Am I Autistic? Utility of the Girls Questionnaire for Autism Spectrum Condition as an Autism Assessment in Adult Women

Abstract

This study aimed to explore the structure of a modified version of the Girls Questionnaire for Autism Spectrum Condition (GQ-ASC; Attwood et al. 2011) to test its utility as an autism screening measure for adult women. We recruited 672 cisgender and trans women aged between 18 and 72 online. The sample contained 350 autistic women (M age = 36.21, standard deviation [SD] = 10.10) and 322 nonautistic women (M age = 34.83, SD = 9.93), screened using the Autism Quotient. A principal component analysis and parallel analysis revealed a five-component solution that accounted for 40.40% of the total variance. The extracted components appear to be consistent with what is known about the way girls and women display their autistic traits and interpreted as (1) Imagination and play: Describes interest in fantasy, fiction, and reflection on the quality and content of imaginative play in childhood. (2) Camouflaging: Describes effortful attempts to reduce the visibility of autistic traits. (3) Sensory sensitivities: Describes sensory processing hyper-and hyposensitivities across various modalities. (4) Socializing: Describes barriers to social understanding and participation. (5) Interests: Describes age-advanced and nonstereotypically feminine interests. We observed significant differences between autistic and nonautistic women across all extracted components, and the total score. A receiver operating characteristic analysis indicated an excellent level of discrimination. When applying a cutoff score of 57, the GQ-ASC correctly identified 80.0% of cases. The modified GQ-ASC is an effective and highly discriminant screening tool for use in adult autistic women. It provides valuable insight into the shared features and experiences of this underrecognized and underrepresented subset of the autistic community.

Camouflaging in autism: A systematic review

“…This association was not maintained after accounting for autistic traits and education, suggesting that the relationship between camouflaging and autism diagnosis may be driven by autistic traits. Finally, in a large sample of cisgender and transgender women, formally diagnosed autistic women scored higher than non-autistic women on the Camouflaging subscale of the modified GQ-ASC (Brown et al, 2020). However, higher scores on the Camouflaging subscale were only associated with higher autistic traits for non-autistic women.…”

“…Internal consistency for the Social Masking scale was α =.61. Another study used a version of the GQ-ASC modified for use with women (Brown et al, 2020). The camouflaging scale on this version of the GQ-ASC includes four items measuring self-reported engagement in camouflaging behaviours (e.g., "I adopt a different persona in different situations").…”

“…The literature we reviewed suggests the following three preliminary findings about the nature of autistic camouflaging. First, emerging evidence suggests that adults with higher self-reported autistic traits report greater camouflaging efforts (Brown et al, 2020;Hull et al, 2019;Livingston et al, 2020).…”

“…In seeking to design camouflaging research that is more representative of the broader autistic community, it is important to understand why current camouflaging research involves such a specific minority of the larger population of autistic adults. A subset of included studies purposely recruited females or women or those without intellectual disability, to examine specific research questions (Beck et al, 2020;Brown et al, 2020;Lai et al, 2017Lai et al, , 2019Schuck et al, 2019). However, in the remaining online questionnaire-based studies, individuals largely self-selected to participate by responding to adverts distributed via social media, autism organisations, or research databases.…”

The Diagnosis and Management of Autism Spectrum Disorder (ASD) in Adult Females in the Presence or Absence of an Intellectual Disability

“…These conceptions are mainly based on autistic male populations [16,43,44]. Females present differently from males and, as such, may be missed under current criteria [45]. The female autism phenotype has the same core features of autism (impaired social communication abilities and RRB), though these may present differently from males [16,46,47].…”