This is a recent FAQ on self-deprecation in neurodiverse females. As always, If you like it please share and leave your positive comments or other questions below. This video was made by the Neurodiversity Academy, founded by and funded by AspienGirl girl.com
Updated February 18th, 2017
This is a sample of the book entitled Behind The Mask and is therefore under copyright law. Behind The Mask give voice to neurodiverse females and discusses the assessment diagnosis and support of females on the Spectrum.
Tania Marshall, M.Sc. is available for diagnostic impressions reports, assessment, diagnosis and intervention, support and problem-solving sessions in-person and/or via Skype. All queries, please email firstname.lastname@example.org
I chose to write my book series after numerous requests for information on the topic. I also chose to self-publish, so that I can regularly update my work, keep my work current with the speed and amount of the research in the area (a challenge to keep up with for a professionals in the area), keeping my work fresh, current and in real time, rather than a long waiting period and being out-dated.
Over my career, I have I worked with hundreds of neurodiverse, Gifted and Talented, and 2e individuals.They may have labels that consist of Autism, Aspergers, Non-Verbal Learning Disability, Twice-Exceptionality, Semantic-Pragmatic Language Disorder, Oppositional Defiant Disorder, Anxiety Disorder, Bi-Polar Disorder, and many more. Irregardless of the ‘label’, these individuals have many significant strengths, gifts, abilites and/or talents, and this topic is discussed in ‘ AspienPowers’.
In working with neurodiverse individual across the lifespan, I have written and spoken about and or refer the ‘female autism crisis’. There are many factors involved, some of which include: a lack of professionals trained in the area, gender differences, the female autism bias and the lack of assessment tools. We are a long way from developing efficient tools for assessing neurodiverse girls and woman. The following slide is from the Recent presentation review of key measures, gender and autism at the 2016 XI Autism-Europe International Congress and shows that the ADOS/ADOS-2, the ADI-R and the SCQ favor males. This is a real problem and a crisis because these are the very tools that many professionals use when they assess females. They are sometimes a cause of females flying under the radar of a professional.
I have been referred many females who have had these tools previously completed on them and have not been given a diagnosis. This can be due to the tools inability to measure the subtle signs, client masking, compensatory mechanisms and strategies and/or the even the rigidness of the professional in using the tool or the over-reliance of using these tools versus asking the right questions and looking for the subtle signs in body language, facial expressions, asking the right social questions, evaluating areas such as context blindness, synaesthesia, Irlen Syndrome, sensory processing issues, and more.
In assessing girls on the Spectrum, it is important to ask the right questions. I cannot emphasise this enough. There are many questions to ask and what follows are some examples. Keep in mind that high average to profoundly intelligent girls can tell you the socially acceptable answers that you as a professional want to hear, but they are unable to actually perform those unwritten social rules or if they can, they are not as fast at it as their peers or it comes off as just slightly awkward. You need to look at this subtle non-verbal signs which I will be discussing In an educational series.
Many girls and women with Asperger Syndrome or Autism have a tendency to be over-loyal and over-trusting, have a lot of emotional empathy, often just ‘seeing’ that a person needs help or saying they person needs help and taking things literally or not being able to ‘see’ the social context of a situation (for example, bringing home a homeless man because he has no home or food, yet not seeing the inherent dangers in doing this).
- What is bullying? What is teasing? What is bitchiness? How do you know the differences? When should you help someone? When shouldn’t you help someone?
- Sample questions in the area of friendship friendship should consist of: What is a good friend? What are some healthy ways of making and keeping friends? How long does it take to make and keep a best friend? Who are your friends? How do you know they are your friends? Do your friends try to get you to do things you dont feel is the right thing or that you feel uncomfortable with? (For example, do they try to get you to do your their homework, reports school work? Do they get you to buy things for them? Do they try to get you into trouble (for example, do they say they’ll be your friend if you do something for them?) What do you do at lunchtime? What do you do with your friends? What kinds of activities do you do with your friends? Do you prefer one best friend or a few friends? How long have you known your friend/friends for? Do they come stay over at you house and vice versa (if applicable). What do you talk about with your friend(s)? Professional Tip: Try to find out if the conversations are more one-sided or are they reciprocal, that is the conversation takes turns; it is a two way street rather than just a one person conversation involving 2 or more people.
