Looking behind the mask: Social coping strategies of girls on the autistic spectrum

Abstract

The socio-communication deficits of individuals on the autistic spectrum are well documented. However, this has largely been based on the male population and less is known about how females with autism manage social relationships across the developmental period.Ten adolescent female participants with a diagnosis of autism were interviewed and Interpretative Phenomenological Analysis used to explore their experiences of managing their social relationships. The results showed that participants were motivated to develop and maintain friendships, but during adolescence this became increasingly difficult.Consequently, they developed explicit strategies to manage these relationships, including masking and imitation. The use of such strategies was both advantageous and disadvantageous, and such findings should be considered in developing gender sensitive assessment and developmentally appropriate support.Keywords: Adolescence; female; Autism Spectrum; social relationships; imitation.Coping strategies of girls with ASC 3 IntroductionThe prevalence of autism in 2010 in the UK was estimated at 3.9/1,000 in eight year old boys and 0.81/1,000 for eight year old girls (Taylor, Jick, & MacLaughlin, 2013). In a review of 32 epidemiological studies between 1966 and 2011, the male: female ratio was estimated at approximately 4:1 in autism and 10:1 in Asperger's Syndrome ([AS] Fombonne, 2003). Whilst exact ratios differ across studies, the gender disparity has been consistent since the condition's initial identification, often credited to Kanner in 1943. Various theoretical accounts for this gender difference have been offered, and criticism has been directed at the research and diagnostic practices which may perpetuate and exaggerate this difference. It is important that the reality of this imbalance and the gender sensitivity of assessment instruments and services are investigated, as it seems that girls with Autism Spectrum Conditions (ASC) may remain un-or mis-diagnosed, and more gender appropriate support not offered (Gould & Ashton-Smith, 2011).It is beyond the scope of this paper to present the breadth of theories around gender and ASC (see Rivet & Matson, 2011, for a comprehensive review), but one influential theory is the Extreme Male Brain ([EMB] Baron-Cohen, 2002). Here males are described as typically having greater skills in rule-governed, systemising activities whilst typical females are described as having superior empathy and general emotional sensitivity. Hence, males are more likely to be on the autistic spectrum as they are more predisposed to autistic traits.. Whilst the EMB theory describes biological factors as a strong determinant of risk of ASC, Fine (2008) argues that the theory underplays the influence of non-biological factors. Debates around the aetiology of ASCs continue, and there is also mounting evidence that the androcentric nature of assessment instruments, together with the self-confirming bias of gendered expectations about typical presentations within services, are maintaining this gen...

Protective Effect or Missed Diagnosis? Females with Autism Spectrum Disorder

“…However, closer examination reveals autistic girls may have significant difficulties maintaining friendships and dealing with conflict, and therefore are not functioning socially to the same extent as their typically developing peers [56]. As previously described, both intuitive and explicit camouflaging techniques mean that adolescent girls can mask their ASD characteristics from others around them, even in clinical settings [62]. Autistic girls and adolescents may therefore miss out on official diagnosis for years due to lack of awareness of their difficulties from others around them.…”

“…Simultaneously, several self-reported anecdotes and a few newly emerging studies have identified camouflaging techniques used by autistic females to mask and distract from their ASD difficulties, and to present a more socially competent self than they actually feel [61,62]. These strategies, which are used both to cope with ASD difficulties and minimise others' awareness of them, may result in under-identification of females who are struggling with their ASD, as the outward portrayal to teachers or clinicians is of someone who is developing typically [59,63].…”

“…These strategies, which are used both to cope with ASD difficulties and minimise others' awareness of them, may result in under-identification of females who are struggling with their ASD, as the outward portrayal to teachers or clinicians is of someone who is developing typically [59,63]. This behavioural technique may also explain why increasing numbers of females receive their ASD diagnosis in adolescence or adulthood, when either the effort of maintaining camouflaging strategies or the ASD itself becomes overwhelming, and so brings the individual to clinical attention [62]. Interestingly, camouflaging strategies are also reported by autistic males, although gender differences in the success of and satisfaction with camouflaging may still exist [64].…”

“…For instance, autistic women report lower levels of educational attainment and employment than non-autistic women, and attribute this gap partly to their ASD characteristics holding them back [70]. Of even greater concern are the high levels of sexual assault and other types of abuse reported by women with ASD and high autism traits [62,71]. If these assaults are occurring in women and girls with ASD diagnoses, it is likely that similar experiences occur for females with ASD but no diagnosis, who may be less likely to seek support as they are not already known to clinical services.…”

Autistic people’s perspectives on stereotypes: An interpretative phenomenological analysis

“…However, the accuracy of autistic stereotypes has been brought into question, with evidence suggesting that the vast majority of autistic people are not savants (Conn and Bhugra, 2012;Draaisma, 2009;Freeman-Loftis, 2015), or emotionless (Tierney, Burns and Kilbey, 2016). With this in mind, Garner, Jones and Harwood (2015) conducted a study using the Childhood Autism Rating Scale (CARS, 2) (Schopler, Van Bourgondien, Wellman et al, 2010) to measure the accuracy of film portrayals of autistic people according to 15 behavioural categories (e.g., relating, listening and intellect).…”