#francesca happe

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There are women with autism who go and speak about their experiences and are such gifted orators, so funny, so poised on stage, that people really doubt that they even have autism. But then if you could see that same woman trembling at the thought of having to buy a ticket at the train station or having to brush past a dog in the railway carriage to get to her seat, you see the ability of some women with autism to mask their difficulties. Even though it doesn’t fit the stereotype of autism, it doesn’t look like Rain Man or one of the portrayals of male autism in the media ... how brave they are to struggle to live in our neurotypical world.

Francesca Happe, a professor of cognitive neuroscience at the Institute of Psychiatry in London

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Socialisation might play a key role in how girls and women on the autism spectrum present, however, there’s growing suspicion that the underlying biology of ASD in males and females is quite different. ‘I think there are probably both biological differences and social and cultural reasons why we may not be very good at picking up autism in girls. We’ve done some work that suggests that girls who have autism have been hit harder or have a larger genetic dose than boys with autism,’ says Happe. ‘You can tell this because if you look at their brothers and sisters, the brothers and sisters of girls with autism are more likely to have autism or some traits of autism than the brothers and sisters of boys with autism. That’s suggesting there’s a bigger genetic hit for girls than for boys,' says Prof. Happe.

Lynne Malcolm and Olivia Willis, 'Why autism spectrum disorders are under-diagnosed in women and girls', ABC News

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Males are generally more affected by neurodevelopmental disorders than females, and boys account for more instances of ADHD, dyslexia and dyspraxia during adolescence. It appears that this imbalance is even more pronounced when it comes to autism spectrum disorder (ASD). But as Francesca Happe, a professor of cognitive neuroscience at the Institute of Psychiatry in London, explains, statistics tell only part of the story. ‘The general prevalence suggests that about four times as many males as females get an autism diagnosis, and this varies across the spectrum,’ she says. ‘So the proportions are higher in high functioning or more subtle forms of autism, and more even at the lower end of the spectrum where there is an intellectual impairment. We know very, very little really about how autism presents in girls and women. There are some studies, but the main problem is that the studies start in a clinic. If we are missing women and girls with autism because we are not good at recognising them, then studying those we do spot isn’t going to tell us very much about the ones we miss.’

Lynne Malcolm and Olivia Willis, 'Why autism spectrum disorders are under-diagnosed in women and girls', ABC News