Discussion:Women & Autism

Greetings Earthlings! 🙂

Today, I’m going to discuss a very important issue within the autistic community- gender bias and the misdiagnosis of women with autism.

If I asked you to close your eyes and picture a person with autism, the majority of you will have pictured a man (most likely Dustin Hoffman! 😛 ).

Image result for rain man gif

The current ratio for male to female diagnosis of autism is estimated at 4:1 as the condition is thought to be rarer in women; however, many experts now believe that this figure may be as low as 2:1.

So why the discrepancy?

Did you know: Women with autism present differently to males on the spectrum?!

bitmoji169946342.png

Yep- as neurotypical men are from Mars and women from Venus, so too are autistic men and women from entirely different planets (maybe Krypton and Daxam for the DC nerds out there 😉 )!

So how do women with autism differ from men?

For starters, several neurobiological studies have shown distinct anatomical differences between the male and female autistic brain (which I will explore in a separate post at a later stage 🙂 ). Girls with autism are thought to have more active imaginations than boys and participate more in pretend play, often creating elaborate fantasy worlds (I had a particular penchant for this. My sister and I created an elaborate world for our teddies each night, so elaborate that our star couple had their own imaginary portable mansion when we went on holidays!! 😀 ). Reports also indicate that women have lower levels of restrictive and repetitive behaviours than men.

Evidence has also shown that women are better at recognizing emotions than males, almost as well as their neurotypical peers in fact, and demonstrate signs of better attentiveness in social situations.

As a gender, women are more socially inclined than men, and so female autists feel a greater need to make an effort socially.It is expected that women should be more social than men when it comes to communication, and as a result, we are often held to greater social standards. I can’t count how many times a teacher/my mother pulled me aside to advise or chastise me for my social ineptitude! 😛 It was thought that I struggled, not because something was wrong, but that I simply didn’t try hard enough socially. Had I been a boy this would not have been the case.

One of the biggest differences between men and women with autism is the tendency among women towards social mimicry. Girls are particularly adept in masking their symptoms through observation of their peers, obscuring them from the view of parents, teachers and medical professionals.

I’m particularly guilty of doing this. For example, when someone asks ‘How are you?’, I honestly don’t know how to respond! Should I just say fine? Should I reciprocate the sentiment? Should I detail the many ways my life sucks at present?! Three of the simplest words in the English language and I struggle to respond! I eventually developed a mental phrase card in my head for common questions like these so that I would have a standard answer when called for, and 90% of the time you pass for a functioning human being! Other times you get caught off guard and situations like this happen 😛 :

15978097_10209539652072238_4508618477815437814_n.jpg

My life is full of these little social coping mechanisms, which I’ll expand on separately at a later stage 🙂

Finally, as previously discussed, when it comes to specialist interests, female autists tend to have interests resembling those of their neurotypical peers (horses, Harry Potter, soap operas, Justin Bieber etc.), which can additionally hide them from view. Psychologists have also noted a ‘mothering’ tendency among peers of autistic girls, taking autists under their wing and adopting them into a social group. This further creates an illusion of social functioning for teachers, allowing these women to further slip beneath the radar.

As a result of all these differences, women are diagnosed much later than men, (men on average are diagnosed in childhood (~7 years); women as teenagers or adults)  if at all.

But why it it only now that these gender differences are emerging?

Gender bias in autism can trace it’s lineage to the original observations of both Leo Kanner (described autism) and Hans Asperger (described Asperger’s syndrome) in the 1940’s. In Kanner’s work, ‘Autistic Disturbance of Affective Contact’ (1943), Kanner observed a group of 8 boys, but only 3 girls with autism. Hans Asperger on the other hand, exclusively observed groups of boys, believing that AS was uniquely male! As a result, AS was not described in women until the 1990’s!!

whatgif_zps8269bc70.gif

I know!

Consequently, the diagnostic criteria for autism has been largely based on the male model of the condition, and as such, many women like me have slipped under the diagnostic radar.

Due to our inherent talent for social mimicry, women with autism unknowingly find themselves hidden from view. The warning signs that are obvious in males are not always visible, and as a result thousands of women go un-diagnosed, or worse still are misdiagnosed.

Mental health issues such as OCD, eating disorders, ADD, bipolar disorder, anxiety and depression are frequently linked with ASD’s and are particularly prevalent among women.
Experts believe that women with autism tend to internalize their autistic symptoms, leading them to exhibit greater depressive symptoms and experience higher levels of anxiety than male autists.

Women are frequently mis-diagnosed with mental health issues, whilst the underlying root ASD goes unnoticed.

The internet is filled with stories of these women who spent years in mental anguish without receiving the one diagnosis they needed. I recently came across an article where it took “10 years, 14 psychiatrists, 17 medications and 9 diagnoses” before a 21 year old girl got her autism diagnosis! You can read the article here: (https://spectrumnews.org/features/deep-dive/the-lost-girls/).

Researchers and clinicians have in recent years begun to adapt the diagnostic criteria to better serve autistic women, but there is much work still that needs to be done.

Rain Man‘ has dominated for too long- we need now to focus on “Rain Woman”.

bitmoji-1475045929.png

Aoife

 

Autism on Screen- Rain Man

Greetings Earthlings! 🙂

I’m going to change things up a little today with a new series examining the portrayal of autism on screen.

