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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AspienWoman April Elit Award1

 

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

Myths, barriers and reasons females may be unable to obtain an Autism diagnosis

 

Currently, I am writing two books, “AspienPowers” and “Behind the Mask”. Quite often, as I am writing, certain memories or themes from my years of work come to the forefront of my mind. In my clinic work with individuals who are discussing their history’s or reasons they are seeking a diagnosis, I have come across a variety of barriers (other than cost) to a diagnosis. I also discuss briefly in my second best selling book I am Aspienwoman that other people may not believe the person once they receive a diagnosis.

Briefly, these include:

“My doctor told me I am a professional working woman so I couldn’t possibly have Autism/Aspergers”.

“I was told I have children, am a good mother and am functioning quite well, so why would I want a diagnosis? He refused to refer me”.

“I went in for an assessment and they gave me child assessment forms to fill out. I couldn’t answer most of the questions”.

“The majority of professionals I called said they only work with children”.

“My psychiatrist said I make great eye contact and talk well with him, so I couldn’t have Autism/Aspergers”.

“The local Autism Society had no-one they could recommend who was trained and experienced in working with Autistic females”.

“The professional I went to see said I couldn’t have Aspergers because it is no longer in the DSM5”.

“The professional I see said I only have anxiety, depression and social anxiety which I have had all my life (from birth). I tried to explain the sensory issues, my Irlen Syndrome and my gender fluidity, to no avail”.

“Ï was told I am a professional actress, making money and working and that I did not fit the profile (the male profile) of Autism/Aspergers”.

“I was told I present too well to have Autism/Aspergers. I am a professional model and I love make-up, clothes, fashion design and shoes, but I have always had social problems. I was told because I am well  liked by others that I could not possibly have Autism/Aspergers”.

“I was told by a professional that Autism/Aspergers is a ‘male’ thing”.

“I was told I have Social Communication Disorder and that’s all. I know that’s not all I have, so I am going for a second opinion”.

“I was told I am too social and therefore it’s impossible for me to have Autism”.

“I didn’t/don’t know how to drop my mask (with my psychologist) and only managed to get an anxiety diagnosis”.

“I have spent so much time teaching myself social skills, reading books on social skills, going to drama classes, that no-one believed me until I saved my money up and saw someone who is both a psychologist (and has worked with many females) and an author (writes about females)  for many years”.

“My daughter met two of the 3 criteria on the ADOS but has no RRP’s, so she did not receive a diagnosis”

“They said my daughter has some traits but not enough, so she now has a label of ‘Disruptive Mood Dysregulation Disorder'”

“My daughter is a Jekyll and Hyde and did not receive a diagnosis because she is so well-behaved at school”

To Be Continued…more coming soon

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For more information of female Autism, please go to:

http://www.aspiengirl.com

http://www.taniamarshall.com

Free webinar The female Autism Conundrum

http://www.autisminpink.net

To contact Tania for fee-based impressions assessment/diagnosis, consultations, media interviews/inquiries, workshops and.or conferences, book reviews, translations, please email Tania at tania@aspiengirl.com

 

Copyright Tania Marshall, 2014-2016

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

Assessing the behaviors, traits and abilities of young females on the Autism Spectrum

Assessing the behaviors, traits and abilities of young females on the Autism Spectrum: For professionals and parents

Girls with high functioning Autism (Asperger Syndrome) often have subtler characteristics that lead them to be missed by professionals. Many (not all) are able to use compensatory strategies to mask their difficulties and these are learned from before they start grade school. Autism tends to be a condition of extremes; an either/or condition in which two girls who present quite differently can both be on the Spectrum. For example, one is shy, quiet and mute and the other is loud, has a lack of boundaries and talks too much. The both have social communication and interaction difficulties.

Girls on the Spectrum may present as shy, quiet and at times mute, taking a long time to warm up to situations or they may present as overly talkative, verbal and lacking boundaries.

The quiet girl can be described as passive, a follower, watching and observing her peers much of the time to learn what to say or how to act. She is very shy in social situations. The verbal girl is often dominating, described as “bossy and controlling”, often described as having to have the best at everything and have her own way. She dominates and controls social situations.

Both girls may not receive many birthday invites, prefer one or two close friends, prefer to play with younger or older children rather than their peers, prefer to talk to boys or have boys as friends.

The quiet type may be attracted to extraverted personalities who tell her what to do or are controlling towards her due to her passivity and shyness. The verbal type may be domineering and controlling in her interactions with others.

Why do girls who have an assessment not receive a diagnosis?

Females can and do make eye contact and can have superficial reciprocal conversations in initial interviews with professionals.

