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Women and girls with autism may face greater challenges with day-to-day tasks, study finds

Katleya

Sarcasm Lover
V.I.P Member
This article was brought to my attention by the lovely staff at a non-profit I interact with, and I thought some of you might find it interesting. It links to a longer study; I would have liked some practical examples of their findings, but perfection doesn't exist...
You can find the source here.


Women and girls with autism may face greater challenges with real world planning, organization, and other daily living skills, according to a study published in the journal Autism Research.

Led by researchers within the Center for Autism Spectrum Disorders at Children's National Health System, the National Institute of Mental Health, and The George Washington University, the study is the largest to date examining executive function-including the ability to make a plan, get organized, and follow through on the plan as needed-and adaptive skills-ability to perform basic daily tasks like getting up and dressed or making small talk- in women and girls with ASD.

"Our goal was to look at real world skills, not just the diagnostic behaviors we use clinically to diagnose ASD, to understand how people are actually doing in their day to day lives," says Allison Ratto Ph.D., a psychologist in the Center for Autism Spectrum Disorders at Children's National and one of the study's authors. "When parents were asked to rate a child's day-to-day functioning, it turns out that girls were struggling more with these independence skills. This was surprising because in general, girls with ASD have better social and communication skills during direct assessments. The natural assumption would be that those communication and social skills would assist them to function more effectively in the world, but we found that this isn't always the case."

The study collected parent-reported data from several rating scales of executive function and adaptive behavior, including the Behavior Rating Inventory of Executive Function, Parent Form (BRIEF) and the Vineland Adaptive Behavior Scales-II (VABS-II). The group included 79 females and 158 males meeting clinical criteria for autism spectrum disorders, ranging in ages from 7 to 18 years old. The groups were matched for intelligence, age and level of autism and ADHD symptoms.

The findings are part of a growing body of research focused on how ASD may affect females differently than males. The ratio of girls to boys with autism is approximately three to one. As a result of the larger numbers of males, existing data is predominantly focused on traits and challenges in that population. This is especially true in clinical trials, where enrollment is overwhelmingly male.

"Our understanding of autism is overwhelmingly based on males, similar to the situation faced by the medical community once confronted with heart disease research being predominantly male," notes Lauren Kenworthy, Ph.D., director of the Center for Autism Spectrum Disorders and the study's senior author. "We know how to identify signs, symptoms, and treatments for autism in males, but we know very little about unique aspects of it in females."

The historical lack of specific discovery around how autism presents in females may contribute to misdiagnosis or delay, and prevent implementation of necessary interventions. Such delays can have a major impact on outcomes, as recent research has demonstrated the critical importance of early diagnosis and intervention in ASD.

"Our focus in caring for children with autism is equipping ALL of them with strategies and skills to allow them to function and succeed in day-to-day living," Dr. Kenworthy continues. "This study highlights that some common assumptions about the severity of challenges faced by girls with ASD may be wrong, and we may need to spend more time building the adaptive and executive function skills of these females if we want to help them thrive."

"Enhancing our understanding of how biological differences change the presentation of autism in the long term is crucial to giving every person with ASD the tools they need to succeed in life," she concludes.

Study:
Females with Autism Show Greater Difficulty with Day-to-Day Tasks than Male Counterparts - Children's National Health System
 
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I've always believed that woman with ASD always worked harder to hide their social deficiencies. Sadly though, this has worked towards their determent. All they are doing is just bottling up all this pain inside.
 
I thought executive function was an umbrella term for many things, not just organization and adaptive skills. I can organize myself and I can adapt. It might not be natural, but I can do it, and so can my daughter.

I thought executive function was also multitasking (fail) paying attention at something that does not interest me (fail) remembering things I’ve heard without writing them down (fail), having regular to bad fine motor skills or being clumsy (guilty). There might be other issues that I don’t remember...

Just because I feel like ranting: my almost 13-year-old daughter does not know how to eat ‘decently’ with a fork and knife and I give up:eek:; and doesn’t like to brush her hair either, and I give up.

And because I feel like showing off: she just finished the five Percy Jackson books in less than two weeks :p.
 
I'm not sure if it's that we struggle any more than men with executive functioning. I think women just have more daily random tasks they have to do compared to men. Things like getting ready for work always take me about 40 minutes longer than any man I've lived with since I'm expected to wear make up, do something tidy with my masses of hair, pluck my eyebrows, keep my nails looking nice, etc. It's worse if you have a female boss, as they notice very quickly if you 'don't look professional'. I've always had more comments from female managers than male ones if I was in a rush and only had an hour to get ready. Women are still judged far more on appearance, so if you want to blend in then you have to play that game. But it does mean remembering all those little extra things.
 
My executive functions are a disaster. I lose things that are sitting right next to me that I put there only seconds ago. I have burned stuff on the stove while standing there stirring something on the burner next to it. Never seem to get the order right for doing something no matter how many times I do it. All I seem to do is make list and go over list and forget my list. Have no idea if males have a many problems with the executive functioning as females, though. I only know that is a huge problem for me and I'm a no make-up, barely comb my hair type of person(I do shower daily, I'm not gross, I promise).
 
