20 Reasons for obtaining an Adult Autism Diagnosis

20 Reasons for obtaining an Adult Autism diagnosis

One of the most frequent questions I am asked is about the relevance of obtaining a formal diagnosis or formalizing a self-diagnosis. My 2nd book, I Am AspienWoman alludes to this very topic through powerful images, experiences, thoughts and feelings of many adult autistic women. There are many valid reasons for obtaining a diagnosis and the majority of women who receive one explain the benefits in the book. I  have included a couple of pages from the book and you can now pre-order I Am AspienWoman, available in eBook, paperback and hardcover, at http://www.aspiengirl.com You will receive $10 off if you order an I Am AspienGirl© and I am AspienWoman Combo. I hope you enjoy the book as much as I did writing it!

AspienWomanApril25th2016

20 reasons for a diagnosis

20 reasons for a diagnosis1

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Tania is available for in-person or Skype consultations, assessments or problem-solving sessions. To book appointments or discuss and/or book availability for presentations, conferences, publishing, translation and media interviews or inquiries, please email Tania@aspiengirl.com

ABOUT THE AUTHOR

Tania Marshall is a best selling author, a 2015 ASPECT Autism Australia National Recognition Award Nominee (Advancement Category) and a 2015 eLIT Gold Medal Award winner for her first self-published book entitled “I Am AspienGirl© : The Unique Characteristics, Traits and Strengths of Young Females on the Autism Spectrum”, foreword by Dr. Judith Gould.  The sequel to this book entitled “I Am AspienWoman: The Unique Characteristics, Traits and Strengths of Adult Females on the Autism Spectrum”, Foreword by Dr. Shana Nichols is available September, 2015. Tania is currently writing the third book in her book series entitled “AspienPowers: The Unique Constellation of Strengths, Talents and Gifts of Females with Autism Spectrum Conditions”. The Spanish version of I am Aspiengirl© , entitled Soy AspienGirl is now available. Tania’s work has been translated and/or cited in numerous publications including Sarah Hendrickxs’ recent release entitled “Women and Girls with an Autism Spectrum Disorder” (2015), foreword by Dr. Judith Gould.

Tania currently works in busy full-time private practice, providing diagnostic assessments, intervention and support to males and females ages 2-76 years of age. Tania is an Australian Psychological Society (APS) Identified Autism Practitioner, a Helping Children with Autism Early Intervention Service Provider (HWCA), a Better Start for Children with a Disability Provider, an approved Medicare provider of psychological services and a trained Secret Agent Society (SAS) Practitioner.

© 2015-2017 All rights reserved Tania Marshall

I Am AspienWoman Book Testimonials, Coming September 2015 and available for pre-order at www.aspiengirl.com

I Am AspienWoman: The Unique Characteristics, Traits and Gifts of Adult Women on the Autism Spectrum (Foreword by Dr. Shana Nichols) is the sequel to the best selling and IPPY eLIT Gold Medal Award winning I Am AspienGirl (2014), Foreword by Dr. Judith Gould. To pre-order, go to http://www.aspiengirl.com/english

The book is available in eBook, paperback and a gorgeous hardcover version and can be bought separately or along with I Am AspienGirl.

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Have you ever wondered about a friend, a partner, a mother, sister or daughter? Wondered why she has said she feels ‘different’? Wondered why some things are so easy for her yet other things that most people perform with ease seem so challenging? Out of step with her peers, she may struggle keeping friends and a job, yet she has multiple degrees. She may be a gifted singer, yet she struggles with social interaction and performance anxiety. Maybe she was told she was shy and just needed to come out of her shell. Told she’d grow out of her social awkwardness. Maybe she had or has an eating disorder. Maybe she has been given too many ‘labels’? She may have spent years going to counselors, therapists, doctors or psychiatrists, with no real improvement or answers. Maybe Autism or Asperger Syndrome was mentioned but she did not resonate with the male profile or even with the stereotypical female profile.

Bright from early on, she may have single-minded focus, sprinkles of anxiety, sensory and social issues, be gifted in art, writing, research or singing. Maybe she is ‘Aspien’, an adult female with Asperger Syndrome or Autism. She has a unique constellation of super-abilities, strengths and challenges. She may feel or say that she is from another planet. Maybe nothing so far has really fit in your search for understanding her. Maybe she herself has been searching for self-understanding, or maybe she has recently self-diagnosed and is struggling to obtain a formal diagnosis. She may have a child or children on the Autism spectrum or it runs in her family and she is now recognizing it in herself.

If you are looking for a book on the often perplexing and unique adult female autism spectrum traits, then this is the book for you. This book showcases the female profile in a unique format, presenting a combination of images and quotes to illuminate the newly emerging Autistic female phenotype. This highly visual format showcases what Autism is like for females, as spoken by females on the Spectrum and those that love or support them. This book is about awareness and education of the female phenotype.

Drawing from years of practitioner experience, Tania Marshall takes you inside the world of adult females with Autism or Asperger Syndrome. Current research supports an inherent gender bias with females being under researched. This book was specifically designed to be a ‘layman’s’ guide for the general population, professionals, family members, the education and psychiatric fields.

Foreword by Shana Nichols, PhD

“Having written an endorsement for I Am AspienGirl ®, and recommending it as a must read to anyone parenting or working with a girl on the autism spectrum (including the girls themselves), I was delighted to be asked by Tania Marshall to write the foreword for I Am AspienWoman®.

I began working regularly with AspienGirls in 2005, having developed ‘girls only’ social coping groups. At that time, there were no resources available for families that specifically addressed the issues faced by females, and limited research had been conducted with the goal of understanding the experiences of girls and women. Few clinicians had begun to specialize in this area, yet those of us who did knew that these girls and women have unique needs and that a subset of females present with behaviors and characteristics that can be quite dissimilar from their male counterparts. When viewed through a ‘male’ lens, AspienGirls and Women are often overlooked, missed, misdiagnosed, and misunderstood, resulting in a rallying call for the professional community to pay attention and work towards remedying the situation.

