Autistic Women & Girls

How many autistic women do you know? Probably more than you think. Autism is typically thought of as something which affects mostly males but recent research shows that it could be affecting just as many females; it’s just that they don’t exhibit the same signs.

Girls and women with autism tend to ‘mask’ socially. That is, they mimic other people as a way of blending in but they also don’t show their true feelings or opinions. As you can imagine, this becomes exhausting and means they may well go unnoticed and undiagnosed for many years.

So what are the signs of autism in girls?

Challenges with Social Skills

According to Katherine G. Hobbs, a researcher and journalist for Autism Parenting Magazine, “One of the more classic symptoms of the autism spectrum can be seen when looking at difficulties involving social interactions. This is much easier to spot in men as girls and women tend to adapt to social situations more naturally than men.

It is inherently easier for autistic girls to mimic the behaviors of others when it comes to certain interactions at least initially.

This can change in the teenage years. During puberty when social interactions become more complex and the requirement to start understanding social cues becomes more important, the social difficulties of girls with Asperger’s syndrome become more obvious.

For example, young girls with Asperger’s might perform at an average to an excellent level at school, even socializing at what appears to be an age-appropriate level. “Some girls with Asperger’s will manage to keep their difficulties under wraps at school, but might have ‘meltdowns’ at home, where they feel safe to relax and release the feelings that they have been squashing down all day.”

Subtle clues such as difficulty maintaining eye contact during social interactions or escaping difficult events through mental processing or daydreaming can provide clues that girls may be autistic.”

Visual Thinkers

While we may associate boys on the spectrum as being predominantly visual thinkers, this can apply to girls too. In fact, one of the most famous women with autism is Dr. Temple Grandin and she pioneered revolutionary concepts in animal care due to her ability to think in pictures. In her book Thinking in Pictures, she writes about how this has proved to be such an advantage: “I think in pictures. Words are like a second language to me. I translate both spoken and written words into full-color movies, complete with sound, which run like a VCR tape in my head. When somebody speaks to me, his words are instantly translated into pictures. Language-based thinkers often find this phenomenon difficult to understand, but […] visual thinking has enabled me to build entire systems in my imagination… I value my ability to think visually, and I would never want to lose it.” It is now widely recognized that many women and girls on the spectrum tend to also think and process information visually, rather than verbal thinkers.

Sensory Issues

Many women with autism experience issues with “filtering” sensory input, which can lead to an overload of information and the need to focus intently on one thing in order to avoid being overloaded.

People with ASD may be highly sensitive and over-responsive to sounds, sights, smells, touch, and tastes. Many women are particularly sensitive to the feeling of clothes and makeup, pulling off clothing tags and opting for comfortable clothes over fashionable clothes and shoes every time. 

According to Claire Jack Ph.D. , some signs of sensory processing issues may include:

  • Disliking tags in clothes
  • Being sensitive to high-pitched noises
  • Finding some sensations (such as wool or nylon) difficult to cope with
  • Disliking tight or uncomfortable clothes or shoes
  • Choosing practical clothes over “attractive” clothes
  • Disliking feeling of foundation or lipstick
  • Disliking feeling of substances on fingertips (e.g. fruit, dirt, roughness)
  • Being affected by bright lights
  • Feeling overwhelmed in supermarkets/shopping stores
  • Feeling overwhelmed or disliking being hugged/kissed by acquaintances
  • Desire for spatial organisation, such as colour coordination
  • Disliking loud environments (such as concerts)
  • Having a strong reaction to certain scents (such as perfume)
  • Strong aversions to types of foods

(Please note that this list is not exhaustive and may be indicative of a different condition.)

Special Interests

My favourite researcher into the presentation of autism in girls and women is Tania Marshall MSc, an Australian psychologist who has produced a extensive profile of women on the spectrum. What is particularly interesting about her research is the sheer number of cases she has studied and the variety of ways autism presents. In Dr. Tony Attwood’s book ‘The Complete Guide to Aspergers Syndrome’, there is mention of how a girl with autism may have similar interests to other girls her own age; it’s just the intensity and dominance of the interest in her daily life that is different. I feel also, though, that women and girls on the spectrum do tend to have a variety of special interests and those interests are not quite so idiosyncratic as the ones we may see in boys on the spectrum.

Here is an excellent list of possible special interest from Tania Marshall’s profile of women with autism:

  • Current research shows that individuals on the Spectrum do not have “restricted interests”, but rather a lifetime of interests that can vary. A special interest may involve the person’s career, Anime, fantasy (think Dr. Who, superheroes, and Harry Potter), just to name a few, writing, animals, reading, celebrities, food, fashion, jewelry, makeup, tattoos, symbols and TV Series (think Game of Thrones). This is not inclusive
  • May attend ComicCon, SuperNova, love dressing up as a character.
  • Ability to “hyperfocus” for long periods of time involved in the special interest, without eating, drinking or going to the toilet, is able to hyperfocus on her special interest for hours, often losing track of time
  • Loves and revels in solitude, peace, and quiet. Solitude is often described as “needing it like the air I breathe”
  • An intense love for nature and animals
  • Often not interested in what other people find interesting
  • May collect or hoard items of interest
  • Introspection and self-awareness. Many women spend years trying to understand themselves, reading self-help and psychology books and wonder why they feel so different, from another planet or that the “Mothership has dropped me off on the wrong planet”.
  • Justice Issues
  • May know every lyric to a song or every line to a movie from repetitively watching them or listening to them

It’s a sad fact that many girls on the spectrum are not diagnosed until they are shows signs of depression, anxiety or other mental health issues. They may even end up being misdiagnosed with a completely different condition. Thankfully, awareness of the way autism presents differently in girls and women is increasing, and with it, hopefully, the tools and therapies to help will increase also. I urge anyone who feels they, or a family member, may have autism to look at Tania Marshall’s blog post “Moving Towards a Female Profile“.

