Variations in the Presentation of AS Women
This could very well be true. The gender role of a female isn't well defined, whereas for a male, there are only 2 gender roles. The one of a straight man, and the one of gay man. If you don't fit one of the two roles, and there is little difference between the two in the younger years, you are viewed as abnormal, which makes it really easy to pick out an autistic child. Females on the other hand aren't forced into a single role (can't figure that out, but I think it has a historical reasoning), and thus their traits are generally viewed as within the norm, and easily could be. Without a genetic test, many females with AS will fall through the cracks, I don't like this, but its just the way it is.
Now as for me... My dad has suspected me of being gay since I was in grade 6... Then a few weeks ago, he finda out I am not gay, but transexual... Oh the irony... I hope he finally can make sense of why I never was much of a man now... and that was just one way I didn't fit the typical male role.
They just think, like, 'oh, she's shy' and they don't give it a second thought?
I think this is the case. This is the usual sequence: they'd verbally apply the shy or quiet label, briefly study me as though I were some odd specimen, provide some patronising advice based upon projection, reassure me I'd grow out of it--just like such and such they knew--then rarely bother me again (apart from one professor who made me his pet project/amusement.)
I thought i had a different presentation - but the more i look into it and the more i receive feedback from others, the more i am told I am very ASDish.
My special interest is arts related and not teckie-based or maths/science inclined.
I have poor eye contact and when i do look at facew which i can do when i know people, i look at their teeth. I monologue> i do not have a flat affect but have an almost rubber and over-expressive face with expressions that do not match my internal state of being or feeling or lack thereof.
I got social skills training in a rehab at age 36. I can fudge it. BUt it is exhausting and most people do not interest me.
In some ways as a child I was feral. I looked and acted like a boy and dressed like one. Most of teh cues for behaviour were taken from other children and i would try to mimic. I never felt connected at all, even with people who felt close or really emotionally linked with me. Out of sight and out of mind, for me, largely.
My ASD psych said he knew within half a session I was on the spectrum - that it was very obvious to him. But he is trained.
I have highly advanced verbal skills - true big word round about ways monologuing with fairly poor reciprocity.
as a child, the whole feeling of people talking to me sociall y was unbearable and still is. But back then it was like knives going through me - or like the Tin Drum Boy in the Gunther Grass novel ---- just wanting to SCREAM to make them stop engaging with me. My whole adolescence and twenties felt like that too. One big internal SCREAM of pain re engaging with other people.
I did however learn some social skills from coming from a big family wtih 8 kids - forced into it. hectic and hideous. I am told i was the invisible brainiac who was a tomboy who had hysterical outbursts and meltdowns.
THe fact it is a spectrum means some are more mild and some are more severe.
I need nearly every day alone to survive in the world. Others work in the world and engage albeit with difficulty.
I just know I have an ASD and have been dx'ed. that's good enough for me
i really related to a lot of this post.
...i believe my father is on the spectrum, and my mother shows some traits although i don't think i would say she has an ASD. i wasn't really properly "trained" to be a girl, i think they gave up on the idea when i was pretty young
....also always been very verbal, always had a large vocabulary and pedantic style of speaking, but social talking has always been painfully awkward and unpleasant for me, as well. when i was little and we would have family over to the house i would either sit on the stairs so i could listen but didn't have to talk to everyone, or i would just play in my room.
....my special interests are, perhaps not so surprisingly, mostly related to people and understanding them better (sociology, psychology, history, philosophy, literature, the arts, music, etc)...basically the humanities.
.....i have always had very poor eye contact, and even when i manage it with people i know well (really the only time i can), i still feel like i'm doing it wrong somehow, and making the other person uncomfortable.
....i definitely monologue, and i've gotten lots of complaints about it over the years from people i've known. got a lot of "you nag too much" or "you're always off on a rant", or "you started talking about this half an hour ago and i wasn't interested in it then, nor am i now"
.....my facial expression doesn't seem to match what's going on in my head most of the time. had lots of people ask me why i look so mad when i feel happy, etc. i know i have a blank expression a lot too, like i space out. my voice is pretty variable and expressive, however.
.....i used to be able to fudge my way through things socially, but in the last few years i seem to have lost much of that ability. i don't seem to have the energy or motivation to try as hard, and it seems to get more tiring to try as i get older. i also don't seem to encounter many people that interest me enough (or that i trust enough) to bother.
...i need to be alone much more of the time now than i used to, and i don't feel like interacting with people on a daily basis is an option for me anymore. it is too painful and awkward, and for me too often dangerous (i can be extremely socially naive).