Film scholars have remarked that the portrayal of autism on film is generally inaccurate and highly stereotyped, so I’ve decided to take a closer look at things from a personal and scientific perspective 🙂

So let’s start at the very beginning with perhaps the most famous portrayal of autism in cinema- 1988’s ‘Rain Man‘.

Rain_Man_poster.jpg

For those of you who have not seen the film, ‘Rain Man’ focuses on the relationship between brothers Charlie and Raymond ‘Rain Man‘ Babbitt as they embark on a cross country road trip to Los Angeles (Raymond refuses to fly unless it’s with Qantas- the safest airline in the world!). Charlie grew up without any knowledge of Raymond, only discovering his existence upon learning that his father’s multi-million dollar fortune had been bequeathed to the mental institution in which he resides. And so Charlie sets out to be Raymond’s carer in order to access the fortune, but *SPOILER ALERT*- ultimately has a change of heart. Classic Hollywood ending.

Here’s a trailer for anyone who’s thinking of watching it 🙂

‘Rain Man’ is often considered to be the main reference point for autism on film, as it prompted the breakthrough of autism into the wider conscious of the public. Prior to this, characters displayed autistic like traits in film, but autism itself was not discussed- likely due to the fact that the diagnostic criteria for autism was only just emerging in the late 1980’s. The term ‘Rain Man‘ has also become synonymous with autism and other mental disabilities in popular culture, as seen in this example from the film ‘Miss Congeniality‘ (2000):

jttgfdurgiphy

As a “female rain man”, I find this highly insulting, so try not to brand autistic people using the term 😛

Winner of  4 Oscar’s, ‘Rain Man’ has been highly critically acclaimed- but does the film match up to the reality?

Rain Man‘ is generally thought to be an accurate portrayal of the autistic condition in scholarly papers. Indeed, there are many areas in the film in which Raymond perfectly demonstrates some of the classical signs of autism- sensitivity to touch, restrictive and repetitive behaviors, specialist interests, coordination issues, deficits in social communication, autistic meltdowns etc.

Interestingly while I thought that I would not be able to relate to Raymond from previous viewings, I found that his literal thinking had me written all over it. There’s a scene in the film (which you can see in the trailer) where Raymond stops in the middle of the road on a pedestrian crossing after the light flashes “DON’T WALK”! I have a terrible habit of dawdling at pedestrian crossings. Oftentimes I can see that the road is clear, but still I’ll wait for the green man (although this may be related to getting clipped on the ankle by a car crossing the road in Dublin as a teenager! 😛 ). However, I’m not as bad as I used to be since learning to drive; hesitation gets you nowhere on a roundabout after all! 😉

The story where Raymond inadvertently burned Charlie in the bathtub as a child (which led him to be institutionalized), also brings back many memories from my childhood. There have been many cases where I have inadvertently harmed my siblings- why just yesterday I threw a foam roller at my sister in an attempt to help her stretch out her legs, only for it to whack her in the throat…oops!

Bad Aoife! 😛

Lindsay-facepalm.gif

But my intentions were good!!

Acting without thinking is something that I tend to do an awful lot of (probably why I overthink and don’t act when it comes to love 😛 ). My mother had to keep a really close eye on me growing up after she found me attempting to push hair-clips down my sisters throat…I have no real answer for why I did that, but based on similar experiences, I’d say scientific curiosity probably had a role to play! 😛 😉 We’ll explore curiosity and impulsivity a little bit more in the coming weeks.

On the other hand however, this film has largely perpetuated the stereotype that autists typically have superb memories and savant skills. As I’ve stated previously, these traits are rare, and the vast majority of autists do not possess them. The same goes for card counting- a family friend actually inferred that I should be able to do it once! 😛

Here’s a fun article I found about a man who lost $17,000 after trying to use his autistic friend to count cards!

http://www.betootaadvocate.com/uncategorized/i-took-my-autistic-friend-to-the-casino-and-lost-17-000-in-ten-minutes/

In addition to this, Raymond is also described as ‘high functioning’ in the film, BUT Raymond is incapable of living independently. Whilst the definition of what constitutes high functioning autism varies, for many, Raymond does not fit the high functioning category and therefore does not come across as a true reflection of autism.

One of the biggest issues here I believe, is the fact that the character of Raymond is based on Kim Peek- a “megasavant” who did not in fact have autism, but FG syndrome (a rare genetic syndrome characterized by intellectual disabilities, low muscle tone and an abnormally large head).

Kim_Peek_on_Jan_16,_2007.png

Bit hard to write a film about autism when the inspiration doesn’t actually have autism if you ask me! 😛

On top of this, Dustin Hoffman famously prepared for the role by observing autistic adults for months in psychiatric institutions. However, Hoffman by his own admission describes Raymond’s character as an unrealistic grouped composite of high functioning autists he encountered during his research.

With this in mind, don’t believe everything you see in the movies folks! 😉

When I first got my diagnosis, this film naturally came to mind, however, I really struggled to relate what was presented on screen to my reality. Indeed, ‘Rain Man‘ reflects some of the realities of autism, but not all. ‘Rain Man‘ is an excellent film with superb acting from Dustin Hoffman, but it comes from a time before the ‘spectrum‘ when knowledge of autism was limited.

So when it comes to films about autism remember- autism is a spectrum; one size does not fit all 🙂

Aoife

 

 

 

 

Blog at WordPress.com.

Up ↑