- Sample Questions of play or hanging out may involve: How often do you play it hang our with your best friend/friends? Who initiates the play? Do you ask your friends to come over? Do they ask you to come over? Professional Tip: Often girls will text or cling too much to a girl, often driving them away.
- Does the girl or teen understand the social hierarchy? Do they understand how groups in school work? Do they understand the role the group members play? Why do you think the girls at school engage in these behaviors?
- Why is it important to keep a promise? Should every promise be kept?
- Why is it important to apologize when you’ve hurt someone? Professional Tip: Some girls adamantly refuse to apologize and some girls over-apologize.
- How do you know if someone is trying to get you into trouble? How do you know who you can and cannot trust as a friend?
- How do you know a particular person is safe to have as a friend? What kinds of clues might alert you that this person is dangerous? How would you know you are being taken advantage of?
- What are boundaries? How do you enforce a boundary?
- Do you prefer one-on-one friendships or hanging out in a group?
- Do you feel anxious around other girls? Girls often internalize their anxiety and can hide it very well. For those girls that are unable to “hold it in”, they may receive a diagnosis earlier than other girls. Remember that is it common for girls to be unable to explain why they are having difficulty in a social situation. They do often discuss not feeling well or may speak of feeling sick, feeling nervous or scared. They may often be in the sick bay.
- How long can you socialize for? Do you feel like you need a break? Does socializing make you tired?
- Teenagers with Aspergers often have eating disorders, an escalation of anxiety and depression and/or self-harm. Asking these questions is important. Investigating self-harm is also important. Girls are very good at hiding their cutting. Demand Avoidance is commonly seen in girls and women with Aspergers. Avoiding demands is caused by anxiety and/or not knowing how to do the task at hand and /or being embarrassed or socially anxious about a task. This is context-dependent and can look like making up excuses as to why she cannot do something that you know she can do to refusal to do something asked of her to refusing to comply with requests by an adult to avoiding the social playground.
- Many girl and women have a flat affect on their face, so that family members or professionals cannot tell how they are feeling.
- Some girls and women have Alexythymia and/or Faceblindness. Most experience extreme emotions and some girls may receive a diagnosis earlier than others to their meltdowns and/or violence.
- Many, if not all girls and women mis-interpret social situations (for e.g., “none of the teachers or kids at school like me”). Upon further investigation/assessment, it is found out that the individual misinterpreted facial expressions and social context, in an assessment.
- An assessment should involve reading of the eyes to see how well an individual can read non-verbal facial expressions from the eyes.
- An assessment may include listening to a variety of different tones of voice to see if the individual can distinguish the underlying feeling behind the tone.
- An assessment should also investigate other senses (both sensory issues and emotional empathy or “empath” characteristics). These questions need to be asked in a certain way as many females are literal, so a careful exploration is essential. An investigation of synaesthesia may be warranted.
- An assessment should also explore social naivety, the differences between lying and ‘white lies’, ‘pink lies’, social diplomacy, social tact and theory of mind.
- For teens and women, how do you know when someone is flirting with you or wants to go on a date with you? Do you know how to diplomatically reject the advance of another person? Professional Tip: Assertiveness training is essential for many females.
