Abstract
This chapter deals with the unique characteristics of women on the High-Functioning end of the Autism Spectrum (HFA), a group that is underrepresented in the research literature. Research findings support the hypothesis that women with Autism Spectrum Disorder (ASD) are different from men with ASD in many ways. The issue of late diagnosis or misdiagnosis, camouflaging of autistic characteristics, and the risks of gender-dependent phenotypes of ASD, is explored through a contemporary literature review and using personal interviews conducted with a sample of adult women on the high-functioning end of the autism spectrum. The findings suggest the need for a focused effort to construct diagnostic tools for the identification and treatment of girls and women with ASD-HF, and to correct the long-standing discrimination in diagnosis and treatment. Conclusions address some relevant recommendations for the professional staff and therapists.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Attwood, T. (2007). The complete guide to Asperger’s syndrome. London: Jessica Kingsley Publishers.
Attwood, T. (2008). Is there a difference between Asperger’s syndrome and high functioning autism? Retrieved November 13, 2017, from http://www.tonyattwood.com.au/index.php/books-by-tony-m/resource-papers/69-is-there-a-difference-between-aspergers-syndrome-and-high-functioning-autism.
Attwood, T., Garnett, M. S., & Rynkiewicz, A. (2011). Questionnaire for Autism Spectrum Conditions (Q-ASC) [Measurement instrument]. Retrieved from: https://mindsandhearts.net/wp-content/uploads/2018/12/GQ-ASC_13-19_Years.pdf.
Baio, J., Wiggins, L., Christensen, D. L., Maenner, M. J., Daniels, J., Warren, Z., … Durkin, M. S. (2018). Prevalence of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveillance Summaries, 67(6), 1–23. http://dx.doi.org/10.15585/mmwr.ss6706a1.
Baldwin, S., & Costley, D. (2016). The experiences and needs of female adults with high-functioning autism spectrum disorder. Autism, 20(4), 483–495. https://doi.org/10.1177/1362361315590805.
Banach, R., Thompson, A., Szatmari, P., Goldberg, J., Tuff, L., Zwaigenbaum, L., & Mahoney, W. (2009). Brief report: Relationship between non-verbal IQ and gender in autism. Journal of Autism and Developmental Disorders, 39(1), 188–193. https://doi.org/10.1007/s10803-008-0612-4.
Bargiela, S., Steward, R., & Mandy, W. (2016). The experiences of late-diagnosed women with autism spectrum conditions: An investigation of the female autism phenotype. Journal of Autism and Developmental Disorders, 46(10), 3281–3294. https://doi.org/10.1007/s10803-016-2872-8.
Baron-Cohen, S. (2006). Hahevdel ha-mihuti: Gevarim, nashim v’hamoach hagavri hakitzoni [The meaningful difference: Men, women and the extreme male brain.] Tel Aviv: Am Oved.
Baron-Cohen, S., & Wheelwright, S. (2004). The empathy quotient: An investigation of adults with Asperger syndrome or high functioning autism, and normal sex differences. Journal of Autism and Developmental Disorders, 34(2), 163–175. https://doi.org/10.1023/B:JADD.0000022607.19833.00.
Barrett, S. L., Uljarević, M., Baker, E. K., Richdale, A. L., Jones, C. R., & Leekam, S. R. (2015). The Adult Repetitive Behaviours Questionnaire-2 (RBQ-2A): A self-report measure of restricted and repetitive behaviours. Journal of Autism and Developmental Disorders, 45(3), 680–692. https://doi.org/10.1007/s10803-015-2514-6.
Barrett, S. L., Uljarević, M., Jones, C. R. G., & Leekam, S. R. (2018). Assessing subtypes of restricted and repetitive behaviour using the adult repetitive behaviour questionnaire-2 in autistic adults. Molecular Autism, 9, 58. https://doi.org/10.1186/s13229-018-0242-4.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory-II. San Antonio, TX, 78, 204-2498. Retrieved from https://m.blog.naver.com/PostView.nhn?blogId=mistyeyed73&logNo=220427762670&proxyReferer=https%3A%2F%2Fscholar.google.co.il%2F.
Begeer, S., Mandell, D., Wijnker-Holmes, B., Venderbosch, S., Rem, D., Stekelenburg, F., & Koot, H. M. (2013). Sex differences in the timing of identification among children and adults with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(5), 1151–1156. https://doi.org/10.1007/s10803-012-1656-z.
Bölte, S., Duketis, E., Poustka, F., & Holtmann, M. (2011). Sex differences in cognitive domains and their clinical correlates in higher-functioning autism spectrum disorders. Autism, 15(4), 497–511. https://doi.org/10.1177/1362361310391116.
