Autism and Girls: World-Renowned Experts Join Those with Autism Syndrome to Resolve Issues That Girls and Women Face Every Day! New Updated and Revised Edition
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ISBN-13: 9781941765234
Media Type: Paperback(Revised)
Publisher: Future Horizons Inc.
Publication Date: 08-02-2019
Pages: 150
Product Dimensions: 6.00(w) x 8.90(h) x 0.70(d)
Dr. Tony Attwood is a practicing clinical psychologist with more than twenty-five years of experience. He has worked with over 2000 individuals of all ages with Asperger's syndrome. He presents workshops and runs training courses for parents, professionals, and individuals with AS all over the world, and is a prolific author of articles and books on the subject.Temple Grandin is an international lecturer on autism, a best-selling and award-winning author, an autism activist, a consultant to the livestock industry on animal behavior, and an engineer. She also created the "hug box," a device designed to calm those on the autism spectrum. The subject of an award-winning, 2010 biographical film, Temple Grandin was also listed in the TIME 100 List of the one hundred most influential people in the world. Dr. Grandin is one of the most respected individuals with high-functioning autism in the world. She presents at conferences nationwide, helping thousands of parents and professionals understand how to help individuals with autism, Asperger’s syndrome, and Pervasive Developmental Disorder (PDD). She is the author of Emergence: Labeled Autistic, Thinking in Pictures, Animals in Translation, The Autistic Brain, and The Loving Push. One of the most celebrated — and effective — animal advocates on the planet, Dr. Grandin revolutionized animal movement systems and spearheaded reform of the quality of life for the world's agricultural animals. She earned her Ph.D. in animal science from the Universityof Illinois, and is a professor at Colorado State University. She lives in Colorado. Catherine Faherty works with children and adults with autism through the well-renowned TEACCH program in North Carolina. She is also a parent consultant and child therapist; consults to school programs; trains teachers and other professionals locally, nationally, and internationally; and runs social groups for children and adults with autism. She has written manuals used in TEACCH trainings, developed training models, and has written a workbook for children with autism and their parents and teachers, titled Asperger’s: What Does It Mean To Me? Catherine Faherty resides in Asheville, North Carolina. Sheila Wagner, M.Ed., received her undergraduate degree in Education from the Universityof Wisconsin, Whitewater, and her graduate degree in Special Education from Georgia State University. Past experience in autism began at the Indiana Resource Center for Autism at Indiana Universitywhere she was an associate teacher, then demonstration teacher in the autism demonstration program and, later, an educational consultant to teachers and schools across the State of Indiana under the tutelage of Nancy Dalrymple, the first of many mentors. Currently, Ms. Wagner is an autism consultant, school consultant, teacher trainer, guest lecturer, and published author of numerous articles and books. Her books include Inclusive Programming for Elementary Students with Autism (1999), Inclusive Programming for Middle School Students with Autism/Asperger’s Syndrome (2001), Inclusive Programming for High School Students with Autism and Asperger’s Syndrome, and Understanding Asperger’s: Fast Facts (2004). She also contributed a chapter to Asperger’s and Girls (2006). She received the Autism Society of America’s Literary Award for the book on inclusion in elementary schools, and was named the ASA’s (Greater Georgia Chapter) Professional of the Year in 2002. Ms. Wagner lives in the Atlanta, Georgia area with her husband and son. Lisa Iland is a presenter and consultant in the autism community, and a student of speech and language pathology. She is a contributing author of the award-winning book Asperger's and Girls, and is a regular contributor to the Autism Asperger Digest magazine as columnist of the Sib Talk newsbite. Lisa specializes in teen social skills, Asperger's Syndrome, and sibling issues. Mary Wrobel is a speech-language pathologist with more than twenty years of experience working with students who have autism and other disabilities. She wrote Taking Care of Myself to help teach students with disabilities the necessary information and skills they need to live safe, healthy lives as independently as they are physically and mentally capable of. Mary believes that by teaching these special young people self-care skills, we can instill personal safety and reduce confusion, fear, and the incidence of abuse. Teresa Bolick is a licensed psychologist with a special interest in neurodevelopmental disorders, including