- In relation to gender and sexuality, a smaller group of girls (and boys) feel confused by their gender, and this can range from mild to severe. A thorough exploration of this issue often finds the individual relating better to the opposite gender, with girls getting along better with boys, being androgynous and/or Tomboy-like, and boys seeing other females as very socially successful and appearing to have lots of friends. Sometimes, an individual in their search for why they are different or why the social aspect of their life are so much more work for them, then come to the conclusion, for a variety of reasons (the feeling that others do not like or accept them, they do not like themselves, always having that feeling of being “different” to their peers), that they may have been born in the wrong body (they may be able to have more friends or be liked more, feel more accepted, feel “better” inside their body, be happier within themselves and within their family, be socially better or more popular), if they change their gender or their sexuality. Rarely, does changing one’s gender or sexuality fix the underlying social communication and identity issues, including being bullied, ignored or excluded and/or self-esteem challenges. Depending on how rigid or black and white the person is in their thinking, this can be a challenging issue to work on with the person.
- An exploration of identity in teenagers and women is important. This is because, over time, an assimilation of other people’s characteristics traits, voices, accents, behaviors has occurred, in addition to what others and society expect of them and from them. This high price (masking) often leads to a complete loss of identity.
- Many professionals are not aware that females can and do make eye contact, do make superficial conversation for short periods of time, and can have friends.
- Many professionals are unaware of the variety of sub-type presentations of girls across the Spectrum, with the ‘princess’ or ‘supermodel’ type, and/or those with higher intelligence, being the ones to be least diagnosed or diagnosed at a much later age. They are often Twice-exceptional (2e) individuals and blend in very well.
- Strengths and abilities are often overlooked due to the “presenting problem(s)”. Once these are addressed, then can an individual’s true gifts (for example, perfect pitch, artistic creativity, acting, dancing, programming, languages, just to name a few) can be nurtured and evolve into careers.
- Individuals on the Spectrum can and do lie, just like anyone else does. They dont do it as well as their peers and the reasons for lying may be different
- In terms of friendships, females are able to make friends, however they can often have a challenging time keeping them.
- A females sense of justice and high moral compass can be a clue and some females have been known to take their enlarged justice glands too far in their causes.
- Females with social problems often use their intelligence (sometimes quite successfully) to compensate for their lack of social skills, often falling into leadership roles, caring roles, teaching roles, acting roles, lawyers, professors, amongst other, where social reciprocity is least expected and social scripts (and slides!) can be adhered too.
Briefly, what we need to be asking are the right questions, looking and searching for and asking about questions that have to do with social confusion, camouflaging (how are the hiding it?), compensatory mechanisms (strategies they use to attempt to fit in, hide their confusion), eating disorders, gender, sexuality (if appropriate) and identity issues.
This is a sample chapter of ‘Behind The Mask’, and is therefore under copyright law. In Part I of this book, it explores the narratives and themes of the neurodiverse female clients that Tania has worked with over the course of her 20-year career. Part II includes chapters on assessment, diagnosis, how to explain the diagnosis, what next and support and intervention. For more information on female neurodiversity, go to:
Copyright 2014-2017 © All rights reserved. Duplication in whole or part is explicitly forbidden. Thank you.
The following article is copyrighted and may not be posted anywhere without permission from the author.
In working with females (and males) on the Spectrum for approximately 20 years, I have learned a lot from my clients. When I first started out as a psychologist, I was seeing female on the Spectrum; they just were not called or labeled that back then. In working with hundreds of females, it is safe to say that there is much neurodiversity within this group. This is extremely important to talk about because these are their narratives.
By this, I mean that there exist varying presentations of girls and women on the Spectrum. Some are easier to diagnose than others. This is due to temperament, personality type, the severity or mildness of the person's specific Autistic traits, how many traits they have, gender differences, how much the traits impact on their ability to function, other conditions or disorders and much more.
Due to a variety of lagging skills and/or differences, many females with Autism do not get along with each other, yet many do, just like neurotypical people. Many females with mild symptoms are unable to get a diagnosis, even though their traits and exhaustion impact them on a cyclical basis. Those with the subtle traits usually never receive a diagnosis.
Now that I have worked with thousands of women, they have taught and shown me through their narratives, just how different they are from each other. It is important to discuss this issue so that no more females are left behind.