Brown, W. T., Jenkins, E. C., Friedman, E., Brooks, J., Wisniewski, K., Raguthu, S., & French, J. (1982). Autism is associated with the fragile-X syndrome. Journal of Autism and Developmental Disorders, 12(3), 303–308.
Carter, C. S. (2007). Sex differences in oxytocin and vasopressin: Implications for autism spectrum disorders? Behavioural Brain Research, 176(1), 170–186. https://doi.org/10.1016/j.bbr.2006.08.025.
Carter, A. S., Black, D. O., Tewani, S., Connolly, C. E., Kadlec, M. B., & Tager- Flusberg, H. (2007). Sex differences in toddlers with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37(1), 86–97. https://doi.org/10.1007/s10803-006-0331-7.
Centers for Disease Control and Prevention. (2016). Prevalence and characteristics of autism spectrum disorder among children aged 8 years: Autism and developmental disabilities monitoring network, 11 Sites, United States, 2012. Morbidity and Mortality Weekly Report, 65(3), 1–23. https://doi.org/10.15585/mmwr.ss6513a1.
Cohen, I. L., Tsiouris, J. A., Flory, M. J., Kim, S. Y., Freedland, R., Heaney, G., … Brown, W. T. (2010). A large scale study of the psychometric characteristics of the IBR modified overt aggression scale: Findings and evidence for increased self-destructive behaviors in adult females with autism spectrum disorder. Journal of Autism and Developmental Disorders, 40(5), 599–609. https://doi.org/10.1007/s10803-009-0908-z.
Connor, K. M., & Davidson, J. R. (2003). Development of a new resilience scale: The Connor-Davidson resilience scale (CD-RISC). Depression and Anxiety, 18(2), 76–82. https://doi.org/10.1002/da.10113.
Cridland, E. K., Jones, S. C., Caputi, P., & Magee, C. A. (2014). Being a girl in a boys’ world: Investigating the experiences of girls with autism spectrum disorders during adolescence. Journal of Autism and Developmental Disorders, 44(6), 1261–1274. https://doi.org/10.1007/s10803-013-1985-6.
Davidovitch, M., Hemo, B., Manning-Courtney, P., & Frombonne, E. (2013). Prevalence and incidence of Autism Spectrum Disorder in an Israeli population. Journal of Autism and Developmental Disorders, 43(4), 785–793. https://doi.org/10.1007/s10803-012-1611-z.
Dworzynski, K., Ronald, A., Bolton, P., & Happé, F. (2012). How different are girls and boys above and below the diagnostic threshold for autism spectrum disorders? Journal of the American Academy of Child and Adolescent Psychiatry, 51(8), 788–797. https://doi.org/10.1016/j.jaac.2012.05.018.
Eme, R. F. (1992). Selective female affliction in the developmental disorders of childhood: A literature review. Journal of Clinical Child Psychology, 21(4), 354–364. https://doi.org/10.1207/s15374424jccp2104_5.
Fattigh-Smith, M. (2009). Disproportionate referral rates may falsely impact the ratio of girls and women on the spectrum. Journal of Developmental Disabilities, 16(1), 53–56. Retrieved from https://search.proquest.com/docview/751423874?accountid=48286.
Fombonne, E. (2003). Epidemiological surveys of autism and other pervasive developmental disorders: An update. Journal of Autism and Developmental Disorders, 33(4), 365–382. https://doi.org/10.1023/A:1025054610557.
Fombonne, E. (2005). The changing epidemiology of autism. Journal of Applied Research in Intellectual Disabilities, 18(4), 281–294. https://doi.org/10.1111/j.1468-3148.2005.00266.x.
Frazier, T. W., Georgiades, S., Bishop, S. L., & Hardan, A. Y. (2014). Behavioral and cognitive characteristics of females and males with autism in the Simons Simplex Collection. Journal of the American Academy of Child and Adolescent Psychiatry, 53(3), 329–340. https://doi.org/10.1016/j.jaac.2013.12.004.
Giarelli, E., Wiggins, L. D., Rice, C. E., Levy, S. E., Kirby, R. S., Pinto-Martin, J., & Mandell, D. (2010). Sex differences in the evaluation and diagnosis of autism spectrum disorders among children. Disability and Health Journal, 3(2), 107–116. https://doi.org/10.1016/j.dhjo.2009.07.001.