autism, Asperger’s Syndrome, and other developmental disorders. Dr. Bolick graduated from the Universityof North Carolina at Chapel Hill with a BA in Psychology and now holds MA and Ph.D. degrees in psychology from Emory University. Dr. Bolick provides evaluation and treatment to children, adolescents, and their families. She consults frequently to schools in New Hampshire and Massachusetts. She is an enthusiastic speaker, presenting workshops for parents, paraprofessionals, and professionals across the nation. Jennifer McIlwee Myers, A woman with Asperger’s Syndrome, Jennifer is a terrific writer and presenter—funny, eloquent, and to the point. Growing up, her brother had autism, so ASD was a part of life in her household. But as she grew into an adult, she noticed more and more ASD characteristics in herself and was finally diagnosed with Asperger’s in 2002. She has taught herself many unique, innovative ways to navigate the world of “normal” people over her lifetime. In her intriguing and very entertaining presentation, she provides parents, educators, and others on the spectrum countless tips and ideas that can make their lives better immediately. An author and contributor to Asperger’s and Girls, Jennifer has a Bachelor’s degree in Computer Science and currently lives in California with her husband Gary. Ruth Snyder is a self-advocate for autism. She has dedicated her life to public awareness and frequently lobbies for political freedom on behalf of people living with autism. She works hard to be a positive role model, speaking often at conferences and contributing to several publications. She lives in Illinois with her four great kids. Ruth wasn’t diagnosed with autism until her children came along, two of whom are on the spectrum as well. Ruth is currently an RN and is working on her Bachelor’s degree. She plans to become a Certified Registered Nurse Anesthesiologist is interested in pursuing neuroscience.
CHAPTER 1 Adaptations to Autism Minds and Hearts Clinic Brisbane, Australia TONY ATTWOOD is a clinical psychologist whose original qualifications were achieved in England and who now lives in Queensland, Australia. He has specialized in autism spectrum disorders since 1975, and achieved a PhD from the University of London in 1984. He currently works in private practice and is adjunct professor at Griffith University Queensland. His book Asperger's Syndrome: A Guide for Parents and Professionals, published in 1998, became the seminal book on Asperger's syndrome and his subsequent book, The Complete Guide to Asperger's Syndrome, published in 2006, has become the primary text book on Asperger's syndrome. He is the senior consultant at the Minds and Hearts clinic in Brisbane, Australia. His current clinical interests are in developing screening tools and diagnostic procedures for autism and developing and evaluating cognitive behavior therapy programs for children and adults with Asperger's syndrome. He has contributed to over thirty research publications on autism and authored or joint-authored ten books on autism. Tony has also been invited to be keynote speaker at many international conferences on autism. MICHELLE GARNETT is a clinical psychologist and founder and director of Minds and Hearts, a clinic for Asperger's syndrome and autism. She has specialized in autism spectrum conditions for twenty-five years, developing expertise in all expressions of autism across all ages. Michelle created the first screening instrument for Asperger's syndrome, the Australian Scale for Asperger's Syndrome (ASAS) in 1993. She obtained a PhD for her research into autism in 2007 from the University of Queensland. She has been invited keynote speaker at many national and international conferences and was a contributor and editor of Spectrum Women: Walking to the Beat of Autism, published in 2018. Until recently, the gender ratio for autism was estimated as four boys for each girl. However, clinicians are increasingly receiving referrals for diagnostic assessments of girls and women, and a recent research study has established a ratio of two-to-one (Rutherford, McKenzie, & Johnston 2016). Why have we not previously diagnosed the true prevalence of autism in girls and women? The answer is that girls and women have so often successfully camouflaged their autism. One of the central characteristics of autism is a deficit in social communication and social interaction (American Psychiatric Association 2013). The social and interpersonal aspects of life are a challenge, so how does the person who has autism adapt to these challenges? Clinical experience suggests there are three potential adaptations: the introvert, the "intensive" extrovert, and the "camouflaging" extrovert. The Introvert The more easily recognized adaptation is that of the person who could be described as an introvert. The child (and subsequent adult) actively minimizes or avoids social