Stereotypes exist due to the history of Autism and describing boys rather than girls certainly comes into play. Other stereotypes include cultural perceptions and the social focus of culturally "female" interests. So, assessments based on males and cultural perceptions and biases are certainly factors. In my work, I have seen the stereotype of the "Tomboy" play a part in other females with a different presentation not receive a referral for an assessment or a diagnosis.
The use of a social mask, compensatory mechanisms, level of intelligence (for example, being 2e), being able to get by in life day to day and then have cyclical breakdowns, and the subtle differences all contribute to a delay in diagnosis or a misdiagnosis. These differences mixed in with genetics, temperament, personality, co-existing conditions, family environment and upbringing all impact and affect how Autism presents in a female (and male).
Subtypes or presentations are extremely important to understand if one is to be trained appropriately. It is imperative to understand how many different ways a female on the Spectrum can present to a clinician. A diagnosis is critical, not only for self-understanding; but for support, services, and academic accommodations. I am talking about how girls and women have presented themselves in my clinic over 20 years, from a variety of countries and cultures. This blog is but a small part of my book entitled, "Behind The Mask" due 2017.
There are a few ways that females on the Spectrum adopt a role. In particular, if they really want to fit in and conform with society. There exist some common types or sub-types of women on the Autism Spectrum. The reason this is important is so that, as I said before, no females are left behind, and that professionals are trained in the various presentations so that they do not miss a female and also to educate the wider population about the neurodiversity of neurodiversity itself! So, let's discuss just a few presentations:
TheTomboy is usually indifferent to gender, preferring to have boys for friends and dress in an androgynous way or dress in boys clothes. She finds it much easier to talk to boys (or men). However, some individuals have gender dysphoria and this is not to be taken lightly.
The Academic superstar uses her intelligence to achieve degrees, awards, honors and more. She has an intelligence above 130, qualifying for MENSA, and has used her intelligence to get through social situations. The higher the giftedness, the more different the presentation may appear.
The Passive female is a people pleaser. She is shy, quiet, cooperative, rarely asks for help and compliant, too compliant, and blends into the wall (in the classroom or at school). She rarely stands up to bullies and is often taken advantage of.
The Aggressivefemale has often had a history of misunderstanding and misinterpretations, both ways; on her part and on others parts. She often misinterprets others, burns bridges, is impulsive and is the type most often associated with or been diagnosed with Borderline Personality Disorder or BPD traits.
The Scientific female may have a special interest in physics and/or Quantum Physics, mathematics, chemistry, animal sciences, biology or space, programming, just to name a few. Often, this type of woman is quite focused on their topic of interest and reaching high levels of distinction (a Masters or PhD).
TheStyleIcon is aware, even overly aware of style and fashion. She may work in fashion design, be an actor or a supermodel. She has got the outfits, makeup, hairstyles and appearance perfect. Her appearance tends to intimidate males and females, who are threatened by her appearance, presence or knowledge of the fashion and stylist world. She grasps small talk, making her appear to be neurotypical and allowing her to cope in social situations and fit in with her peers. Even if her appearance is eccentric, she gets away with it due to her other talents; whether they be a singer, a costume designer, an actor or DJ.
The Housewife or Cook loves to entertain and is very good at it. She is whom people want to hire for their home. She loves to have people over, but remains the ultimate host, so as not to have to socialise with others.
TheArtist gets away with being different or eccentric because society expects them to be that way, so in this way, they often remain undiagnosed until they fall off the rails. they may be the more eccentric painters, writers, actors, supermodels, singers, and band members.
TheJusticeWarrior is obsessed with justice, fairness, and right and wrong. These are admirable traits, but not when it turns into obsession, misguidedness or inappropriate recruiting of members. Some women (and men) are 'one woman' groups because others do not want to join their cause due to the social way they attempt to get others to join their cause. These people end up starting their cause over and over again. It is true (although some may not like to admit it) that some women (or men or neurotypicals) have a “misguided sense of social justice”, going too far or the wrong way of going about their crusade. There is a socially appropriate way to get people to join your cause. I have met clients (both neurodiverse and neurotypical) who have gotten into trouble with the law or are in jail because of their enlarged justice gland, lack of social context and impulsivity.