....i'm not big on maths, but i've always loved and had an aptitude for the sciences, ever since i was a little kid (especially biology and chemistry).
i'm not sure where this puts me, whether i present more typically like other AS females or like AS males. i know i've never felt particularly "girly" in my life.
One of my special interests to this day is psychology. I'd gather up self-help books from the library, and once I got the internet read about psychology. I've made so many lists on things that I need to change about myself. I really believed that a big part of my problem was that I was flawed, and if I could just gather up enough willpower I could overcome my problems. When I wasn't able to, I thought that I was just weak.
I think that I could make a good profiler, because of my extensive study of human behavior. People think, and act in predictable patterns. Being able to detect these patterns became a coping skill for me. I can't tell if someone is lying to me by their body language, but if I'm given some time to intellectually run it all through my head I can tell by their pattern of behavior. I spent a lot of time just being on the sidelines just watching people, and how they interact.
Wow, this all sounds EXACTLY like me!
And like you, I´ve also gone through phases of being obsessed with my looks. (I do wear makeup, and try to dress well). I assumed that that was the reason why my relationships with men weren´t working, and if I only looked right, then everything else would slip into place!
I just looked at your profile, and noticed that you had spirituality listed as one of your interests. I believe that I read in one of Attwoods books that religion, and spiritual studies is another one of those intense interests that mostly females on the spectrum get.
I know that I did. I think my husband is probably relieved by the fact that my new special interest is ASD, so he can get a break on listening to me drone on about spirituality. When the pshychology books didn't fix me, and willpower didn't cut it, that's the next place I turned. I've such a collection of new agey books about positive thoughts, Spirit Guides, and angels. All that meditation, and positive thinking didn't quite fix me up, either. Thankfully, I found WP, and now I realize that I'm not broken!
I just looked at your profile, and noticed that you had spirituality listed as one of your interests. I believe that I read in one of Attwoods books that religion, and spiritual studies is another one of those intense interests that mostly females on the spectrum get.
I know that I did. I think my husband is probably relieved by the fact that my new special interest is ASD, so he can get a break on listening to me drone on about spirituality. When the pshychology books didn't fix me, and willpower didn't cut it, that's the next place I turned. I've such a collection of new agey books about positive thoughts, Spirit Guides, and angels. All that meditation, and positive thinking didn't quite fix me up, either. Thankfully, I found WP, and now I realize that I'm not broken!
Wow, this is so like me too! For awhile, I tried the Law of Attraction, and I thought maybe the reason why things weren´t going well for me was that I wasn´t "vibrating" right, that I had to be more positive, etc. I tried meditation and positive thinking, forgiving people from my past- (I wasn´t totally successful)- surrounding myself with white light, etc. Though I´m not totally disillusioned by all spirituality, I did get disillusioned by some aspects of it, most particularly these "fixer-upper" things which never really quite worked.
And like you, my special interest is now ASD too! I´m reading loads of books about it, ordering something from Amazon every week it seems, and hanging out on Wrong Planet. Boy, we seem to have a lot in common...
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"death is the road to awe"
Here is another thing I thought of today: when I was very young, probably starting around age 2, I used to walk on my tiptoes all the time- (I read this is also a possible sign of AS in some people, though this was not known about when I was young). Anyway, I did that for years, and I remember very clearly that everyone who saw me would say "oh, she´s going to be a ballet dancer when she grows up!" (Funny thing was, I took them quite literally and DID actually become a ballet dancer when I grew up.
)
But seriously, the point I wanted to make is that if I had been a boy walking on my toes, I´m sure the reaction would have been much different. People would have probably been freaked out, or would have checked what was going on. I wonder how many girls slip through the cracks with something like this because people just think they´re pretending to be a ballet dancer. But I did this years before I even knew what ballet was; come to think of it, I learned what ballet was because of the fact that I was walking on my toes.
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"death is the road to awe"
Wow, so you got away with that! I was forced to engage in social interaction, even when I didn´t want to. When I was very young, it was noticed by my teachers in school that I wanted to be alone all the time, and that I had trouble interacting with the children, so my parents made huge efforts to get me to interact with people. My mother used to tell me, every now and then, that I had to invite a kid over to play. She would make the phone call, and arrange for the kid to come over. If I didn´t know what to do, my Mom would bring out an activity for us to do and get us involved in it; (usually clay or something artistic, since that was my special interest). And if someone came over to the house, family or whatever, I was required to interact with them. I thought this was all because I was a girl, but maybe not. It´s interesting to hear all the different perspectives and backgrounds of everybody....
