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Girls with Aspergers and HFA

More often identified in males than females, Aspergers and High-Functioning Autism (HFA) are characterized by compulsive pursuits, awkward communication skills, and problems with social cues.

The signs and symptoms of the disorder in females are often exhibited in a more subtle manner, which leads to missed or incorrect professional diagnoses, a lack of access to special education services and provisions in education, along with an increased potential for interpersonal and psychological difficulties in the adult years.

A number of unique differences exist regarding the ways that young ladies versus males with Aspergers behave:

  • Females that have Aspergers and HFA aren't usually aggressive once they get irritated; instead, they tend to be withdrawn and may very easily "fly under the radar" in classrooms and other interpersonal situations. 
  • Females with the disorder can communicate their feelings in a more calm way than their male counterparts. 
  • Aspergers and HFA females tend to be safeguarded and nurtured by their neurotypical friends, who assist them to deal with challenging interpersonal situations. Acceptance from friends can occasionally cover up the problems these girls have so they aren't recognized by educators and moms and dads. Consequently, grown-ups are not as likely to suggest psychological and social evaluations.

There are specific personality characteristics and warning signs that moms and dads, educators, and specialists can search for when they believe that a young female may have Aspergers or HFA:

  • Females with the disorder often exhibit compulsive traits regarding animals, dolls, and other female-oriented pursuits. While neurotypical females will play with dolls by pretending that they're interacting socially, Aspergers and HFA females might collect dolls and never use them to interact socially with other females. 
  • Their passion for certain subject matter can result in them lagging behind their friends in terms of maturation and age-appropriate conduct (e.g., a pre-teen on the autism spectrum may be captivated by stuffed animals or cartoons long after other females their age have outgrown this stuff.
  • Females that have Aspergers and HFA may be incorrectly assumed to possess a character disorder simply because they imitate typical kids - but use phrases inappropriately. 
  • They are usually bored with kids their age and possess problems empathizing with their friends' concerns/problems. 

While their behaviors tend to be less aggressive than males on the spectrum, grown-ups who pay close attention to females with social and psychological delays can make sure that correct diagnosis and therapy will take place. The younger a female is when she starts to receive the appropriate speech, occupational, and psychological services, the greater likelihood she'll have a completely independent and functional adult life.

Females with Aspergers and HFA have the same difficulties with sensory processing and social navigation as males. In addition, they have telltale intense focus on a particular subject of interest.

Symptoms include:

Routine—
o Appears anxious when there are changes in routine
o Intense focus on a particular subject
o Practices rituals that appear to have no function
o Resists change

Physical—
o Difficulty coordinating movements
o Odd posturing
o Repetitive movements (stims)

Sensory processing—
o Dislikes textures in foods, clothes or objects
o No response or extreme response to noises
o Resists activities that involve movement (slides, escalators…)
o Seeks out sensory experiences (spinning, rocking…)
o Strong aversion to certain smells

Social difficulties—
o "Scripts" daily conversations
o Appears excessively shy
o Appears uncomfortable during conversation
o Avoids interacting with others
o Hesitant to make the first move
o Tends to "blend" into the crowd
o Tends to mimic rather than providing natural responses

It's not uncommon for females with Aspergers and HFA to go undiagnosed well into adulthood. Like heart disease, autism spectrum disorders are 10 times more prevalent in boys, so doctors often don't think to look for it in girls. But some experts have begun to suspect that unlike heart disease, the disorder manifests differently - and less obviously in females - which is also causing them to slip through the diagnostic cracks.

This gender gap may have implications for the health and well-being of females on the spectrum, and some specialists predict that as we diagnose more females, the profile of the disorder as a whole will change. Unlike males, females with ASpergers and HFA seem to have less motor impairment, a broader range of obsessive interests, and a stronger desire to connect with others despite their social impairment.


More resources for parents of children and teens with Asperger's and High-Functioning Autism:



Comments:

Anonymous said... Dear Dr. Mark, I am speaking at a retreat Aug 4 on the female perspective of AS. I am co-founder of Asperfemme, a support group for self- and officially-diagnosed women with ASD in Ottawa, Canada. I was 48 when I was diagnosed, three years after my two-decade long married ended, and have splinter skills in music (absolute pitch) and language (hyperlexia) which I have parlayed into self-employment as a private music teacher (after several failed careers.) We older women are struggling with financial needs, broken or troubled relationships, sometimes children on the spectrum, on top of the regular aging stuff. I would be interested if any of your research and writing deals with this largely unexplored group (a subgroup of "the spectrum within the spectrum" as Dr. Kevin Stoddart of Toronto's Redpath Centre calls Asperger's). I do find we women are less rigid about routines, and have fewer self-soothing behaviors (stims) than the men. We also tend to get sad and anxious rather than angry, a fact my marriage counselor could not deal with. I was introduced to you in the article "Children with High-Functioning Autism: 'Gifted' or Hyperlexic" on the My Aspergers Child web site (excellent by the way.) My precocious reading skill was considered cute, and not a sign in 1963 that anything was wrong. I think my parents were relieved that I amused myself with books, because I was quiet and no trouble while they dealt with my two rambunctious younger brothers born 11 months apart. I ended up in a Gifted class for 4 years (Grades 5 to 8) and had few friends, being chosen only for the spelling team. I flew entirely under the radar with my good academic record--a child seen and not heard. Looking back I also had selective mutism, excellent mimicry, apraxia and poor executive function. I firmly believe the piano saved my life, as it gave me an outlet and later a means to communicate. Public performance was very hard, but I learned to develop 'show' and private persona.

