High Functioning Autism in Females
Wednesday, July 10, 2024.
High-functioning autism (HFA), often referred to as Asperger's Syndrome, is characterized by challenges in social interaction, communication, and repetitive behaviors.
While autism spectrum disorder (ASD) is more commonly diagnosed in males, recent research has highlighted that high-functioning autism in females presents unique symptoms that often go unrecognized, leading to underdiagnosis and misdiagnosis.
Symptoms of High-Functioning Autism in Females
Social Communication Challenges: Females with HFA often struggle to understand social cues, maintain eye contact, and engage in back-and-forth conversations.
However, they may mask these difficulties by mimicking social behaviors observed in others, making their challenges less apparent (Attwood, 2007).
Intense Interests: While both males and females with HFA may have intense interests, females' interests are often more socially acceptable (e.g., animals, books, or celebrities) and thus less likely to be flagged as atypical (Gould & Ashton-Smith, 2011).
Sensory Sensitivities: Sensory sensitivities are prevalent among females with HFA. They may experience heightened sensitivity to lights, sounds, textures, or smells, which can lead to sensory overload and anxiety (Baron-Cohen et al., 2014).
Anxiety and Depression: High levels of anxiety and depression are common in females with HFA, often stemming from their efforts to fit in socially and their experiences of being misunderstood (Hull et al., 2017).
Executive Functioning Issues: Females with HFA may struggle with executive functioning tasks, such as organization, time management, and multitasking. These challenges can impact academic and professional success (Lai et al., 2015).
Masking and Camouflaging: Females with HFA are adept at masking or camouflaging their autistic traits. They may develop coping strategies to hide their difficulties, which can lead to exhaustion and mental health issues (Hull et al., 2017).
Difficulty with Change: A preference for routines and resistance to change is another common symptom. Unexpected changes can cause significant stress and discomfort (Kirkovski et al., 2013).
Latest Research on High Functioning Autism in Females
Recent studies have begun to address the gender differences in autism presentation and diagnosis. Research by Mandy et al. (2012) emphasizes that the diagnostic criteria, traditionally based on male presentations of autism, often miss or misinterpret the symptoms in females.
A study by Hull et al. (2017) discusses the phenomenon of masking in females with HFA. The research found that many females with HFA develop sophisticated strategies to hide their autistic traits, which can delay diagnosis and lead to mental health challenges.
Lai et al. (2015) conducted a comprehensive review of sex/gender differences in autism, highlighting that females with HFA often exhibit different symptom profiles compared to males. This study advocates for gender-sensitive diagnostic criteria to improve early identification and support for females with HFA.
Baron-Cohen et al. (2014) explored the sensory processing differences in females with HFA. The study found that females are more likely to experience sensory sensitivities, which can significantly impact their daily functioning and mental health.
Gould and Ashton-Smith (2011) reviewed the clinical implications of these findings, suggesting that healthcare providers need better training to recognize and diagnose HFA in females accurately. This includes understanding the subtler presentations of autism in females and the impact of social expectations on their behavior.
Contrary Points of View in the Research
While there is a growing consensus on the unique presentation of HFA in females, some researchers argue that the differences between males and females with autism are not as pronounced as suggested. For instance, Beggiato et al. (2017) found that when accounting for the overall severity of autism symptoms, the gender differences in presentation diminish, indicating that the core symptoms of autism might manifest similarly across genders.
Hiller et al. (2016) present another contrary viewpoint, arguing that the increased focus on gender differences may lead to over-pathologizing behaviors in females within the typical development range.
They caution against overemphasizing gender differences without sufficient evidence, as this might lead to unnecessary interventions and stigma.
The role of societal and cultural factors in shaping the diagnosis and perception of autism in females is also a point of debate. Ratto et al. (2018) suggest that societal expectations and gender norms significantly influence the identification and reporting of autism symptoms. They argue that these external factors may lead to biases in diagnosis rather than actual differences in symptomatology between genders.
Final thoughts
High-functioning autism in females presents with unique symptoms that often go unnoticed due to traditional diagnostic criteria being male-centric.
The latest research highlights the need for gender-sensitive approaches to improve diagnosis and support for females with HFA.
However, it is essential to consider contrary viewpoints that caution against overemphasizing gender differences without robust evidence. Recognizing the distinct symptoms and challenges faced by females with high-functioning autism can lead to better outcomes and quality of life.
Be Well, Stay Kind, and Godspeed.
REFERENCES:
Attwood, T. (2007). The Complete Guide to Asperger's Syndrome. Jessica Kingsley Publishers.
Gould, J., & Ashton-Smith, J. (2011). Missed diagnosis or misdiagnosis? Girls and women on the autism spectrum. Good Autism Practice (GAP), 12(1), 34-41.
Hiller, R. M., Young, R. L., & Weber, N. (2016). Sex differences in autism spectrum disorder based on DSM-5 criteria: Evidence from clinician and teacher reporting. Journal of Abnormal Child Psychology, 44(7), 1407-1417.
Hull, L., Mandy, W., & Petrides, K. V. (2017). Behavioural and cognitive differences in males and females with autism spectrum disorder. Journal of Autism and Developmental Disorders, 47(10), 3281-3294.
Lai, M. C., Lombardo, M. V., Auyeung, B., Chakrabarti, B., & Baron-Cohen, S. (2015). Sex/gender differences and autism: Setting the scene for future research. Journal of the American Academy of Child & Adolescent Psychiatry, 54(1), 11-24.
Baron-Cohen, S., Robinson, J., & Woodbury-Smith, M. (2014). The sensory sensitivity of individuals with autism spectrum disorders. Molecular Autism, 5(1), 1-11.
Beggiato, A., Peyre, H., Maruani, A., Scheid, I., Rastam, M., Amsellem, F., ... & Delorme, R. (2017). Gender differences in autism spectrum disorders: Divergence among specific core symptoms. Autism Research, 10(4), 680-689.
Ratto, A. B., Kenworthy, L., Yerys, B. E., Bascom, J., Wieckowski, A. T., White, S. W., ... & Scarpa, A. (2018). What about the girls? Sex-based differences in autistic traits and adaptive skills. Journal of Autism and Developmental Disorders, 48(5), 1698-1711.
