Characteristics of Adult Females with Autism Spectrum Disorders in a Large Multicultural Sample

Background:

Female Autism has been generating increasing efforts in research still most adult females studies of ASD has targeted neuro anatomical differences or specific cognitive profiles, but little efforts have been made to understand and describe the characteristics of adult women with ASD in depth and in large cross-cultural Spanish speaking sample.

Objectives:

The aim of the study was to design an online questionnaire and analyze in depth a large sample of woman with ASD in diagnostic routes, comorbidity, socialization strategies, special interests, sensory profile, developmental history, self-regulation and personal autonomy.

Methods:

After a period of exhaustive literature revision, an online Spanish questionnaire was designed and completed voluntarily by 265 woman of whom 188 had a formal diagnosis from a reliable and traceable source and were older than 18 years old. Statistical data was analyzed with SPSS for descriptive results n=188.

Results:

Participants were from 22 countries, most of them from Spain, México, Argentina, Venezuela and Chile aged from 18 to 73. The average delay for diagnosis was 5 years. Half of the women were mothers. Previous diagnosis and comorbidity were similar depression (40%, 34%) anxiety (36% 46%) eating disorders (11%, 20%) among others. Most women reported to have one or two friends, and many used socializing strategies as observation (63%) social scripts planning (58%), imitation, back analysis, (47%) and analysis of films and movies (40%). Memory and vocabulary were perceived as strengths by a large part of the sample (70%).Most woman reported social related hiper sensitivity (crowded places, physical contact, and sounds 65-70%). Anger behavior were explosive in many cases (57%) or blockage (54%).Interest in infancy were perceived as different from peers (70%) but more conventional in adulthood with striking interest in reading (63%) human behavior (35%) and psychology (39%) In their development they reported to had challenges in group play as girls (61%) and public speaking (60%).

Conclusions:

Though many limitations, for the size and depth of the study results has many implications. Diagnosis and identification of woman with autism is still late and a challenge in many countries, women are first treated for their comorbidities. Most of diagnosis routes resulted in comorbid conditions and more effort should be done for screening and diagnosis instruments design to clinical judgement and training.

Very few women did not have friends, and that support literature that woman might have better socials skills than males, their accommodation is less intuitive and more cognitive than neurotipicals, and indicate that camouflage strategies from literature do exist, however they might mask symptoms. In addition, emotional regulation is not always successful as might be polarized. Results on development history support the subtle presentation hypothesis during childhood, and more evidence during adolescence. In depth analysis of results might be helpful for identification and program design, an urgent need to guarantee appropriate diagnosis and treatment across different community and countries.