autistic tendencies to be direct and to take things seriously can make women and girls easy targets to sexual exploitative behavior. O’Toole herself was a victim of a sexy relationships, she believes that the issue is “endemic” for women with autism in particular because they are aware of their social insecurities. “When you feel that you’re difficult to love, you’ll be willing to love for an ounce of bread,” she says.

In this manner, autism could be more painful for women. People with autism who don’t have a desire to socialize likely don’t worry about their lack of connections, but those who are looking to connect but aren’t able to are plagued by loneliness. 

A 2014 study by Baron Cohen and his coworkers discovered that 66 percent of people with the milder version of ASD (so-called Asperger’s) expressed thoughts of suicide at a rate that was 10 times greater than observed within the population as a whole. 

The percentage was 71 percent for women, which comprised approximately one-third of the study sample.

Up until recently, only a there were few resources made available to assist autistic girls with these issues. 

Today, researchers and clinicians are beginning to fill the holes. For instance, Rene Jamison, an assistant clinical professor at the University of Kansas Medical Center is the director of an initiative located in Kansas City called Girls Night Out. 

It aims to help girls who are struggling get through the adolescence phase, it concentrates on particular concerns like hygiene and dressing. 

Although this focus may appear insignificant or an attempt to change gender stereotypes, the truth is neglecting to address these “superficial” issues can lead to serious issues in the life of a girl and hinder her the freedom of.

Many high-achieving girls on the spectrum experience problems with their hair washing or wearing deodorant, and dress in a manner that is appropriate, Jamison says. 

The reason for this may be related to sensory issues, while others can be attributed to a lack of understanding the correct sequence of actions when you do something that isn’t important. “When Grainne was in seventh grade I had to remind her it was against law to not wear bras,” Halliday says of her daughter, who was uncomfortable wearing bras uncomfortable. 

Grainne was also reluctant to put on deodorant. She said, most likely exactly, that boys smelled more.

Girls Night Out Girls Night Out group does exciting activities, from manicures to sports. Girls who receive school credits for volunteering offer guidance and discuss boys , as well as other issues that girls might not be able to talk about with their parents. “One thing we work on is encouraging them to experiment with new ideas to see what they’d like to try,” Jamison says.

Within New York City, Felicity House, which its creators claim is the world’s first community center specifically for women who are autistic was opened in the year the year 2015. 

The center was funded through the Simons Foundation, it occupies the top floors of a magnificent mansion from the Civil War near Gramercy Park and offers classes as well as social events where people with autism can meet and be supportive of each other. 

Five women who founded Felicity House met for a couple of weeks prior to the opening to discuss their lives in the spectrum. 

Two had been diagnosed as children, one who had Asperger’s syndrome and another who suffered from what she described as “ADHD with autistic traits.” Of the remaining 3 women who attended, two been depressed prior to being diagnosed as adults.

Emily Brooks, 26, is a writer who is studying for her master’s degree in disabilities studies at City University of New York. She is gender-queer and believes that gender norms create several issues for people who are on the spectrum. 

She pointed out, with broad acceptance, that males have more freedom to break from the norms of society. “If someone engages in behavior that is considered to be socially unacceptable … the buddies might encourage these actions,” she said, noting that “teen girls are likely to be able to shut you down for doing something distinct from the norm.”

Leironica Hawkins, a comic artist who’s created a comic book on Asperger’s and has to deal with the social cues regarding race. “It’s not only because I’m female who is on the spectrum. I’m a black female on the spectrum and have to be aware of social signals that others can be able to disregard,” she said. 

She also said that she believed women “are probably more retributed because they don’t behave as we ought to. I’ve always heard that women are aware of the needs of other people but that’s not the case for me Most of the time … The thing is, I am constantly in a position of being pressured to act the same the way.”

Because of these expectations there’s less tolerance for unorthodox behavior, and not just at high school. A lot of women have reported being unable to keep jobs, but not getting them despite their excellent credentials. “You will see this in an academic meeting, even at the most prestigious departments of academia,” Yale’s Pelphrey says. “The students still manage to have the luxury of doing more.”

As autism awareness grows as awareness of autism increases, girls and women are increasing at risk of being identified. this generation clearly has substantial advantages over the previous generation.

But more research needs to be conducted in order to create better and more gender-specific diagnostic tools. Perhaps , in the meantime women’s experiences with autism could make us more accepting of the socially unsound behaviour in women, or less of it in males. 

In either case, it’s evident that a better understanding of girls’ autism is necessary to identify this disorder. In the process, it can reveal new aspects of normal behavior as well as the ways that gender influences the social landscape.

THE PROTECTED SEX

Simon Baron Cohen, a Professor of the field of development psychopathology and the director of of Cambridge’s Autism Research Center, has contributed to the development of several important theories that shape the current research on autism. 

One of these theories which he is continuing to examine one of them are that of the “extreme male brain” theory that first became popular in 2002. The theory of autism the result of exposure to higher levels than normal of male hormones for example, testosterone. 

This causes a brain which is more focused “systemizing” (understanding as well as categorizing ideas and objects) instead of “empathizing” (considering the social interactions and the perspectives of other people).

Autistic minds might be more powerful in areas that male brains, on average, are likely to be stronger than female brains, and weaker in areas where females in general terms tend to be the more superior gender. 

(When you consider the individual obviously these figures do not reveal anything about a specific male or female’s abilities or capacity. Neither does it necessarily mean that the differences reflect an immutable biological system rather than cultural.)

Recent research has confirmed Baron-Cohen’s theory. In 2010, he and his colleagues discovered that male fetuses who are exposed to greater levels of testosterone in amniotic fluid during pregnancy are more likely to develop more autism-related traits. 

A study he co-authored in 2013 with his Cambridge co-author MengChuan Lai, showed that the differences in brain scans observed in children with autism were mostly in areas which tend to be different according to gender in normal children.

In 2015, Baron-Cohen and colleagues released results from their analysis of vast collection of amniotic fluid samples from Denmark which are linked to the registries of population mental health. 

They discovered that in boys who had the autism spectrum diagnosis associated to increased concentrations of the hormone fetal testosterone as well as other hormones.

However, the first group of participants tested did not have enough girls diagnosed with autism, so they’re studying later births to determine whether the same findings will be discovered. 

Additional evidence was provided by an extensive Swedish study, which was also published in the year 2000, that revealed a 59 percent higher likelihood of having an autistic child among women suffering from polycystic Ovarian Syndrome, which is an hormonal disorder that results in testosterone levels that are elevated in males.

Few scientists–including Baron-Cohen–think that the extreme male brain theory is the whole story. A different idea comes up when we look at the common advantages of women. 

If the presence of female hormones and having a female-type brain structure improves your ability to discern the feelings of other people and makes social problems more prominent It could take an increased number of environmental or genetic “hits” to change this ability to the point that autism could be identified. 

This concept is called”female protection “female protective” theory.

As a result, several studies have revealed that for families with daughters with autism have higher levels of copy-number variants than in families in which only boys are affected. 

A study in 2014 conducted of geneticist Sbastien Jacquemont from at the University of Lausanne in Switzerland and his coworkers discovered an increase of 300 percent in the number of harmful copy-number variations in the females who have autism, in comparison to males.

If one of these theories is true it is likely that there will be more girls than boys who are on the spectrum. “I think that when we’re able to recognize the presence of autism in females, there will be male bias,” Baron-Cohen says. “It will not be as obvious as four-to-one. It might be more of two-to-one.” –M.S.