CoolMama said... I'm glad to see someone writing about girls/women on the spectrum. Like ADHD, women tend to present differently than boys/men do with regard to "symptoms" or characteristics. For myself, when I got into middle school (junior high back then), I learned about acting. For me, being involved in theater classes allowed me to become someone else, someone who wasn't "weird", who wasn't bullied or teased. I learned about personas, roles, and finally felt like I'd found a group where being a misfit was accepted and even embraced. Some might think being on stage as completely opposite to the social awkwardness inherent to ASD/Asperger's--I disagree. When you act, you aren't yourself, so you have the freedom and confidence to overcome your weaknesses. Plus, most interactions are scripted (I didn't do so well at improv, for example). You memorize your lines, and you learn techniques for portraying emotion. It's pretend play at the highest level. Not only was it a life-saver for me in school, it helped me once I tried to get a professional job. Interviews are all about presenting an image, and presenting an image is about projecting a persona, or playing a role. Other ASD individuals may have difficulty with "feeling like a fraud", and I totally get that--but I chose to look at it as being on stage. The "role" I created was just the best parts of me, the parts I wanted to stand out and be noticed. Theater isn't the solution for every person with ASD...but it is something to consider.

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Aspergers Teens and Online Gaming Addiction

For many children and teens, computers offer an escape from difficult social situations along with a partial remedy for the loneliness of Aspergers (High-Functioning Autism).

The PC itself offers a predictable false-companionship, and teens who use computers may also band together in common-interest clubs. Such teens may become involved with PCs to the exclusion of almost every other hobby.

Despite the fact that there's a lot of mayhem on the web, inter-personal contact on the web can provide a "nerdy child" a level of defense against actual face-to-face contact. For example, in chat rooms, body language, facial expression, intonation, pacing, and timing of speech are removed in the interpersonal exchange. In role playing games, the interactions between participants are influenced by guidelines associated with traits the virtual person has accrued throughout play. A young man who's just a geek in class may become a strong and dreaded warrior within an online fantasy game.

Since a number of these children are so hungry for interpersonal connection, most of them invest a massive amount of time at their PCs, ignoring family members, homework, and much of the "real world." Even worse, for sleep patterns, the PC is "usually open." A number of these kids fall asleep later and later, particularly in the summertime, ultimately moving their sleep cycle so that they snooze when the rest of the family is up. This only worsens their lack of social skills, regardless of how successful their virtual character is becoming inside an online fantasy game.

While such cases are rare, mental-health professionals say the fantasy worlds offered by video games can become the stuff of very real addictions that destroy the education of an Aspergers teen. It's a huge and growing problem with older teenage males and young adult males with Aspergers. I've seen a number of cases with 18- to 23-year-old males where they have an Internet connection, and they basically haven't left the house for years. I had one young man who was trying to get on Social Security disability for agoraphobia. He didn't really have agoraphobia …he just didn't want to leave his computer.

My Aspergers Teen: Discipline for Aspergers Teens
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Aspergers and Lack of Eye Contact

Eye-to-eye contact is a type of communication. However, there ought to be a shared language involving two individuals when eye-to-eye contact is made. A person should be able to read what the other person is thinking and feeling. That's the way "neurotypical" (i.e., non-Aspergers) eye contact functions. With Aspergers (high functioning autism) however, that's not often the situation.

Eye-to-eye contact isn't something that is natural or even desirable to Aspies. They have trouble with the interpretation of this language. Many reasons exist why they can't share the language.

First, looking at someone's eye balls is extremely awkward. It is just like looking at the headlights of a train. Eye balls flicker and move, which can be unpleasant for those who have Aspergers. Even if they do make eye contact, they do not know the silent language. They need to learn each thing that the eyes tell them, from very obvious to very subtle.

The next issue is in what they send. They have no clue about what messages they're sending using their eyes. That triggers confusion for the one who is attempting to read them, because they don't send obvious messages. With this confusion on both sides, conversation using this method doesn't work well. The big deal relating to this whole eye-to-eye contact issue is the fact that our culture has built in a lot of meaning into the use of eye contact. We've interpreted this as an indication of trustworthiness and not hiding something, being secure, and the skill of listening.

These are the expectations that are put on everyone in this culture, whether we are able to make eye contact or not. If you don't use it, you are charged with lying, not being comfortable, having something to hide, not listening, etc. This may not seem sensible when you have Aspergers. I have yet to meet individuals with Aspergers who are natural liars. A number of them have had to learn to be devious when they need to be and tell the little white lies, so they don't hurt the feelings of non-Aspergers individuals. Bluntness has never harmed anybody. They lie only if they have to, and it is not very natural to them. Therefore, convinced that they lie due to not having eye-to-eye contact makes no sense.

Eye contact has nothing to do with listening. The eyes as well as the ears aren't linked on a single band. Aspergers people may hear and learn without needing to really look at somebody. There's also peripheral vision, which is looking - but from the sides of the eyes. Non-Aspergers individuals believe that if the eye-to-eye contact isn't full in the face, it's not eye contact. Aspergers individuals can be comfortable and never give eye-to-eye contact. Actually, they're much less comfortable should they have to give it every time. It is stressful and diminishes their self-ease. The truth is, should they meet someone who they don't know, they don't give eye-to-eye contact. They have a tendency to avoid stressing themselves to provide eye-to-eye contact and have a dialogue simultaneously.

Eye-to-eye contact is for the benefit of non-Aspergers individuals and not much of a benefit for the people with Aspergers. They can't do it adequately, nor communicate it very well. Additionally, it stresses them and makes them uneasy.

The Aspergers Comprehensive Handbook
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