Females are reluctant to admit they are having difficulty and will say they have friends, that they know what to do socially, when they are actually socially confused

Females start learning, often from before grade school to camouflage their difficulties and pretend every thing is fine

Females will say everything is ok and there are no problems even in the face of contrary evidence or difficulties

Professionals are viewing the female as just a “shy” and/or “sensitive” child or a “hormone driven” teenager, when in fact they have Autism. Around the age of 12-13 are when the proverbial wheels may begin to fall off and the inability to cope comes to the forefront

Professionals may diagnose only the presenting issue (for e.g., anxiety disorder)

They may receive high scores on the ADOS but not enough for a diagnosis

The majority of assessment tools are based on males

Professionals are not trained in understanding the gender differences, the gender bias, the questions to ask, compensatory strategies and camouflaging techniques

Some clues look for in an assessment

The Social World

1. exaggerated facial mannerism or a flatter affect. Many girls I have worked with have a slight grimace to their smile. This is a clue that they may be having difficulties with their own non-verbal body language. Many childhood photos reveal either no smiling or a slight exaggerated smile or facial expressions

2. look for facial expressions not matching the mood or the situation being discussed. For example, it is common to observe smiling or laughing whilst talking about a situation that would usually be associated with a different emotion (and therefore a different facial expression and tone of voice).

3. many girls say they know what to do in a social situation but when asked, are not able to tell you what they would do or give an answer that leads to to believe otherwise. An investigation into levels and types of friendships and social skills often reveals difficulties

4. exaggerated non-verbal body language is often a clue. Some girls present in the clinic with body language that appears “odd”, unnatural or like they are acting with you in a conversation.

5. Many females are well-behaved (often too well-behaved) in school but the opposite at home (due to social exhaustion and holding it all in)

6. Many females are observed using behaviors or words from their peers, other people or television. They may copy, look like or act like others, taking on the characteristics, mannerisms, voice, sayings, of others.

7. Many females present in different ways depending on the situation and this can be confusing to family members.

8. Many females will tell you they know what to do in social situations, but the evidence is contrary and/or you will get the impression that they are confused or are not being truthful.

9. Some females may not apologize when they have made a social error and some females over-apologize due to being confused about social rules. Some females refuse to apologize even when it is plainly obvious it would be in their best interests to do so.

10. Many females are able to socialize quite well for small periods of time but them experience social exhaustion or a ‘social hangover’, needing solitude to recharge her batteries.

The Play World

1. Some girls have a preference to play with stereotypical boys toys, having no interest in dolls whilst others have an obsessive-like quality towards dolls and stereotypical girls toys (for e.g., collecting all barbie dolls).

2. Girls can often be observed spending the majority of their time putting together the scene of play, rather that actually playing. For example, spending the majority of time ensuring all the furniture, accessories and dolls are in the right place). They often have elaborate scenes of play set up and organized.

3. Whilst playing on their own, girls are often observed to be role-playing adults. For example, a girl may set up all her teddy bears bears, dolls, etc., and role play the teacher, doctor, nurse or other role. She may take attendance, give time-outs, write out lesson plans and/or teach class lessons.

4. Girls on the Spectrum are often far more imaginative than their peers. They are often observed pretending to be animals and/or imitating them. They may also have some difficulty distinguishing between reality and fantasy

5. A tendency to have imaginary friends and/or animals who are very real to the child, to the point that they may have table settings for them at the table, seats for them in the car, and so on.

6. Girls often spend more time playing with the family pets and/or on nature than their peers, having a natural affinity/gift in the areas of nature and animals. It is the intensity of the interest as compared to neurotypical peers that is key here.

7. May have obsessions with other people which can be observed as too clingy, not allowing the friend to have other friends, not giving them enough ‘space’, or obsessing over them

8. Females tend to have more avoidance traits and strategies when demands are placed on them

9. Some females may flitter from group to group in school not really having any real friends but giving the appearance of having friends, so that no one would pick up on this

Abilities, Gifts and Talents

Abilities, Gifts and Talents are plural due to the many females I have met who display multiple talents. These abilities often include:

hyperlexia/reading ability, perfect or near-perfect pitch, languages, art, performing arts (dance, acting/drama, singing, musical theatre, modelling, involvement in a band, comedy), the care of animals, mathematics, writing fiction and/or fan-fiction and/or poetry and/or songwriting, intelligence,

Mature interests may include interests advanced for her age (philosophy, psychology, opera, a language)

Immature interests may include an interest well past her developmental age (for example, my little pony, doll or teddy bear collections).

Some presentations

Some females present as more of a “tomboy” appearance (preferring an androgynous clothing style) and disliking make-up and sterotypical girls clothing

Some females present as a “ultra-feminine” or “princess” like appearance (love make-up, fashion, trends and shoes). they may spends time involved in shopping for clothes and/or designing clothes, perfecting the art of makeup and.or modelling

Regardless of presentation, a difference in terms of clothing as compared to her peers is usually observed. My screener which was the basis of I Am AspienGirlL The Unique Characteristics, Traits and Gifts of Females on the Autism Spectrum is here:

https://taniaannmarshall.wordpress.com/2013/03/22/moving-towards-a-female-profile-the-unique-characteristics-abilities-and-talents-of-young-girls-with-asperger-syndrome/

A female autism assessment tool I often use in conjuction with other tools includes this screening questionnaire developed by Kopp and Gilberg and it is excellent.

