Thousands of GIRLS may have undiagnosed autism because they

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btbnnyr
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27 Nov 2013, 1:15 am

I think this is the abstract of the article from the science daily article.

Kopp/Gillberg 2010: Girls With Social and/or Attention Deficits: A Descriptive Study of 100 Clinic Attenders
Objective: Examine clinical correlates and distinguishing features of autism spectrum disorders (ASD), ADHD, and tic disorders in girls referred for social impairment, attention/academic deficits, and/or tics. Method: One hundred 3- to 18-year-old girls referred for social impairment and attention symptoms were assessed in detail. Sixty of these girls, 7 to 16 years of age (IQ ≥ 80) were compared with age-matched girls (IQ ≥ 80) from the community. Results: Main diagnoses of ASD, ADHD, tic disorders, and “other psychiatric disorder” were made in 46, 46, 3, and 5, respectively, of the referred girls. The ASD and ADHD groups (mean age at diagnosis 8.8 and 13.0 years, respectively) had the same types and high rates of psychiatric comorbidity. Girls with ASD had more problems with global functioning and adaptive levels of daily living skills than girls with ADHD. Differences between these girls referred for investigation and the community sample of girls were very considerable across a range of factors. Conclusions: Girls referred for social and/or attention deficits usually meet diagnostic criteria for either ASD or ADHD. They have severe psychiatric comorbidities and low global levels of functioning.


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27 Nov 2013, 1:19 am

Looking back on my teenage years, when I should have been into boys and makeup and dating and all that, I was in therapy for being socially awkward, withdrawn, afraid of people and basically a weirdo. I easily would have been diagnosed with AS, even as a girl -- IF there had been such a thing. I was in therapy in 1978, a full 16 years before AS became an official diagnosis. Besides the aforementioned, I rocked back and forth all the time (still do), was scared to talk on the phone, was considered very intelligent but didn't "apply myself", repeatedly tore paper into little pieces and put them in little piles, had poor motor skills (was/am clumsy as all hell), poorer hygiene, and few friends. Know what all that added up to in 1978? Low self-esteem.


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27 Nov 2013, 2:09 am

I don't buy the idea that girls can "hide" it better than boys. The real issue is that girls are perceived differently than boys, treated differently and eventually will be socially conditioned to behave in different ways. I remember noticing it often in elementary school that the teachers treated the boys very differently than the girls.

While I was growing up I was not aware of anyone who understood what HFA is or what it looks like. Never mind gender, they just wouldn't have recognized it unless it was really extreme.

I think females are more likely to be viewed as having emotional issues, mood disorders or eating disorders. I was always a very picky eater, and no one considered the idea that I might have sensory issues with food. People would assume that I was dieting or had an eating disorder. I never saw anyone apply the same logic to a guy who was picky about his food. It was just accepted that a male didn't have to eat something he didn't want to eat.

I gradually did learn to hide things I didn't want people to know about, but it took a LONG time. I mean it took me a long time to even understand why a person would WANT to hide anything about themselves. Even when I figured out why it was really hard to learn how to do it.



naturalplastic
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27 Nov 2013, 5:59 am

dianthus wrote:
I don't buy the idea that girls can "hide" it better than boys. The real issue is that girls are perceived differently than boys, treated differently and eventually will be socially conditioned to behave in different ways. I remember noticing it often in elementary school that the teachers treated the boys very differently than the girls.

While I was growing up I was not aware of anyone who understood what HFA is or what it looks like. Never mind gender, they just wouldn't have recognized it unless it was really extreme.

I think females are more likely to be viewed as having emotional issues, mood disorders or eating disorders. I was always a very picky eater, and no one considered the idea that I might have sensory issues with food. People would assume that I was dieting or had an eating disorder. I never saw anyone apply the same logic to a guy who was picky about his food. It was just accepted that a male didn't have to eat something he didn't want to eat.

I gradually did learn to hide things I didn't want people to know about, but it took a LONG time. I mean it took me a long time to even understand why a person would WANT to hide anything about themselves. Even when I figured out why it was really hard to learn how to do it.


They dont necessarily mean that either gender deliberately 'hides' the condition on purpose. They mean -what you're saying- that the condition doesnt stand out as manifestly in girls as in boys.

Neither boys nor girls purposely 'hides' it. Indeed most of the idiots employeed as shrinks in the USA never even heard of aspergers before 2004 ( a decade after it was recognized as dx in the USA). So few 'experts' even heard of it until a fortnight ago. So proportionately even fewer lay grownups ever heard of it-so there was even less awareness of it by children. Even if you knew of aspergers - I dont know why you would conceal it. But you certainly wouldnt conceal it if you never heard of it.



