On the bright end of the Spectrum and the female Autism crisis

On the Bright end of the Autism Spectrum and the female Autism Crisis: How and Why Do Bright Autistic Females fly under Professional Radar?

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Female Autism is a new and complex area of research with information in this area of Autism growing exponentially. Both empirical studies and qualitative differences are starting to show show that females ‘meet the diagnostic criteria’ in different ways from males. This then leads to females being misdiagnosed, mistreated and/or medicated. In 2015 alone, there have been over 15 gender studies published regarding the differences between males and females. While research is starting to catch up with clinical and anecdotal research, the time it will take for this to trickle down to professionals and those at the ground level may take many years, with females continuing to be under diagnosed and/or misdiagnosed. Many girls and women exist today without a diagnosis. She may have even been assessed by a professional working in the area, but was told she did not meet the “criteria”. If a female can get an accurate diagnosis, she is then often left without intervention and/or support. This is what I call the ‘Female Autism Crisis’.

The ‘Female Autism Crisis’

There is a lack of awareness, understanding and education regarding the female profile or ‘phenotype’, a range of often subtler characteristics, strengths and challenges that do not fit the male profile nor does a female with a diagnosis of Autism feel she fits that profile Common characteristics have been outlined in my initial blogs which were then turned into my book series (bestsellers I Am Aspiengirl and I am AspienWoman).

There is a need for research on:

the differences between neurotypical girls and Autistic girls

camouflaging of autistic symptoms and impairments, adaptation, learning, masking or compensation abilities

diagnostic and classification challenges

the factors that increase or decrease the risk of a female being misdiagnosed or completely missed; the consequences associated with this

information as to how culture, social factors, gender and/or familial upbringing play a part in female Autism

Why do Autistic females fly under the professional radar and why will this continue to occur for some time?

  1. Autism was and still is presumed by many people, professionals included, to be a “male” condition. Some professionals acknowledge that females have Autism and may be unaware that males and females often present very differently.

2. Adherence to a very strict DSM5 criteria which has a gender bias. Whilst DSM 5 has hinted at sex differences in Autism, it does not acknowledge brighter individuals. It also does not elaborate much on what these actual differences are or whether there is a female profile or phenotype.

DSM-5 may better serve girls with autism

Unfortunately, some girls are now being diagnosed with the DSM5 Social Communication Disorder (SCD)

3. A female phenotype is emerging that suggests an inherent gender bias. The Sfari webinar entitled The Female Autism Conundrum  is a great place to start to understand this bias

The female autism conundrum

4. Professional ‘bias’

The child’s behaviors are more a function of the families “alternative” lifestyle

The child does not present with significant enough behaviors, appearing to be “normal” externally

The child does not present with the “male” stereotype or “female” stereotype of what Autism should look like

The childs anxiety, eating issues or behaviors are the focus and the diagnosis is missed

Strict adherence to the diagnostic criteria

5.The emerging female phenotype or profile

A steady collation of anecdotal, clinical and autobiographical reports and current research discuss different presentations, phenotypes or a “female profile” and when assessed with “male-biased” or male-centric tools, many females slip through the cracks. Females on the Autism Spectrum can and do hold eye contact and make superficial conversation. If fact, they can hold superficial conversation for an entire session with a professional!

The girl does not have stereotypical repetitive behaviors

1. There is a lack of assessment tools created for females across the lifespan. The ADOS often shows elevated traits, but not enough to meet the criteria for a diagnosis. Females are often missed because they do not meet the cut-off score, although there are often clues in the ADOS results. Females can have the ability to discuss many social-emotional areas by responding cognitively well. However, many parents, school officials, and/or professionals have found that those social-emotional areas are not often displayed or used adequately, and often then, see the individual using other strategies to cope. It appears that the characteristics and traits as captured by “gold standard” assessment tools may be male-biased due to the gender-centric items that contribute to the scoring. A further comprehensive assessment and/or a second opinion then reveals the individual does meet criteria for Autism or Asperger Syndrome.

2. Females often can and do engage in superficial conversation, make good eye contact and conversation, for the first initial session or hour. This can confuse professionals who are used to seeing particular social clues more immediately and who may think that a female is just “too social”.

3. A lack of understanding regarding coping strategies, compensatory strategies, masking behaviors and the more subtle presentations. Female body language can be expressed quite differently as they learn to act, pretend, mask and compensate for their social difficulties.

4. A lack of trained professionals working in the area of female autism

5. Confusion as to the diagnostic overshadowing, for example, whereby a female may be diagnosed may be told she is “shy” rather than “social anxiety”, may be diagnosed with an “eating disorder” rather than Autism.

