APD & Autism: The Impact on Women and Female Adolescents

Common myths related to autism state that males are more likely to be diagnosed with autism than females. While there are autism prevalence studies that males are more likely to have autism than females, recent studies suggest that the predominance of males in autism may be decreasing which suggests a lesser chance of child autism therapy for female children with autism. 

Even with Auditory Processing Disorder (APD), certain studies state that boys are more likely to get diagnosed with APD than girls, which also leads to learning delays – “higher levels of hearing loss is slightly higher among males than among females”

Gender stereotypes influenced male-centric views on Autism Spectrum Disorder (ASD), but the real question that prevails:

How did the percentage of women and adolescent females developing autism or Auditory Processing Disorder rise up in the last few years? And do child autism therapy interventions differ for females than male?

Why was autism considered a predominantly male condition?

Equally critical, do gender-specific trajectories of autism result in missed or delayed diagnosis for females ? If so, are more female children deprived from necessary child autism therapy than their male counterparts?

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APD and Autism in Female

What is The Female Protective Effect? 

When it comes to girls, autism affects them differently. This happens probably due to the way they express their autism which does not meet the current diagnostic criteria. What is shocking is that the mild symptoms of autism in girls are brushed aside because their restricted interests seem normal according to social norms. 

With girls reaching their teen self in terms of language and communication, while some try to blend in, also resulting in anxiety and depression, others signify an inherent component of camouflaging which reduces the likelihood of developing autism, also laying out the term ‘female protective effect.‘ 

Even with significant autistic symptoms and challenges faced by female adolescents, the girls hid in plain sight because they are better at hiding when they are young, but also because they don’t fit the typical presentation of autism. 

Do Autistic Female Adolescents Present Differently Than Boys? 

Unlike the typical characterisation of girls with ASD, teenage females are less likely to act out along with a quieter presentation. And since girls or female adolescents are better at camouflaging their autistic symptoms for the purpose of fitting in, their signs may go unnoticed or misdiagnosed, especially when the female is verbally fluent and equipped with normal intelligence. 

Researchers found that girls with ASD are equipped with less obvious autistic symptoms than boys, one of them being repetitive and restricted behaviours. With the same diagnosis of autism performed on both boys and girls, most studies found autistic traits in both genders. However, the lack of behaviour and learning issues in girls results in developmental paediatricians or other autism professionals missing the tools to diagnose ASD for them. 

This is why girls are not diagnosed with autism until adolescence when peer pressure and being distinctive makes it difficult to cope with the comprehensive rules of social relationships. 

Symptoms of Autism in Girls

Girls with autism are more likely to have anxiety and depression, which can lead to self-isolation. In adolescence, these challenges can manifest as poor performance in school and difficulty navigating peer relationships. 

And, autistic girls are much more likely to be bullied than boys, which leads them to avoid social situations. Researchers also found a low percentage of girls who are diagnosed with ASD seek treatment for their condition.

Let’s look at some of the signs and symptoms of autism and what it looks like in girls or female adolescents.

  • Being unusually attached to objects – Autistic girls or women become a bit restrictive yet passionate about specific interests, such as music, animals, art or literature.  
  • Having issues in following instructions – While there is a desire to organise objects, girls with ASD mostly fail to play cooperatively with their female peers. 
  • Difficulty in understanding other people’s feelings – Since female adolescents experience a bit of an understanding issue related to how other people are feeling, they tend to keep their conversations restricted to limited people. 
  • Avoiding eye contact – While there is difficulty with social interaction when it comes to autistic adults, girls with ASD have a tendency to blend in and the ability to hold their emotions in social situations or a public space, such as school. 
  • Anxiety and meltdowns – Frequent meltdowns are somewhat a sign of autism. However, autistic women use their ability to keep up with the situation to camouflage or be prone to meltdowns. It should be noted that with age, female adolescents may gradually find themselves in situations that can lead to frustration, anxiety and isolation.

They may also engage in repetitive behaviours, such as hand flapping or spinning.

Girls on the spectrum tend to be less verbal than boys, and they may have difficulty making eye contact. Additionally, girls with autism often struggle with social skills and may have a hard time understanding nonverbal cues. And they still go unnoticed because their quiet and introverted signs are assumed as their personality, and no eye contact gives the characteristics of a typically shy and naive female adolescent.

Girls with autism also experience higher rates of mental health problems, including eating disorders and obsessive-compulsive disorder (OCD). 

APD Affect Women in Terms of Language and Communication

How does APD Affect Women in Terms of Language and Communication? 

Auditory processing disorder (APD) is a neurological condition that affects the way the brain processes sound. The symptoms of APD can vary, but they often include difficulty understanding speech, trouble following directions, and poor listening skills. 

