Autism in women and girls

The features of autism are the same regardless of whether you are male or female.  For example you might:

• Have difficulty understanding or following social rules or behaviours
• Have a passionate interest in a particular subject to the exclusion of all others
• Find it difficult to understand or express how you feel
• Find it difficult to understand or interpret the feelings or facial expressions of other people
• Have an intense need for routine or a strong aversion to change
• Have difficulty eating and drinking 
• Feel a strong aversion to certain textures, smells or sounds but be attracted to others
• Have speech and language differences

However, some autistic women and girls, particularly those with average or above average spoken language ability are more prone to 'camouflage' or 'mask' their behaviour.  Although boys mask, girls and women experience an intense need to 'fit in' with others, driven by both gendered social expectations and social pressures which are comparably lower in boys.   Masking makes detecting girls difficult and many are often missed or 'hidden in plain sight'.  This can result in significant mental health challenges as girls grow up and struggle to navigate and understand increasingly complex social rules.

Please see our blog post on autistic masking for more detailed information.

After our initial discussion we may use a separate screening tool if we require additional information to identify autistic traits in female clients.  Our own screening tool is currently in development, however we currently use some self-report questionnaires to give us a more accurate idea of your strengths and difficulties.  If autistic identification is the right pathway for you, the standard multi-disciplinary autistic identification process will be followed.  

Although we do offer face to face appointments, we would particularly recommend that the client remain in their home environment or any environment of their choosing in which they are relaxed and able to 'be themselves'.  Our clinicians are highly trained to notice and identify masking behaviour, and our process is designed to help our clients feel comfortable, understood and able to be their true, authentic selves.  We will collate as much information as possible from multiple sources, including medical records, informant questionnaires where appropriate, information from education settings and parental interviews.  

The assessment process for women and girls will follow the same process as any other and adheres strictly to the NICE guidelines for autism assessment:

• Initial screening
• Reviewing additional information
• Developmental history (or diagnostic interview for older adults)
• In depth clinical interview.  The format is different depending on age and individual requirements, and our clinicians work flexibly using a range of tools to ensure that we give our clients the best opportunity to discuss their experiences, strengths and difficulties, and to explore the extent to which they identify with the autistic experience
• A multidisciplinary team meeting between clinicians comparing all of the information collected against DSM-5 criteria for autism (medically termed as a diagnosis of autism)
• A feedback session with our client and their family

How is our process different?

We recognise that being autistic, having ADHD, or any other form of neurodivergence, is just another way of experiencing the world around us. As such, it is part of the broad spectrum of neurodiversity. Our clinicians aim to celebrate and affirm neurodiversity as natural variations in thinking and engaging with the world, and our process is designed to reflect this.  

Humans are all different, and being autistic is part of being human. Our clinic was founded by an autistic clinician, on the basis that autism is not a medical condition or a ‘disorder’, despite being labelled as such at present. We do not follow a deficits-based model of autism, or use deficits-based language, despite the fact that all of the diagnostic literature and the majority of clinicians involved in the process follow this methodology at present. Instead, we work with you or your child to identify your own/your child’s unique profile or strengths and differences, passions, lived experiences and difficulties. We will never make you feel as though you are ‘abnormal’ or ‘broken’, and will value your own unique perspective at all times.  We still thoroughly evidence all areas of the DSM-V and adhere to the NICE protocol for autism assessment. However, unlike the majority of clinics at present (although we hope this changes soon), we do not use a medical/deficits-based model for autism assessment.

We are in the process of compiling an information leaflet for female clients who may be presenting with autistic traits.  This page will be updated in the near future.  In the mean time, we can recommend this blog post as an excellent starting point (although we steer clear of words such as 'impairment' within our practice.  We prefer to use the term 'differences').