6. A lack of understanding how females with Autism present across the lifespan

7. A lack of both quantitative and qualitative data and research regarding females

8. Co-occurring conditions can make assessment a complex and challenging process for diagnosticians working with adults. Whilst many adults have been or are misdiagnosed with a personality disorder, there are adults with both Autism and a personality disorder or those who have been misdiagnosed with Autism and really have a personality disorder

9. A lack of knowledge about the heterogeneity within the female group and the variance in how it presents. There exist different subgroups in females with Autism and range from a more “male” autism profile-type presentation (maybe diagnosed earlier) to those with many “masking” characteristics, where professionals or family members may not believe the person who is telling them about their diagnosis. The female group as a whole consists of much heterogeneity and thus females can present in sub-types (for example, a tomboy, a fashion princess, a bookworm professor type, the athlete). This further causes confusion for diagnosticians who are not familiar with the range of presentations within female Autism (often diagnosed much later, if at all). There is a tendency for an “obsession” to become the person’s identity.

10. For some young females, the need does not appear to be “obvious”, or the “issues” are misinterpreted, UNTIL the teenage years. Presenting concerns may be interpreted as another disorder or generalized. For example, “she’s just got some social issues”, “she”ll grow out of it”, “she is just shy”. Some females present with an eating disorder and Autism is never considered.

11. Some common misconceptions or myths about female Autism can contribute to this issue: “She can make friends, make eye contact and socialize, so she can’t have Autism” “She is too sensitive, so she can’t have Autism” “She holds down a full-time job, so she can’t have Autism” “She has too much empathy so she can’t have Autism”.

12. Females tend to exhibit better expressive behaviors (reciprocal conversation, sharing interests, integrating verbal/nonverbal behavior, imagination, adjusting their behavior by situation) despite similar social understanding difficulties as males), present with different manifestations of friendship difficulties (better initiation but problematic maintenance, overlooked rather than rejected by peers, better self-perceived and parent-reported friendship), and different types of restricted interests and less repetitive use of objects.

13. Some common female differences include: less repetitive behaviors, a greater awareness of the pressure and desire for social interaction, a passive personality, often perceived as “shy”, a “loner”, a tendency to imitate others (copy, mimic, or mask) in social settings, a tendency for social exhaustion (or as I like to call it a “social hangover”), a tendency to “camouflage” their difficulties by masking and/or developing strategies to compensate for the challenges and difficulties they are facing, a tendency to have 1 or few close friendships, a tendency to be “mothered” in a peer group in primary school, BUT often bullied in secondary/high school.

14. There appear to be better linguistic abilities, more imagination (fantasizing and spending time involved in fiction and pretend play and when observed closely the play can be observed to have a lack of reciprocity, to be scripted and/or controlling.

15. Less restricted interests/activities tend to be common involving people and/or animals rather than objects/things (e.g., animals, stationary, soap operas, celebrities, pop music, fashion, horses, pets, and books/literature), which may be seen as less recognized as related to autism. She may be viewed pr perceived as just a “moody bookworm”.

16. A lack of understanding sensory sensitivities and how they impact the ability to function from day to day. An individual may not be able to explain what they are experiencing. In particular, professionals may be more likely to view an individuals’ comments about how they perceive the world as “psychotic”, rather than sensory processing disorder or sensory sensitivities.

17. Diagnostic confusion and not asking the right questions or clarifying what the client has said, can lead to misdiagnosis. Many adult women have multiple labels or diagnoses before they receive the correct diagnosis. As mentioned previously, a lack of understanding as to how sensory sensitivities affect an individual can lead to misdiagnosis. Having a fantasy world and imaginary friends or animals can lead professionals to suspect prodromal schizophrenia in a girl or adolescent. A girl who has developed routines and rituals around food and calories, nutrition and/or exercise may be diagnosed with Anorexia Nervosa and the Asperger Syndrome is missed. Borderline Personality Disorder is a common misdiagnosis with females usually not fitting neatly in the diagnostic criteria. Furthur complications include individuals who meet criteria for both Autism and a personality disorder.

Professionals may not understand that many females have the ability to “feel” other people’s feelings and this can be quite overwhelming for them. They may not trust talking about their hyperempathy, hence they will  be misunderstood. Females may not trust other people due to the ‘cognitive dissonance’ between non-verbal body language and what she “feels” off the person. In combination with social and relationship challenges, her behaviors look like Borderline traits or Borderline Personality Disorder.

