Wednesday, April 15, 2009

Are we underdiagnosing autism in girls?

by Malavika Balachandran

At Camp Sunshine, a summer camp for mentally disabled children that I used to work at as a camp counselor, we had very few (if any) female participants with autism spectrum disorders. The female campers on the autism spectrum always had autism, and not Asperger’s Syndrome, which is characterized by delay in social development, but not verbal development. Doctors, when diagnosing Asperger’s Syndrome, search for lack of friendship, poor social skills, and very intense interests. However, these symptoms represent stereotyped behaviors of males with the disorder, and thus thousands of girls with Asperger’s Syndrome are going undiagnosed. Females with the disorder, while lacking the social interaction skills, often mask their disorder through silence or imitation of others; also females with the disorder are more likely to have friends than males with the disorder and are less likely to externalize their frustrations and instead passive-aggressively deal with their anger. Further, females often channel their intense interests into activities such as day-dreams and imaginary worlds, whereas males focus their interest on a more concrete interest. One camper with Asperger’s at Camp Sunshine displayed an avid interest in dinosaurs; he had memorized thousands of facts on dinosaurs and always sat in a corner creating amazing clay models of obscure species of dinosaurs. The behaviors of males are much easier to classify as abnormal, and the intense behavior of females then go undetected.

Not only do doctors fail to recognize the symptoms of females with Asperger’s Syndrome, but often turn away female patients and refuse to diagnose them! Many doctors believe that Asperger’s Syndrome does not even affect females and instead misdiagnose the females with the disorder. Moreover, the difficulties in social interaction caused by the disorder often result in females developing eating disorders and depression, but these problems are often mistreated as they are not properly diagnosed with Asperger’s Syndrome. Prominent psychologist and author Tony Attwood, believes that "[as many as] 20% of females with anorexia have undiagnosed Asperger’s."

Dr. Laura Gould, the psychologist who conducted groundbreaking research in the late 70s linking Asperger’s to autism, calls for a complete upheaval in the way that Asperger’s is being diagnosed. Currently, the symptoms that signal the disorder to doctors are stereotyped to male behavior; the recognizable symptoms need to be extended to apply to female behaviors as well. Psychologists need to rethink their approach to diagnosing the disorder so that these females do not go undiagnosed. The article reports that nearly 16 times as many boys are diagnosed with Asperger’s Syndrome than girls; with the restructuring of diagnostic tests, the difference between the numbers of boys with the disorder compared to girls will surely fall. The existing forms of diagnosis and attitudes of doctors are doing a disservice to females with the condition. Until doctors reshape their theory pertaining to the disorder, many more females will continue to go undiagnosed. But with improvements to the current approach to the disorder, we can help treat and provide the assistance to these females that they need but presently do not receive.


At April 15, 2009 at 2:40 AM , Blogger Roscoe said...


Awesome first post, Malavika. Thank you so much. I had no idea this was happening. I don't think many people really know (or care to know, sadly), or even thought about this. Super interesting!


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