Assessing Autism in Women: A Journey to Understanding and Thriving

​When looking at the research, different studies, together with anecdotal evidence, there are various results in ratios between males and females identified as autistic, 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)
• Assessment measures, diagnosticians and trainers are not recognising certain autistic experiences, with some of the more common assessment tools not evaluating traits often found in autistic girls and women.
• Autism is often not 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 Autism 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’. 

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 identifying these individuals as autistic.
 
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.
 
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 who are autistic.

There is so much support out there and this will continue to grow as our understanding of autistic needs deepens.  Listening to so many autistic individuals talk about their relief and enhancement of self-understanding when the assessment process identifies them as autistic 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 being autistic, and are content with being aware of their strength and struggles, and don’t want a formal assessment. 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 autism assessment process. If you want more information on this process, please complete our assessment booking enquiry form FOUND HERE