Gould, J., & Ashton-Smith, J. (2011). Missed diagnosis or misdiagnosis? Girls and women on the autism spectrum. Good Autism Practice (GAP), 12(1), 34-41. Retrieved from https://www.ingentaconnect.com/content/bild/gap/2011/00000012/00000001/art00005.
Hartley, S. L., & Sikora, D. M. (2009). Sex differences in autism spectrum disorder: An examination of developmental functioning, autistic symptoms, and coexisting behavior problems in toddlers. Journal of Autism and Developmental Disorders, 39(12), 1715–1722. https://doi.org/10.1007/s10803-009-0810-8.
Hattier, M. A., Matson, J. L., Tureck, K., & Horovitz, M. (2011). The effects of gender and age on repetitive and/or restricted behaviors and interests in adults with autism spectrum disorders and intellectual disability. Research in Developmental Disabilities, 32(6), 2346–2351. https://doi.org/10.1016/j.ridd.2011.07.028.
Head, A. M., McGillivray, J. A., & Stokes, M. A. (2014). Gender differences in emotionality and sociability in children with autism spectrum disorders. Molecular Autism, 5(19), 1–9. https://doi.org/10.1186/2040-2392-5-19.
Hofvander, B., Delorme, R., Chaste, P., Nydén, A., Wentz, E., Ståhlberg, O., … Råstam, M. (2009). Psychiatric and psychosocial problems in adults with normal intelligence autism spectrum disorders. BMC Psychiatry, 9(35), 1–9. https://doi.org/10.1186/1471-244X-9-35.
Holliday-Willey, L. (1999). Pretending to be normal: Living with Asperger’s syndrome. London, UK: Jessica Kingsley Publishers.
Howe, Y. J., O’Rourke, J. A., Yatchmink, Y., Viscidi, E. W., Jones, R. N., & Morrow, E. M. (2015). Female autism phenotypes investigated at different levels of language and developmental abilities. Journal of Autism and Developmental Disorders, 45(11), 3537–3549. https://doi.org/10.1007/s10803-015-2501-y.
Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M., et al. (2017). “Putting on my best normal”: Social camouflaging in adults with autism spectrum conditions. Journal of Autism and Developmental Disorders, 47(8), 2519–2534. https://doi.org/10.1007/s10803-017-3166-5.
Israel Ministry of Health. (2013). Evaluation of children on the autism spectrum. Israel Ministry of Health: Jerusalem. Retrieved from https://www.health.gov.il/hozer/mk15_2013.pdf.
Joshi, G., Wozniak, J., Petty, C., Martelon, M. K., Fried, R., Bolfek, A., et al. (2013). Psychiatric comorbidity and functioning in a clinically referred population of adults with autism spectrum disorders: A comparative study. Journal of Autism and Developmental Disorders, 43(6), 1314–1325. https://doi.org/10.1007/s10803-012-1679-5.
Karjalainen, L., Råstam, M., Paulson-Karlsson, G., & Wentz, E. (2019). Do autism spectrum disorder and anorexia nervosa have some eating disturbances in common? European Child and Adolescent Psychiatry, 28(1), 69–78. https://doi.org/10.1007/s00787-018-1188-y.
Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H. U. (2012). Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International Journal of Methods in Psychiatric Research, 21(3), 169–184. https://doi.org/10.1002/mpr.1359.
Kirkovski, M., Enticott, P. G., & Fitzgerald, P. B. (2013). A review of the role of female gender in autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(11), 2584–2603. https://doi.org/10.1007/s10803-013-1811-1.
Kopp, S., & Gillberg, C. (2011). The Autism Spectrum Screening Questionnaire (ASSQ)-Revised Extended Version (ASSQ-REV): An instrument for better capturing the autism phenotype in girls? A preliminary study involving 191 clinical cases and community controls. Research in Developmental Disabilities, 32(6), 2875–2888. https://doi.org/10.1016/j.ridd.2011.05.017.
Kreiser, N. L., & White, S. W. (2015). ASD traits and co-occurring psychopathology: The moderating role of gender. Journal of Autism and Developmental Disorders, 45(12), 3932–3938. https://doi.org/10.1007/s10803-015-2580-9.
Lai, M. C., Lombardo, M. V., Auyeung, B., Chakrabarti, B., & Baron-Cohen, S. (2015). Sex/gender differences and autism: Setting the scene for future research. Journal of the American Academy of Child and Adolescent Psychiatry, 54(1), 11–24. https://doi.org/10.1016/j.jaac.2014.10.003.