Until professionals catch up with current research on females, they will continue to be diagnosed and/or misdiagnosed with:

Anxiety Disorder, Social Anxiety

Eating Disorders

The new DSM5 diagnosis of Social Communication Disorder

Borderline Personality Disorder

Intermittent Explosive Disorder

Schizophrenia or Schizotypal personality disorder

18. Cultural bias can leads to under-identification. For e.g., some immigrant women have been unable to gain an assessment as their differences in communication and behavior are not seen or viewed as unusual, but more of a ‘cultural’ difference

Even if a girl has subtler difficulties than other children with the disorder, those problems may nevertheless have a tremendous impact on her life.

Girls appear to use their intelligence and their abilities to to learn quickly how to combine non-verbal and verbal behaviors in addition to maintaining a reciprocal conversation and be able to initiate, but not maintain friendships. In combination with less to no and different restricted interests and an inability to communicate their needs, girls appear “less” impaired than they really are, especially in the school environment. Females on the Spectrum present with a “look” to them that suggest they are merely more sensitive, emotional and/or anxious than others.

Autism is particularly challenging to detect in girls, especially bright young girls, because generally there are little to no concerns at school. Typically, the Autistic female is doing everything to hide it, from using her cloaking device (hiding in a group) to blending in with the wall (hiding in the classroom) to chameleonism (adopting the social behaviors of another student or adult), allowing them to be much better socially over Autistic males but not neurotypical females. Their ability to hide their Autism is a superpower, but there is a high cost to pay.

Seen in private practice, the subtleties in bright females are abundant, from subtle clues externally (from a slight grimace in their smile to over-exaggerated body language) to social scripts (only observed if you see the girl a few times) to older children or teens who are questioning their gender (because they have always been unable to relate to their peers). Some females want to become boys, some are happy with their androgyny, some are happy to remain female and some change their gender entirely.

Observing, describing and understanding the unique presentation of autism in girls is the beginning to improve identification rates and create unique resources just for females. Understanding the heterogeneity of this group of females is also very important. In my 2nd book I Am AspienWoman, I discuss the differences and subtypes. Developing diagnostic tools is imperative as are intervention resources specifically for femaleCoverJune2015

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Tania can be reached for fee-for-service impressions assessments (in person or Skype), consultations, problem solving consultations and/or support, interviews and/or presentations/workshops, and/or book translations at tania@aspiengirl.com

Tania divides her time between full-time private practice, research and writing her books series.

To subscribe to the AspienGirl newsletter or to become and affiliate and earn 10% on all books referred, go to http://www.aspiengirl.com

To purchase I Am AspienGirl or I Am AspienWoman or pre-order AspienPowers or I Am AspienBoy, go to http://www.aspiengirl.com

For more information about female Autism or female Asperger Syndrome, go to http://www.taniamarshall.com

Future Books and Webinar Series

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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!

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20 reasons for a diagnosis

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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

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

Aspienwomen: Moving towards an adult female profile of Autism/Asperger Syndrome

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Updated June 1st, 2017

Tania Marshall© 2013-2017. All rights reserved. Aspiengirl and Planet Aspien are trademarked. Thank you.

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p style=”text-align:center;”>Aspienwomen : Adult Women with Asperger Syndrome. Moving towards a female profile of Asperger Syndrome. This blog has been viewed almost 350,000 times since I initially wrote it and was the inspiration for my second book, released August 29th, 2015, Foreword by Dr. Shana Nichols. and now an international best seller. I am pleased to announce this book just received a 2016 IPPY eLit Gold Medal award in the ‘Women’s Issues’ category. This book is available at http://www.aspiengirl.com, Amazon, the Australian Council for Educational Research (ACER) and other fine book stores.

Tania is available for fee-based in-person or Skype remote assessments, consultations, problem solving sessions, intervention and support. She also works regularly with a variety of professionals in many countries, in the areas of referrals and assisting individuals to obtain and/or receive an assessment, diagnosis and/or support in their own country. She can be contacted at tania@aspiengirl.com regarding fee-based assessments, intervention, support, problem solving, referrals, her diagnostic impressions, book inquiries and translations, publishing inquiries, media enquirys, workshops and/or conferences.

The following list is an official detailed working screener document consisting of the unique characteristics and traits of adult women with Asperger Syndrome, or Aspienwomen. It is not a research-based formal assessment tool. It is a screening tool based on the many females I have worked with over the years. I have assessed, observed, diagnosed and worked with hundreds of girls and women of all ages. This document is based on my clinical anecdotal evidence and research by other well-known professionals. I will be modifying and/or updating this list from time to time. This list was written from my reflections, observations and experience, and is written in no particular order. No-one person needs to have every trait, and it is rare that a person would identify with every trait. Autism is a heterogeneous condition and as such, whilst people may share similar abilities and challenges, no two people with Autism are alike.  This is a descriptive anecdotal profile, much like the early day descriptions that Asperger, Kanner and Frankl described of the boys they observed. Please be mindful that research often lags behind anecdotal, observational and clinical work.