In recent years that call has begun to be answered. Over 15 studies addressing gender differences and the experiences of females have been published in professional journals in 2015 alone. Attendees at the annual International Meeting for Autism Research in 2015 were able to participate in a session devoted entirely to research concerning females on the autism spectrum. A number of clinical conferences with the goal of offering practical strategies and facilitating the understanding of females have popped up globally in the last two years, providing the opportunity to learn from professionals and from women on the spectrum themselves. Lastly, the number of books and resources that are available to families, professionals, and females has grown. I Am AspienGirl was a rich and unique contribution to this literature, and I am thrilled to say that I Am AspienWoman ® is equally creative and inspiring.

With its characteristic eye-catching photos and powerful quotes from members across the entire female autism spectrum community, readers of I Am AspienWoman will find no shortage of knowledge, illumination and encouragement – after all, an important message of the book is for women to be their own superheroes. I Am AspienWoman celebrates the strengths, triumphs, talents and beauty of females, yet does not shy away from a balanced discussion of challenges, concerns, and important yet often overlooked issues such as gender and sexuality, personal safety, mental health, and motherhood. Essential themes that run throughout include Identity, Connection, Validation, Self-Care, Inspiration, Strategies, and Optimism. Top tips from over 20 Real-life AspienWoman Super-hero Mentors offer a smorgasbord of suggestions and support.

The pages of I Am AspienWoman hold a diamond of a message for any reader. It may be big, life changing, and fabulously eye opening. It may touch your heart and whisper “I see you.” It may provide the much-needed words to explain, describe or share thoughts, feelings and experiences. It may open doors, or it may give a gentle push to close those that are no longer helpful. It may be a hint of Hope, or perhaps a spark of Superhero-ness. It may be all that is needed to get started, re-start or continue on the journey of becoming the best version of who you are: an AspienGirl or Woman, a family member, a friend, an educator, a professional.

As a field, we still have a long way to go in advocating for better understanding of female autism, educating and training professionals, developing appropriate assessments and treatments, and creating a community of support and inclusion for AspienGirls and Women. Given all that has happened in the last few years, I am encouraged that we are headed in the right direction. Thankfully there are those special books, like I Am AspienWoman, that act as a guide and an incredibly accessible resource. As with her prior book, Tania’s latest offering has not surprisingly leaped onto my recommended reading list.”

Shana Nichols, PhD
Owner, Director, Researcher                                                                                        ASPIRE Center for Learning and Development                                                             Author of ‘Girls Growing Up on the Autism Spectrum: What Parents and Professionals Should Know About the Pre-teen and Teenage Years’

“Tania Marshall has created a groundbreaking book. Most often we hear the voice of the parent or professional, at last we hear the voice of women with Aspergers. Aspienwomen can be totally inspiring! Thoroughly recommend.”

Carrie Grant
Vocal coach, judge and TV presenter
Judge, BBC 1’s Fame Academy and BAFTA Award winning “Glee Club.”
Presenter, The One Show
Author, bestselling book “You Can Sing”
Mother to two daughters on the spectrum
United Kingdom

“There is definitely a need for more information for individuals who get diagnosed later in life. Diagnosis as an adult can provide tremendous insight into why relationships were so difficult. When I was in college, I remember many older quirky adults who seeked me out and helped me. Today many of these people would be diagnosed with either autism or Asperger’s syndrome. One woman was the associate dean’s wife and she gave me many hours of emotional support during difficult social times in college.”

Temple Grandin, Author, USA
The Autistic Brain and Thinking in Pictures

In this sequel, to her first book Aspiengirl, Tania Marshall examines the topic of autism in women, utilising the personal perspectives of women themselves. Despite a greater awareness of autism more generally, autism in girls and women is only just beginning to receive wider attention and the majority remain undetected, in many instances leading unhappy unfulfilled lives and often struggling to survive. This ‘lost generation’ of women is only now beginning to have the nature of the condition and needs recognised. Despite the talents and qualities such women may possess, they largely remain disadvantaged and vulnerable. This is often compounded by a lack of self-awareness and by their families and a poorly informed professional community.

As with its forerunner the essence of this book is its attractiveness, readability and clarity. It will open eyes of the reader in so many ways and although adopting a positive tone throughout avoids trivialising or glamourizing the topic or pulling its punches. Tania Marshall does not shy away from difficult areas or topics and has sensible approaches to offer. I am sure it will have a wide appeal – from those women who are or suspect they may be on the autism spectrum, families and professionals in many fields such as employment, education, health and social support.

Richard Mills

Research Director, Research Autism, London

Hon. Research Fellow, Dept. Psychology, the University of Bath, UK

I have been fortunate enough to work with a number of young people and their families in the UK and Ireland during the last 20 years.  I am also lucky to be involved with practitioner research; previously developing our ‘saturation model’ for including young people with autism in mainstream education (Morewood et al, 2011) and most recently considering the impact of interventions through case studies (Bond et al, 2015).  This research is vital; however I always feel I understand most from listening to young people, hearing their stories and talking to their families.

AspienWoman is the latest book from Tania A Marshall, and a vital addition to the growing knowledge-base about females and autism.  The ‘first-hand’ accounts throughout the book support the outcomes of our research; a personalised approach is essential.  The comprehensive ‘real-life’ examples support a rapid increase in understanding and allow for a truly unique viewpoint; highlighting strengths and personal characteristics of the women who have contributed, skillfully linked and collated by Tania, drawing on a wealth of personal experience and expertise.

I am reminded of a quote one of our students, Megan told me once: ‘I feel rather positive about my Autism, because it is part of me and without it I would not be me anymore.’  Anyone reading AspienWomen will understand immeasurable more after reading it, as I have.  I am always learning, from our young people and their families; Tania’s contribution to this knowledge will have considerable impact, as I am certain that AspienWoman will for many, many others around the world.  Essential reading, if you are directly involved in working with young people, their families or women with autism, or if you just want to understand more about some of the amazingly talented individuals who have contributed to this amazing work.