THE AUTISM SPECTRUM SCREENING QUESTIONNAIRE (ASSQ)-REVISED EXTENDED VERSION (ASSQ-REV), by Kopp and Gilberg

Kopp and Gilberg found that certain single ASSQ-GIRL items are often much more typical of girls than of boys with ASC. These items include “avoids demands”, “very determined” and “interacts mostly with younger children”. The ASSQ-REV is a new assessment tool that includes a set of “girl” items.

ASSQ-GIRL, 18 new screening items believed to tap into the autism phenotype of girls

ASSQ-GIRL item No Somewhat Yes

  1. Copies you (can be in a very discrete way)
  2. Episodes of eating problems
  3. No time perception*
  4. Too much sympathy
  5. Extremely interested in pop/ rock bands, soap operas or natural disasters
  6. Avoids demands*
  7. 34 Very determined*
  8. 35 Difficulties with choice; always avoids choosing
  9. 36 Difficulties with self-care*
  10. 37 Carefree or overmeticulous as regards physical appearance/dress
  11. Naïve
  12. Comes too close to others
  13.  Interacts mostly with younger children*
  14. Engages in dangerous activities
  15. Exaggeratedly fanciful
  16. Talks without content*
  17. Writes long stories (can be in stark contrast to level of talk)
  18. Acts or lives different parts (TV stars, videos, animals)

Note. *indicates items which were considered most specific in girls with ASD (see study V)

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I Am AspienWoman is due for release September 2015 and available for preorder at http://www.aspiengirl.com

cropped-all-books-with-award.jpg3To contact Tania for assessments, Skype or clinic consultations, problem solving sessions, workshops and presentations, book interviews, book translations, or publishing, please contact Tania at tania@aspiengirl.com

For more information about Autism Spectrum Conditions in females go to:

http://www.taniamarshall.com and http://www.aspiengirl.com

Copyright Tania A. Marshall 2015

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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Post-Diagnostic Themes from the Autobiographical Narratives of AspienWomen

Some Post-DiagnosticThemes from the Autobiographical Narratives of AspienWomen

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

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Many female adults question and reflect upon the whether or not they should seek out a diagnostic assessment. A common pathway to a diagnosis is via their own child's diagnosis. Another common pathway is through Google, also known as self-assessment. Many female adults either seek post-diagnostic support and/or write to me post-diagnosis, discussing some of their most common thoughts and feelings.

1. A sense of relief is the most common reaction, post-diagnosis. Finally, there is an explanation for the difficulties and challenges experienced, to date. Finally, they are getting somewhere in terms of getting the questions they have had throughout their life answered. Finally, they switch the labels, keeping the appropriate ones and  inappropriate "label"'s

"I think I had an idea in my head that once an official diagnosis was obtained my world would open up and all of a sudden my difficulties would melt away. (I didn't think that one through very well!). But of course you wake up just the same …. I'm finally getting to a place where waking up as me is ok! I am 41 and spent years thinking I was defective so it's going to take a few more to disregard that belief"

2. Later on, other emotions may appear, such as anger and grief and lots more questions. Usually, the anger stems from the often obsessive "what-if's". What if I had been diagnosed when I was in school? What if my teachers, family members knew I had Aspergers, rather than being "naughty"?  What if the teachers knew I had Aspergers instead of being labelled dumb, lazy, angry, too shy, socially anxious, bi-polar, borderline? What if I had had learning support? What if? What if? What if? I could have…got through school, university, my courses, med school…..? Maybe my marriage would have…. Maybe I could of had a career in…? Maybe, maybe, maybe.

"Before, I was a little scared that you would say I don't have it, and I will fall apart again wondering why I am the way I am. And feel a bit silly telling the few people I have mentioned my Self Diagnosis too. Even though I have answered alot of questions, I find I have a lot of "what if's?"

3. A reframing takes place, one in which the individual goes from present day backwards in time reframing her life experiences, events, relationships, in light of her new diagnosis of Asperger Syndrome or Autism. This reframing provides a catharsis, much understanding and mourning. It is then that the individual sees herself through the lens of Autism, presently and in the future.

To Be Continued…

Tania can be contacted for assessment, diagnosis, intervention and support, in addition to interviews and articles regarding her books. Contact her at tania@aspiengirl.com

Tania currently spends her professional time divided between private practice, research, and writing and looks forward to releasing the next installment in her AspienGirl™ book series, available at http://www.aspiengirl.com

Aspiengirl™ and Planet Aspien™ are registered and trademarked. Copyright 2013-14