***Please be mindful that research often lags many years behind anecdotal, observational and clinical work.

***This list does not characterize all people and Autism is a heterogeneous condition. It presents itself differently in each person

***Research shows that everybody has Autistic traits. Out of a 100 piece jig-saw puzzle, everybody on the planet has a couple or a few pieces. Those that have 60 pieces would be said to have Broader Autism Phenotype (BAP) and those with 80 or more pieces are diagnosable or diagnosed with the condition.

***Self-diagnosis does not equal a formal diagnosis. Some people who self-diagnosis do not have Autism or Asperger Syndrome and some do. There can be false positive self-diagnoses.

The following profile was created for females who are self-diagnosing or considering formal diagnosis and to assist mental health professionals in recognizing Asperger Syndrome in adult females.

Females with Asperger Syndrome experience their symptoms in varying levels, so while some Aspienwomen are highly introverted, others are not. Many women would not meet formal criteria for a diagnosis due to their coping mechanisms. They would be defined as “sub-clinical”, “residual Aspergers”, otherwise known as Broader Autism Phenotype (BAP). Females with Asperger Syndrome or Autism tend to be discriminated due to the wide spectrum of abilities or levels of functioning that exists. The majority of females do not receive a formal diagnosis until well into their adult years.

This list typifies many of the adult Aspienwomen I have worked with. These traits also depend to some extent on the severity, whether you’ve been assessed and diagnosed and/or receives support and intervention, and also whether there is a co-existing condition(s) (for e.g., a personality disorder) present.

1.  Cognitive/Intellectual Abilities

Tend to have high average to genius intelligence, often (but not always) with significant splits between verbal and perceptual reasoning abilities, lower working memory and/or processing speeds, learning disabilities (for e.g., dyscalculia, dyslexia, reading comprehension)

Superior long-term memory

Weaker short-term memory

May need academic accommodations in University

A distinct learning profile consisting of a spikey profile of strengths and weaknesses, peaks and troughs, learning disabilities/differences

Often have a rigid negative thinking, inflexible black or white thinking style or rogidity of thinking

Context Blindness

2.  Education/University Life

May have dropped out of high school and gone back later, or may have repeated a grade. May have unfinished or partial degrees, may have many finished degrees, many have Doctorate of PhD level qualifications. Many have taken longer to achieve their education, as compared to their peers.

May have a history of enrolling and attending university classes, followed by dropping out of classes or semesters. Sometime later, she then re-enrols/attends later on, in life. This is usually due to be overloaded and overwhelmed. A history of deferring exams, not attending classes, dropping out of classes or programs, is common.

May have repeated high school or courses OR dropped out completely.

A history of many doctors and counsellors visits throughout university life, without any significant improvement

Difficulty taking the same amount of courses or classes as her peers

May get lost on campus easily, lose possessions, be late for classes or exams

3.  Career/Work

Often drawn to the helping, artistic or animal professions, and often an “expert” in her chosen field. I know of many Aspienwomen who are successful in the following careers: Artists, singers, actors, poets, writers, teachers, psychologists, psychiatrists, special needs teachers/consultants, horse trainers/whisperers, doctors, scientists, accountants, authors, childcare workers, models, comedians, artists, computer-related specialists, animal handlers or zoo keepers, university professors, nurses, psychics/mediums, entrepreneurs and photographers.

May miss days of work due to social exhaustion

May find great difficulty attending/participating in staff meetings, lunch breaks, work social events

May make up excuses for not attending work/staff functions

May have a history of being unable to cope with work/employment environments, often moving from job to job, especially in younger adult years

Hard-working conscientious worker

May get stressed if have a lot of work to do in a short amount of time

May become frustrated/stressed if asked to do too many things at once

Tries very hard to avoid making mistakes, forgetting things

Tries hard to please others

May burn bridges (for e.g., walk out or quit jobs or relationships without notice)

4.  Social and friendships/relationships

Preference for one-on-one social interactions, single close friendships

Need more time away from people than their peers (solitude)

May experience stress, anxiety and confusion in social group or group work situations

Strong preference to engage in conversation related to their special interest

Strong dislike for social chit-chat, gossip, nonsense, lies or conversation that lacks a ‘function’ to it, but some are known to engage in it themselves

A history of being bullied, teased, left out and/or not fitting in with same-age peers, unless she had/has similar “Aspie” friends

An intense dislike of lies, but may lie herself

Has an ability to socialize, however is unable to do so for long periods of time. Suffers from “social exhaustion” or a “social hangover” when socializing too much. The hangover can last hours to days, which can be debilitating

Experience great difficulty with conflict, arguments, being yelled at, fighting, war

Has great difficulty asserting herself, asking for help, setting boundaries

May need to drink to be able to socialize

May currently have or have experienced Post-Traumatic Stress, often due to being misunderstood, misdiagnosed, mistreated, and/or mismedicated.