In summary, this is just a brief look at how girls and women experience Autism and the variety that exists in presentation. There are other presentations that will be discussed in my book. Girls and women vary differently from each other and also differ in their ability of lack of ability to use compensatory mechanism and/or coping mechanisms. They also vary in intelligence levels. Those who are both Autistic and Gifted have a different presentation. However; they all share the same core challenges (from mild to severe) and some remarkable strengths or gifts.
This blog is written to address the neurodiversity with a large group of females and has nothing to do with sexism or ableism, nor that neurotypicals cannot have the same careers. Most importantly, it is imperative that we understand the differences in neurodiverse females, the different ways they cope or not cope, and the different ways they present.
Within the Neurodiverse population, there is no particular way to be a girl or a woman. Many of my clients have all kinds of preferences and interests, including my Lego pens sets. Many of my clients have a wide and varied style of clothing, from fashion to boys clothes to Victorian clothing to gender-neutral clothing to completely loving being in a princess Tulle dress or an Elf costume. Some of my clients wear "boy" clothing and "girl clothing". Some like cargo pants, some like dresses and/or corsets, some like dressing up in their favorite character, some love femininity and some do not and many like books, stationery, dolls, and theater.
Finally, the purpose of writing about presentations is to leave no female out; to never exclude not even one female. We understand the neurotypical world (to the degree that we do), but we are only on the cusp of learning about the neurodiverse female world and what this group are truly capable of, when given the right support. This is about understanding females on the Spectrum and then designing appropriate interventions according to their presentation. For example, the passive presentation will need assertiveness training whereas a different social type will need a different intervention. It would be unfruitful to put all females in the same social skills or intervention group.
Whilst these girls and women are different, they all share the same common core characteristics, that of social, emotional, cognitive, sensory, intelligence differences, in addition to other co-existing disorders or conditions. This makes for complex presentations. By no means can one type be put in a box. A female can be 2 or 3 types or morph into all types throughout their life-time.
These are just some of the various ways that Autism presents, how some females may present and how they may cope with having a different brain. Autism influences many factors and all types and interests are just as important as each other. We need as many different brains and as many different neurodiverse females as possible. We also need to know the differences in presentation, so that we can now design and implement the right support and intervention for the right girl or woman.
Neurodiverse girls and women have much to offer, regardless of neurotype, interests, dress, differences and/or similarities. There are no stereotypes, just a variety of presentations and profiles, all valid and all very special.
#nomoreemalesleftbehind #beyourownsuperhero #aspiengirl #aspienwoman #aspienpowers #behindthemask
No part of this may be used, reproduced, borrowed or copied. This is an excerpt from Behind The Mask
AspienGirl.com is pleased to be nominated for a 2017 ASPECT Autism Australia Award in the Advancement Category, for advancing the area of female Autism. AspienGirl.com advocates for neurodivergent females, educating and bringing a strengths-based awareness about the autistic female presentation/profile, and contributes to its’ goal of “no more AspienGirls left behind” and “Be your own superhero”, being the best version of yourself. Females will continue to be misdiagnosed, mis-medicated and/or receive the wrong interventions, until research is conducted on females, female-based screening and diagnostic tools are created, gender differences are clearly understood, and female-specific interventions and professionals are trained to assess, diagnose and work with females. In order to assist in getting closer to these goals, the AspienGirl Project was created and has already donated 450 books and will continue to donate a certain percentage of its profits to sending out free books and resources to professionals, schools, teachers, special needs coordinators, libraries, and Autism organizations.