I always assumed AS females had it far easier because women generally take passive roles in social situations making it far easier to make friends and find a mate whereas we males have to be initiators and aggressors or we'll spend our lives alone. I was never quite sure of the downsides to being a female Aspie.
 
I thought executive function was an umbrella term for many things, not just organization and adaptive skills. I can organize myself and I can adapt. It might not be natural, but I can do it, and so can my daughter.

I thought executive function was also multitasking (fail) paying attention at something that does not interest me (fail) remembering things I’ve heard without writing them down (fail), having regular to bad fine motor skills or being clumsy (guilty). There might be other issues that I don’t remember...

Just because I feel like ranting: my almost 13-year-old daughter does not know how to eat ‘decently’ with a fork and knife and I give up:eek:; and doesn’t like to brush her hair either, and I give up.

And because I feel like showing off: she just finished the five Percy Jackson books in less than two weeks :p.
I identify with all the things you've said here - even about your daughter. My 9 year old daughter is exactly the same (though not diagnosed as she apparently doesn't show enough indicators for them to consider her for assessment)
 
I always assumed AS females had it far easier because women generally take passive roles in social situations making it far easier to make friends and find a mate whereas we males have to be initiators and aggressors or we'll spend our lives alone. I was never quite sure of the downsides to being a female Aspie.

Is social ostracism different for men than for women?

Ie. the single guy living alone - how dangerous is it for him versus a woman?

The village around him may develop ideas about how weird he is.... certain news items may make him a target... ie he's a pedophile etc, all rumors that can manifest in the village of yahoos.

A woman ,alone,never goes out.... the weird cat lady?, the witch,

How do the different dangers manifest to the man or woman alone in that situation?
From the wider world. Etc.
What help is available?
Would a man or woman be treat differently by the wider society in perception or asking for help?
 
Is social ostracism different for men than for women?

Ie. the single guy living alone - how dangerous is it for him versus a woman?

The village around him may develop ideas about how weird he is.... certain news items may make him a target... ie he's a pedophile etc, all rumors that can manifest in the village of yahoos.

A woman ,alone,never goes out.... the weird cat lady?, the witch,

How do the different dangers manifest to the man or woman alone in that situation?
From the wider world. Etc.
What help is available?
Would a man or woman be treat differently by the wider society in perception or asking for help?
I can't tell if you are asking me questions or being snarky.
 
I always assumed AS females had it far easier because women generally take passive roles in social situations making it far easier to make friends and find a mate


Now imagine an initiator and aggressor trying to act passively in order to fit in to an acceptable, social, female role.
How easy do you imagine that to be?

Observation and mimicry is generally thought to be easier for females to practice but it's an act, hard work and can't be maintained indefinitely (without a break or a melt down)
 
I lose things that are sitting right next to me that I put there only seconds ago.

I constantly lose the TV remote, when I just put it down next to me.

I always assumed AS females had it far easier because women generally take passive roles in social situations making it far easier to make friends and find a mate whereas we males have to be initiators and aggressors or we'll spend our lives alone. I was never quite sure of the downsides to being a female Aspie.

I know you put "generally", but I still felt the need to point out that there are plenty of women (NT and ASD) who are not passive.

I'd also take living alone for the whole of my life than being a passive little wallflower getting walked over by everyone.
 
I thought executive function was an umbrella term for many things, not just organization and adaptive skills. I can organize myself and I can adapt. It might not be natural, but I can do it, and so can my daughter.

I thought executive function was also multitasking (fail) paying attention at something that does not interest me (fail) remembering things I’ve heard without writing them down (fail), having regular to bad fine motor skills or being clumsy (guilty). There might be other issues that I don’t remember...

Just because I feel like ranting: my almost 13-year-old daughter does not know how to eat ‘decently’ with a fork and knife and I give up:eek:; and doesn’t like to brush her hair either, and I give up.

And because I feel like showing off: she just finished the five Percy Jackson books in less than two weeks :p.
That's one of the reasons I feel the article and the study that was published (a much longer read than the article) is missing some clear examples.
I understood executive function to be an umbrella term as well, but I couldn't say if adaptive skills are part of it or not. And even then... what type of adaptation? Sure, there are things I can adapt to, plenty of them. But there are also a variety of situations where, if I learn what to do in Scenario A, and a variation is introduced that would make it Scenario B, I might be completely clueless as to what to do, and unable to transfer the knowledge I would use in Scenario A to Scenario B.
I can plan some things, but I'm awful at planning others: sure, if I need to travel, you better believe I will create a PowerPoint complete with itinerary, schedules, transportation, hotel, and so on. But give me 5 tasks to complete at work, asking me to rank them in order of priority (if it's not obvious with actual deadlines), and you would never believe you're talking to that same person who makes travel PowerPoints. Throw in an unexpected event, such as delay in a reply from someone, because no job goes without its share of surprises, and you're looking at a disaster in the making.