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27 Nov 2013, 6:07 am

Verdandi wrote:
But the sexism is real. It's not made up, and it has a significant impact on how women and girls are treated and diagnosed by medical professionals. It is probably not the only factor, but I do not think it is really possible to make authoritative claims on how many girls vs boys are autistic as long as that factor is not addressed.


Yes, sexism exists of course.
In my case, being FtM-Transsexual, I know out of own experience that after my sex change even different disorders were discussed than befor and psychiatrists treated me a lot different. 8O

In the past, being a "girl" when I said: "I have problems with my social understanding", most psychiatrists just assumed I mean: "I don't wanna interact normally, but also don't wanna deal with my real problems." and started talking to me in "strange" psychiatric ways I wasn't able to understand and when I didn't they very often even saw it as "proof" for their theories. 8O
It wasn't always the case like this, but it was very common...

Now being male when I say: "I have problems with my social understanding", most psychiatrists assume I mean: "I have problems with my social understanding." :P

:lol:


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27 Nov 2013, 8:44 am

cyberdad wrote:
Ganondox wrote:
I read that that isn't quite true for one reason: it's that the 4:1 ratio exists within Autistic Disorder, but within those diagnosed with it the girls are significantly more likely to be lower functioning than the boys. When you stratify it along intellectual disability a ration of around 5.5:1 was found for without intellectual disability, and 2:1 for with intellectual disability. One interpretation of this is girls only get diagnosed if they are more disabled.


Are you are stratifying your statistics based on IQ? what is intellectual disability? if it includes learning disability then there's plenty of smart kids out there who are labelled with an intellectual disability.

A further interesting observation, In mainstream government schools here in the south eastern education division of Melbourne Australia. According to the school psychologist - Of the total number of children diagnosed with autism attending mainstream school numbering in several thousand my daughter is the only girl diagnosed with autism attending a mainstream government school. Apparently all the girls in the region we live in are diagnosed with Aspergers, and there are about a hundred boys diagnosed with autism attending government schools with integration aides.

The only reason I found this out is because I've been trying to search for schools in my area with other girls with autism for my daughter to be friends with.


Look, these aren't my statistics, I didn't collect or compile them, I didn't choose to stratify it along Intellectual Disability. Anyway, I'm pretty sure that's more or less based entirely around IQ. Not the best measurement, especially for autistic people, but it's probably used because measuring it is more objective than other things, whether or not it actually represents intelligence the results are fairly consistent and not too biased.

To clarify, all the girls in the mainstream schools are diagnosed with aspergers? There could still be countless girls diagnosed with autism deemed to low functioning to be mainstreamed, with a similar amount of males.


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27 Nov 2013, 8:58 am

I don't think I hid the signs when I was a kid - although they wouldn't have diagnosed me anyway as it was quite a long time ago. I have a high IQ and good mimic skills and used those to mask a lot of it, although if anyone who knew about autism had bothered to talk to me I think they would have realised quite quickly that I'm on the spectrum. Nowadays I present as a well-groomed, well-dressed professional in most situations. But it's taken a heck of a lot of hard work to get here.

I was bullied extensively at school - in a different way to how boys are bullied, probably, as it was mostly verbal and psychological. And the teachers just assumed I was lazy and awkward. Any attempt on my part to use my considerable intelligence in class was dismissed as showing off, so I just gave up studying properly when I was still a kid. I didn't know until recently how to ask for the help I need instead of getting paranoid and anxious, blaming myself and then having a meltdown. Being on SSRIs has taken the edge off the anxiety and allowed me to focus on the remaining areas I have issues with - I was prescribed them at the beginning of this year when I had a massive meltdown and was diagnosed with anxiety and depression.

I don't think it's just that we hide it better. I think that's a very simplistic view. I think there's a perception that we don't have it, because that was, until recently, the accepted truth. If people don't think it exists, they don't see it. So now that more and more professional are becoming aware that women are affected, they are diagnosing us more. And that awareness is also prompting more women to push for a correct diagnosis instead of ust being fobbed off as having some kind of anxiety disorder.



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27 Nov 2013, 6:50 pm

Ganondox wrote:
To clarify, all the girls in the mainstream schools are diagnosed with aspergers? There could still be countless girls diagnosed with autism deemed to low functioning to be mainstreamed, with a similar amount of males.