Social Skills differences – is exceptionally good one-on-one and presenting to groups, however has difficulty working within group situations

May find herself in social situations or relationships that she is unhappy with, but not know how to remove herself from them

History of being taken advantage of by others, even though she has taken the appropriate business, legal or social advice from others

Often bored in social situations or parties and/or does not know how to act in social situations

May say “yes” to social events, then later make up an excuse as to why she cannot attend, often staying home in solitude (reading a book or engages in her special interest)

Often prefers to be engaged in her special interest, rather than socializing

May be considered the “black sheep” of the family

Others consider her different, odd, eccentric or “weird” by others

May feel like she has to act normal” to please others OR does not care at all about fitting in

Copies, mimics, acts in order to fit in and make others like her

A people pleaser, but then may burn bridges suddenly (for e.g., quit relationships), as they have difficulty managing conflict

Females appear to be better than males at masking the traits of autism in social situations. However, girls are less able to do so in unfamiliar settings.

May be considered a “loner” OR may have many acquaintances, but no real friends

Social Naivity, may believe anything told to them by others (gossip, stories, jokes and teasing), difficulty interpreting the intentions of others, Misinterprets other peoples intention, often jumping to conclusions about others

5.  Communication

Difficulties communicating her thoughts and feelings, in words, to others, especially if anxious, stressed or upset. Often can type or write her thoughts much better

May dislike asking others for help, be unable to ask or not know how to ask for help

May be passive, not know how to assert her boundaries in a healthy manner

May offend others by saying what she is thinking, even if she does not mean to

May point out other people’s mistakes

May give too much detail and end up boring others unintentionally

May ask embarrassing questions (usually when younger)

Unusual voice (flat, monotone, high-pitched, child-like)

Tendency to take things literally, missing what people are trying to say

May talk too loudly or too softly, often unaware that she is doing so

Often surprised when people tell her she has been rude or inappropriate

Poor pragmatic language skills

6.   Physiology/Neurology

A. Highly Sensitive

Highly sensitivity, may not be able to listen to or watch the news, listen to the radio, read the newspaper, watch violent shows/movies or horror movies, see hurt or injured animals, abuse, war, trauma, are sensitive to the emotions and “emotional atmosphere” of the environment, experience referred emotion and psychic “6th sense” abilities, may have strong intuitive and/or psychic abilities

B. Sensory Processing Disorder/Condition

May have sensory sensitivities in the following areas: hearing, vision, taste, touch, smell, balance, movement, intuition

May be very sensitive to pain or have a high pain threshold

May notice how food tastes or feels and one may be more important than the other

May be clumsy or un-coordinated

May dislike loud noises and/or be overwhelmed or stressed by bright lights, strong smells, coarse textures/clothing, sirens close by or people too close behind her.

May find children hard to cope with due to crying, screaming or other loud noises

Sensitive to the way clothes feel and how they may be more important than how they look

May have to withdraw, isolate herself when overwhelmed by her senses

May not be able to tolerate sounds, sights, smells, textures, movement that she dislikes

May not like to be hugged, cuddled or held. “I only like to hug if it’s my decision”

Can get upset or distressed if unable to follow a familiar route when going somewhere

Things that should feel painful may not be (bruises but not know how they got there, due to clumsiness)

In social situations, the nervous system tends to be overwhelmed easily, leading to withdrawal (for e.g., wander off to a quiet spot at a party, play with children or animals)

Strong hunger may disrupting her mood and/or ability to focus

She may notice and enjoy delicate or fine scents, tastes, sounds, works of art, and pieces of music.