What’s his super power?

Believe it or not, parents of autistic children get asked this a lot.

It’s hard to know how to reply, because if a person is genuinely curious, it’s nice to encourage dialogue, but they may be disappointed with the answer of “He takes 17 minutes to put on a shoe” or “She is adept at smearing poo”. I don’t think that’s the answer they would be expecting to be honest.

There is still the notion that if a child has a diagnosis of autism, they must have an incredibly high IQ or be a musical / mathematical / artistic prodigy.

It is true a proportion of people with autism are ‘savants’, that is, they are individuals with autism who have extraordinary skills not exhibited by most persons” (Autism Research Institute, 2017). However, this figure is thought to be in the region of 10%. Films like Rainman and Mercury Rising , while bringing attention to the wonderful abilities some children may have, can give people the inaccurate view that all our children are prodigies. This can be really disheartening for those of us who view trying on a different colour top as a real accomplishment. For the child who struggles with leaving the house, something as simple as going to the letter box is something worth celebrating.

Please try to remember that if you’ve met one child with autism, you have met only one child with autism.

It is a spectrum, with an amazing variation of permutations, differences and similarities.

By all means, celebrate the genius and the savants but don’t forget to commend the little boy who managed to make fleeting eye contact when he said ‘Hello’ today. And do marvel with me at the ability to make putting shoes on last nearly half an hour. All of our children are superheroes in their own special ways.

How many times have you been asked that question, and what’s your favourite response?

References

Edelston, Stephen M. ,2017, Autistic Savants, Autism Research Institute. https://www.autism.com/understanding_savants

© Peta Slaney, 2020, All Rights Reserved.

Introduction to Sensory Processing

Many children with autism struggle with sensory processing. As shown in a previous article, sensory issues are now part of the diagnostic criteria.

Our senses affect how we respond to the world around us. Many children are either over-sensitive (hyper) or under-sensitive (hypo) and it can be tricky for them to cope with their reactions to what is going on around them.

Below are some examples of different issues that our children may have and just a few tips on how to help them. This is an extensive subject with many research projects underway, so there will be more in depth articles to follow.

  • Taste

Some children may need to sniff their food before tasting it, or they may have a preference for very bland flavours. Similarly, they may prefer textures that are only crunchy, dry, or liquid or they might love spicy food. Trying new foods can be really challenging. My son declared that he hates kiwi fruit and it’s the worst thing in the world; he’s never tried it but he wanted to make sure he didn’t have to. When he did try it later, he decided that he loved it. I still can’t persuade him to try anything that looks too wet or ‘slimy’ (as he puts it).

How To Help: Offer the child a small amount, but don’t force it. If your child has a preference for certain textures or flavours, try to introduce similar items to their diet so it is balanced and healthy.

  • Sound

I’ve found that for most children and adults that I’ve worked with noise is a big trigger for negative behaviour. Many autistic people are sensitive to certain noises or pitches. Sudden noises, such as a police car or fire alarm, can be really distressing. In addition, areas with a lot of background noise- such as a busy cafe or supermarket can cause a build up in anxiety.

How To Help: Ear defenders are a good option and available in many colours and sizes. Alternatively, having an iPod or MP3 player handy when out and about can give the child something auditory to focus on and block out the rest of the noise.

  • Touch

This can be pressure on the body, the feel of clothes, physical contact with other people like hugging or holding hands, brushing teeth, getting their face wet, or experiencing pain. Some of our children may be hypo (under) sensitive to pain or temperature, whilst others may really struggle with something as (apparently) simple as a hug.

How To Help: For a child that is over-sensitive to touch, a verbal or visual warning may be needed. Don’t force the child to hug/cuddle/touch something if they find it too distressing as this could only exacerbate the issues.

For a child that is under-sensitive, then they may like a weighted jacket or blanket, or deep pressure massage.

  • Vision

Children with autism are predominantly visual learners. This means that they take in a lot of information through what they can see. Some colours or sights may be distressing or overstimulating. They may struggle with bright sunshine or the flickering of a strobe light.

How To Help: Sunglasses and window shades in the car- these have been a lifesaver for me and avoided many a meltdown due to the sun being “too shiny”. Try to keep bedroom walls clear of clutter and posters, this will help the child to be settled at bedtime rather than visually over-stimulated.

  • Smell

Smell can be a particularly emotive sense for many people and children with autism are no different. Some scents may be preferred and a source of comfort,  whereas a change in washing powder or air freshener can be very upsetting.

How To Help: Introduce new scents slowly. If a change in behaviour is noticed as a response to a certain smell, it may be best to avoid it.

  • Proprioception

This is basically our sense of position and movement. It’s something that many children with autism and ADHD struggle with as their sense of spatial awareness and connection with their own body can be a bit disjointed. This may manifest as clumsiness and issues with personal space.

  • Vestibular

This ties in very closely with proprioception in that it affects spatial awareness but also incorporates balance. Again, it can manifest as clumsiness or a child who spins or swings quite vigorously in order to get some sensory feedback from that sensation.

How To Help: Sensory circuits and physiotherapy exercises can really make a difference with these issues. There will be a guide to sensory circuits on the website in a few weeks, as it is such an effective way to help with behaviour due to sensory imbalances.

Occupational therapy and physiotherapy can help the child to master their fine motor control and strengthen their core. An occupational therapy assessment would be the first port of call to assess which difficulties the child has and how to help them individually. 

As I said before, this is just a brief introduction to sensory issues and there are more in depth articles on the way. In the meantime, please feel free to e-mail me for advice or further information.

© Peta Slaney, 2020, All Rights Reserved.