Females on the Autistic Spectrum

Georgina Psomiadis, Clinical Psychologist

​When looking at the research, different studies, together with anecdotal evidence, there are various results in ratios between males and females on the autistic spectrum, ranging from 2:1 to 16:1, respectively!   
 
So why are there such differences across studies? There are several possible reasons for this, some of them being:

• More subtle presentation in females (though subtle presentations can present in males also)
• Diagnosticians and trainers are not recognising girls given the current diagnostic criteria is more associated with the more ‘obvious’ criteria, more often seen in males.
• Autism is usually not being considered as an explanation for the difficulties experienced by women (the specific questions are not being asked)
• Other diagnoses are often used to explain autistic experiences

 
The below table illustrates the differences between more obvious characteristics of ASD compared to more subtle characteristics (National Autistic Society):
 

Often, I hear parents say that their daughter’s teachers don’t notice any ‘problem’ in the classroom, and in fact, they’re considered the perfect student! This is often quite distressing for parents as their child may to experience intense emotional outbursts the moment they arrive home.

Girls tend to mask their behaviours quite well, as they are more motivated to engage socially. They spend excessive amounts of energy doing so at school, as to not get noticed and fly under the radar. Because of this mental and emotional exhaustion, here comes the meltdowns when they finally feel like they can be ‘themselves’. 
 
Unfortunately, there may be very little clear ‘red flags’ in early childhood other than shyness, being quiet and having interests that are ‘typical’ for young girls, though the intensity of this interest is excessive.

The expressive language used by autistic females is often exceptionally good, which can then mask their difficulties processing verbal information. Their eye contact might also be quite good, they may do ‘small talk’ well and can be very chatty, though these tend to be quite exhausting and when their energy is not replenished, can cause significant distress and other mental health conditions over time.

Females who seek therapy present with mental health issues such as eating disorders, personality disorders, depression, anxiety and self-harming behaviours that can divert the clinician’s attention away from a possible underlying autism.
 
Mothers who identify with having autistic characteristics are typically the ones who bring their young daughters into therapy or for assessment, as they notice the difficulties in their child as similar to their own difficulties, and don’t want their child to go through the same challenges as they did growing up.

We know that appropriate support at younger ages leads to better outcomes. Early intervention is always a good idea, whether a formal diagnosis is made or not (although having a diagnosis can open up funding support for interventions); if the clinician is attuned to the ASD presentation, they will provide the appropriate interventions.
 
Our mission at Hopscotch and Harmony is to smash the stigma of mental health conditions and a big part of our work is working with young children, teens and adults on the autistic spectrum.

Having an Autism Spectrum Disorder (ASD) does not have to be scary.

There is so much support out there and this will continue to grow as our understanding of their needs deepens.  Listening to so many individuals with autism talk about their relief and enhancement of self-understanding when they receive a diagnosis are some of the benefits of going through the formal assessment process. Though this is not true for everyone.

​Some people identify with having autistic characteristics or self-diagnose as having ASD, and are content with being aware of what they struggle with and their strengths and don’t want a formal diagnosis. Some people may overly-identify with a diagnosis and feel like ‘something is wrong with them’. This is where clinical judgement and parental intuition come into play… there is never a black and white answer, is there?
 
Many psychologists at Hopscotch and Harmony are highly skilled in the assessment process for ASD. If you want more information on this process, please call us and we will guide you through this.

Georgina Psomiadis is a Clinical Psychologist who sees children, teens and adults regarding a broad range of mental health concerns. She has a particular interest in supporting young people in creating an inner calm and confidence with their identity. Georgina considers the brain-body connection and incorporates mindfulness in her treatment. Call 9741 5222 to make an appointment with Georgina at Hopscotch & Harmony's Werribee or Point Cook practices.