I was quite bad verbally when I was a child; though I could read and understand words, I was horrible at expressing myself, and my speaking was stilted. I think I sounded unintelligent, and that was one of the reasons, for years, that I thought I was stupid because my words didn´t flow easily like other people´s. When I didn´t know what to say my mother would prompt me. That was how I learned how to get by socially, by learning all the "texts", like a big play. When someone says "A", you answer with "B"...etc. Nowadays, my verbal abilities are WAY better than they used to be, so it paid off, very slowly...(when I was a teenager, I was constantly told that I was "stilted" and "formal"). Now in my relative "old age", I think in purely verbal interactions, and superficially, I probably come off as being quite "normal". My problems really come out in non-verbally laden situations, hidden meanings, unseen intrigue, etc. (I still never got the hang of dating or flirting, for instance...
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"death is the road to awe"
But seriously, the point I wanted to make is that if I had been a boy walking on my toes, I´m sure the reaction would have been much different. People would have probably been freaked out, or would have checked what was going on. I wonder how many girls slip through the cracks with something like this because people just think they´re pretending to be a ballet dancer. But I did this years before I even knew what ballet was; come to think of it, I learned what ballet was because of the fact that I was walking on my toes.
I think you must be my long lost twin!
My son walks on his tip toes, and walks with a skipping kind of gait. It does look really feminine. Still, people just thought he was quirky. It didn't get him a diagnosis any quicker, even though I started questioning what was going on with him at age 3. His pediatrician kept dismissing it as ADHD. He got diagnosed with PDD-NOS when he was almost 5, and that wouldn't have probably have happened if his younger brother wasn't so severely autistic that it was impossible to not notice. He actually got diagnosed first. That's when I learned about autism, and made an appointment for my first son to be seen by a specialist myself. Otherwise, he would've fallen through the cracks, too. That's what I was getting at in my first post on this thread. He does seem to mirror much of what I was like as a child. Yes, he is much more masculine, but much of his masking behaviors are similar. However, he's seen as 'hyper', and 'naughty' when I wasn't. Don't know why. Maybe it's because my verbal ability has always been above average, whereas his is below?
Haven't read pages 2-7 but felt compelled to share. Just stumbled across this recently as my weight has been dropping towards below 18 BMI again (wouldn't be anorexia nervosa as I have no body image issues this time. Just anorexia). Tried to take bits out but liked most of the article so this will be a long-ish post.
Do you think this could form the basis for helping to further develop criteria for diagnosing AS in women/girls? Of course a lot more research will need to be involved.
http://www.newscientist.com/article/mg20227054.900
Mental health professionals are now attempting to train the brains of people with anorexia to be more flexible and to see the big picture as well as fine details. In doing so, they hope patients will be less inclined to obsess about body weight and calories and be better equipped to overcome their eating disorder in the long term, as well as gaining weight more immediately.
Last month, the international Academy for Eating Disorders published a paper calling for eating disorders (EDs) such as anorexia and bulimia to receive the same degree of healthcare as other biologically based mental illnesses such as schizophrenia, bipolar disorder and obsessive compulsive disorder (OCD) (International Journal of Eating Disorders, DOI: 10.1002/eat.20589). Other groups are even calling for anorexia to be placed in the same diagnostic category as autism spectrum disorders (ASD).
The main reason for this change is a growing understanding of the biological basis of EDs. Twin studies suggest that between 50 and 83 per cent of EDs have a genetic basis. Now, evidence suggests that people with anorexia have cognitive traits associated with ASD. "Eating disorders and autism spectrum disorders are obviously not the same thing, but they do have some things in common," says Janet Treasure of the Institute of Psychiatry in London.
Treasure had already discovered that anorexia was associated with extreme attention to detail and a rigid, inflexible style of thinking - traits also associated with ASD.
To investigate further, her team used neuropsychological tests to measure central coherence, or the ability to see the big picture as well as the finer details, in 42 women with anorexia and 42 without it. Women with anorexia had weaker central coherence, with a bias towards local, rather than global processing (International Journal of Eating Disorders, vol 41, p 143).
In a separate study, Treasure and her colleagues found that 45 per cent of people with anorexia or bulimia have problems "set-shifting", or modifying their behaviour in response to changing goals, compared to just 10 per cent of healthy people.
This type of focused thinking can be a beneficial skill, but when thinking becomes obsessive, for example, it can be destructive, says Treasure, who presented her results at a meeting of the British Psychological Society in Brighton, earlier this month.
