I Am AspienWoman wins a 2016 IPPY eLit Gold Medal Award!

The AspienGirl Project is pleased to announce that the sequel to ‘I am Aspiengirl’ entitled ‘I Am AspienWoman’ recently won a 2016 IPPY eLit Gold Medal Award in the “Women’s  Category” in April. I am AspienWoman is the culmination of a blog Tania wrote a couple of years ago entitled ‘Moving Towards a female profile of Asperger Syndrome’, with close to 300,000 views, to date. That blog is regularly updated. You may purchase copies at http://www.aspiengirl.com, Amazon or other fine books stores.

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2016 Award Announcements

Tania spends her professional time in private practice. She provides diagnostic assessment impressions reports regularly (across the lifespan), and provides interventions and support. For more information regarding diagnosis and assessment, bookstore wholesale discounts, book contracts, interviews, translations, workshops and conferences, please email admin@centreforautism.com.au

 

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Jekyll and Hyde or Pathological Demand Avoidance Syndrome (PDA)?

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Updated January 3rd, 2016. This post will be updated on an on-going basis

I have written this blog specifically to educate, advocate and provide awareness for an unknown syndrome in Australia, called Pathological Demand Avoidance (PDA) Syndrome.  Many children are misdiagnosed with other conditions and/or parents are sent on parenting courses that are ineffective or make things worse for these types of children.

Presently, Pathological Demand Avoidance (PDA) Syndrome is not recognized in Australia and is not recognized by the DSM5. It may be confused with intermittent explosive disorder, oppositional defiant disorder and other disorders or conditions. It is extremely challenging to find support or assistance for PDA in Australia. Many professionals are unaware of PDA. However, the National Autistic Society in the UK has recognized PDA as a form of Autism (http://www.autism.org.uk/about/what-is/pda.aspx#). This is a most progressive and positive move.

Over my career, I  have worked with some of the most behaviorally and emotionally disturbed children (and adults). I have worked with a number of children and adults (in two countries) who have been described by their family members, school officials, educational consultants, as “naughty”, “Jekyll and Hyde”, “bi-polar”, “schizophrenic”,”possessed” or even “a devil’s child”. I have worked in private special needs school, hospital psychiatric, outpatient and inpatient and private practice settings. In one professional development session I attended, a psychiatrist suggested “these children needed to be thrown out the window on the drive by past school” (in order to help them overcome their anxiety). I have seen and heard it it all, and I can tell you, these children do not need to be thrown out windows and are not possessed by any “devil”, although they can and do behave in some very scary ways, at times.

Presently Pathological Demand Avoidance (PDA) Syndrome is not recognized in Australia and is not recognized by the DSM5. It may be confused with intermittent explosive disorder, oppositional defiant disorder and other disorders or conditions. It is extremely challenging to find support or assistance for PDA in Australia. Many professionals are unaware of PDA. However, the National Autistic Society in the UK has recognized PDA as a form of Autism (http://www.autism.org.uk/about/what-is/pda.aspx#). This is a most progressive and positive move.

Pathological Demand Avoidance Syndrome (PDA) is a term by Elizabeth Newson, used to describe children and adults who have an extreme need for control that is led by high levels of anxiety. They have difficulty coping and complying with day to day activities and their behaviors are out of proportion to the task being requested of them (for example, a violent act over being ask to pick up a toy). They have a lack of sense of a social hierarchy and have been described by others as socially manipulative and having anger management difficulties, which may include growling, grunting, spitting, hissing, violence and/or swearing. They may have a “look” in their eyes that is indescribable and/or scary to the parents(S) and family members.

The word ‘pathological’ is used to describe the avoidance as impairing their ability to function. Avoidance is used in many ways and the strategies are manipulative in a social way to avoid a demand. I have seen children use distraction, a multitude of excuses, stories and/or lies, negotiation and arguing, screaming and biting, hostility, attacking other people and/or becoming violent, running away, hiding, engaging in highly embarrassing activities in public, withdrawing into a fantasy world and acting like animals, just to name a few strategies.

Socially, children with PDA appear to have better or more social skills, however they do not have full empathy. I have observed them use empathy to control and/or manipulate others or a situation, but there is a stark lack of emotion involved. They may use their intellect to manipulate others.

At times, these children can appear as though they are just like any other child and at other times, they can be extremely challenging. These types of children are extremely moody, highly anxious, love role play and pretending, may have sensory sensitivities, tend be be bossy and domineering, and may not realize that they are a child, in the true sense of a little person. Some believe they are animals, rather than human. If you believe your child has PDA, typical parenting or even Autism parenting strategies will NOT usually work.

If you think your child has PDA or traits of PDA please read the following books. I am also available to consult with by emailing me at tania@aspiengirl.com

There are specific assessment tools to assist with diagnosing PDA.

Recommended reading

Duncan M, Healy Z, Fidler R & Christie P (2011). Understanding Pathological Demand Avoidance Syndrome in children. London: Jessica Kingsley Publishers.

Fidler R, Christie P (2015). Can I tell you about Pathological Demand Avoidance Syndrome? London: Jessica Kingsley Publishers.

