Gender bias in the diagnosis of autism spectrum disorder is failing females

Gender bias in the diagnosis of autism spectrum disorder is failing females

There is a historical gender bias rooted in the diagnosis of autism spectrum disorder (ASD), according to 22-year-old disability advocate Chloé Hayden. (Image supplied)

By Sophie Gauvin | @Sophgauvin

The diagnosis process for Chloé Hayden was frustrating and isolating.

But, after years of bullying at 10 different schools by the age of 13, Ms Hayden and her family finally had some answers when she was diagnosed with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD).

Following her diagnosis, Ms Hayden started an anonymous blog to express her feelings, which turned into a strong community.

But despite trailblazers like Ms Hayden leading the way, there is still little support for females with ASD in Australia and worldwide.

National guidelines say studies have found males are more likely to be diagnosed with ASD than females, even when their symptoms manifest on the same level.

Data from the Australian Bureau of Statistics suggests males are 3.5 times more likely to be diagnosed than females, with females making up less than a quarter of the 205,200 Australians diagnosed with ASD.

Females make up only 22.2 per cent of ASD diagnoses in Australia, according to the ABS’s 2018 disability, ageing and carers data. (Image: Sophie Gauvin)

Industry expert and paediatric clinical psychologist Angelique Foran from Think Wise Psychology says the diagnostic instruments used for ASD come from research primarily based on males.

As a result, these instruments reflect how autism presents in ways that are more common in males than females, and do not adequately identify autism characteristics in females.

A survey conducted by the National Autistic Society suggests 42 per cent of females with ASD were originally misdiagnosed.

“Anecdotally, a female with autism may receive a diagnosis of an anxiety disorder rather than ASD initially,” Ms Foran says.

There are continual studies exploring the idea that females with ASD are better at “camouflaging” their symptoms than males.

“A different way to understand gender bias in ASD diagnosis may come from the ideas that male and female brains are hardwired differently, shown in how females are better at navigating emotions,” Ms Foran says.

Studies investigating gender biases in ASD suggest that females demonstrate higher verbal communication skills and social empathy, enabling them to hide their challenges more easily.

This sentiment rings true for Ms Hayden, for whom it took over a decade to be diagnosed.

“No one ever considered that I could be autistic,” Ms Hayden says.

“I am creative, emotional, caring and a girl.”

One of the screening tools, the Autism Diagnostic Observation Schedule (ADOS), recently reviewed the outcome of further assessment and noted the threshold score should be lower for females; otherwise, the condition could be missed.

However, the ADOS is only one element of an ASD diagnosis.

For anyone with concerns about undiagnosed ASD, contact your GP, psychologist or an organisation such as Autism SA.

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