C. Anxiety, stress and/or anger. Recent brain scanning research points towards enlarged Amygdala’s role in intense emotions, anxiety and anger

D. May have auditory processing issues

E. May have Irlen Syndrome

F. May grind teeth or have lockjaw (anxiety)

G. May have Obsessive Compulsive Disorder (OCD) or traits

H.  May have one or more of the 7 types of ADHD (see http://www.amenclinics.com)

I.  Usually has executive function difficulties (i.e., time management, planning ahead, organization)

J. May rock, leg-bounce, fidget or other movements with hands, twirl hair, stroke soft fabric to self-soothe (aka stimming or self-soothing)

K. May be very sensitive to medications, caffeine and/or alcohol

L. May have gluten, wheat, casein or other food allergies/intolerances, gut issues

M. May have sleep difficulties, a preference for staying up late at night, usually not a morning person, may be very creative at night

N. May have Dyspraxia

O. May have tics (for example, throat-clearing, coughing)

7. Physical Appearance

Usually dresses differently from her peers, often eccentric, may dress more for comfort than appearance.

May dress “over the top” or unusually for occasions

May try very hard to fit in appearance wise or may not care at all

May have a special interest in fashion and femininity

May not shower or upkeep hygiene at times, due to different priorities (usually being involved in special interests)

Looks younger than her years

Has an unusual voice; may be “child-like”, monotone, loud or soft, quality to her voice

Often does certain things with hands (twirling hair or items, different movements) or legs (leg “bouncing” or rocking while standing)

8. Lifestyle

Books, computers, the Internet, animals, children, nature may be her best friends

She loves quiet, solitude, peaceful surroundings

She may be ultra-religious or not at all. Buddhism appears to be common

May prefer to spend as much time as possible by herself, with animals or in nature

May have a strong preference for routine and things being the same day after day

Gets pleasure from being engaged in her chosen work and/or special interests

She may make it a high priority to arrange her life, events, work, and environment to avoid overwhelming, stressful or upsetting situations

9. Relationship Choices/Sexuality/Gender

May date or marry much older or much younger partners, same gender partner, tending not to see the “age”, “gender”, but rather the personality of the person first

May be asexual, having preferences that are deemed as more important than sex or a relationship

May be ‘hypersexual”, fascinated by physical sexual contact

May differ from peers in terms of flexibility regarding sexual orientation or may think about or want to change gender. Some individuals may change gender or experiment with sexuality as a means to find social success or to “fit in” or feel less different

May not have wanted or needed intimate relationships (asexual)

There is a greater flexibility in sexuality and/or gender. May be heterosexual or may be asexual, gay, bi-sexual or transgender.

10. Special Interests

A special interest may involve the person’s career, fantasy, writing, animals, reading, celebrities, food, fashion, jewellery, make up, tattoos, symbols, to name a few

Ability to “hyperfocus” for long periods of time involved in the special interest, without eating, drinking or going to the toilet, is able to hyperfocus on her special interest for hours, often losing track of time

Loves and revels in solitude, peace and quiet. Solitude is often described as “needing it like the air I breathe”

An intense love for nature and animals

Often not interested in what other people find interesting

May collect or hoard items of interest

Introspection and self-awareness. Many women spend years trying to understand themselves, reading self-help and psychology books and wonder why they feel so different, from another planet or that the “Mothership has dropped me off on the wrong planet”.

Justice Issues

11. Emotional

Feels things deeply

Other people’s moods affect her, especially if they are negative

Tends to be very sensitive to emotional pain

Deeply moved by arts, music, certain movies

May be unable to watch horror, violence, disturbing movies, and news programs

Lives with continual generalized anxiety, bouts of depression that creep up on her

Difficulty regulating emotions and managing stress

Is socially and emotionally younger/immature than her chronological age, much younger if in her twenties

Emotionally too honest (inability or difficulty hiding true feelings when it would be more socially acceptable to do so) and naive

Experiences intense emotions of all kinds (for e.g. when she falls in love, she ‘falls’ in love deeply)

May think she is being compassionate, but her actions may not come across that way

Often too sensitive and possesses a lot of empathy

Usually connect and/or are very sensitive to certain characters in movies

Highly sensitive to issues affecting earth, animals, people, advocacy, justice, human rights and the “underdog”

Some women are quite “child-like”, not reaching a maturity until roughly 40 years of age

12. Personality characteristics and/or traits and abilities

A natural born leader, independent, strong-willed, determined and can be highly competitive (even with herself)

High levels of introversion OR can be extroverted

Generally lack a strong sense of self, self-esteem and/or identity. May use chameleon-like skills to assimilate and be involved with to a variety of groups or different people over time, in a search for true identity.