I'm not sure if it's that we struggle any more than men with executive functioning. I think women just have more daily random tasks they have to do compared to men. Things like getting ready for work always take me about 40 minutes longer than any man I've lived with since I'm expected to wear make up, do something tidy with my masses of hair, pluck my eyebrows, keep my nails looking nice, etc. It's worse if you have a female boss, as they notice very quickly if you 'don't look professional'. I've always had more comments from female managers than male ones if I was in a rush and only had an hour to get ready. Women are still judged far more on appearance, so if you want to blend in then you have to play that game. But it does mean remembering all those little extra things.
I think in that case, they were looking at the completion of certain tasks in particular, without the influence of other tasks throughout the day.
My "beauty routine" is actually one of the most streamlined, efficient and optimized things in my life, along with putting together outfits. Everything is lined up, timed, in a very set order. Now, I have a set of binders with all my administrative stuff: it's all in the binders, and I don't see it, so it's like the paperwork is in a perpetual blackhole. For me to see it, it would need to be out on the desk... and if everything is out on the desk, some things are bound to be out of sight (and back in the black hole). That's the organization I suck at. Ask me about my appointments, if I can't find my diary AND the desk calendar, I'm lost. Lost, lost, lost, mind going blank and all. Which is odd, because I'm quite the systematizer, otherwise. Having grooming expectations that differ from men plays zero role in that, at least in my experience.

(I mean... one night years ago before I even heard the word Asperger's, I was so lost in some paperwork tasks at work --note, one night, everybody else in the company had left already--, I had to call my mother and beg her to come help me. At my workplace. All I needed was for her to sit across me and watch me work. What took over 3 hours of "what the heck am I supposed to do, why am I here, what am I doing?" and some tears was finished in under 45 minutes, just by being watched by a friendly, familiar person. In high school, I couldn't even read the assigned books unless she sat in my room and timed me, going "Next" every minute to let me know I needed to turn the page, otherwise I'd just wander and stay stuck on a phrase that I found weird)
 
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"My "beauty routine" is actually one of the most streamlined, efficient and optimized things in my life, along with putting together outfits."

Teach me, oh wise one!!
 
I really struggle with EFD. BTW, its an official diagnosis in the DSM as of 2019 (Frontal lobe damage; Executive Function Deficit). So not really as much of an umbrella term as it used to be. Some of the things it includes for me and others: forgetting everything unless written down and referred to over and over, clutter and disorganization, losing stuff all the time, forgetting where I put stuff I just had, not remembering names for months and months, not able to put the face with the name (this really did NOT endear me to people of color at work! And I can't explain its EFD not racism cause of where I work), getting lost on the road, getting lost even with a GPS that talks and has a visual map, getting lost in a restaurant, driving really badly - like the wrong way on a one-way street, leaving the stove on, or the coffee pot on, forgetting who I told what to, irritability and difficulty controlling anger, multitasking is a train wreck, I'm late all the time, everywhere, no matter how much I plan and try not to be late, having to go back in the house multiple times to get whatever I remembered I forgot, anything done 'out of the usual routine' is probably gonna get messed up now or later, I could go on and on....
 
I really struggle with EFD. BTW, its an official diagnosis in the DSM as of 2019 (Frontal lobe damage; Executive Function Deficit). So not really as much of an umbrella term as it used to be. Some of the things it includes for me and others: forgetting everything unless written down and referred to over and over, clutter and disorganization, losing stuff all the time, forgetting where I put stuff I just had, not remembering names for months and months, not able to put the face with the name (this really did NOT endear me to people of color at work! And I can't explain its EFD not racism cause of where I work), getting lost on the road, getting lost even with a GPS that talks and has a visual map, getting lost in a restaurant, driving really badly - like the wrong way on a one-way street, leaving the stove on, or the coffee pot on, forgetting who I told what to, irritability and difficulty controlling anger, multitasking is a train wreck, I'm late all the time, everywhere, no matter how much I plan and try not to be late, having to go back in the house multiple times to get whatever I remembered I forgot, anything done 'out of the usual routine' is probably gonna get messed up now or later, I could go on and on....

I used to be like that. Changing to a minimalistic lifestyle has improved things a lot, along with a life-long self-improvement process.

Still, there’s days, like today, when I am exhausted and it takes all the energy that I have just to live and get the essential duties of being a mom, done.

I don’t “work”, but I have an alimony from my ex husband until the kids are old enough to move out.

I have no idea what I’ll do when they don’t live with me anymore. I’ll be 55, with almost no job experience, because I cannot fathom how can I be a mom and also work, when “just” being a single mom takes up all of my energy (the ex is an absent father, and I live in a foreign country, without any other family members or close friends living in my city; I can’t afford a nanny or a maid, either).

Lately I’ve been having recurrent fatalistic thoughts of becoming an old homeless person, or just “disappearing” in a car accident when my youngest kid leaves for college.
 
I thought executive function was an umbrella term for many things, not just organization and adaptive skills. I can organize myself and I can adapt. It might not be natural, but I can do it, and so can my daughter.

I thought executive function was also multitasking (fail) paying attention at something that does not interest me (fail) remembering things I’ve heard without writing them down (fail), having regular to bad fine motor skills or being clumsy (guilty). There might be other issues that I don’t remember...

I 100% agree. It's very similar for me when it comes to Executive Functions.
 

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