engagement, recognizing that social interaction is indecipherably complex, overwhelming, and stressful. This conspicuous adaptation, therefore, is to choose (where possible) to be alone to accomplish things while not necessarily feeling lonely. But we are increasingly recognizing those people with autism who are extroverts and highly motivated to socialize. For these people, there are two potential adaptations that facilitate social engagement. The "Intrusive" Extrovert The first of these two adaptations is to actively seek social experiences, even though the person may not be able to read all the subtle social signals that regulate and moderate the intensity of social engagement. Due to impaired theory of mind, those who have autism often have difficulties reading the nonverbal communication used in a social interaction. Their social behavior is then perceived as intrusive, intense, and irritating. A metaphor to describe this adaptation to autism is that of a driver who does not see the traffic signals (nonverbal communication) or abide by the traffic code (social conventions). They are unable to accurately read social situations and therefore act inappropriately. While there is considerable motivation for social interaction and making friends, these experiences may nevertheless be ended prematurely by the social partner. The consequence is that the person feels bitterly disappointed that conversations, friendships, and relationships are short-lived, and social popularity remains elusive. Another issue is that once friendship is achieved, the person can become possessive, idealizing their new friend with an intensity that is overwhelming. When the friendship or relationship ends, there can be intense despair and feelings of abandonment, betrayal, and of being misunderstood. The "Camouflaging" Extrovert The second adaptation for the person with autism who is an extrovert is to recognize their difficulties in reading nonverbal communication and in making and keeping friends. With this insight, they acquire successful social and interpersonal abilities by keenly observing peers and people in general, analyzing their social behavior, and interpreting and abiding by social rules and conventions, thus effectively camouflaging their social difficulties. The person creates a social "mask." This chapter focuses on this third adaptation to autism — camouflaging — which was first recognized as an adaptation to autism by girls and women, but which we now recognize as also occurring with males (Lai et al. 2017). To understand the camouflaging process, it is important to first consider how the social development and abilities of girls and women who have autism may differ from boys and men who have autism. The Developmental Profile of Girls and Women with Autism Early Childhood Clinical experience and parental reports indicate that girls who have autism have greater social motivation and engagement than their male peers. However, a characteristic of the girl with autism when playing with her peers is a tendency to be overly dominant and controlling or to be attracted to other girls with strong personalities who tell her what to do (Ormond et al. 2018). Parents often report that she is indiscriminate and excessive when expressing affection or extremely reticent or uncomfortable expressing affection, even with family members. Parents also describe extreme emotional meltdowns in particular situations, such as having to cope with a change in expectations or in response to specific sensory experiences (e.g., being in a crowded shopping mall). The despair and agitation are intense, and parents are often unable to distract or console the child. Girls who have autism may decipher and analyze social experiences by replaying social events with doll play. Each doll represents a person and the reenactment helps clarify the social signals, conventions, and script. Girls who have autism can have a remarkable ability to engage in solitary imaginative play, creating imaginary worlds, and having imaginary friends, which provides an opportunity to create and rehearse social scripts. The child's teacher and parents may notice that she rarely engages with female peers, who she perceives as behaving in an incomprehensible way and following inexplicable social rules. When she is engaged in imaginary social play, there is no criticism or rejection. In contrast, some girls avidly observe other girls playing and socializing and may copy or "clone" themselves after other girls, "borrowing" their gestures and phrases to achieve the social abilities needed when playing with peers (Ormond et al. 2018). The child may imitate gestures, facial expressions, and phrases, which are reenacted and rehearsed when she is alone. Parents may notice that she is more animated when imitating and engaging with her peers than when engaged with family members. Early School Years An adaptation in the