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Autism spectrum disorder (ASD) is a group of neurological and developmental disabilities that affect behavior, learning, communication, interaction, and social and emotional skills. It is sometimes referred to as neurodivergent. People of any age can and are diagnosed with autism, though it is more often diagnosed in childhood. Historically, ASD is diagnosed at a higher rate in males, but it affects females as well. Autism in women is something that needs more awareness and understanding. I discuss what autism is, how it is diagnosed, and how it impacts women.
Autism Spectrum Disorder
ASD, or Autism spectrum disorder, affects males and females, though it is diagnosed at a much higher rate in males. The Centers for Disease Control and Prevention (CDC) estimates that 1 in 36 children in the United States are identified as autistic, according to their most recent data. These rates have steadily increased over the last few decades. In 2000, about one in 150 children in the U.S. were diagnosed with autism.
Today, four out of every 100 boys are identified as autistic, and one in 100 girls is diagnosed.
What Is Asperger’s Syndrome?
You may have seen the term Asperger’s or Asperger’s syndrome in relation to autism or as a form of ASD. Asperger’s is a previously used diagnosis, referring to extremely high-functioning people on the autism spectrum. People with this diagnosis are often highly intelligent and can function well in their daily lives. However, they have certain areas of difficulty around social interaction. People with an Asperger’s diagnosis are often highly focused on specific topics of interest.
Asperger’s was once thought to be a separate disorder, but in 2013, it became part of the larger autism spectrum. The medical community retired the diagnosis of “Asperger’s syndrome,” but many people still use the term.
Autism can affect any individual of any race, ethnicity, or socioeconomic class. While some research has been done into both genetic and environmental factors, we still have an extremely limited understanding of the exact cause of ASD.
ASD does tend to have a higher rate of occurrence in:
- Families with another autistic individual or sibling
- Children with older parents
- People who had an exceptionally low birth weight
- People with certain genetic conditions, including fragile X, Down, and Rett syndromes.
Autism Symptoms – Asperger’s Symptoms
No two people share the exact same symptoms of autism (or Asperger’s). Symptoms can present at any time in life but often start in young childhood. Because ASD is a spectrum, it affects everyone uniquely, though people may have similar experiences and symptoms.
Asperger’s is often used to refer to people who are high-functioning but have some noticeable behaviors, difficulties, and challenges. These often center around interaction with others and can include social, physical, and behavioral habits that seem odd to others. These can be broken into three main categories.
1. Social Communication And Interaction
Communication and difficulty with social interaction affect children and adults with ASD. Sometimes, these challenges can be quite severe, and some individuals may be completely nonverbal, requiring the use of assistive technology like autism communication apps.
Communication challenges include spoken language skills, showing affection, personal space, and understanding what others are saying. It can impact how someone handles social interactions, recognizes emotions in oneself and others, and understands social cues like eye contact, facial expressions, gestures, and tone of voice.
2. Restrictive And Repetitive Behaviors
Restricted and repetitive behaviors are often part of ASD. These can vary greatly, and it is unlikely that anyone has the exact same behaviors as another individual on the spectrum. Repetitive behaviors can include body movements and motions such as rocking, spinning, pacing, walking, running back and forth, and so forth. Other repetitive motions might include touching things, pushing buttons, flipping levers, shaking objects, or making hand and finger movements.
In some cases, autistic individuals can engage in a ritualistic type of behavior, wanting things to be set in a particular order. These rituals can apply to both physical items and behaviors. For example, having a set schedule and reliable routine every day, including wearing a specific type of clothing or having a certain lunch menu.
Repetitive or restrictive behaviors can often center around one specific area of interest or focus. While these specific topics and interests might change over time, they can sometimes become quite extreme.
3. Symptoms That Impact The Ability To Function In Areas Of Life, Including School And Work
Autistic individuals do not outwardly show indications of having a disability but face significant challenges that can impact their ability to function in key areas of life, including academic studies and professional work. However, an individual’s ability to succeed in education and a professional work environment is significantly impacted by the support system they have around them.
This can be quite challenging because ASD is not a disability that is presented physically. Many people do not understand the diverse ways it can impact an individual’s ability to perform and interact in high-pressure situations.
Other Symptoms To Be Aware Of
Some people with ASD may experience a range of sensory issues, which can affect how they carry themselves and how they act physically.
