Autism In Women: Its 7 Distinctive Characteristics
Autism is a neurodevelopmental disorder that has experienced a significant rise in recent decades. Every day more precise tools are available to detect it and to address the resonances on the daily life of those who present it.
A related issue (which has “aroused the interest” of the scientific community) is that of a possible bias in its diagnostic process, which would reduce the likelihood that women or girls could be identified as autistic and benefit from multiple forms of therapy available for this condition.
Although a series of organic factors have traditionally been postulated whose objective was to explain why there are many more boys than girls with autism, theories about psychological and social variables of enormous importance for clinical practice and research are beginning to emerge.
In this article we will address the issue of autism in women , and we will also detail how autism can be expressed, both in generic terms and in the female population. The reasons why, in the latter case, it could be more difficult to confirm its presence will also be outlined.
Since autism was described by Leo Kanner in 1943 as a lack of interest in social aspects and an intense resistance to environmental fluctuation, This neurodevelopmental disorder has undergone numerous changes in its clinical formulation and even in its diagnosis Together with those of the aforementioned author, the contributions of Hans Asperger (with special emphasis on verbal expression) allowed the health sciences to articulate a series of theoretical models and practical keys aimed at their understanding and identification in the consultation. All of them flourished throughout the 70s, eventually coming together in the drafting of the criteria of the DSM-III manual (1980).
In the first moment The possible presence of three cardinal dimensions was considered, with which the presentation of such disorder could be summarized although recently these have been reduced to only two: communication or social interaction (difficulties in starting a situation of reciprocal exchange with an interlocutor, together with severe alterations in the pragmatics of language) and restrictive or repetitive behavior (inflexibility). for thought and behavior, irritability/poor impulse control, and tendency toward symmetry and repetition).
The new diagnostic manuals (DSM-5, 2013) have also made other changes in the traditional way in which the most classic autism was contemplated: elimination of Asperger syndrome and definitive inclusion of pervasive developmental disorder and disintegrative disorder in one label. comprehensive disorder that received the name Autism Spectrum Disorder (or ASD), through which all its possible expressions are summarized in a single and heterogeneous category These modifications have not been spared some criticism, based above all on an increase in ambiguity.
Likewise, with this new redefinition it became necessary for the clinicians who made such a diagnosis to also indicate the existence of some degree of intellectual disability in their patient (since not all of them present it to the same intensity) and the threshold of severity attributable to the problem. For this case, a differentiation was made into three possible levels (the inarticulate level 1, 2 and 3), according to the power of the symptoms to interfere with the evolution of daily life. In this way, autism acquired a dimensional nuance, as opposed to its former categorical prism.
The greater theoretical/clinical contextualization of autism in recent years has made it possible for a lot of information to be available about its epidemiology. Today it is known that 1.6% of people suffer from some form of autism (among all those mentioned above and with very diverse degrees), and that this percentage has experienced a very notable growth in the last decade. Likewise, all the literature on this topic agrees in pointing out that it is a more common condition in men than in women (approximately 80% of those affected are men).
The last fact, which has been unanimously accepted since the dawn of the study of autism (even supported by hypotheses such as that of the “hypermasculinized” brain, which the prestigious Simon Baron-Cohen proposed in the 90s after investigating many people with TEA), is today being reconsidered in a serious and rigorous way. It is being postulated that Traditional results on the way in which the biological sex variable is distributed in this population could be conditioned by gender stereotypes or explained by the popular camouflage theory.
Autism in women: does it have distinctive characteristics?
What is really true is that the question posed in the title of this section still does not have clear answers today. There is a wide variety of studies aimed at delving into this issue, but their results are ambiguous and inconclusive. Today we know that everything that differentiates neurotypical boys and girls (without ASD) in their way of interacting could also be transferred to the territory of those who live with the neurodevelopmental disorder, which is why they could have more refined social skills. in the early years and during adulthood.
The differences at the cognitive level do not show a clear profile either In some cases it has been described that women with this diagnosis have more alterations in dimensions such as attention and/or inhibitory control, but this has not been able to be replicated consistently. The same can be said regarding emotional regulation, where very contradictory results are seen. All of these functions, which are included within those considered executive (and which depend on the functional integrity of the frontal lobe), would not allow us to successfully “discriminate” between boys/men and girls/women.
Let’s see what are the signs that could help detect this problem in girls , although the isolated presence of these traits is insufficient to confirm that one suffers from ASD. However, knowing them is essential, since it is common for diagnostic errors to occur (being confused with ADHD or other psychopathological conditions of mood or even anxiety).