Lai, M. C., Lombardo, M. V., Ruigrok, A. N., Chakrabarti, B., Auyeung, B., Szatmari, P., … MRC AIMS Consortium. (2017). Quantifying and exploring camouflaging in men and women with autism. Autism, 21(6), 690–702. https://doi.org/10.1177/1362361316671012.
Lai, M. C., Lombardo, M. V., Ruigrok, A. N., Chakrabarti, B., Wheelwright, S. J., Auyeung, B., … Baron-Cohen, S. (2012). Cognition in males and females with autism: Similarities and differences. PloS One, 7(10), e47198. https://doi.org/10.1371/journal.pone.0047198.
Lai, M. C., Lombardo, M. V., Pasco, G., Ruigrok, A. N., Wheelwright, S. J., Sadek, S. A., … MRC AIMS Consortium. (2011). A behavioral comparison of male and female adults with high functioning autism spectrum conditions. PloS one, 6(6). doi:https://doi.org/10.1371/journal.pone.0020835.
Levaot, Y., Meiri, G., Dinstein, I., Menashe, I., & Shoham-Vardi, I. (2019). Autism prevalence and severity in Bedouin-Arab and Jewish communities in southern Israel. Community Mental Health Journal, 55(1), 156. https://doi.org/10.1007/s10597-018-0236-x.
Maccoby, E. E. (1998). The two sexes: Growing up apart, coming together. Cambridge, MA: Harvard University Press.
Mattila, M. L., Kielinen, M., Linna, S. L., Jussila, K., Ebeling, H., Bloigu, R., & Moilanen, I. (2011). Autism spectrum disorders according to DSM-IVTR and comparison with DSM-5 draft criteria: An epidemiological study. Journal of the American Academy of Child and Adolescent Psychiatry, 50(6), 583–592. https://doi.org/10.1016/j.jaac.2011.04.001.
McGillivray, J. A., & Evert, H. T. (2014). Exploring the effect of gender and age on stress and emotional distress in adults with Autism Spectrum Disorder. Focus on Autism and Other Developmental Disabilities, 33(1), 55–64. http://dx.doi.org/1088357614549317.
Newson, E. (1988). Defining criteria for diagnosis of pathological demand avoidance syndrome, with comparison to autism. Ravenshead, UK: Child Development Research Unit, University of Nottingham/Early Years Diagnostic Centre.
Newson, E., Le Marechal, K., & David, C. (2003). Pathological demand avoidance syndrome: A necessary distinction within the pervasive developmental disorders. Archives of Diseases in Childhood, 88(7), 595–600. https://doi.org/10.1136/adc.88.7.595.
O’Nions, E., Viding, E., Greven, C. U., Ronald, A., & Happé, F. (2014). Pathological demand avoidance: Exploring the behavioural profile. Autism, 18(5) 538–544. https://doi.org/10.1177/1362361313481861.
Ormond, S., Brownlow, C., Garnett, M. S., Rynkiewicz, A., & Attwood, T. (2018). Profiling autism symptomatology: An exploration of the Q-ASC parental report scale in capturing sex differences in autism. Journal of Autism and Developmental Disorders, 48(2), 389–403. https://doi.org/10.1007/s10803-017-3324-9.
Parish-Morris, J., Liberman, M. Y., Cieri, C., Herrington, J. D., Yerys, B. E., Bateman, L., … Schultz, R. T. (2017). Linguistic camouflage in girls with autism spectrum disorder. Molecular Autism, 8. http://dx.doi.org/10.1186/s13229-017-0164-6.
Pearlman-Avnion, S. (2014). The low incidence of girls versus boys diagnosed as HF-ASD. In S. Lowinger (Ed.), Beyond the spectrum: Recent developments in the assessment and treatment of children with autism spectrum disorders (pp. 106–137). Kiryat Biyalik, Israel: Ach Publishers. [in Hebrew].
Råstam, M. (2008). Eating disturbances in autism spectrum disorders with focus on adolescent and adult years. Clinical Neuropsychiatry, 5(1), 31–42.
Rubenstein, E., Wiggins, L. D., & Lee, L. C. (2014). A review of the differences in developmental, psychiatric, and medical endophenotypes between males and females with Autism Spectrum Disorder. Journal of Developmental and Physical Disabilities, 27(1), 119–139. https://dx.doi.org/10.1007/s10882-014-9397-x.
Russell, G., Steer, C., & Golding, J. (2011). Social and demographic factors that influence the diagnosis of autistic spectrum disorders. Social Psychiatry and Psychiatric Epidemiology, 46(12), 1283–1293. https://doi.org/10.1007/s00127-010-0294-z.
