Female Autism Infographics

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

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

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For more information go to:

http://www.aspiengirl.com

http://www.taniamarshall.com

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

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Sfari Webinar: Summarizing The Female Autism Conundrum and my Thoughts

Webinar: A Summary of The Female Autism Conundrum

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

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

Part One by Dr. David Skuse

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

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

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

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

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

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

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

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

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

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

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

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

Part Two by Dr. Will Mandy

We need to understand the female Autistic phenotype

Current ASC assessment processes are biased against females

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

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

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

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

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

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

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

So is Camouflaging a friend or foe? Both

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

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

At what age does female compensation start?

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

Q & A Session with David Skuse and Will Mandy

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

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

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

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

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

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

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

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

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

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

Some thoughts from me

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

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

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

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

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

More to come about subtypes in upcoming book series

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

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

Motherhood and Autism

Gender Identity and Transgender

Autism and the sex trade

Body Dysmorphic Disorder

Sensory Processing Disorder in females with Autism

Mature females with Autism

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

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

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

Please follow these female autism researchers:

Will Mandy

David Skuse

Rachel Hiller, University of Bath

Christopher Gillberg and Svenni Kopp

Judith Gould

Meng Chang Lai

Simon Baron Cohen, University of Cambridge

Francesca Happe

Marianna  Murin and Rebecca Chilvers from Great Ormond Street Hospital

I Am AspienGirl reaches Amazon Australia #1 rank in 3 categories

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The AspienGirl Project is pleased to announce that the I Am AspienGirl® book is now #1 on Amazon Australia in 3 different categories. Thank-you to everyone who purchased a copy. The book was released on June 20th as an eBook. Both paperback and Special Edition hardcover versions are coming soon. The book is currently being translated into Norwegian, Spanish and Italian. Furthur translations will become available this coming year.

You can your copy at www.aspiengirl.com, Amazon or other bookstores! Please leave a review on Amazon if you like the book:-)

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The following are the Amazon rankings:

Amazon Bestsellers Rank: #1,983 Paid in Kindle Store (See Top 100 Paid in Kindle Store)
#1 in Kindle Store > Kindle eBooks > Parenting & Relationships > Special Needs > Disabilities
#1 in Kindle Store > Kindle eBooks > Health, Fitness & Dieting > Counselling > Pathologies > Autism
#1 in Kindle Store > Kindle eBooks > Health, Fitness & Dieting > Personal Health > Women’s Health

 

 

 

For more information on the author:

Facebook: https://www.facebook.com/taniamarshallauthor

Twitter: https://twitter.com/TaniaAMarshall

Pinterest: https://pinterest.com/taniaamarshall

WordPress: https://taniaannmarshall.wordpress.com

LinkedIn: au.linkedin.com/in/taniaannmarshall/

 

AspienGIRL can be found at:

Website: http://www.aspiengirl.com   

Amazon: www.amazon.com/author/taniamarshall

Facebook: www.facebook.com/AspienGIRL

Twitter: https://twitter.com/aspiengirlVIP

 

I Am AspienGirl Book’s 1st Week!

I Am AspienGirl Book’s 1st Week has been insane! The book came out in e-book format and made it straight to the Amazon #2 best seller list! Today I received the paperback version which will begin shipping out the end of the month of June 2014. We are also putting out a special hardcover edition, coming soon.

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If you like the book, please go to Amazon.com and leave a book review and let your friends, school staff, professionals, Autism organisations and libraries know.

For more information on the book series or the book’s author:

http://www.Taniamarshall.com
http://www.aspiengirl.com
http://www.Facebook.com/TaniaMarshall author
http://www.facebook.com/aspiengirl
http://www.twitter.com/aspiengirl
http://www.pinterest.com/aspiengirl

Its finally here! I Am AspienGirl Ebook is now available for download

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‘I am AspienGirl®’ is in the process of releasing and for download from http://www.aspiengirl.com

The eBook released first thing this morning so those of you who pre-ordered the eBook all you need to do to start the download is click on the name of the book on your invoice and it will automatically begin downloading. Also those of you who pre-ordered the printed book printing has just begun so your copy will be shipped to you before the end of the month. For those of you who purchased one of our combination packs your printed copy will also be on the way to you towards the end of the month but don’t forget to download your eBook by also clicking on the name of the pack you purchased on your original invoice.

Also the sample chapter is now available for everyone who registered to receive it so please click on the following link to download: http://www.aspiengirl.com/files/MINI_150DPI_9780992360900_txt%20(1).pdf

If you like what you see don’t forget to let your friends know the book has released by sharing about it on social media. You may like to join our affiliate program (link is on homepage) so we can track whom you send and reward you with a 10% commission for anyone who buys based on your recommendation.

I Am Aspiengirl® Book Release June 25, 2014

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Here at Aspiengirl®, we are proud to announce that the first book in the Aspiengirl® series is now at pre-press! The I Am Aspiengirl® book release is slotted for 25th of June, 2014 (bar no hiccups). Here’s a sneak peek look at the cover, back cover, Introduction, a testimonial, the Foreward by the brilliant Dr. Judith Gould and a sneak look at some totally awesome Aspiengirl® mentors. This book is also slotted to be translated into a number of other languages including: Spanish, Italian, French, German, Chinese, Norwegian, Portuguese, Hungarian and Dutch, in 2014! Stop by www.aspiengirl.com and sign up for our newsletter, become an affiliate (and earn money) and/or read our blog and the Aspiengirl/Aspienwoman Mentor Interviews.