Has a high sense of justice and fairness, is a truth-seeker

Highly creative and may have ‘rushes’ of original ideas

Dislikes change and may find it disorienting and stressful

Highly sensitive to criticism or perceived criticism

Dislikes being observed when having to perform (performance anxiety)

May have been told she cares to much, does too much for others and/or is too sensitive

Is perfectionistic (may have attended a perfectionism group program)

Attention to detail

Obsessions/special interests can be short-term (switching from one to another quickly) or long-term (can make a great career)

Naivety, innocence, trusting too much and taking others literally are a powerful concoction for being misused and abused

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A strong sense of feeling different from her peers, often described as being from a different planet

May not have a sense of self and/or identity, self-esteem

Tend to be very serious, often too serious at times

Is intense in everything she does

In childhood, may have been described as highly sensitive and/or shy

Highly imaginative

May have trouble distinguishing between fantasy and reality

13. Past and/or current mental health history

May have a history of crying a lot, without knowing why

May have a lengthy history of going to therapists, psychiatrists, psychologists

May have tried a variety of medications,

Experiences social anxiety and generalized anxiety disorder

May have Obsessive Compulsive Disorder or traits

May have one or more of the 6 types of ADHD

Has experienced ongoing depression and/or tiredness/exhaustion, without knowing why

A history of trying to understand oneself, of finding answers to explain one-self and why she feels she is different or doesn’t fit in, as a woman

A history of many doctors and counsellors visits throughout university life

May have a family history of Autism, Asperger Syndrome, Bi-polar disorder, schizophrenia, ADHD, OCD, anxiety disorders

May be been misdiagnosed with bi-polar disorder, borderline personality disorder or schizophrenia

May have been previously diagnosed with anxiety disorder depression, an eating disorder, borderline personality disorder, bi-polar disorder and/or ADHD

A history of depression, anxiety, eating disorders, mood swings

14. Coping Mechanisms

May have turned to alcohol, drugs, smoking in order to cope with intense emotions, self-medicate and/or socialize/fit in and/or be accepted with a group.

May use a different persona when out in the public, in order to cope

May have developed a variety of dysfunctional coping mechanisms (for example, arrogance and/or narcissism)

May change gender or sexuality in an attempt to “fit it” and/or find the right group

Has used imitation, social echolalia to pretend to be normal, fake it or pass for normal

May rock standing up, lying down, in a rocking chair to calm down or self-soothe

May need to withdraw into bed or a dark area or a place of solitude to gain privacy, quiet and manage sensory and/or social overload

Withdrawal and/or Avoidance

May have developed a personality disorder as a means of coping with Asperger Syndrome

15. Sixth Sense, Intuition, Psychic Abilities

Has the ability to feel other people emotions

May “know” or have knowledge of certain things, but no idea how she knows

May be a professional psychic or medium

Possesses one or more psychic abilities

Is an “empath”

16. Unique abilities and Strengths

May have perfect or relative perfect pitch

Autodictic – teaches herself

Intelligence, craves knowledge and loves learning

Can teach herself just about anything she puts her mind too

Has a strong will, is determined and independent

Perfectionistic

Have a remarkable long-term memory, photographic memory

A great sense of humour

Can work very well in a “crisis” situation

Deeply reflective thinker

Resilience, an ability to go from one crisis to another, to bounce back, to start again time and time again

Attention to detail

Great in one-on-one situations or presenting to a group

More like “philosophers” than “professors, but can be both.

Seeing in the “mind’s eye” exact details, gifted visual learner

May be gifted with art, music, writing, languages

Highly intuitive

Capable of deep philosophical thinking, females with Aspergers often beceome writers, poets, artists, singers, performers, actresses or professors.

17. Challenges

May be difficult to understand subtle emotions, for e.g., when someone is jealous or embarrassed, uninterested or bored

Keeping up appearances, passing for normal

Managing emotions

Learning difficulties

May get very upset with unexpected change

May not be able to tell when someone is flirting with her

Challenging to work and function within a group

Great difficulty and very sensitive to conflict, stress, arguments, fighting, wars, gossip and negativity

Social-chit chat, small talk, conversation without a “function”, maintaining friendships and relationships, social anxiety or social phobia

May like or prefer to be by herself as much as possible

May find it challenging to understand what others expect of her

Being taken advantage of due to naivety, innocence and trusting others too much

Boundaries (usually when younger)

May have difficulty filling out forms, doing paperwork (completing taxes), budgeting money

May have difficulty recognizing or remembering faces (prosopagnosia)

18. Empathy May have a lack of cognitive empathy and hyperempathy (for e.g., too much affective or sympathetic empathy)

Cognitive Empathy: The ability to predict other’s thoughts and intentions, knowing how the other person feels and what they might be thinking. Also known as perspective-taking.