In another series of studies, Treasure's team, together with Kate Tchanturia, also of the Institute of Psychiatry, assessed empathy, systemising ability, and other traits on the autistic spectrum in 22 women with anorexia and 45 without it. They found that although those with the eating disorder didn't differ from healthy women in terms of empathising or systemising, they did show elevated scores on other autistic traits like poorer social skills, and greater attention to detail (British Journal of Clinical Psychology, DOI: 10.1348/014466507x272475).
Simon Baron-Cohen of the Autism Research Centre in Cambridge, UK, is also measuring whether adolescents with anorexia score higher on autistic traits than healthy people, as he suspects that some of them may actually have undiagnosed Asperger's syndrome. "We have always known that Asperger's syndrome was diagnosed more often in males," he says. "The new question is whether it takes a different form in females, and can account for at least a subgroup of those who are diagnosed with anorexia."
...
I've been anorexic in the past (nervosa), long before I learned what autism was. At the time I read somewhere that "you can never fully recover from anorexia" but didn't believe it and thought that was a silly way to live, so eventually got hold of myself and recovered (don't remember exactly how). But I can understand why they'd say that, if there's a neurological component. and I guess I'm there again, so maybe there's some truth to it. mmmm.
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- Liresse
^ very interesting. thanks liresse. I had many years of eating disorders and view it as a manifestation of my ASD. No doubt about it in my case. One of my special interests in adolescence was general starvation and travel everywhere with a calorie counter (pocket size) which was memorised and referred to on the odd occasion I did not know the calorific value of a particular food. Interesting to note Baron-Cohen's quote. Like Attwood, he seems to be opening up the debate on the presentation of ASD's in girls and women.
Last edited by millie on 23 May 2009, 10:09 pm, edited 1 time in total.
The recent article online about anorexia and self harming being common in females with AS did interest me, since I had both.
The anorexia was like an extreme obsession with me... it involved listing all I had eaten and drunk in immense detail, and I found this relaxing..this listing of things. I loved sitting and reading through calorie books, memorising it all. I loved the counting involved, the extreme organisation, the listing. I knew I was emaciated, I knew I was thin, but I was addicted to the control, the routine, the stability of it.
I seem to have fit both female and male interests and still do. I did play with dolls, and cuddly toys, but I also had an interest in computers and gaming and programming and science fiction. I also had great obsessions with literature and film. I always preferred animals to humans.
I had a giggle just the other day as I was watching a little girl walk past, pushing her doll in her pram. Well, as a little girl, I didn't put dolls in my pram, I put snails and woodlice! That certainly broke the gender stereotype somewhat. I recall that in order to try and fit in at school, I would copy what the other little girls had interests in. When I saw my little pony was the in thing, I got my little pony, but I got it to an extreme degree. This happened with various things, until I got older, when I only had interest in my science fiction and my poetry. I never had an interest in boys and parties, and getting modern clothes and I hated wearing dresses as a little girl. It was a real bone of contention with my mother who would force me to wear dresses and sulk if I wore something other than...
My main concern was being comfortable and it still is.
indeed, caloric values... eesh, I'm determined never to go there again. (am not proud of it anymore, but used to be sort of to the point that I would know the different caloric values of different standard sizes of egg, or cereal components like sultanas etc.)
Interestingly my current problem doesn't seem to be related to obsessional style. i think it's a lack of awareness of bodily needs (hyposensitive maybe). It's not that I try to starve myself - sometimes will eat more than my share and people are surprised! but I'm not aware of when I'm hungry, when I'm full, etc. Don't feel tired so I forget to sleep, until my cognitive function deteriorates significantly due to exhaustion. Don't feel thirsty so I forget to drink, until my hands and feet hurt because my skin is so dry. Maybe it's partly due to obsession, in that I have a lot of assessments and leisure interests at the moment, that are taking up so much attention that I forget about everything else. Food, for example, is very low on my priority list at the moment (interesting, because when I was anorexic the first time I was obsessed with it in the way you and Graelwyn are describing - with documenting, counting, and NOT eating it.)
The article makes clear that not every anorexic female is necessarily autistic, and I presume not every autistic female would necessarily be anorexic. it would be fascinating to see if this could be developed further, even to the point that we could differentiate neurology patterns in these groups. Would do a lot to raise awareness of both disorders, especially formal diagnostic criteria for female ASD which is more or less nonexistent at the moment.
The article was published on Newscientist only in April this year. I might adopt this as a pet project to see what sort of research comes out of this (uni students get access to a wide variety of databases so I could keep tabs on it).