Tania Marshall, M.Sc., AMAPS, is an international best selling author, psychologist, publisher, educator, 3X and most recently 2017 ASPECT Autism Australia National Recognition Award Nominee (Advancement Category), recognized for her work in advancing the field of female Autism. Her first book, entitled “I Am AspienGirl©: The Unique Characteristics, Traits and Strengths of Young Females on the Autism Spectrum”, foreword by Dr. Judith Gould, won an IPPY eLIT Gold Medal Award in 2015 and is an Amazon best seller. I am AspienGirl has been translated into Spanish and is entitled Soy AspienGirl. She currently works with the gifted and talented, celebrities, performing artists, and twice-exceptional and/or neurodiverse individuals, across the lifespan. Tania was recently interviewed by Dr. Harold Reitman in a 2 part series by Different Brains, where Part I can be found here: http://differentbrains.com/aspiengirl-embracing-strengths-women-aspergers-syndrome-tania-marshall-edb-51/ and Part II here http://differentbrains.com/gender-differences-neurodiversity-recognizing-diversity-within-autism-spectrum-tania-marshall-edb-54/
Tania can be reached at email@example.com for assessments, telepsychology (Skype) or clinic consultations, interviews, presentations, workshops, and/or conferences, translation inquiries, collaborations, publishing/book and/or media inquiries. She is an Australian Psychological Association (APS) Autism Identified Medicare Provider, a Helping Children With Autism Early Intervention Service Provider (HWCA), a Better Start Early Intervention Provider, a Medicare Approved Mental Health Provider and a Secret Agent Society (SAS) Trained Group Facilitator.
Copyright 2016-2017 Tania Marshall
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.
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 firstname.lastname@example.org
I Am AspienWoman releases at #29 Amazon USA, #1 in Australia (2 categories) and 1st spanish world female autism conference
Pre-orders of I Am AspienWoman paperback from the AspienGirl webstore
Pre-orders of I Am AspienWoman hardcover from the AspienGirl webstore
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.
24 Inspiring and Motivational Autistic Women and Positive Role Models
I Am AspienWoman is a highly visual book describing the newly emerging Autistic female phenotype in over 300 pages and features 24 inspirational and motivating Autistic Woman who serve as positive role models, showcasing ability and possibility. This section is headed up by none other than Dr. Temple Grandin, whose strengths based positive approach I admire. The mentors come from countries including the United States, Canada, Australia, the United Kingdom and Denmark and were chosen for their positive strengths based attitude, their personal abilities and their passion for advocating for Autism and/or helping others. Here is a snapshot of the Mentor section.
To see and read more about these inspirational mentors, pick up your copy of I Am AspienWoman, available in eBook, paperback and hardcover versions at http://www.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. She is the author of I am AspienGirl
(2014), I Am AspienWoman (2015) and AspienPowers. She currently works in busy full-time private practice, providing diagnostic assessments, intervention, support and problem solving consultations to males and females ages 2-76 years of age, in-person or via Skype.
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. All inquiries to email@example.com
2015 All rights reserved Tania Marshall
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!
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: 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 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:
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
- Copies you (can be in a very discrete way)
- Episodes of eating problems
- No time perception*
- Too much sympathy
- Extremely interested in pop/ rock bands, soap operas or natural disasters
- Avoids demands*
- 34 Very determined*
- 35 Difficulties with choice; always avoids choosing
- 36 Difficulties with self-care*
- 37 Carefree or overmeticulous as regards physical appearance/dress
- Comes too close to others
- Interacts mostly with younger children*
- Engages in dangerous activities
- Exaggeratedly fanciful
- Talks without content*
- Writes long stories (can be in stark contrast to level of talk)
- Acts or lives different parts (TV stars, videos, animals)
Note. *indicates items which were considered most specific in girls with ASD (see study V)
To contact Tania for assessments, Skype or clinic consultations, problem solving sessions, workshops and presentations, book interviews, book translations, or publishing, please contact Tania at firstname.lastname@example.org
For more information about Autism Spectrum Conditions in females go to:
Copyright Tania A. Marshall 2015
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:
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.
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.