Wednesday, June 4, 2008

The Challenges Behind Diagnosing Girls with Asperger's Syndrome

This week I'm posting about girls with autism. In my previous two posts I wrote about Retts Syndrome and low birth weight. Those posts were more health oriented. In my posts today and tomorrow, I will explore the issue in a sociological context.

In a previous post, I wrote about girls with autism and my skepticism that only 1 out of four or five people on the spectrum are girls. I'm wondering if there are many females with autism who have yet to be diagnosed, particularly Asperger Syndrome (AS) or mild autism.

My son was six before we were able to get a formal diagnosis of autism/pervasive developmental disorder not otherwise specified. In contrast, the reality television star, Heather Kuzmich from America's Next Top Model, was fifteen when she received the diagnosis of AS. I do realize that Kuzmich is older than my son which means that there was more information about autism available when my son showed signs of developmental delays. However, I'm still wondering if Kuzmich would have been diagnosed earlier if she had been male.

One author of a recent article titled "Girls with Asperger's Syndrome:
Gender Differences in Behavior and Social Interaction "
came up with a few reasons why AS may be more difficult to indentify in girls. In that article, Jennifer Copley asserts that girls with Asperger Syndrome are more inconspicuous than boys because they have:

  1. Invisibility Strategies
    Girls with AS are adept at disappearing within a large group, staying safely at the periphery without really interacting socially.
  2. Camouflaging Strategies
    Girls with AS may appear to use ordinary gestures and facial expressions during a conversation and to reciprocate appropriately. However, in many cases they are basing these gestures, facial expressions and responses on someone they have observed who is socially adept. Additionally, they use their intellect rather than natural social intuition to choose the correct responses.
  3. Seemingly Normal Interests
    Autistic spectrum disorders are characterized by narrow, obsessive interests. Although boys who are obsessed with trains or bus schedules tend to stand out, there are few who question a young girl’s obsession with dolls or horses. However, the girl with AS will prefer to play with her dolls alone rather than with other children.
  4. Avoiding Physical Activities
    Because girls are less inclined to engage in rough-and-tumble play, their difficulties with motor coordination may be less apparent. Girls with AS may avoid physical activities in which their motor skill deficits would be noticeable.

Copley also asserts that girls are more social than boys and that if they exhibit little professor traits they are more likely to be seen as merely being intelligent. She also says that other conditions like Anorexia Nervousa may mask the condition.

My thoughts: Does the professor-like Hermione Granger from J.K. Rowlings Harry Potter series have Asperger Syndrome? Hmm. I always thought she was "just brainy." Seriously, though, it's up to the professionals to decide who has Asperger Syndrome and who does not. They have their work ahead of them in terms of identifying AS in girls.

Anyway, according to Copley's article it seems like the author is saying that girls with AS have more innate social skills than boys. Her points make sense, but I should note that this doesn't mean (and I don't think Copley is saying this) that girls with the syndrome are better off in society than boys. Tomorrow, I will write a post about an article (published online just yesterday) that explores more fully the difficulty that girls with Asperger Syndrome encounter.


Anonymous said...

Quite interesting. M was very hard to diagnose. I am not sure how much of her being a girl played into it though.

Siobhan said...

I myself am a female Aspie...and wasn't diagnosed until I was in my 40's.

Throughout my life the mental health professionals looked at my symptoms (ie. anxiety, depression, etc) rather than the cause of said symptoms.
With most of the other aspie females of my generation that I've met this has been the case. It seems that it was especially prevalent in the 60's and 70's...and that many of us from that generation were put on cocktails of drugs to make us 'calmer' and more socially 'integrated' rather than treated as individuals with a difference who needed not pharmacological but social help.

I'm pleased to see that AS in general is getting more attention....especially in the area of little girls. An AS kid could be spared a lot of pain.

J said...

To Marla: Thanks for commenting.

To Siobhan: Thanks for sharing your story.

S said...

Hi, I'm also a female Aspie, and it took them till I was 21 to diagnose it. they first throught borderline because I'd been in a socially very stressful situation for a long time, but after I mellowed out they re-tested me and Aspergers rolled out, which made a lot more sense to me. I think because we're told to be sociable and chat more as children we developmore chatty (in my case overly chatty) coping mechanisms to look sociable, while boys are told off less for not engaging in social gatherings with family as much. On the other hand social exclusion as a girl is much easier, as the social rules for girls and girls among girls are so complex, and all unwritten. I'll have to do some ready by Copley I think, she has some interesting ideas. :)