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Characteristics of Females with ASD Level 1

"We think our daughter may have a form of autism due to her severe shyness, excessive need to have things just so, certain rituals she has with food, major touch sensitivity, a lot of anxiety, just to name a few. What are some of the signs to look for to help us decide if an assessment is in order?"

Females with ASD, or High-Functioning Autism. often present with a unique set of characteristics that can make diagnosing their disorder very difficult. In addition, their strengths often mask their deficits.

There has been considerable discussion among professionals about the way girls with ASD demonstrate their major characteristics. Some girls have obvious social difficulties, whereas others appear to have excellent skills because they imitate the behaviors of others (often without understanding them).



There are many females who do not receive a diagnosis, possibly because, compared to males, (a) they have fairly good social skills (particularly when interacting with adults in a one-to-one situation), (b) their special interests are different, and (c) their clinical presentation is different.

Sometime during childhood, a female with autistic traits will begin to know she is different compared to her peers. For example:

1. Due to adopting an alternative persona, she may begin to have problems of self-identity and low self-esteem

2. Due to observing and analyzing social behavior and trying not to make a social error, she may become emotionally exhausted

3. During the stress of adolescence, she may develop routines and rituals around food and a special interest in calories and nutrition that develops into the signs of an eating disorder

4. Her interests may be different to her peers in terms of intensity and quality of play

5. She may be an avid observer of human behavior and try to decipher what she is supposed to do or say

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism
 
6. She may be extremely sensitive to the emotional atmosphere at a social gathering

7. She may be like a chameleon, changing persona according to the situation

8. She may be more likely to apologize and appease when making a social error

9. She may be overly well-behaved and compliant at school so as not to be noticed or recognized as a different.

10. She may be vulnerable to “peer predators” who take advantage of her social immaturity

11. She may become increasingly aware of her social confusion and frequent faux pas, and thus prefer to be on the periphery of social situations

12. She may enjoy living in a fantasy world and creating a new persona

13. She may escape into the world of nature, having an intuitive understanding of animals, but not people

14. She may fear that her “true self” must remain secret because she is defective, thus she is almost always acting like someone else

15. She may have a pet that she views as a loyal friend

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

16. She may have a single - but intense – friendship with another female who may provide guidance for her in social situations

17. She may have a strong desire to collect and organize her toys (e.g., dolls) rather than to share her toys with friends

18. She may have an aversion to the traditional concept of femininity

19. She may have an encyclopedic knowledge of specific topics

20. She may have an intense interest in reading and escaping into fiction

21. She may have an interest in ancient civilizations to find an old world in which she would feel at home

22. She may have an interest in other countries (e.g., France) where she would be accepted

23. She may identify with a fictional character (e.g., Harry Potter), who faces adversity but has special powers and friends

24. She may not be interested in the latest craze among her peers to be 'cool' and popular

25. She may not identify with her peers

26. She may not play with her toys in conventional ways

27. She may not want to play cooperatively with her peers

28. She may prefer non-gender specific toys (e.g., Lego)

29. She may prefer to play alone so that she can play her way

30. She may prefer to play with males, whose play is more constructive and adventurous than emotional and conversational

==> Teaching Social Skills and Emotion Management to Children and Teens with ASD

31. She may suffer social confusion in silence and isolation in the classroom or playground, but she may be a different character at home

32. She may talk to imaginary friends, or write fiction at an early age

33. She may think that the way her peers play is stupid and boring

34. She may use imaginary friends that can provide companionship, support and comfort when she feels lonely

35. She may use passive-aggressive behaviors in order to control her family and/or social experiences


  
As young girls, many (but not all) females with ASD:

1. Apologize frequently and want to please others

2. Are an expert on certain topics

3. Are determined

4. Are honest

5. Are involved in social play, but are led by their peers rather than initiating social contact

6. Are kind

7. Are misunderstood by peers

8. Are more able to follow social actions by delayed imitation because they observe other kids and copy them, perhaps masking the symptoms of autism
 
9. Are more aware of - and feel a need to - interact socially

10. Are perfectionists

11. Are so successful at "faking it" that they only come to the attention of a therapist when a secondary mood disorder emerges

12. Are specially gifted in the areas of mathematics and engineering

13. Are very good at art

14. Are visual thinkers

15. Are well-liked by adults

16. Become a target of teasing

17. Do not ‘do social chit chat’ or make ‘meaningless’ comments in order to facilitate social communication

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

18. Enjoy solitude

19. Have a faster rate of learning social skills than males

20. Have a single friend who provides guidance and security for them

21. Have a special interest that is more likely to be unusual in terms of intensity rather than focus

22. Have difficulty knowing what someone else may be thinking or feeling

23. Have difficulty making friends

24. Have difficulty managing feelings

25. Have difficulty showing as much affection as others expect

26. Have difficulty taking advice

27. Have difficulty with writing skills

28. Have extremely detailed imaginary worlds

29. Have imaginary friends

30. Have interests that are very similar to those of neurotypical girls (e.g., animals, dolls, classical literature), and therefore are not seen as unusual

31. Have what is classified as a "male brain"

32. Make reliable and trustworthy friends

33. Mimic or even try to take on all the characteristics of someone they are trying to emulate

34. Notice sounds that others do not hear

35. Read fiction to help them learn about inner thoughts, feelings and motivations

36. Show little interest in fashion

37. Speak their minds (sometimes to the point of being rude)

38. Still need to be directly taught certain social skills

39. Try to understand a situation before they make the first step

40. Use doll play to replay and understand social situations

By

Undiagnosed and Misdiagnosed ASD [Level 1]

ASD manifests in many ways that can cause difficulties on a daily basis.