early school years for girls who have autism can be a preference for playing with boys, as they are perceived as engaging in simpler and more logical play. She may become known as a tomboy, preferring to look androgynous and enjoying sports and physical, rather than conversational, interactions. She may prefer single, close friendships, a characteristic that may continue throughout her life. Alternatively, she may try to be included with her female peers by developing an interest in expressing femininity in clothing and color coordination and becoming knowledgeable about the topics of conversation of her peers, such as popular films, television programs, and computer games. If she is effectively rejected by her peers, she may develop an interest in reading fiction, sometimes at a level in advance of her chronological age. Fiction can often provide insight into people's thoughts and feelings, which can give the child a better understanding of her peers. If she happens to enjoy the Harry Potter books, she may appreciate the thoughts and feelings of Hermione, who herself expresses many characteristics associated with girls who have autism; for example, all her friends at Hogwarts are male. The girl may also show a greater interest in socializing with pets and animals rather than with peers. Animals accept you for who you are, do not tease and ridicule you, want to play with you, and are always genuinely pleased to see you. She may not want her social confusion to be recognized by her teacher and peers, so she becomes very well behaved in class in order to be left alone. She also knows that if she is quiet, no one will notice her. She effectively suppresses her autism. However, when she returns home, she becomes a very different character — a Dr. Jekyll and Mr. Hyde transformation. She is no longer timid and shy, and she may be emotionally volatile, demanding, and angry. Parents frequently experience behavior that would never be expressed at school. High School Years The nature of female friendships changes throughout the school years, and the teenage girl who has autism may not understand the innate social "rules" of typical adolescent girls, such that when with female peers, she frequently makes social faux pas (Baldwin & Costley 2016). She may have difficulty understanding and responding to the subtle, nonverbal communication of typical teenage girls, such as eye rolling, shared glances, and giggling (Dean, Harwood, & Kasari 2017). Adolescent girls who have autism are extremely loyal, kind, and helpful friends. They rarely engage in gossip and are not "bitchy" or mean. These engaging qualities may be recognized by a typical girl, and a friendship may develop between them. The typical teenager can then provide social guidance and prompting and a sense of security, especially from the teasing, bullying, rejection, and humiliation by female peers. If she has a small group of friends, she may be overly sensitive to conflict between her friends. She may take on the role of peacemaker and be eager to restore emotional harmony. If she belongs to a larger group of friends, she may have difficulty coping with too many opinions, egos, and factions within the group (Vine, Foggo, & Webster 2017). She may not identify with or enjoy the interests of teenage female peers, such as fashion, makeup, boys, and dating. She may be less able to identify with her peers' construct of femininity. She may then question her own gender identity (Kanfiszer, Davies, & Collins 2017). By not enjoying the same interests, she is more likely to be ostracised, feel lonely, and be aware of and sensitive to derogatory comments such as "you are weird," which will affect her developing sense of self. In contrast, she could become an expert in teenage fashion and know all there is to know about the popular boys. She may be aware of the social scripts of her peers and know what to say. However, if in her early school years she observed and imitated her peers but was still rejected, she may decide to have a paradigm shift in her persona, despising femininity and social and gender conventions. She may identify with marginal groups, deliberately defy social conventions, and engage in risky behavior. The Adult Years The teenage girl may have effectively camouflaged her autism. She may have "flown under the radar" and not have been considered for a diagnostic assessment for autism. Every day she has acted out the role of a typical girl, so much so that she should be awarded an Oscar for her performance. She has a superficial sociability that is effective, but exhausting. She also has a lack of social identity, other than being the person that others expect her to be. This social acceptance and success will have been achieved at some psychological cost. There can be performance anxiety in social situations, as though she has been continually "on stage." The resulting stress may evolve into