Affective/Emotional Empathy: The ability or capacity to recognize emotions that are being experienced by another person, when you feel the feelings of another person along with the other person, as though their emotions are your own. Social neuroscience has found that this kind of empathy has to do with the mirror neuron system. Emotional empathy contributes to an individual being well-attuned to another person’s inner emotional world, an advantage for individuals in a wide range of careers from nursing to teaching to social work, psychology and other caring professions.

Compassionate Empathy, or “empathic concern”. This kind of empathy helps us to understand a person’s predicament and feel with them, and also be spontaneously moved to help them, if and when other need help. Under stress, Theory of mind skills may appear to be completely absent.

Sympathy: often has too much sympathy, placing her in danger, for example I once had a young client who brought a homeless man home because, as she said, ” he had no hone”

19. May have Ehlers-Danlos Syndrome

20. May have an intense desire to please others and/ be liked by others. May become highly distressed if she has the perception that someone does not like her or actually does not like her.

21. Executive functioning difficulties may include: trouble making decisions, time management, planning ahead, organization, completing tasks.

22. May have spend a lifetime of using enormous effort to socially “pretend”, “fake it”, “fit in”, “pass for normal”. May have utilized body language books, mirrors, acting/drama classes to improve social skills.

23. May have tocophobia, the fear of childbirth

24. May have gender dysphoria, also known as gender identity disorder (GID) dysphoria, and is a formal diagnosis for individuals who feel and experience significant stress and unhappiness with their birth gender and/or gender roles. These individuals are known as transsexual or transgender.

25. Photographic visual memory

No one woman will have all of these traits. Some of the traits in this list may not apply to you. A level of insight and awareness is required in terms of recognizing the traits, characteristics and behaviors in oneself. Asperger Syndrome often co-occurs with  Dyslexia, Dysgraphia, Dyscalculia, Irlen Syndrome, Dyspraxia/Disability of Written Expression, Auditory Processing Disorder and/or Ehlers-Danlos Syndrome. Individual traits and characteristics can vary from mild to severe.

26. An intense and continual need to figure oneself out.

27. Hypermobility Syndrome

28. Typical sex difference has been reported (i.e., female advantage), in relation to the “Reading the Mind in the Eyes” test (Eyes test), an advanced test of theory of mind.

29. Subtypes

Within a very large group of females we begin to see variations, preferences and heterogeneity. Whilst all females struggle to some degree with social communication, intense interests, sensory issues and many traits as mentioned above, there is not one “type” of presentation. The most commonly known presentation of a females in the Spectrum is the “Tomboy”, how there exist other presentations and it is important to talk about these, as it is these females who may never receive a diagnosis.

A. The FashionDiva

B. The Highly Sensitive Male

More Coming

About Tania Marshall

Tania Marshall is an award winning author and psychologist. She holds a Masters of Science in Applied Psychology and a Bachelor of Arts in Psychology. She completed and 18-month full time post-masters externship at a private special needs school, working with many neurodiverse people, K-12 and their families. During that time, she also worked in private practice under the supervision of a clinical psychologist. In December 2016, she was nominated for a 2017 ASPECT Autism Australia National Recognition Award, in the Advanced category for her work advancing the field of female Autism. She has previouslyly been nominated for a 2016 and 2015 ASPECT Autism Australia National Recognition Award (Advancement Category) for her work. Her first book entitled I Am AspienGirl: The Unique Characteristics, Traits and Gifts of Young Females on the Spectrum, Foreward by Dr. Judith Gould, is an international best seller and an IPPY 2015 ELit Gold medal award winner. Her second book entitled I Am AspienWoman: The Unique Characteristics, Traits and Gifts of Adult Females on the Spectrum, Foreward by Dr. Shana Nichols was released late 2015, is an international best seller and recently won a 2016 IPPY eLIT Gold medal in the Women’s Studies category.

Tania is also an APS Autism Identified Medicare Provider, a Helping Children With Autism Early Intervention Service Provider, a Better Start Early Intervention Provider, a Medicare Approved Mental Health Provider and a Secret Agent Society (SAS) Trained Group Facilitator.

Tania regularly provides diagnostic assessments, impressions assessments, support, problem solving sessions, coaching and intervention for neurodiverse individuals of all ages across the lifespan. She sees people of all ages who are are artists, scientists, engineers, entrepreneurs, gifted and talented, supermodels, singers, authors, performers, dancers, celebrities and/or Twice-exceptiomal (2e). To enquire or book Skype or in-person assessments, problem solving sessions and/or support, interviews, articles, publishing enquiries, translations/translating of her books, presentations, workshops, conferences, please e-mail Tania at tania@aspiengirl.com

Tania is now completing the third book and fourth in her series of books on female Autism. Her book series is available for purchase at http://www.aspiengirl.com&nbsp;

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