 

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The Aspiengirl Book Series

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AspiengirlcoverFBTeam Aspiengirl are gearing up for the release of the first, in a series, of books for females on the Autism Spectrum. We are very excited to have just received the following endorsements from trailblazers in their own rights: Dr. Temple Grandin, Dr. Judith Gould, Dr. Francesca Happe and Dr. Shana Nicols! Have a read at what they have to say about the I Am Aspiengirl book.


 

“An imaginative book with a positive message for girls with Autism or Asperger Syndrome”

Dr. Temple Grandin

Author, The Autistic Brain, USA


 

“Thank you so much for sending me your wonderful book. I think it is great, and fulfils a real need to raise awareness about females on the spectrum. There is an urgent need for more research with women and girls on the autism spectrum. We don’t yet know how much current diagnostic criteria and processes disadvantage females and whether those undiagnosed suffer in silence or manage to compensate effectively. Raising awareness of autism spectrum conditions in females is an important first step, which this book achieves while reflecting the great diversity of experiences and opinions in this complex area”.

Dr. Francesca Happe, Professor of Cognitive Neuroscience, Director & Head of Department, President, International Society for Autism Research (INSAR), MRC Social, Genetic & Developmental Psychiatry Centre, UK


 

FOREWARD

The term Aspien Girl, as the title of Tania Marshall’s book is very appropriate and reflects what girls on the autism spectrum often say; that they feel they are from a different planet.

The rationale for this book is to address awareness of females with Autism or Asperger Syndrome who are often misdiagnosed and receive inappropriate interventions or who are simply not diagnosed. The book also emphasises advocacy for this group with their unique needs and challenges, education about the female profile and the differences between males and females.

For professionals working in this fascinating field the comments and statements of the girls and their parents are illuminating, clever and often funny. They highlight the obvious and not so obvious subtle differences in the way autism is manifested in females. This has special significance when considering a diagnosis. The core difficulties in Autism are the same for all individuals within the spectrum but there are gender differences and it is the way these behaviours are manifested and interpreted that is important. Many clinicians/diagnosticians still have a male stereotype of what behaviours constitute autism and dismiss girls and women because they do not fit this rigid, narrow view. It is now time for change and the examples given in this book constitutes a major step forward in re-thinking the diagnosis of females in the spectrum.

The emphasis throughout the book highlights the strengths and positive attributes of the females but their ‘differentness’ has to be acknowledged by everyone living and working with them. A sympathetic ‘mentor’ in the education system can make or break a young girl’s future. As professionals we need to be informed about the way young women think and perceive the world. This book gives us this insight. Tania Marshall’s way of describing the strengths and pitfalls for females on the spectrum using pictures and photographs is much more meaningful than words alone. These visual presentations will give guidance to professionals when explaining the diagnosis as this type of presentation makes more sense to a girl in the spectrum.

The book is divided into sections with delightful visual presentations covering all aspects of daily life, play, social interaction, language and communication, sensory and emotional needs, together with strengths and challenges in all these areas.

Five important needs of Aspien girls are highlighted which remind us of the uniqueness of each individual and how we as professionals and parents should accommodate them. The appendices give further useful information on commonly observed traits and characteristics of girls, the unique strengths of the girl profile when explaining the diagnosis and gender differences from both research based information and clinical observation.

A final quote from a girl in the spectrum. “With the diagnosis and the right support we Aspien girls have been known to soar…..”.

This book is a must for everyone living and working with girls on the autism spectrum.

Dr Judith Gould

Consultant Clinical Psychologist

Director of the NAS Lorna Wing Centre for Autism, UK

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“One of the brightest building blocks contributing to the emergence of a sisterhood of females on the autism spectrum and those who support and love them. I Am Aspiengirl is a true gift to the community.”

Shana Nichols, PhD, Leading Author of Girls Growing Up on the Autism Spectrum, USA


Sneak-A-Peek of Page 1 of 9 pages devoted to outlining the unique characteristics and traits of females (young girls through teenage years) on the Autism Spectrum

 

Female ProfileProfessional Translators Wanted

The Aspiengirl Project is devoted to the awareness, advocacy, education and sharing of information regarding the female profile to as many other countries/languages as possible. So far the book series will be translated into Norwegian, Italian, French, Spanish, Chinese, Brazilian and Portugese this year. If you would like to translate one or more of my book series, please contact me at tania@aspiengirl.com

We are thrilled to be working with translators, who understand the importance of their own work, in addressing the critical need for information on female Autism in a variety of countries.

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As a result of this great feedback we have put together some very special offers for both the eBook and printed book as well as for people who can’t decide which format they would prefer at a discounted price to receive both including complimentary postage.

All 3 books in both Paperback and eBook plus FREE shipping for $89.99, available at http://www.aspiengirl.com! You can also sign up for our newsletter and become an affiliate.

We have been receiving a wide variety of inquiries related to diagnostic assessments, problem-solving and support sessions and book-related interviews, articles, webinars and workshops. Please email me at tania@aspiengirl.com if you would like to book a session.

Take care and remember, Aspiengirls are not your average Superheros

Tania

http://www.aspiengirl.com