1. Apparent insulation
Girls with ASD may sometimes resort to isolation in situations where other children engage in active play behaviors (parties or recess, for example). In such contexts, especially when children with whom they have a closer bond are not present, they choose to retreat to a quiet place and cease all interactions. These behaviors can be interpreted as sadness, although they are not always related to this emotion
Another common behavior in girls with ASD is show emotional reactions that do not seem to respond to a situation that is objectively in the environment For this reason, they could cry or scream in an unexpected or unexpected way, and even suffer acute anxiety attacks without being able to find a precipitating factor.
It is often a cause of concern among parents, which warrants consultation with various health professionals in their distressing search for reasonable explanations.
3. Imitation and absence of spontaneity
The social behavior displayed among girls with autism lacks any naturalness The adult who observes her has the feeling that she is out of place, as if she were only limiting herself to reproducing with some clumsiness what others are doing. And these girls do not spontaneously seek to participate, but rather they usually do so at the initiative of others. For this reason they seem to concentrate, without much interest, on what they do; ignoring all his “original” contributions (in form and content).
4. Egocentrism and rigidity
Girls with autism may adopt rigid habits, even when playing. In the event that a colleague wishes to participate in these dynamics, they tend to behave with excessive “authority”, directing the activity and imposing very narrow limits on what can be considered correct and what is not That is why their opinions are “immovable”, and it is not easy to change their minds when the task becomes boring for the rest of those involved in it.
5. Exclusive friendships
Girls with autism They may develop a tendency to seek friendships that are only reserved for them , forging a limited social network (in numerical terms), but for which they draw a bond of great dependence. Added to this situation is the possibility of them becoming “obsessed” with the person they consider their friend, restricting the possibility of expanding their own circle and insistently seeking their presence. Such relationships come to be experienced from anguish, and even cause intense explosions of jealousy.
6. Rigid game
On many occasions, girls with autism focus their efforts more intensely on the preludes to the game than on the game itself. Thus, They spend a lot of time explaining how to play and arranging the necessary elements in the place for this purpose (dolls, for example), but they only participate a little in the play activity itself. It is common for this way of proceeding to cause other children to get bored, or even to give up interacting with them. It could be the reason for many early forms of rejection.
Alternative view for the low prevalence of female ASD
There are many studies that have been carried out on autism, and most of them confirm a higher risk among men, in a 4:1 ratio compared to women This fact has frequently been explained by referring to disparate neurological and genetic reasons, although recently social nuances are being incorporated to account for this issue (as well as psychological and sociocultural ones). We now proceed to explore the question.
Although autism can be detected from the first months of life in the form of very subtle signs (eye contact, for example), the most common thing is that it is a little later (from 3 to 7 years) when it can be elaborated. safer way to diagnose. Most studies agree that during this period boys show more obvious symptoms than girls, for whom these usually become evident in adolescence. It is at this moment where not only its social impact becomes evident, but also where comorbid mood and anxiety problems arise that mask its expression.
Girls with autism usually have different problems in adolescence regarding the ways of interacting with their peers, when compared to those experienced by boys. Social expectations about each other are also different, in such a way that They are expected to forge their friendships in smaller groups and that the activities they share are of a calmer nature , while a more active involvement in large groups is expected for them where friendship takes on a nuance of greater collectivism. This means that isolation can be detected more easily in males, in such a way that suspicion of ASD is precipitated very quickly even among teachers.
Feminine dynamics make it easier for girls with autism to forge dyadic relationships (“best friend”), following the pattern expected in their case, while at the same time “veiling” a problem that would be expressed much more eloquently if expected from them a “social pattern” similar to that of men. Many authors propose that they have better social skills than theirs, as well as a better capacity for imitation and superior use of language, which would also contribute decisively to camouflaging the problem. In short, they could “hide” their difficulties more successfully (from the age of six).
Other authors consider that The range of restricted interests of women with ASD is more socially accepted than that usually adopted by men Thus, it would be common for these to be associated with fashion or literature, to name an example. Thus, less alarm would be generated among parents, since these would be activities for which society reserves a positive judgment, and the presence of the problem would not be suspected.
In short, the different expectations that parents and society place on their children based on their gender, together with the disparate social expression of boys/girls, could be an explanatory factor for the particular distribution of ASD based on biological sex (together to the traditional genetic and neurological variables). In fact, there is evidence that (starting from a comparable cognitive/intellectual level), parents detect autistic symptoms in girls less than those in boys. And all this despite the fact that, in their case, the psychopathological consequences associated with social difficulties are more severe upon reaching adolescence.