Sensory Issues And Sensitivities
Autistic individuals often experience sensory differences, including over or under-sensitivity to certain smells, sounds, textures, and sights. These sensitivities often include staring at objects or lights, sniffing things, and avoiding certain sounds or fabrics. It can also impact food and eating habits. A heightened sense of emotions such as fear, anger, or happiness can also occur.
Physical Characteristics
Autism, or Asperger’s, has no specific physical characteristics. However, some physical traits can be associated with ASD. For example, some children on the spectrum may walk on their tip toes or rock back and forth regularly. In some cases, they have what is described as a flat affect, with hard-to-decipher or seemingly no different facial expressions. Often, this leads to an individual being characterized as apathetic, though that is not the case.
Diagnosing Autism
Diagnosing autism is a process that is different for everyone. There is no specific blood test or imaging available to assist. Instead, a diagnosis looks at an individual’s behavior and developmental history. Often, ASD is identified in children when they are quite young, around 18 months to two years of age. T
The first year to two years of life is a critical developmental stage, especially for communication. At this time, developmental delays, challenges, or regressions can start to appear. Other children might be diagnosed a little older in elementary or even middle school.
Autism diagnostic tests include observations and a series of questions to help evaluate how someone behaves and thinks.
Autism Diagnostics
- Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) Module 4 – Considered the gold standard for diagnosing ASD in all ages.
- Developmental, Dimensional, and Diagnostic Interview-Adult Version (3Di-Adult): A standard diagnostic tool that evaluates how one communicates and interacts in social situations.
- Social Responsiveness Scale (SRS): A 65-question test that evaluates social challenges.
- Autism Diagnostic Interview-Revised (ADI-R): A 93-question test that focuses on the three main areas of autism (language and communication, social interaction, repetitive interest, and behaviors.)
For some individuals, a diagnosis might happen later in life, in their teen or even adult years. As with an ASD diagnosis in children, there are no diagnostic criteria that apply specifically to adults. Doctors and clinicians will interact with and observe patients and look at their history to determine an accurate adult ASD diagnosis. Often, a psychiatrist assists in this diagnosis.
Self-Diagnosis Of Autism
Many individuals have started to learn more about ASD and have begun to self-diagnose or identify themselves as autistic. Self-diagnosis can happen for several reasons, including a lack of access to care or limited financial resources. Some may self-diagnose, seeking self-awareness, understanding, and community.
Seeking medical assistance in getting an autism diagnosis is helpful to ensure you have access to support and services. Some of this support may not be readily available without an official diagnosis.
Women And Autism
While it was once thought that it was rare for a female to be autistic, that notion is no longer held, nor is it true. Women are affected by ASD, and it is a lifelong condition. It just looks a little different in females than it does in males. As more research and long-term observations are done on ASD, a greater understanding of how it affects women and girls is being developed.
One very famous woman with autism is Temple Grandin, who was one of the first disabled people to speak publicly about her life and experience with ASD. Grandin is famous worldwide, and though she did not speak until she was three and a half years old, she is one of the most accomplished individuals in the world.
Other notable women with ASD include actress Daryl Hannah, poet Emily Dickinson, Nobel prize winner Barbara McClintock, singer Courtney Love, singer Susan Boyle, climate activist Greta Thunberg, and many more remarkable women.
What Are The Differences Between Men And Women With ASD?
There are no outright differences between ASD in men and women, but it affects every individual differently. There has not been a large amount of research done on how autistic traits and symptoms might change over an individual’s lifespan.
The limited research that has been done indicates that autistic females may have higher functioning social and communication skills in their younger years. As they age, social and communication difficulties start to become more apparent. Males with ASD tend to have more pronounced and extreme behaviors than females.
Unfortunately, more and more research indicates that women with autism are more likely to commit suicide. A 20-year study through the University of Utah showed that suicide in autistic women was twice as likely as in men with autism and three times more likely than in women without ASD. The data is alarming and shows that significantly more resources and research need to go into supporting and understanding how autism affects females of all ages.
Why Is Autism Underdiagnosed In Females?