Gareth D Morewood

UK Special Educational Needs Coordinator

Honorary Research Fellow, University of Manchester

Associate Editor, Good Autism Practice Journal

www.gdmorewood.com
“Once again, Tania has provided a visual conversation starter to demonstrate the wide and varied adult presentation of female autism. Featuring individual profiles of successful autistic women along with quotes from individuals and family members, this book will help to further increase the understanding that women with autism are out there – even if they are hard to spot”.

Sarah Hendrickx,
Autistic adult
Masters (Autism), Postgraduate Certificate (Asperger Syndrome)
Author of Women and Girls with ASD, Understanding Life Experiences from Early Childhood to Old Age. JKP, (2015)

“When reading Tania Marshall’s AspienWoman, the reader gets wave after wave of deep understanding about women with Asperger Syndrome, filled with affirmation, positive reinforcement and difficult facts softened with empathy.  This book is unique and sensitive and full of wisdom.  For those on the spectrum it will be like a breath of fresh air to be understood and lifted up. For those just wanting to learn more, it is an exciting journey full of revelation and hope. AspienWoman is not a book to read once.  It is a book to be absorbed over time.”

Kathy Hoopmann,

Author, All Cats have Asperger Syndrome, All Dogs have ADHD

The Essential Manual for Asperger Syndrome (ASD) in the Classroom

Tania, your book is a reflection of the bright and beautiful possibilities that await women on the autism spectrum. Many had said, “She will grow out of it,” but rather, your book shows that “We grow into it,” emerging from confusion and misunderstanding into a new appreciation of our unique and powerful profile. I am Aspien Woman is a celebration in word and picture, affirming our rightful place in the society in which we live!

Rachael Lee Harris

Psychotherapist specializing in Women and Girls on the Autism Spectrum.

Author of My Autistic Awakening: Unlocking the Potential for a Life Well Lived

As the parent of an adult son who was diagnosed with Aspergers after many years of misdiagnosis and assumptions, ie “little professor” “lazy’ and more + the spouse of a man who was diagnosed with Aspergers as well I enjoyed reading your book.

The layout of I Am AspienWoman is quite impressive. The photos are vivid. The self descriptive disclosures regarding living with Aspergers by individuals and family members provide a venue for other woman on the spectrum to identify with. The photos and self disclosures are uniquely reinforced with factual information regarding the bio/psycho/social characteristics of those on the spectrum by the author in a format that the laymen can understand. I Am AspienWoman takes Aspergers and living on the spectrum out of the clinical context and provides a human and real window into the meaning of living with Aspergers.

I Am AspienWoman focuses on the positive aspects of living with Aspergers. It does not focus on the deficits. For sure, this book portrays the challenges associated with being on the spectrum but the strengths that individuals possess due to having Aspergers is reinforced. This will be resultant in providing hope and  the reader perceiving themselves, or a family member who has Aspergers in a more positive light.

The unique combination of presenting bios of “real people”, challenges, and the strengths of individuals with Aspergers will provide a venue for not only appreciation of strengths but challenges that effect individuals on the spectrum as well. I Am AspienWoman cracks the heuristics of society at large and any misnomers regarding Aspergers.

Many different aspects regarding traits, characteristics, challenges  are portrayed which reinforce the individuality of individuals on the spectrum. As with neurotypicals, each individual possesses different traits, talents and personalities. Hence, this is not a cookie cutter diagnosis where everyone with Aspergers is talented in math or computers. 

Thanks Tania for writing a much needed and “human” book that many on the spectrum will seek out for positive role models and will cause  society at large to change their perception about individuals on the spectrum who they live, love, work and play with on a daily basis.

Mari Nosal M.Ed. Author

Ten Commandments Of Interacting With Kids On The Autism Spectrum And Related Commandments

When I first read I am AspienGirl last year, I knew immediately that we would be treated to sequels. I am AspienWoman takes up where AspienGirl leaves off, taking the concept through a beautiful age progression.  AspienWoman does not glamorize Asperger’s but rather gives a balanced, factual picture of the strengths and challenges that characterize this population. The short vignettes tell the stories of the lives of real people, told from both the perspective of AspienWomen themselves, and from those who surround them in life. Tania Marshall outlines common traits and needs of the AspienWoman, with which many women will identify.

This book is alive with pictures and stories of beautiful, successful AspienWomen. The focus is on the strength of those spotlighted, and includes personal tips for success from these role models to the reader. Reading the stories of this group of featured role models, it is clear that “different” does not mean “less”. Ms. Marshall also includes a section of ideas on how a professional might use I am AspienWoman to enhance the lives of women with Asperger’s.

I am AspienWoman throws a life line to young ladies dealing with a feeling of isolation or frustration due to Asperger’s Syndrome. Ms. Marshall offers a sense of community to this population, along with proof that success and happiness can be a reality for the AspienWoman.

 Linda Barboa, PhD

Author of:

Stars in Her Eyes: Navigating the Eyes of Childhood Autism

Tic Toc Autism Clock

Steps to Forming A Disability Ministry

And the Albert is My Friend series teaching children about autism.

Watch for AspienPowers: The Unique constellation of Gifts, Strengths and Abilities of Females on the Autism Spectrum, coming late 2015.

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Book 3 of the series

Tania Marshall is a best selling author, a 2015 ASPECT Autism Australia National Recognition Award Nominee (Advancement Category) and a 2015 eLIT Gold Medal Award winner for her first self-published book entitled “I Am AspienGirl: The Unique Characteristics, Traits and Strengths of Young Females on the Autism Spectrum”, foreword by Dr. Judith Gould. She divides her time between private practice, research and writing. Tania is an Australian Psychological Society (APS) Identified Autism Practitioner, a Helping Children with Autism Early Intervention Service Provider (HWCA), a Better Start for Children with a Disability Provider, an approved Medicare provider of psychological services and a trained Secret Agent Society (SAS) Practitioner.