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- Liresse
Interestingly my current problem doesn't seem to be related to obsessional style. i think it's a lack of awareness of bodily needs (hyposensitive maybe). It's not that I try to starve myself - sometimes will eat more than my share and people are surprised! but I'm not aware of when I'm hungry, when I'm full, etc. Don't feel tired so I forget to sleep, until my cognitive function deteriorates significantly due to exhaustion. Don't feel thirsty so I forget to drink, until my hands and feet hurt because my skin is so dry. Maybe it's partly due to obsession, in that I have a lot of assessments and leisure interests at the moment, that are taking up so much attention that I forget about everything else. Food, for example, is very low on my priority list at the moment (interesting, because when I was anorexic the first time I was obsessed with it in the way you and Graelwyn are describing - with documenting, counting, and NOT eating it.)
The article makes clear that not every anorexic female is necessarily autistic, and I presume not every autistic female would necessarily be anorexic. it would be fascinating to see if this could be developed further, even to the point that we could differentiate neurology patterns in these groups. Would do a lot to raise awareness of both disorders, especially formal diagnostic criteria for female ASD which is more or less nonexistent at the moment.
The article was published on Newscientist only in April this year. I might adopt this as a pet project to see what sort of research comes out of this (uni students get access to a wide variety of databases so I could keep tabs on it).
I fully understand the distinction you made about anorexic tendencies and anorexia nervosa.
Food and eating are often low on my list of priorities and are often crammed in between special interests and other more meaningful pursuits. My self care is high in the area of cleanliness and scrubbing my skin (hyposensitivity) but can be low in relation to diet and nourishment. Food for me is fuel and a kind of necessity. I also have no interest in the kind of social rituals that surround food - eating together as a family unit, cooking together and chatting at the same time. So, interest in it - now that I am no longer a sufferer of anorexia and bulimia nervosa - is purely functional. it can get lost down the list in a way that others around me need to make comment on. I have however learned to eat two meals a day for the most part. Boring as heck. But I do it. And i frequently forget. It needs to be written out on a list and woven into a schedule so it is part of daily life.
A lack of attunement to bodily feelings (in my case, hyper and hypo ) doesn't help, as you point out.
hartzofspace
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I agree about this. Two nights ago, I was finding a dining experience frustrating. I attended a support group, and we decided to dine out afterward. Everyone else had managed to juggle conversation and socializing, while I could barely chew and digest my food. They had already moved on to dessert, while I was still struggling with my appetizer! Thank God I wasn't that hungry. I had the appetizer wrapped up, and ordered dessert. But it was frustrating. I prefer to eat in front of my computer, get it over with, and get back to what I was doing.
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Dreams are renewable. No matter what our age or condition, there are still untapped possibilities within us and new beauty waiting to be born.
-- Dr. Dale Turner
Wow, this is all so interesting! Thanks for posting that article, Liresse.
I was anorexic too for many years. I also did the calorie counting! Hard to say if it was due to an ASD OR my special interest, which was dance- (many dancers become anorexic, as there is quite a lot of pressure to be thin). However, I did notice that I slipped very easily into anorexic mode, as if that were a natural aspect of my personality. But in some ways, I´m the opposite of many of you. I finally got over my anorexia because it got to the point that it actually detracted from my special interest, my dancing. I realized that I had no energy, I was weaker, my technique was worse (due to lack of energy), and I felt constantly unhealthy, so it was uncomfortable to dance. One day, in a dance studio in New York, I saw a dancer who was NOT thin; but she was the most amazing dancer I had ever seen. She had a light, airy quality, and it was then that I realized that dance was all illusion, caused by proper technique, not emaciation- (even most directors don´t seem to realize this). So from that day on, I started eating normally and have never looked back. I used to have that problem that many of you mentioned, of not being able to know what my body was feeling- (actually, I had that in quite a big way)- but I think due to my experience with dancing, as well as my body basically rebelling when I didn´t take care of it, finally helped me to develop a better body awareness. Basically, I realized that my body is my tool, and I need it for my special interest.
Nowadays, I really try to eat healthy food- (in fact, maybe you could say that is my new rigidity?) I learned that my body only works well when I feed it properly. Nowadays, I am obsessed with eating well, regularly and healthily. Because I am a celiac, with allergies to dairy products and soy as well, finding food to eat and preparing meals is pretty stressful! It´s tiring, but I do it because I feel I need to. I have to be very organized in this...ugh, it´s difficult...
Now if I could only get myself to bed at a decent hour...(wish I didn´t have to sleep, as THAT takes time from my interests...and I don´t even sleep anywhere near enough...)
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"death is the road to awe"