Autistic females are underdiagnosed for a few different reasons. It is becoming apparent as more research is done that many girls are undiagnosed if they do not have an intellectual development disorder. Females can internalize symptoms more effectively and often have the appearance of fewer social difficulties than autistic males. A gender bias has likely led to fewer referrals and more missed or misdiagnoses for autistic women.
Research published in the Journal of the American Academy of Child & Adolescent Psychiatry estimates that, in reality, the true male-to-female ratio of children with ASD is three to one rather than four to one.
In recent years, it has become more common for adult women to receive an ASD diagnosis. This development could be due to the lower diagnosis of girls and because females with higher-functioning autism are able to mask, accommodate, and internalize their struggles and symptoms. These different contributing factors have led to a gender disparity in the diagnosis of ASD in males and females.
Female Autism/Asperger’s Traits
Autistic traits and symptoms in women are often more subtle than in men but are not any less significant. However, adult, adolescent, and younger females are more likely to mask their symptoms than males.
What Is Autism Masking?
Autism masking refers to behavior an individual uses to hide or suppress certain traits or characteristics of their disability.
Autism masking is also referred to as camouflaging or neurodivergent masking. Essentially, it is the conscious or subconscious covering up or suppressing behaviors and challenges associated with being on the autistic spectrum. Masking also involves mimicking the behavior of neurotypical peers. In some cases, they may rehearse behavior for certain social situations or develop scripts for different scenarios.
Camouflaging is something that autistic individuals do with the end goal of being perceived as the same as their neurotypical peers. Many young autistic girls may mask by mimicking the behavior and fashion of their peers. They may show curiosity in socially acceptable interests such as television shows, characters, movies, and music to fit in.
Of course, males with ASD also engage in masking. However, research shows that girls are more likely to internalize symptoms and will later develop mental issues such as anxiety or depression. Additionally, ASD is often labeled as shyness in females. It has traditionally been more acceptable for girls to be shy than boys, which may also contribute to the gender disparity when diagnosing autism in young female children.
4 Signs Of Autism In Female Adults
There’s a growing number of people who are not learning about or realizing that they might be autistic until they are in their adult years. Many times, behavior that has just been labeled as normal, shy, reserved, or quirky can worsen or change, leading them to look more deeply at themselves and their history. With the help of physicians and mental health professionals, many women are realizing that the feeling of oddness, or something being off, might be something more.
Autistic women experience a range of different symptoms. These include:
1. Social Difficulties
Social difficulties can include anxiety and social situations, difficulty responding and interacting with others, inability to decipher social cues, and constant worrying about their behavior. Many autistic women have a desire for socialization and can handle themselves in smaller situations but may not do well in larger groups. Making eye contact, physical contact, and physical interaction may also be challenging.
2. Intense Or Obsessive Interests
Obsessive interests, including in activities such as sports clubs, art, and other areas, continue from childhood into adulthood. In adult women, this often manifests as needing to know everything about a specific person or situation. Autistic women tend to have more interests and focus on a broader range of subjects than males. Both men and women with ASD often find careers that require a very intense amount of focus and concentration, as well as attention to detail.
3. Repetitive Behavior
In adult neurodivergent women and girls, repetitive behavior connected to autism is common. Often, this behavior is self-stimulating and helps them regulate themselves. Obsessive and repetitive behavior does not always have to focus on a specific subject. It can involve behaviors like excessive skin picking, twirling hair, pacing, obsessing over makeup or appearance, or repeating certain words and phrases.
4. Sensory Issues
Sensory issues like needing to have an office lit in a certain way, not liking a particular chair, always needing to eat lunch in the same spot, and other repetitive behaviors may also be connected to sensory issues from ASD. While these may be subtle and not as pronounced as in childhood, they can still be challenging. Often, adults learn how to work around these issues, including through the use of medications, which may end up masking symptoms more.
Autistic females are often misdiagnosed or may have coexisting conditions. These can include anxiety, ADHD, depression, OCD, eating disorders, and sleep disorders, and some women may even develop motor or vocal tics.
How Do I Know If I Am An Autistic Female?
You may be wondering how to determine if you have autism. While the signs in adults, especially in adult females, can be more subtle than in children, there are still indicators to look for.
20 Female Aspergers & Autism Symptoms
Below is a sample checklist of symptoms to look for in yourself. Please note: this is in no way a substitute for a diagnostic tool or a consultation with a medical or mental health provider.