Tania is available for Skype or in person assessments, support, intervention, coaching and problem solving sessions. Tania can also be contacted for interviews, workshops, presentations, conferences, articles, publishing inquiries and/or translations at tania@aspiengirl.com

Adult Autism/Asperger Syndrome Assessment in Females

Adult Autism Assessment in Females 
Updated 23/09/2016

Autism spectrum conditions, including Asperger’s syndrome, are challenging to identify in adults. Without appropriate assessment, many individuals may go undiagnosed, without appropriate support and treatment.

Many girls and women are going undiagnosed or misdiagnosed because the majority of the research has been conducted on males and there is a great need of research based on females compared to NT females, research based assessment tools for females and interventions for females. There is also a great need for these tools to be made readily accessible to professionals, in other countries and other languages. At present, there are few professionals in the world both trained and experienced in assessing and/or working with females on the Spectrum, across the lifespan. At this point in my career, I have worked with hundreds, closer to 1,000 females, from ages 18 months to 78 years of age, of various sub-types, symptomatology, mild to severe traits, a variety of levels of Giftedness, many professional performers (singers, musicians, comedians, actors, models), professionals athletes, professional artists, professional authors, high-profile individuals, all at different points on the Social Spectrum, some with gender dysphoria, some with sexual fluidity, parenting and being a mother, being in trouble with the law, stalking and obsessiveness, working in the sex trade, being sectioned into a mental health facility (and the experiences that go with that), have work-related challenges, and much more.

Females with Autism or Aspergers may be picked up for Autism in the teenage years with depression, anxiety or an eating disorder, if they are at all. Many females exist who are undiagnosed or misdiagnosed and continuing to have mental health problems because of this. Some are diagnosed with Borderline Personality Disorder, which may or may not be appropriate, although many have BPD traits, and I have worked with individuals who have both. For adults, no-one knew of Asperger Syndrome or Autism back in their childhood. So a comprehensive early childhood and teenage autobiographical account is an extremely important piece of an assessment. In addition, other perspectives from people who know the person very well are important. A comprehensive assessment of an adult can include a variety of assessment tools, depending on the person. It also involves childhood photographs, report cards and comments, parental and/or partner perspectives, formal assessment tool(s) and an exploration of abilities, talents and/or gifts.

 

The vast majority of women I work with are on the bright end of the Spectrum, and tell me their reasons for seeking a diagnosis range from self-understanding and awareness to improving their relationships, to improving their works relationships, to treating their anxiety and or depressive episodes. are not seeking services, support, nor government support pension or services. They are wanting to know why they have “felt different” for so long, wanting to know what career is best for them, wanting to know how to structure their lives. They don’t want o be on government disability not do they see they value in that. They like working, want to work and contribute.

Presently there are ZERO adult assessment tools for females, very little research that is based on females and no specific research based interventions for females. This is a crisis for females. It is challenging for females to find a professional or organization familiar with the female autism research, how to assess females and then how to support them.

When I conduct impressions assessments, the assessment of adults explore the areas of social communication and interaction, repetitive and stereotypical behaviour, sensory issues and abilities or gifts. Feedback is provided, recommendations, highly recommended resources and a “What Next?” discussion is also involved.

Generally speaking, my comprehensive adult diagnostic impressions assessments include the following:

An autobiographical account from earliest memories until approximately age 25 (usually 4-6 pages)
A written or typed account of why you feel you might have female Autism/Asperger Syndrome
A 10-page Life History Questionnaire to go over various traits, and also collect extensive life/educational/employment/psychological history, developmental information.
Where possible, I interview family members, a partner, or any other family member or friend who know the person very well. I also base my diagnosis on my direct experience of how the person presents during the interviews. Non-verbal body language, facial expressions, the sound of the voice and intonations are all assessed.
An interview exploring present day context and day to day functioning
An exploration of the following is important:
 
Family history, including one’s own children (if any), who may be displaying traits or be formally diagnosed.
History of mental health issues, previous medical, psychiatric, psychological and psycho-educational history (previous IQ test and/or educational assessments), previous diagnoses and/or learning disabilities
Reading of previous reports, letters, hospital admission notes, medical, educational reports
Educational history
Social communication and relationship/friendship history, use of social compensatory strategies
Identity or persona (s)
A thorough exploration of compensatory strategies
A sensory processing assessment
Work history
School report cards, school/teacher comments
Childhood photos from each developmental stage
Abilities, gifts, strengths, talents and/or skills (some examples include samples of poetry, art, blog, short stories, books, singing and/or musical ability, acting, comedy routine, degrees and/or thesis/dissertation work, samples of jewellery, clothing or costumes, website, awards and so on)
Over-excitabilities, sensory sensitivities, self-soothing or stimming behaviors, sensory processing disorder and/or synaethesia
An exploration of visual, auditory, taste, touch, smell, balance, movement and intuitive differences, synaethesia and hyper empathy.
1-3 other perspectives from other persons who know the person really well
An exploration of personal journal entries, autobiographical and/or blog entries
Results of specific adult Autism assessment tools and other tools, completed by the person and also dependent on the person being assessed and the context
Other conditions (for example,  Central Auditory Processing, Irlen Syndrome, Ehlers Danlos Syndrome,  Hypermobility type Syndrome, food allergies)
Formal diagnostic tool(s) depend on the context of client. Research has shown that both the DSM5 and the ADOS are not very good at picking up the subtle characteristics of females on the Spectrum.
It is imperative that professionals learn to ASK females the right questions. These questions will vary from questions that would be asked of males. This is because we research is finally beginning to catch up with clinical experience, telling is what we as clinicians have know for years, that males and females present differently, in quite a few ways. Giftedness also impacts on the presentation of a female on the Spectrum, so professionals need to be aware of all levels of Giftedness and how they affect the assessment process.
So, when someone receives a diagnosis, what then?

A positive assessment or diagnosis is just the beginning.It is never to late to receive a diagnosis and the benefits outweigh any disadvantages.

While my diagnosis is based on the current DSM-5 Criteria, it is by no means a cut and dry process. The DSM is a working document and as such, does not accomodate well to females on the Spectrum.