an anxiety or eating disorder. She may be popular and socially successful, but this is achieved intellectually rather than intuitively. Like Cinderella at the ball, she can maintain the pretense for a while, but then becomes totally drained of mental energy and must return home to recover in solitude. The unrelenting mental exhaustion of processing social information and social expectations can lead to depression and even self-harm. The consequences can be a lack of knowledge of her inner and true self, with some adult women saying, "I don't know who I am." This may lead to a lack of self-identity, low self-esteem, and prolonged self-analysis. She recognizes that her friendships and relationships are based on deceit, where she has presented a "false" identity. This increases her feelings of deep inner loneliness. She yearns to find, and be able to be, her authentic self, but is aware that when her true self is revealed, she may be rejected and despised. In this way, camouflaging aspects of autism, while successful in some respects, can contribute to the development of clinical depression. The Stages in Camouflaging Autism Research and clinical experience suggest a three-stage model of the camouflaging process (Hull et al. 2017). In the first stage, there is motivation to be successful socially and to develop friendships. The second stage is to acquire the ability to camouflage social confusion, social immaturity, and a delay in social reasoning. This is achieved by masking and compensation strategies. The third stage involves short- and long-term consequences, including delaying a diagnostic assessment, access to appropriate support and understanding, and subsequent mood and psychological disorders. We now have a questionnaire to explore whether a person engages in camouflaging in social situations (Hull et al. 2019). The Camouflaging Autistic Traits Questionnaire (CAT-Q) was developed from discussing aspects of camouflaging with adults who have autism describing their experiences. Exploratory factor analysis suggests three factors with the questionnaire, namely compensation, masking, and assimilation. Compensation This strategy is to learn and imitate body language, facial expressions, and conversational scripts. This knowledge can be achieved by observation of peers, but also by reading fiction or watching soap operas and films to acquire scripts and different personas. The girl may also be interested in studying psychology and may avidly read books on body language and friendship. An alternative compensation strategy is to prefer the company of males, whose social dynamics are relatively simpler. Boys and men may be more accommodating of someone who is socially clumsy, but who clearly enjoys and is relaxed in their company. Compensation can also be achieved by developing an interest and talent in science or the arts and becoming an author, artist, musician, singer, or multi-linguist. Social eccentricities are accepted and accommodated due to being valued by peers who recognize and admire a particular talent. Another compensation strategy is to develop an interest in fictional heroes and superheroes and to have friendships based on shared interests, such as cosplay and Comic-Con, providing defined and recognized roles and camouflage by a costume. Masking The person's intention is to create a neurotypical persona by mimicking others, creating a social mask, and changing their personality (Cook, Ogden, & Winstone 2018; Hull et al. 2017). She plays with personalities. To be successful, this adaptation requires the ability to suppress anxiety, appear relaxed, and to constantly monitor social performance, subsequently reviewing that performance or masquerade when alone. It is also important to appear interested in other people and make appropriate eye contact and empathic gestures and comments. When the person is wearing the mask, it is crucial to ensure others do not perceive their discomfort or that their fluent and successful social abilities are an act. Read an Excerpt
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Table of Contents
Foreword: Jennifer McIlwee Myers
Chapter 1: The Pattern of Abilities and Development of Girls with Asperger’s Syndrome [Tony Attwood, Ph.D.]
Chapter 2: Asperger’s Syndrome in Women: A Different Set of Challenges? [Catherine Faherty]
Chapter 3: Educating the Female Student with Asperger’s [Sheila Wagner, M.Ed.]
Chapter 4: Girl to Girl: Advice on Friendship, Bullying, and Fitting In [Lisa Iland]
Chapter 5: Preparing for Puberty and Beyond [Mary Wrobel, MA, CSS/SLP]
Chapter 6: The Launch: Negotiating the Transition from High School to the Great Beyond [Teresa Bolick, Ph.D.]
Chapter 7: Aspie Do’s and Don’t’s: Dating, Relationships, and Marriage [Jennifer McIlwee Myers]
Chapter 8: Maternal Instincts in Asperger’s Syndrom [Ruth Snyder]
Chapter 9: For Me, a Good Career Gave Life Meaning [Temple Grandin, Ph.D.]