A person with APD may also experience hypersensitivity to loud noises or inaudible sounds. It’s important for girls and female adolescents to be screened for auditory processing disorder because it can make them more susceptible to conditions like anxiety or depression. 

Women or female adolescents with APD may find it hard to:

  • Understand where a sound is coming from. 
  • Follow instructions.
  • Listen to music.
  • Hear speech in a noisy environment.
  • Maintain attention. 
  • Remember verbal instructions.

The diagnosis of APD has always been controversial, which is why it is not universally recognised as a disorder and, therefore, isn’t a part of the DSM V (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition). This happens mostly because the symptoms of APD overlap with the symptoms of other conditions, such as autism. Also, certain research shows that APD is a comorbidity of autism.

With a controversial label, girls with APD symptoms either cope with the situation or get neglected due to a lack of required diagnosis tools, which further results in missed or misdiagnosis of autism. 

How Can Parents Tell If Their Child has Autism or Auditory Processing Disorder?

There is no definitive answer to this question. However, there are certain behaviours and signs that may indicate that a child has autism or auditory processing disorder. 

For example, they may have trouble making eye contact or understanding other people’s feelings or talking about their own feelings. They may also be very good at some things but not others.

An autistic person might be very interested in one topic (for example trains) but not care about anything else around them. They might also have some unusual behaviours such as hand-flapping or body rocking when they get excited about something or when they are anxious.

A common sign of APD is an aversion to loud noises. The sound of a vacuum cleaner can be unbearable for someone with APD, while the sound of the rain outside can be soothing and comforting. 

Another possible sign is difficulty in understanding rapid speech, such as when listening to children’s books read aloud. Another sign of APD is a preference for music that sounds very different from what most people listen to, which could include music without vocals or without drums. 

Those who have APD might also have trouble hearing changes in pitch. These types of changes in pitch are important to help make sense of what people say, especially when it comes to more than one person talking at once. 

If your child might have APD, pay attention to how they react during situations where there are many conversations going on at once, such as school assemblies or crowded areas like supermarkets.

Observe their development over time. In general, children with autism tend to show delays in communication and social skills before the age of three, so look for any problems or delays with these skills and help them as soon as they are diagnosed with child autism therapy along with necessary intervention.

Parents Tell If Their Child has Autism or Auditory Processing Disorder

What is The Impact of a Late or Missed Autism Diagnosis on Female Adolescents?

A late or missed autism diagnosis can have a profound impact on female adolescents. Without an early diagnosis, these girls may not receive the support and services they need to reach their full potential. 

As a result, they may experience greater social isolation, anxiety, and depression. They may also be at increased risk for self-harm. Early diagnosis and intervention are critical for ensuring that these girls get the help they need to thrive.

Bring the Ultimate Change for Women and Female Adolescents with Autism or APD

Though the number of girls and women being diagnosed with autism is on the rise, there is still a lack of understanding when it comes to the needs of this population. In order to better support autistic women and girls, we need to: 

  • Address the fact that girls and women are more likely to be misdiagnosed or undiagnosed altogether. 
  • Increase awareness of how autism and symptoms of APD present differently in females. 
  • Advocate for more research specifically focused on autism & auditory processing disorder in females. 
  • Improve access to resources and support specifically tailored for autistic women and girls. 

Many of the symptoms of autism are seen as socially acceptable in girls, so they’re often written off as quirky or eccentric. But when you engage with our autism specialists, you come across a range of services and tools that can help you in redefining your life. 

The spectrum assessments conducted by our autism specialists help them in understanding the difficulties you have been experiencing related to auditory processing and other neurological disorders so that they can guide you to the right information, service and support you need. 

The Tomatis® Method, developed by Dr. Alfred Tomatis, works as access to the brain that effectively retrains the balance, auditory processing, and coordination while also repatterning the connections between the ear, brain, and body. 

Tomatis® Australia makes sure that autistic women and girls have a voice in shaping the conversation about autism. We understand that there’s a lot you probably don’t know about autism, but what you should know is that the condition is underdiagnosed in women and girls. 

We need to change the way we think about autism in order to ensure that more women and girls receive the diagnosis and support they need.

Comment below to share your story that involves a girl, woman or female adolescent with autism or APD.

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Françoise Nicoloff

Official Representative of Tomatis Developpement SA in Australia, Asia and South Pacific, Director of the Australian Tomatis® Method, Registered Psychologist, Certified Tomatis® Consultant Senior, Tomatis® International Trainer and Speaker, Co-author of the Listening Journey Series, 40 Years of Experience, Neurodiversity Speaker

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