Here are some examples of what to look for:

• Being naive and trusting
• Confusion
• Delayed motor milestones
• Delighting in fine details such as knobs on a stereo
• Difficulty in conversing
• Difficulty with multitasking
• Extreme shyness
• Lack of dress sense
• Mixing with inappropriate company
• Not understanding jokes or social interaction
• Quoting lists of facts
• Unusual and obsessional interests

One of the worst problems is that you can never really understand what is going on inside your youngster's head. This makes it so difficult for you to understand his behavior. This can leave you feeling emotionally beat-up and completely useless as a parent. You may have to cope with crisis on a daily, hourly or even minute-by-minute basis.

Undiagnosed ASD—

Undiagnosed ASD is an issue that concerns me because so many kids have the disorder and are struggling to make it in this world with very little help or resources. Just today, I met someone who said that it was suggested that their youngster had Oppositional Defiant Disorder (ODD) without anyone recognizing the other behaviors that are just as relevant.
 

There are many characteristics for autism spectrum disorder, but one thing that goes unnoticed is that there can be a secondary diagnosis clouding the picture and causing undiagnosed ASD. Many kids on the spectrum also have ADHD, for example. ADHD can cause behaviors that draw an excessive amount of attention, thus the undiagnosed ASD can be overlooked.

Commonly undiagnosed conditions in related areas may include:

o ADHD -- Undiagnosed
o Adult ADHD -- Undiagnosed
o Alzheimer Disease -- Undiagnosed
o Bipolar Disorder -- Undiagnosed
o Concentration Disorders -- Undiagnosed
o Epilepsy -- Undiagnosed
o Migraine -- Undiagnosed
o Schizophrenia -- Undiagnosed
o Stroke -- Undiagnosed

Undiagnosed ASD Leads To Life as an Outsider

For most of his life, Michael felt like an outsider. Restless and isolated, he was over-stimulated and uneasy around others. Finally, when he was 45, he was diagnosed with ASD, a syndrome that falls within the autism spectrum. The diagnosis came as a relief: Here, finally, was an objective explanation for some of my strengths and weaknesses

People on the spectrum often struggle to interact with groups and understand social norms. Michael describes himself growing up as a "very lost little kid" who acted out in school by making faces at teachers and being aggressive with the other students. His ability to connect to others didn't improve with age.

Music — particularly the repeating patterns of melody — provided him with a refuge from an early age. He remembers listening to his mother's record collection and experiencing a "passage into a world where everything made sense." He compares listening to music to watching clouds change slowly over the course of an afternoon.

As for his diagnosis with Aspergers, Michael says it has helped him accept the parts of his nature that are "not very changeable." Wearing eyeglasses, for instance, makes him feel like he is "being intimate with everybody on the street." As a result, he rarely wears them now — even though he received his first prescription for glasses when he was in kindergarten.

Misdiagnosed ASD—

Many kids with ASD [high-functioning autism] are misdiagnosed as having ADHD with no investigation by medical professionals of the possibility of ASD. In one case, a child was treated for ADHD for years before anyone mentioned autism. 
 

ASD can be a difficult diagnosis to make because there is no single test to detect it. An accurate diagnosis generally requires the evaluation of a team of professionals who are specialists in developmental disorders. In addition, the symptoms of ASD are similar to some symptoms of some other disorders. This can result in a delayed or missed diagnosis. Kids and adults with ASD may be misdiagnosed with other conditions with some similar behaviors, such as obsessive-compulsive disorder (OCD) or attention deficit hyperactivity disorder (ADHD).

The other conditions for which ASD is listed as a possible alternative diagnosis include:

• Schizoid Personality Disorder
• Schizotypal Personality Disorder

Other Common Misdiagnoses:

• ADHD under-diagnosed in adults: Although the over-diagnoses of ADHD in kids is a well-known controversy, the reverse side related to adults. Some adults can remain undiagnosed, and indeed the condition has usually been overlooked throughout childhood. There are as many as 8 million adults with ADHD in the USA (about 1 in 25 adults in the USA).

• Bipolar disorder misdiagnosed as various conditions by primary physicians: Bipolar disorder (manic-depressive disorder) often fails to be diagnosed correctly by primary care physicians. Many patients with bipolar seek help from their physician, rather than a psychiatrist or psychologist.

