Women and Girls with ASD Misdiagnosed

An estimated 2.21% of the adult US population has ASD. Although ASD occurs in males and females, recent research indicates that women and girls are more likely to be misdiagnosed with this disorder. According to the Centers for Disease Control (CDC), boys are four times more likely to be diagnosed with autism than girls. Increasing evidence, however, suggests that the reason for the diagnostic discrepancy may be the fact that women and girls are more likely to be misdiagnosed.

Male to Female ASD Ratios

Historically, ASD has been found to be more prevalent in males than females, with an estimated ratio of 4:1. However, this discrepancy is not believed to be due to females missing criteria for ASD. Instead, a growing body of research has found that females are under and misdiagnosed with ASD because of presentation differences, gender bias, socialization, and male-focused research.

Different Presentation and Masking

Autism is a developmental disorder that typically presents through communication and social skills deficits and repetitious behavior. Generally, females tend to be more adept at “masking” or “camouflaging” their symptoms.

Masking refers to when individuals internalize their symptoms to attain social acceptance. Research suggests that females with ASD may be underdiagnosed because neurodivergent girls and women tend to engage in "masking." While males with ASD may also mask, their use is often connected to certain discrete social situations. By contrast, females are more likely to be socialized to please others. This socialization may lead to girls and women with ASD developing reactive and ongoing masking tendencies that conceal more of their diagnostic features. Further, females that have been socialized in this manner may make a concerted effort to devote their energy to homework and making friends. Social interactions with peers can lead to diagnostic delays and may also contribute to underdiagnosis.

Repetitive Behaviors

Another reason females may be misdiagnosed is because tend to have less recognizable restricted and repetitive behaviors. When looking for an autism diagnosis, medical professionals look for the typical repetitive behaviors exhibited by boys. However, girls may have these same behaviors manifested in different ways. In fact, according to a 2022 study, many girls with autism never demonstrate repetitive or restricted behaviors. This diagnostic bias leads to many girls not receiving the assistance they need.

Higher Exclusion of Females in Testing and Research

Testing deficiencies may be another reason that females are not being diagnosed correctly. Recently, Massachusetts Institute of Technology (MIT) researchers found that a "test commonly used to determine eligibility for studies of autism consistently winnows out a much higher percentage of women than men, creating a “leaky pipeline” that results in severe underrepresentation of women in studies of autism.”

Studies have also shown that females continue to be underrepresented in ASD research. ASD not presenting in females in the same manner as males may contribute to females being excluded from research subject groups.

Misdiagnosis

In addition, research has also shown that girls and women are often misdiagnosed. According to a 2021 study, females were less likely to be correctly diagnosed and more likely to be misdiagnosed on their first evaluation than males. Further, researchers also found that when compared to males, females showed a significantly greater delay in referral to mental health services and a significantly higher age at diagnosis of ASD.

If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental disabilities. To schedule a consultation, contact us or call (509) 991-7058.

Death sentence from 1992 tossed over ‘delusional’ self-representation

The California Supreme Court on Monday threw out the 1992 death sentence of a man convicted of a series of murders and robberies because he was allowed to represent himself at trial even though a psychological examination had found he likely suffered from a delusional thought disorder.

The court on Monday issued a ruling that Billy Ray Waldon's conviction and sentence had to be vacated. The trial judge who in 1989 allowed Waldon to represent himself at trial, the court said, had been wrong to reverse the decision by another judge from a year before finding Waldon didn't rationally perceive his situation and didn't realize the risks and consequences of not having a defense lawyer representing him.

NY students ‘deliberately inappropriately’ restrained 214 times in recent years, state says

State investigators found staff at New York schools serving children with disabilities intentionally misused physical restraints on students dozens of times annually in recent years, records obtained by the Times Union show.

The Justice Center for the Protection of People with Special Needs, a state agency that investigates allegations of mistreatment, substantiated 214 such cases between 2016 and 2021. The center classifies these encounters as a form of abuse.

How could a mother allegedly kill her children? Experts say mental health can distort thinking.

It seems beyond comprehension: A Duxbury woman has been charged with murdering two of her children, ages 3 and 5, and her third, a 7-month-old, has been hospitalized with traumatic injuries.

Neighbors said they never noticed anything unusual about the home with weathered shingles and a swing set in the backyard. And indeed little is known about what preceded the horrible occurrences of Tuesday evening. Authorities said the mother, Lindsay Clancy, jumped out of a second-story window in what may have been a suicide attempt, and remains hospitalized.

What would prompt a mother to do such a thing?

Autism rates have tripled. Is it now more common or are we just better at diagnosis?

Autism rates tripled among children in the New York and New Jersey metropolitan area from 2000 to 2016, according to a study published Thursday in the journal Pediatrics.

The authors, a team from Rutgers University, calculated the trend by analyzing Centers for Disease Control and Prevention estimates of the number of children who've been identified as having autism spectrum disorder by age 8.

Although there is no medical test for autism, the CDC has established a network of 17 sites across the country that estimate autism rates based on a combination of formal medical diagnoses and records from schools and health care providers.

A better Rx for mental health crisis

This winter has seen a renewed focus on severe mental illness and discussion of how New York can best address the health and safety of these residents. As an emergency room psychiatrist, I began my career on the front line of addressing mental health crises in NYC and saw firsthand the limitations that short-term interventions have on bringing long-term health and stability to residents living with these health concerns.

In a city where an estimated 1 in 25 residents have a severe mental illness, involuntary commitment and a revolving door of emergency department visits have become a permanent stopgap for those with acute needs yet do little to alleviate the root of these residents’ troubles.

High Court Could Change The Rights Of Students With Disabilities To Sue For Damages

The U.S. Supreme Court this week considered whether students with disabilities can seek financial relief under a federal law prohibiting discrimination even if they’ve already settled a case under the Individuals with Disabilities Education Act.

Comments and questions from the justices seemed to lean toward yes.

“All she wants is to be compensated for what she says occurred to her during the period of her education,” Associate Justice Ketanji Brown Jackson said, offering a hypothetical example of a senior who wants to drop out. “Does she have to sit in front of a hearing officer and talk about ways in which her education could be changed?”