That's what I thought originally. But given I've seen plenty (I've estimated close to 50-100) autistic non-verbal boys in mainstream schools and social skills classes working with integration aides and no girls with integration aides it does point to something not quite right.



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27 Nov 2013, 7:16 pm

cyberdad wrote:
Ganondox wrote:
To clarify, all the girls in the mainstream schools are diagnosed with aspergers? There could still be countless girls diagnosed with autism deemed to low functioning to be mainstreamed, with a similar amount of males.


That's what I thought originally. But given I've seen plenty (I've estimated close to 50-100) autistic non-verbal boys in mainstream schools and social skills classes working with integration aides and no girls with integration aides it does point to something not quite right.


That may point to bias in your area. I read the same study Ganondox did, and others have referenced it here as well.

Being nonverbal isn't a guarantee for being diagnosed. There are women who post or have posted on this site who were nonverbal until they were 9-10 (at least, that's what I recall) who were never diagnosed as autistic until they sought diagnoses as adults.



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27 Nov 2013, 7:34 pm

Verdandi wrote:

I am not saying that it's necessarily 1:1. I think Lorna Wing has a fairly educated guess on what the actual (not 4:1) ratio, as well as an informed opinion on why those diagnoses are not happening (the video was posted here some time back, but I do not recall where it is right now - it's not that study, though).


I've heard 2:1 as an educated guess for what he proper ratio was. I don't remember the details, and I don't remember if it was Lorna Wing, but I remember finding it really interesting that that was the educated guess for the proper ratio.



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27 Nov 2013, 7:55 pm

Yeah, that's what I've read and what Ganondox is referring to.



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27 Nov 2013, 9:02 pm

naturalplastic wrote:
They dont necessarily mean that either gender deliberately 'hides' the condition on purpose. They mean -what you're saying- that the condition doesnt stand out as manifestly in girls as in boys.


That's not what I said, or what I meant at all. I am saying that it could be blatantly obvious in a girl but people will interpret the behavior and symptoms differently purely because she is female.



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27 Nov 2013, 9:39 pm

dianthus wrote:
naturalplastic wrote:
They dont necessarily mean that either gender deliberately 'hides' the condition on purpose. They mean -what you're saying- that the condition doesnt stand out as manifestly in girls as in boys.


That's not what I said, or what I meant at all. I am saying that it could be blatantly obvious in a girl but people will interpret the behavior and symptoms differently purely because she is female.


This.

It's not "hiding the symptoms better" necessarily. It's "girls' behavior is interpreted differently from boys' behavior." The "girls learn to hide it" thing strikes me as a means to put the responsibility for not being diagnosed on girls' shoulders rather than accepting that professionals are rather rubbish at properly diagnosing girls.



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27 Nov 2013, 9:56 pm

Verdandi wrote:
This.

It's not "hiding the symptoms better" necessarily. It's "girls' behavior is interpreted differently from boys' behavior." The "girls learn to hide it" thing strikes me as a means to put the responsibility for not being diagnosed on girls' shoulders rather than accepting that professionals are rather rubbish at properly diagnosing girls.


Likewise, this. It strikes me that way too.



btbnnyr
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27 Nov 2013, 10:13 pm

The reason that I was not diagnosed early even with non-verbal was because iParents and iGrandparents and iFamily of BAP people thought that I was verry merry berry good child and not that abnormal, and no one cared much about social development or talking anyway. But people outside my family saw the obvious signs and brought it up, but iParents didn't think there was any problem, and I am rather glad that it happened that way.


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27 Nov 2013, 11:48 pm

Verdandi wrote:
cyberdad wrote:
Ganondox wrote:
To clarify, all the girls in the mainstream schools are diagnosed with aspergers? There could still be countless girls diagnosed with autism deemed to low functioning to be mainstreamed, with a similar amount of males.


That's what I thought originally. But given I've seen plenty (I've estimated close to 50-100) autistic non-verbal boys in mainstream schools and social skills classes working with integration aides and no girls with integration aides it does point to something not quite right.


That may point to bias in your area. I read the same study Ganondox did, and others have referenced it here as well.

Being nonverbal isn't a guarantee for being diagnosed. There are women who post or have posted on this site who were nonverbal until they were 9-10 (at least, that's what I recall) who were never diagnosed as autistic until they sought diagnoses as adults.

I'm assuming they all end up in special needs schools? even then my point remains...why is there are only autistic boys in mainstream schools? in my daughter's school I know there are 10 boys diagnosed with autism she is the only girl? I'm assuming if ratios are really equal then parents of autistic girls are choosing special needs schools over mainstream?