What is Autism Spectrum Disorder?
Autism, or autism spectrum disorder, refers to a range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication, as well as by unique strengths and differences. We now know that there is not one autism but many types, caused by different combinations of genetic and environmental influences. The term “spectrum” reflects the wide variation in challenges and strengths possessed by each person with autism. Autism’s most-obvious signs tend to appear between 2 and 3 years of age. In some cases, it can be diagnosed as early as 18 months. Some developmental delays associated with autism can be identified and addressed even earlier (Autism Speaks, 2017).


Facts about Autism: 
The Centers for Disease Control and Prevention (CDC) estimates autism’s prevalence as 1 in 68 children in the United States. This includes 1 in 42 boys and 1 in 189 girls.

  • An estimated 50,000 teens with autism become adults – and lose school-based autism services – each year.
  • Around one third of people with autism remain nonverbal.
  • Around one third of people with autism have an intellectual disability.
  • Certain medical and mental health issues frequently accompany autism. They include gastrointestinal (GI) disorders, seizures, sleep disturbances, attention deficit and hyperactivity disorder (ADHD), anxiety and phobias (Autism Speaks, 2017).

​​Characteristics of Females with Aspergers and High-Functioning Autism

​​Females with Aspergers (AS) and High-Functioning Autism (HFA) often present with a unique set of characteristics that can make diagnosing their disorder very difficult. In addition, their strengths often mask their deficits. There has been considerable discussion among professionals about the way girls with AS and HFA demonstrate their major characteristics. Some girls have obvious social difficulties, whereas others appear to have excellent skills because they imitate the behaviors of others (often without understanding them). There are many females who do not receive a diagnosis, possibly because, compared to males, (a) they have fairly good social skills (particularly when interacting with adults in a one-to-one situation), (b) their special interests are different, and (c) their clinical presentation is different (My Aspie Child, 2017).

Sometime during childhood, a female with AS or HFA characteristics will begin to know she is different compared to her peers. For example:
1. Due to adopting an alternative persona, she may begin to have problems of self-identity and low self-esteem
2. Due to observing and analyzing social behavior & trying not to make a social error, she may become emotionally exhausted
3. During the stress of adolescence, she may develop routines and rituals around food and a special interest in calories and nutrition that develops into the signs of an eating disorder
4. Her interests may be different to her peers in terms of intensity and quality of play
5. She may be an avid observer of human behavior and try to decipher what she is supposed to do or say
6. She may be extremely sensitive to the emotional atmosphere at a social gathering
7. She may be like a chameleon, changing persona according to the situation
8. She may be more likely to apologize and appease when making a social error
9. She may be overly well-behaved and compliant at school so as not to be noticed or recognized as a different.
10. She may be vulnerable to “peer predators” who take advantage of her social immaturity
11. She may become increasingly aware of her social confusion and frequent faux pas, and thus prefer to be on the periphery of social situations 
12. She may enjoy living in a fantasy world and creating a new persona
13. She may escape into the world of nature, having an intuitive understanding of animals, but not people
14. She may fear that her “true self” must remain secret because she is defective, thus she is almost always acting like someone else
15. She may have a pet that she views as a loyal friend
16. She may have a single - but intense – friendship with another female who may provide guidance for her in social situations
17. She may have a strong desire to collect and organize her toys (e.g., dolls) rather than to share her toys with friends
18. She may have an aversion to the traditional concept of femininity 
19. She may have an encyclopedic knowledge of specific topics
20. She may have an intense interest in reading and escaping into fiction
21. She may have an interest in ancient civilizations to find an old world in which she would feel at home
22. She may have an interest in other countries (e.g., France) where she would be accepted
23. She may identify with a fictional character (e.g., Harry Potter), who faces adversity but has special powers and friends
24. She may not be interested in the latest craze among her peers to be 'cool' and popular
25. She may not identify with her peers
26. She may not play with her toys in conventional ways
27. She may not want to play cooperatively with her peers
28. She may prefer non-gender specific toys (e.g., Lego)
29. She may prefer to play alone so that she can play her way
30. She may prefer to play with males, whose play is more constructive and adventurous than emotional and conversational
31. She may suffer social confusion in silence and isolation in the classroom or playground, but she may be a different character at home
32. She may talk to imaginary friends, or write fiction at an early age 
33. She may think that the way her peers play is stupid and boring 
34. She may use imaginary friends that can provide companionship, support & comfort when she feels lonely
35. She may use passive-aggressive behaviors in order to control her family and/or social experiences


As young girls, many (but not all) females with AS and HFA:
1. Apologize frequently and want to please others
2. Are an expert on certain topics
3. Are determined
4. Are honest
5. Are involved in social play, but are led by their peers rather than initiating social contact 
6. Are kind
7. Are misunderstood by peers
8. Are more able to follow social actions by delayed imitation because they observe other kids and copy them, perhaps masking the symptoms of AS and HFA
9. Are more aware of - and feel a need to - interact socially
10. Are perfectionists
11. Are so successful at "faking it" that they only come to the attention of a therapist when a secondary mood disorder emerges
12. Are specially gifted in the areas of mathematics and engineering
13. Are very good at art
14. Are visual thinkers
15. Are well-liked by adults
16. Become a target of teasing
17. Do not ‘do social chit chat’ or make ‘meaningless’ comments in order to facilitate social communication
18. Enjoy solitude
19. Have a faster rate of learning social skills than males
20. Have a single friend who provides guidance and security for them 
21. Have a special interest that is more likely to be unusual in terms of intensity rather than focus
22. Have difficulty knowing what someone else may be thinking or feeling
23. Have difficulty making friends
24. Have difficulty managing feelings
25. Have difficulty showing as much affection as others expect
26. Have difficulty taking advice
27. Have difficulty with writing skills
28. Have extremely detailed imaginary worlds
29. Have imaginary friends
30. Have interests that are very similar to those of neurotypical girls (e.g., animals, dolls, classical literature), and therefore are not seen as unusual
31. Have what is classified as a "male brain"
32. Make reliable and trustworthy friends
33. Mimic or even try to take on all the characteristics of someone they are trying to emulate
34. Notice sounds that others do not hear
35. Read fiction to help them learn about inner thoughts, feelings and motivations
36. Show little interest in fashion
37. Speak their minds (sometimes to the point of being rude)
38. Still need to be directly taught certain social skills
39. Try to understand a situation before they make the first step
40. Use doll play to replay and understand social situations

​AUTISM SPECTRUM DISORDER

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