- Difficulty understanding what others are feeling or thinking.
- Social anxiety or intense anxiety about any interaction with others.
- Challenges with making friends or interacting with other people.
- Preferring alone time.
- Seeming apathetic, rude, blunt, or uninterested in others.
- Hard time expressing feelings.
- Inability to understand sarcasm or irony.
- Taking everything very literally.
- Resistance to routine changes.
- Depression and low self-worth.
- Inability to read social cues and rules.
- Lack of a social filter or expectations.
- Uncomfortable with close contact, touching people, or making eye contact.
- Fixation on minor details such as smells, sounds, and patterns.
- Tending to plan things extensively before doing them.
- Intense interests in specific subjects and activities.
- Creative thinking and pushing the envelope.
- Honest and straightforward to a fault.
- Exceptionally good long-term memory.
- Not very judgmental.
Autistic women are often quieter, hide their feelings, can copy or mimic social behavior better, and may suppress repetitive behaviors more effectively than men. This makes it harder for women to be identified as autistic.
Samantha Craft’s Unofficial Checklist
Samantha Craft (aka Marcelle Ciampi) is a well-respected autistic author, educator, and community advocate. She was diagnosed with Asperger’s as an adult and started the blog and book Everyday Asperger’s. As an autistic individual herself and the mother of an autistic child, Ciampi has taken her personal journey and used it to help thousands of others.
Craft, aka Ciampi, created an unofficial checklist to assist healthcare professionals in recognizing autism. The list has been updated several times. After working through it, if 75%-80% of the statements are checked in each area, they may want to consider looking into an ASD diagnosis.
Samantha Craft’s unofficial checklist has become a well-respected resource in the autism community and has helped many women look closer at themselves as they seek understanding and acceptance. You can learn more and access the latest checklist here.
10 Coping Mechanisms For Women With Autism
A large part of living with autism is developing coping skills and mechanisms to help work through stress, anxiety, and frustration. Self-care is incredibly important, especially for autistic women. In childhood, caregivers are there to ensure a child’s needs are met, but in adulthood, many women are on their own and may not have access to the full support they need.
Coping mechanisms and skills can include:
- Engaging in a special interest or activity
- Physical exercise like a workout or going for a walk
- Meditation and deep breathing
- Physical fidgets and sensory objects
- Listening to music
- Creating art
- Taking short breaks
- Sticking to a set routine
- Eating a healthy diet
- Journaling or making a sleep diary
A Different Experience For Everyone
No two autistic individuals have the same experience. Because it is a spectrum, some individuals may be severely affected and may be nonverbal and require assistance throughout their lives. Other individuals are highly functioning and able to live highly independent, very productive lives. Some autistic individuals may have several symptoms, while others may only have one or two. How these affect each individual and how they are managed and treated varies greatly.
Supporting Individuals With Disabilities
Acceptance, compassion, kindness, and understanding are key to supporting individuals with ASD and other disabilities. Showing respect, positivity, and patience can help make someone with ASD feel more comfortable and supported. Be sure to include them socially and consider any special considerations or concerns they may have. Try to keep social environments calm and without sensory overload or multiple distractions. It is essential to stay judgment-free and realize that what is one person’s normal is not another’s.
Because disabilities like autism have such a wide range of symptoms and severity, we all must develop an understanding of how to support others. Individuals with these conditions must feel supported and encouraged and are in no way less intelligent, accomplished, or motivated than anyone else. I cover some amazing stories in this article about inspiring famous people with disabilities. Thankfully, many advances in healthcare and technology can benefit people with conditions like autism or social anxiety. Communication apps, for example, have helped make connections with others easier. Online doctors, therapists, and telehealth tools have made access to health care less intimidating and more comfortable for people with disabilities.
Why Trust Safe Smart Living
Danielle is a longtime supporter of individuals with disabilities and a former special education professional. She spent several years working closely with children with multiple levels of disability. Danielle has many hours of specialized autism training to support learning, development, and communication. Additionally, she has a deep understanding of assistive technology to support autism and other disabilities.
Along with her professional experience, Danielle has first-hand experience supporting and caring for disabled family members and has done so for close to 20 years. She has spent several years as a professional researcher and writer, using the most recent data, science-backed research, and developments to bring valuable information to others.