• Blood pressure cuffs misdiagnose hypertension in kids: One known misdiagnosis issue with hypertension arises in relation to the simple equipment used to test blood pressure. The "cuff" around the arm to measure blood pressure can simply be too small to accurately test a youngster's blood pressure. This can lead to an incorrect diagnosis of a child with hypertension. The problem even has a name unofficially: "small cuff syndrome".

• Brain pressure condition often misdiagnosed as dementia: A condition that results from an excessive pressure of CSF within the brain is often misdiagnosed. It may be misdiagnosed as Parkinson's disease or dementia (such as Alzheimer's disease). The condition is called "Normal Pressure Hydrocephalus" (NPH) and is caused by having too much CSF, i.e. too much "fluid on the brain". One study suggested that 1 in 20 diagnoses of dementia or Parkinson's disease were actually NPH.

• Kids with migraine often misdiagnosed: A migraine often fails to be correctly diagnosed in pediatric patients. These patients are not the typical migraine sufferers, but migraines can also occur in kids.

• Dementia may be a drug interaction: A common scenario in aged care is for a patient to show mental decline to dementia. Whereas this can, of course, occur due to various medical conditions, such as a stroke or Alzheimer's disease, it can also occur from a side effect or interaction between multiple drugs that the elderly patient may be taking. There are also various other possible causes of dementia. 
 

• Depression undiagnosed in teenagers: Serious bouts of depression can be undiagnosed in teenagers. The "normal" moodiness of teenagers can cause severe medical depression to be overlooked.

• Eating disorders under-diagnosed in men: The typical patient with an eating disorder is female. The result is that men with eating disorders often fail to be diagnosed or have a delayed diagnosis.

• Mesenteric adenitis misdiagnosed as appendicitis in kids: Because appendicitis is one of the more feared conditions for a youngster with abdominal pain, it can be over-diagnosed (it can, of course, also fail to be diagnosed with fatal effect). One of the most common misdiagnosed is for kids with mesenteric adenitis to be misdiagnosed as appendicitis. Fortunately, thus misdiagnosis is usually less serious than the reverse failure to diagnose appendicitis.

• Mild worm infections undiagnosed in kids: Human worm infestations, esp. threadworm, can be overlooked in some cases, because it may cause only mild or even absent symptoms. Although the most common symptoms are anal itch (or vaginal itch), which are obvious in severe cases, milder conditions may fail to be noticed in kids. In particular, it may interfere with the youngster's good night's sleep. Threadworm is a condition to consider in kids with symptoms such as bedwetting (enuresis), difficulty sleeping, irritability, or other sleeping symptoms. Visual inspection of the region can often see the threadworms, at night when they are active, but they can also be missed this way, and multiple inspections can be warranted if worms are suspected.

• Mild traumatic brain injury often remains undiagnosed: Although the symptoms of severe brain injury are hard to miss, it is less clear for milder injuries, or even those causing a mild concussion diagnosis. The condition goes by the name of "mild traumatic brain injury" (MTBI). MTBI symptoms can be mild, and can continue for days or weeks after the injury.

• MTBI misdiagnosed as balance problem: When a person has symptoms such as vertigo or dizziness, a diagnosis of brain injury may go overlooked. This is particularly true of mild traumatic brain injury (MTBI), for which the symptoms are typically mild. The symptoms has also relate to a relatively mild brain injury (e.g. fall), that could have occurred days or even weeks ago. Vestibular dysfunction, causing vertigo-like symptoms, is a common complication of mild brain injury. 

• Parental fears about toddler behavior often unfounded: There are many behaviors in infants and toddlers that may give rise to a fear that the youngster has some form of mental health condition. In particular, there is a loss of fear of autism or ADHD in parents. However, parents should understand that the chances are higher that it's part of normal development, and perhaps just a "cute behavior" rather than a serious condition. Although parents should be vigilant about monitoring all aspects of their child's development and mental health, they should also take care not to over-worry and miss out on some of the delights of parenthood. For example, a young child that screams when you open his car door to take him out, then makes you put him back into the car to repeat it, so that he can open the car door himself, is not necessarily showing signs of autism or OCD, nor indeed any mental illness. There is a small possibility that it's an abnormality (a chance that increases with age of the youngster), but it's also the type of behavior seen in many normal kids.

• Post-concussive brain injury often misdiagnosed: A study found that soldiers who had suffered a concussive injury in battle often were misdiagnosed on their return. A variety of symptoms can occur in post-concussion syndrome and these were not being correctly attributed to their concussion injury.

• Undiagnosed anxiety disorders related to depression: Patients with depression may also have undiagnosed anxiety disorders (see symptoms of anxiety disorders). Failure to diagnose these anxiety disorders may worsen the depression.

• Undiagnosed stroke leads to misdiagnosed aphasia: BBC News UK reported on a man who had been institutionalized and treated for mental illness because he suffered from sudden inability to speak. This was initially misdiagnosed as a "nervous breakdown" and other mental conditions. He was later diagnosed as having had a stroke, and suffering from aphasia (inability to speak), a well-known complication of stroke (or other brain conditions).

Resources for parents of children and teens on the autism spectrum:
 
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Articles in Alphabetical Order: 2019


Articles in Alphabetical Order: 2019

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