Diagnosis, ultimately from my perspective, is best done when in collaboration with the client (and their partner or spouse when relevant) as a way to inform, educate, reflect and empower.

An important  “What Next” section is very important, and may or may not involve the following,  again dependent on the person, their situation and context of their life. Discussions of the following may include:
Self awareness and understanding
Education and highly recommended resources (including the best academic books, websites, research, researchers, webinars, etc)
Attitude
Strengths
Challenges
Recommended helpful therapy
The Social Spectrum
Referral to other professionals, professional support groups, etc.
Many adults have lived and died not knowing they had Autism or Asperger syndrome. Some benefits of an adult diagnosis include:
Knowledge and self-understanding of oneself and also for family members, friends, co-workers and/or partners
Access to appropriate therapy, medication, support and services
An answer for past experiences and challenges
Permission to ease up on oneself
Possible prevention of other conditions or disorders (i.e., personality disorders, difficulties distinguishing between reality and fantasy), difficulties with work, the law and court system and/or suicide
Prevention of mis-directed treatment
Learning about how one thinks (see the Autistic Brain, by Dr. Temple Grandin)
Identifying strengths, abilities and gifts
There are both benefits and costs to disclosing a diagnosis. Disclosure should be considered thoughtfully and used only if there is is potential benefit.
Who should I look for to help me? How can I find someone to help me?
Today, there are few professionals in the world trained and experienced in assisting females. At this time, the most important factor to look at is “Does the professional have both experience and training in the area of female autism”? Are they aware of the inherent gender bias? What types of assessment tools do they use? What is involved in an assessment? Do they use adult assessment tools? (Yes, I have had two clients tell me that child assessment tools were used on them).
I have developed a database of professionals who work with females which can be found at and is being updated on a regular basis at http://taniamarshall.com/female-asc-professionals.html
Please contact me at tania@aspiengirl.com if you or you know of someone who would like to be added to this database.
Common Pathways to an assessment or diagnosis
Having a child being assessed or who is formally diagnosed with  Autism
Difficulties with work or a current relationship
Discovering and learning about female Autism, aka self-diagnosis
A family member has recently or in the past received a diagnosis
Stalking and/or becoming involved in other criminal activities
I have read your writings and book I Am AspienGirl and it fit like a glove. Can you provide an assessment for me?
Yes, Tania regularly provides comprehensive impressions assessments across the lifespan. The vast majority of adults (both male and female) Tania has assisted are wanting a self-diagnosis confirmed formally. She is also in touch with other professionals who work in this area and also regularly refers to other appropriate professionals at the appropriate time. She can be reached at tania@aspiengirl.com
I really identify with the writings available on female Autism but I am not sure I want a diagnosis? Is Tania available to for sessions other than assessment?
Yes, Tania regularly provides services which may focus on assessment, diagnosis, problem solving, the pros and cons of a diagnosis, the pros and cons of disclosure, career directions, managing stress, anxiety, sensory sensitivities, “What Next” after a diagnosis, the different types of Autistic thinking, gender dysphoria, social difficulties and social skills, relationship difficulties, synaethesia, hyperempathy and the topic of being an “empath”.
For more information about the adult female phenotype, the sequel to the eLIT Gold Medal Award winning I am AspienGirl, entitled I Am AspienWoman: The Characteristics, Traits and Abilities of Adult Females on the Autism Spectrum is in press and due for release September 2015 and is based on her blog entitled “Aspienwomen: Adult Women with Asperger Syndrome. Moving towards a female profile of Asperger Syndrome”

Tania A. Marshall is an award winning and best selling author, a 2016 and 2015  ASPECT Autism Australia National Recognition Awards Nominee (Advancement category) and a psychologist. Her first book, I Am AspienGirl: The Unique Characteristics, Traits and Gifts of Females on the Autism Spectrum, Foreword by Judith Gould, UK, is a Amazon best-seller and a 2015 IPPY eLIT Gold Medal Book Award Winner.

I Am AspienGirl has been translated into both Spanish and Italian (release dates of July and August 2015 respectively). Additional completed translations include: German, Japanese and Brazilian Portuguese. Other languages currently under completion include: Dutch, French, Norwegian (by SPISS), Hebrew and Chinese.

 

Tania has completed the sequel to I Am AspienGirl, entitled “I am AspienWoman: The Unique Characteristics, Traits and Strengths of Females on the Autism Spectrum, foreword by Dr Shana Nichols (lead author of Girls Growing up on the Autism Spectrum). The release was 2015. This book includes a section of 24 females, all diagnosed as on the Spectrum, showcasing their strengths and also offering important advice to others. Tania is proud to announce that her 2nd book “I Am AspienWoman” recently won an IPPY eLIT Gold Medal in the “Women’s Issues” category.

Tania is an Australian psychological society (APS) autism identified medicare provider,
helping children with autism (HCWA) early intervention service provider, a better start early intervention provider and an Australian government medicare approved mental health provider. She is also a trained Secret Agent Society (SAS) social skills practitioner.

Tania can be reached at Admin@centreforautism.com.au for clinic or Skype remote impressions assessments, consultations, problem solving sessions, skills acquisition and intervention, interviews, book translations, presentations or workshops. She divides her time between busy full-time private practice, research and writing her book series.
Tania’s other books include:
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AspienWoman April Elit Award1
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Sample chapter of I Am AspienWoman: The Unique Characteristics, Traits and Gifts of Adult Females on the Autism Spectrum

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Drawing from years of practitioner experience, Tania Marshall takes you inside the world of adult females with Autism or Asperger Syndrome. Using a highly visual format, this book combines powerful imagery and an insiders own words to showcase the complex profile of females with an Autism Spectrum condition. Included is a large Mentor section of positive and powerful women headed by Dr. Temple Grandin. Each woman discuss their strengths, their careers and provide important and helpful advice for women on the Spectrum. The focus of this book is on the female phenotype. Available in eBook, paperback and a special edition hardcover version, approximately August 2015. Pre order now at http://www.aspiengirl.com

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table of contents

crowd Growing Up Quietthe world

tomboys

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FashionDiva costume steampunkengineer

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Preorder at http://www.aspiengirl.com

For more information about female Autism go to http://www.taniamarshall.com or view the Free sfari webinar entitled The Female Autism Conundrum on gender bias at: http://sfari.org/sfari-community/community-blog/webinar-series/2015/webinar-the-female-autism-conundrum

Coming 2016

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Behind the Mask is a book for professionals and explores the themes of a large group of females across the lifespan. Drawing from years of practitioner experience, Tania Marshall takes you inside the world of females with Autism or Asperger Syndrome. Using a combination of academic research and autobiographical accounts, this books explores the female phenotype. More specifically, the who, how, why, when and where of a large group of females who utilize a variety of strategies and abilities to hide their Autism. Masking strategies, social echolalia and chameleon abilities are discussed. The advantages and disadvantages of these strategies are discussed.

