Autism Spectrum Disorders in women

Being a girl with autism is twice exceptional. These females are not only excluded from same-sexed peers who are neurotypical, but they are excluded from the autism spectrum population because of this subtler presentation of autism that does not quite check off all the boxes in gold-standard assessments, nor completely align with the DSM5 criteria like a more classical form of autism. Consequently, females with ASD do not consistently present with overt functional impairments in their social communication abilities, making them enigmatic and underrepresented in the prevalence of autism spectrum disorder.

However, if females with HFA are ‘camouflaged,’ it brings into question whether or not they need to be diagnosed or receive intervention and support for their social skills and behaviors since their disabilities are not pronounced and having an immediate impact from early on in the individual’s development?

The potential for dismissive thinking, given disproportionate knowledge, does not bode well for the long-term prognosis of females with autism because there are significant, pervasive and consequential problems that emerge when a female with ASD is overlooked.  The lack of awareness also accentuates the importance of educators, parents, and clinicians understanding how to take note of understated social communication difficulties since impaired social interaction skills are a defining hallmark of ASD.

While current research supports the use of evidence-based practices to assuage long-term negative consequences of a missed diagnosis, camouflage creates a perception that a female with HFA is “normal” in their social functioning and this perception limits their ability to make and keep friends. Unfortunately, the durability of camouflage as either a conscious and unconscious strategy is not sustainable because as social communication demands increase, and interactions become increasingly sophisticated, so does the ability to understand and respond to nuanced communication successfully; this can have a detrimental effect on friendships over the long-term.

Additionally, there is much research still to surface when exploring camouflage in high-functioning males and also non-binary individuals who are on the spectrum because camouflage research has predominantly focused on the female phenotype as opposed to the concept of camouflage within autism spectrum disorder.  Both Lai & Baron-Cohen (2015), and Hall et al. (2017), agree that to reduced reduce barriers associated with social connection and relationship necessitates increased acceptance within these areas of life.  I, too, concur that it is essential to increase social acceptance for neurodiversity, and understanding the minutia can be an entry point into better finding and diagnosing