I had the pleasure of attending one of Dr. Greene’s conferences in North America and I cannot recommend his work enough.

Greene, Ross W. (2014). rec. 5th edition. The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children

Greene, Ross W. (2014). Lost at School: Why Our Kids with Behavioral Challenges are Falling Through the Cracks and How We Can Help Them

Greene, Ross W., & J. Stuart Ablon (2005). Treating Explosive Kids: The Collaborative Problem-Solving Approach.

 

Sherwin J. A. (2015). My daughter is not naughty. London: Jessica Kingsley Publishers.

Recommended  Resources

Dr. Greenes’ Centre for Collaborative Problem Solving

http://www.ccps.info/

Streaming Video or DVD: Explosive, Noncompliant, Disruptive Aggressive Kids at http://www.cpsconnection.com/store

You don’t have to wait for Dr. Greene to be speaking in your area to watch his one-day overview of the CPS model; you can watch streaming video or download MP4 video or MP3 audio formats.

Recommended Australian Resources

http://www.thepdaresource.com/pages/groups.html

If you know of a professional in Australia who works with PDA, please let me know and I will add them to the ‘PDA Professionals list’, by emailing me at tania@aspiengirl.com

Look for my new book on PDA and females, coming 2016

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Copyright, Tania Marshall, 2014-2016

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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I Am AspienWoman releases at #29 Amazon USA, #1 in Australia (2 categories)

I Am AspienWoman releases at #29 Amazon USA, #1 in Australia (2 categories) and 1st spanish world female autism conference

I Am AspienWoman, Foreword by Dr. Shana Nichols, is the sequel to the best selling IPPY Gold medal award winning I am Aspiengirl, Foreword by Dr. Judith Gould. This book is over 300 pages and explores areas including: social, communication, subtypes, sensory, strengths, challenges, work, family, gender and sexuality, stages leading up to a diagnosis, 24 mentors leg by Dr. Temple Grandin, who offer advice, a comprehensive screener of characteristics, the reasons for a diagnosis, disclosure and a strengths based exercise.
Amazon USA releases I Am AspienWoman paperbook at #29
Amazon USA released I Am AspienWoman this past weekend (August 22nd) at the #29 ranking in the Autism and Asperger Syndrome category and we are thrilled. The eBook version should be available any day now. The hardcover versions is set for release in the near future. All formats and will be available on Amazon USA, then Amazon UK, Canada and others stores as they roll-out over time

Amazon Australia releases I Am AspienWoman eBook Kindle at #1 in 2 categories. Barely released 1 week, we are thrilled to announce that I Am AspienWoman reached #1 in 2 categories August 29th, 2015.
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Free sample chapters
Free sample chapter of both I Am AspienGirl and I am AspienWoman are available upon signing up on the homepages at http://www.aspiengirl.com

Pre-orders of I Am AspienWoman eBook from the AspienGirl webstore
For those of you all who preordered I Am AspienWoman in eBook format, all you need to do is locate the invoice that was sent to you when you purchased your book. Clink on the link within the invoice and your eBook will download.

Pre-orders of I Am AspienWoman paperback from the AspienGirl webstore

For those of you all who preordered I Am AspienWoman in paperback format, these books will be mailed out early next week.

Pre-orders of I Am AspienWoman hardcover from the AspienGirl webstore

For those of you all who preordered I Am AspienWoman in hardcover format, these books will be mailed out as soon as the hardcover version is ready.

The book are now available on Amazon Canada and Amazon UK and the formats will become available as Amazon’s time frame allows.

Here is another sneak peek at a couple of interesting pages from the book, clients I have seen over the years.

World’s first Spanish females Autism Conference
This week Tania was honored to be invited to provide the welcome opening introduction for the World’s first Spanish females Autism Conference taking place this weekend, August 29th-31st, in Beunos Aires, Argentina. We will upload the welcome on Facebook. The conference program can be viewed here: http://mujerestea.com/2015/08/26/298-programa-final-jornada-haciendo-visible-lo-invisible-en-tea/
Soy AspienGirl
Soy AspienGirl is now available on Amazon USA and Amazon Spain at: http://www.amazon.com/SOY-AspienGirl-caracter%C3%ADsticas-talentos-Espectro/dp/0992360978/ref=sr_1_1?ie=UTF8&qid=1440738556&sr=8-1&keywords=soy+aspiengirl
Asia Pacific Autism Conference (APAC)
We will be at the Asia Pacific Autism Conference (APAC) in Brisbane, Australia (Booth #30). APAC runs from 9th-11th September, 2015
You can purchase both books there with I Am AspienWoman hot off the press!
If you wish to email the author about her book, offer a testimonial or review, please email her at tania@aspiengirl with your comments or testimonials.
If you are having trouble downloading your eBook or any other questions or inquiries including Skype or in-person assessments, diagnoses, intervention, support, problem solving or interviews, articles, conferences and workshop or translations, please contact tania@aspiengirl.com
Best Wishes, remember to Be Your Own Superhero and enjoy the book
Team AspienGirl
#nomorefemalesleftbehind

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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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.

Aspienpowerscover

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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