Chapters discuss particular non-verbal and verbal characteristics to look for, particular questions to ask, and include helpful modifications to practitioners offices or clinics and professional approach.


Available in eBook, paperback and a special edition hardcover versions, 2016, at http://www.aspiengirl.com

Cover by Ardent Studios and Model Samantha Tomlin

Behind the Mask 3D

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Female Autism Infographics

Female Autism Infographics to share for awareness and education. More Coming

The following article is copyrighted and may not be posted anywhere without permission from the author.

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For more information go to:

http://www.aspiengirl.com

http://www.taniamarshall.com

To contact Tania regarding consultations, assessment, problem-solving strategies, Skype consultations, book distribution, interviews, book translations, publishing queries, please email her at tania@aspiengirl.com

Sfari Webinar: Summarizing The Female Autism Conundrum and my Thoughts

Webinar: A Summary of The Female Autism Conundrum

By Tania. A Marshall, M.Sc. (App. Psych), Assoc. MAPS

Thank you to Sfari.org and female Autism researcher and experts David Skuse and Will Mandy for presenting a fascinating webinar discussing the gender bias.

Part One by Dr. David Skuse

More individuals who are termed “high functioning” are now being assessed and diagnosed. If Autism is defined by the male stereotype, then females are going to be missed and disadvantaged. We, and other professionals working in this area, believe a serious gender bias exists. So, where is the evidence that we are missing females?

  1. Studies are not recruiting a representative sample of females with Autism and therefore are making spurious conclusions.
  2. The under identification of females with Autism Spectrum Condition (ASC) with average IQ
  1. A South Korea Study screened approximately 55,000 school age children and found that the overall prevalence rate was 2.5:1 for male to female.
  2. A National Health Statistics Report (2013) found that changes in the prevalence of parent reported Autism Spectrum in school-aged children found that there was an 80% increase in the identification of school-age boys with ASC in the 5 year period as opposed to only a 43% increase in identification of school-age girls.
  3. By 2013, approximately 1 in 30 boys in the United States of America had been given a diagnosis of Autism Spectrum Conditions and ONLY 1 in 140 girls had been given a diagnosis of Autism Spectrum Conditions and this is most likely an underestimate. School-ages children (mostly boys) were largely responsible for this increased prevalence. Largest increase is between 14 and 17 years
  1. Identifying, ascertaining and assessing teenage females with Autism Spectrum Conditions if particularly challenging and problematic. Why is this?
  1. Compensation: Females from preschool onwards are much more aware to social behaviours and norms Girls are less able to identify due to their superficial social skills, fewer social communication issues, less stereotyped behaviours and/or unusual motor behaviours
  1. Co-existing Conditions: The majority of females internalize their problems with depression, eating disorder, depression and a lack of “conduct” or behaviour problems and less ADHD in school, but behaviours are often seen at home. Boys are often picked up earlier due to their disruptive behaviours at school.
  1. Biased recording of behaviours, symptom profiling, using standard instruments and tools. Autism has been defined as a male stereotype. Girls have less repetitive and stereotyped behaviours and less motor behaviours.

If Autism is defined by the male autism stereotype, we will not find the girls. The definition of Autism is based upon the male stereotype and there is biased identification

Examples from the Interests and Behaviors section of the ADI-R

  1. Is she unusually interested in things like metal objects, lights, street signs, or toilets? No, she is obsessed with Justin Bieber!
  2. Does she play with the whole toy or seem more interested in part of the toy (e.g., spinning the wheels of a car or opening and shutting the door? No, sheis obsessed with her doll’s hair
  3. Does she have anything to which she is particularly attached, such as a pieve of pipe, a clothes peg or a stone? No, but she does have a collection of 2000 soft toys which are all pink, makeup collections, stationary items (my observations are erasers, pens, pencils, journals)

A population survey of gender differences in Autism traits which was a whole population epidemiological survey of autistic traits called the Avon Longitudinal Study of Parents and Children (ALSPAC), Bristol, UK. All participants were screened with the Social Communication Disorders Checklist (SCDC). Results showed that there were not dramatic differences by gender in parent’s answers on the questions. The results showed a 1.9:1 ratio for boys to girls.

Can females with high verbal IQ compensate for their ASC traits? Yes, females may compensate to some degree.

Females are at high risks of developing co-existing psychiatric disorders in response to social adjustment difficulties in later life.

In secondary school, females often become alienated, depressed and/or suicidal. They may become obsessed with people (to the point of stalking) or self-harm. Obsessions with people are common and can be towards professionals (doctors, psychologists, a best friend) with use of the Internet used to stalk the professionals, their families or their webpages.

The definition of ASC is based on the “male” stereotype. Current diagnostic criteria and the way it is implemented in research and clinics and assessment tools are biased against females and a large proportion of girls are missed in assessment or not included in the research.

We need to develop a better understanding of the ASC female phenotype which is founded on empirical and scientific information.

Ascertaining and assessment of girls with and ASC in the teenage years if particularly problematic.

Part Two by Dr. Will Mandy

We need to understand the female Autistic phenotype

Current ASC assessment processes are biased against females

A disproportionate amount of girl are underdiagnosed and/or misdiagnosed and incorrectly excluded from research studies

The current DSM5 on page 57 now states ”girls without intellectual impairment or language delay may go unrecognized, perhaps because of subtler manifestation of social and communication difficulties”

The key task is to develop a better understanding of the autistic female phenotype founded on empirical and scientific investigation. So, what does current research, clinical experience, anecdotes, a network of collaborations with professionals and narratives by females with Autism themselves say?

The Autism Female Phenotype and distinctive tendencies, patterns and trends (some males have traits of the female type and vice versa).

  1. Females with ASC are more socially motivated than males with ASC, more typical and gender stereotyped interests (Hiller et. al, 2014). Females show greater interest in people and initiate friendships more.
  2. Female obsessions or focused interests include: fashion, people (peers or celebrities or professionals), Barbies, hair, animals, Manga and Anime
  3. More vulnerable to internalizing disorders and are prone to Eating disorders like Anorexia Nervosa, anxiety, depression and less likely to have conduct issues outside the home (Mandy et. al, 2012, Mandy & Tchanturia, in press)
  4. Social difficulties are misattributed to shyness or social anxiety
  5. Greater ability and capacity to “camouflage” and/or hide their autistic tendencies (Lai et. al, 2011)
  6. Gender differences play out or appear across the lifespan, in a developmental context. The greatest risk in gender differences across the lifespan is the issue of females; the greater female risk of missed diagnosis in the young, in pre-schoolers, in adolescence and into adulthood.
  7. Friendships: Girls are often ignored by others rather than rejected
  8. Female autistic difficulties are underestimated in school
  9. A much greater risk for anxiety and depression in primary school and then eating disorders in adolescence and sexual exploitation
  10. Camouflage: the “masking” of ASC behaviours in social situations and/or the performance of behaviours to compensate for difficulties associated with ASC
  11. Masking: Can be conscious (deciding to suppress stimming behaviours in public as they attract negative attention (Mandy & Tchanturia, 2015) or automatic (“doing social mimicry against whomever I’m with. I guess it’s like a cloaking device…I had no idea I was doing it until I as diagnosed”) (Bargiela & Mandy, in press)
  12. Acquisition of new skills and capacities to compensate for autistic difficulties and can be conscious (copying popular peers, dress, gestures, talk and practice it over and over at home; Mandy & Tchanturia, 2015) and unconscious (implicit learning from social experience; “it used to take me weeks to figure out what I had done wrong, but now I know pretty much immediately” HM, 15 years old)

What processes underpin camouflage? What drives the capacity to drive and adapt?

  1. Social Motivation
  2. Socially focused special interests; for example, psychology, anthropology, Jane Austen novels to crack the “social code”, to develop strategies to function socially
  3. Socialization experiences and pressures; the social pressures and expectations placed on women as opposed to men
  4. Executive control: the ability to inhibit, shift and generate plans
  5. Better social imitation and awareness
  6. Better Capacity for reflection
  7. Higher intelligence quotient and using intelligence to camouflage

So is Camouflaging a friend or foe? Both

The Pros include: allow people to function better in the workplace, in the social context, can open up a social world of friendships and can be a form of personal development/self-help

The Cons include: Exhaustion, loss of identity or identity confusion, underestimation of needs, missed and mis-diagnosis

At what age does female compensation start?

It begins in early childhood and breaking down in early adolescence, with adolescent talk and chit-chat being very exhausting, boring or uninteresting. Young girls have to learn from a very young age that you have to be nice, sweet, hug your relatives, act normal, develop a face you can put on and often acting convincingly so, which then makes it so much harder to get a diagnosis, leading to the theory that girls don’t get Autism or get is much less than boys.

Q & A Session with David Skuse and Will Mandy

  1. Q: What does all this mean in the context of early intervention?

A: Information from at-risk siblings revealed if assessment is done skilfully it can be picked up early in females. No evidence of intervention for females. The focus is on co-existing conditions or disorders. It is I,[perative to screen adolescents with anxiety, depression, self harm or eating disorder for an Autsim Spectrum Condition

  1. Q: If someone is able to camouflage e and there functioning better, what does this mean in terms of intervention and getting better, can this be seen as getting better?

A: People often find their own affective ways and strategies of handling difficulties. We need to be aware of the consequences (i.e. lying down in the foetal position after a demanding day pom arriving home). Many adolescents strive to be model students at school and all hell breaks loose at home. Parents are concerned and mental health blame the parents because they are not causing difficulties at school , which them leads to family therapy and parenting programs for the parents. This is sometimes seen in primary or elementary school

  1. Q: Is there a higher percentage of Gender Identity issues in females with Autism?

A: There is small growing literature on gender identity issues in females with ASC, but we are not aware of how common the wish to change gender is.

  1. Q: In the parent reported study you mentioned they weren’t formally diagnosed?

A: The Korean study ascertained cases that had not been diagnosed in the general population. A small proportion of those in the general population had been ascertained as being autistic. A lot of kids were picked up as school aged children, particularly girls who had not been picked up earlier as in clinically diagnosed. In the Bristol one, we screened at 8 and by mid-adolescence virtually everyone who had a diagnosis at that time had been picked up as having a high score in our survey and of course there were lots of children on our survey, the vast majority, almost all of them up with them, those who scored as high on the Social Communication Traits of an Autistic type may well have had secondary psychiatric problems during adolescence but those data are still being analysed

  1. Q: Are there any resources in particular for supporting suspected or maybe undiagnosed girls, teens, women for females, that are suspecting that they themselves or someone else

A: We are not aware of anything here in the UK. We have similar problems in the UK are almost certainly not being picked up and even if they are, the resources to help them are very limited indeed under the National Health Service (NAS). There is enormous popular literature on being a female with ASC. It is worth checking out the work of Tony Attwood on this topic and Tania Marshall and people like that. We are at the stage of interesting, rich and powerful descriptions of the female phenotype but now we need to get a proper evidence base that reflects scientific testing of all these ideas coming out in the literature and to my knowledge those studies haven’t been done yet.

Some thoughts from me

It is wonderful to see clinical anecdotal and qualitative evidence and evidence-based research merge. Thank you to Sfari, Greg Boustead, Dr. David Skuse and Dr. Will Mandy for an excellent webinar.

I do think an issue that makes it challenging for professionals pick up females is a lack of understanding about the female subtypes. Within a large group of autistic females, this can be seen clearly. Some examples follow and I am writing about subtypes in a future book.

1. The Blender. Shy, quiet introverted, maybe mute at times type. This type blends into the wall or the furniture. You often do not know she is there. May be misdiagnosed with social anxiety. If often on her own or follow others

2. The talker. Loud, more controlling and rule-bound, extraverted type who may come across as having ADHD, may control the relationship

3. The flitterer, goes from group to group with no solid friends and goes unnoticed

More to come about subtypes in upcoming book series

Collections can often involve also stationary items; the collecting of erasers, pens, pencils, journals and similar items.

There is still much to learn about female autism and I encourage those with an interest in this area to possibly research the following areas:

Motherhood and Autism

Gender Identity and Transgender

Autism and the sex trade

Body Dysmorphic Disorder

Sensory Processing Disorder in females with Autism

Mature females with Autism

For more information on the female phenotype, the best-selling book entitled “I Am AspienGirl: The Unique Characteristics, Traits and Gifts of Young Females on the Autism Spectrum” is available for order now. The sequel entitled “I am AspienWoman: The Unique Characteristics, Traits and Gifts of Adult Females on the Autism Spectrum”, with a large Mentor section of real-life adult females headed up by Dr. Temple Grandin, is being released shortly. Both are available from www.aspiengirl.com or Amazon

Tania A. Marshall is a Tania Marshall is a 2015 ASPECT Autism Australia National Recognition Awards Nominee  (Advancement category), a best-selling author, psychologist, autism consultant and free lance writer.

eLIT Gold Award Cover

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For more information on female Autism, please visit http://www.taniamarshall.com

Please follow these female autism researchers:

Will Mandy

David Skuse

Rachel Hiller, University of Bath

Christopher Gillberg and Svenni Kopp

Judith Gould

Meng Chang Lai

Simon Baron Cohen, University of Cambridge

Francesca Happe

Marianna  Murin and Rebecca Chilvers from Great Ormond Street Hospital

Announcing I Am AspienWoman: The Unique Characteristics, Traits and Gifts of Adults Females on the Autism Spectrum

I Am AspienWoman: The Unique Characteristics, Traits and Gifts of Adults Females on the Autism Spectrum

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After “I Am AspienGirl” was released in June 2014, it went to #1 in 3 categories on Amazon. The AspienGirl team was inundated with emails, stories, messages and letters. Many of them were from females themselves or from their family members, their loved ones and professionals. We received pictures, poetry, art, short and long stories. We had people, of all ages, wanting to be a part of the Be Your Own Superhero Project. We received messages from a number of countries wanting to know more about female Autism, offering their translation skills to assist in getting the information made available in other languages and/or wanting to know where to go to start the process of an assessment. Messages came in from parents and professionals saying they were using the book to explain the diagnosis or as a reference/starting point for explaining or discussing certain characteristics. Many of the messages or testimonials coming in positively referred to the format of the book, in particular the use of images and verbatim quotes which combined together showcased particular traits, characteristics or talents.

What we learned was that there is a desperate need all over the world for more trained professionals, more adult female research based on females and comparing females with Autism to their neurotypical peers, more information regarding the internal experiences of a large group of females on the Spectrum, more information about the female sub-types, and a huge need for assessment tools, resources, intervention and support designed specifically for females. Current assessment tools appear not to be suitable or designed to identify particular features of Autism spectrum disorder/condition in females.

This book is written for four types of readers. First, this book was written for the general population (neurotypical people), to explain the internal experiences and the unique characteristics of adult females with an Autism Spectrum Condition (ASC). Second, this book is written for the female who may just be starting her journey to understand that she may too, be on the Spectrum herself. Many adults are unaware that they are on the Autism Spectrum. Third, this book is for individuals who are self-diagnosing or with a formal diagnosis who may feel this book may help explain their uniqueness and characteristics to themselves and/or to their loved ones through sharing it with family members, partners, friends and/or colleagues. Lastly, the book is written for professionals, to assist them in understanding the newly emerging Autistic female profile and in their work with their clients.

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Cover of I Am AspienWoman

I Am AspienWoman: The Unique Characteristics, Traits and Gifts of Adults Females on the Autism Spectrum is written by Tania Marshall, MSc., and the second in the AspienGirl book series. This book continues where I Am AspienGirl left off, detailing the newly emerging female phenotype as it often presents in adult females. This highly visual book presents stunning images combined with verbatim quotes by females on the Spectrum, that combined characterize and illuminate the unique strengths and challenges of the this “lost generation” of females. The images and quotes highlight a range of areas including: early memories, cognitive/personality type, sub-types, social, education, sensory sensitivities, emotional, communication/language, work, common interests, gender, family, and relationships, strengths, challenges, stages leading up to and after diagnosis, important AspienWoman needs and an inspiring section of 25 real life AspienWoman Superhero Mentors headed up by Dr. Temple Grandin. Also included is a strengths based exercise and some important references/resources.

Growing Up

Sample Page of I Am AspienWoman

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Sample Page of I Am AspienWoman

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Sample Page of I Am AspienWoman

In celebration of the upcoming release of I Am Aspienwoman, we are offering $5.00 off, from now until release day. Pre-order you copy now at http://www.aspiengirl.com/english/i-am-aspienwoman-paperback

Available in eBook, paperback and a stunning Hard Cover edition. Dont forget to use your $5.00 off Code: #aspienwoman

You can also sign up for the AspienGirl newsletter and/or become an affiliate of the book series and earn 10% for every book your refer

For all inquiries regarding in-person or Skype diagnostic assessments or consultations, interviews, presentation and/or translations, please contact Tania at tania@aspiengirl.com

For furthur information:

http://www.aspiengirl.com

http://www.taniamarshall.com