Rutherford, M., McKenzie, K., Johnson, T., Catchpole, C., O’Hare, A., McClure, I., … Murray, A. (2016). Gender ratio in a clinical population sample, age of diagnosis and duration of assessment in children and adults with autism spectrum disorder. Autism, 20(5), 628–634. https://doi.org/10.1177/1362361315617879.
Rynkiewicz, A., Schuller, B., Marchi, E., Piana, S., Camurri, A., Lassalle, A., & Baron-Cohen, S. (2016). An investigation of the ‘female camouflage effect’ in autism using a computerized ADOS-2 and a test of sex/gender differences. Molecular Autism, 7(10), 1–8. https://doi.org/10.1186/s13229-016-0073-0.
Schuck, R. K., Flores, R. E., & Fung, L. K. (2019). Brief report: Sex/gender differences in symptomology and camouflaging in adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 1–8. http://dx.doi.org/10.1007/s10803-019-03998-y.
Schwarte, A. R. (2008). Fragile X syndrome. School Psychology Quarterly, 23(2), 290. https://psycnet.apa.org/doi/10.1037/1045-3830.23.2.290.
Spek, A. A., van Rijnsoever, W., van Laarhoven, L., & Kiep, M. (2019). Eating problems in men and women with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 1–8. http://dx.doi.org/10.1007/s10803-019-03931-3.
Sucksmith, E., Allison, C., Baron-Cohen, S., Chakrabarti, B., & Hoekstra, R. A. (2013). Empathy and emotion recognition in people with autism, first-degree relatives, and controls. Neuropsychologia, 51(1), 98–105. https://doi.org/10.1016/j.neuropsychologia.2012.11.013.
Szatmari, P., Liu, X. Q., Goldberg, J., Zwaigenbaum, L., Paterson, A. D., Woodbury-Smith, M., … Thompson, A. (2012). Sex differences in repetitive stereotyped behaviors in autism: Implications for genetic liability. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 159(1), 5–12. https://doi.org/10.1002/ajmg.b.31238.
Tantam, D. (1991). Asperger’s syndrome in adulthood. In U. Frith (Ed.), Autism and Asperger’s syndrome (pp. 147–183). Cambridge, UK: Cambridge University Press.
Taylor, J. L., & Mailick, M. R. (2014). A longitudinal examination of 10-year change in vocational and educational activities for adults with autism spectrum disorders. Developmental Psychology, 50(3), 699–708. https://doi.org/10.1037/a0034297.
Taylor, J. L., & Seltzer, M. M. (2012). Developing a vocational index for adults with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(12), 2669–2679. https://doi.org/10.1007/s10803-012-1524-x.
Tint, A., Weiss, J. A., & Lunsky, Y. (2017). Identifying the clinical needs and patterns of health service use of adolescent girls and women with autism spectrum disorder. Autism Research, 10(9), 1558–1566. https://doi.org/10.1002/aur.1806.
Trubanova, A., Donlon, K., Kreiser, N. L., Ollendick, T. H., & White, S. W. (2014). Under-identification of ASD in females: A case series illustrating the unique presentation of ASD in young adult females. Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 2(2), 66–76. Retrieved from: http://www.publication/305854542_Underidentification_of_Autism_Spectrum_Disorder_in_Females_A_Case_Series_Illustrating_the_Unique_Presentation_of_this_Disorder_in_Young_Women.
Van Wijngaarden-Cremers, P. J. M., Van Eeten, E., Groen, W. B., Van Deurzen, P. A., Oosterling, I. J., & Van Der Gaag, R. J. (2014). Gender and age differences in the core triad of impairments in autism spectrum disorders: A systematic review and meta-analysis. Journal of Autism and Developmental Disorders, 44(3), 627–635. https://doi.org/10.1007/s10803-013-1913-9.
Vencill, J., Tebbe, E., & Garos, S. (2015). It’s not the size of the boat or the motion of the ocean: The role of self-objectification, appearance anxiety, and depression in female sexual functioning. Psychology of Women Quarterly, 39(4), 471–483. https://doi.org/10.1177/0361684315587703.
Watkins, E. E., Zimmermann, Z. J., & Poling, A. (2014). The gender of participants in published research involving people with autism spectrum disorders. Research in Autism Spectrum Disorders, 8(2), 143–146. https://doi.org/10.1016/j.rasd.2013.10.010.
Weiss, M. J., & Harris, S. L. (2001). Teaching social skills to people with autism. Behavior Modification, 25(5), 785–802. https://doi.org/10.1177/0145445501255007.
Wentz, E., Lacey, J. H., Waller, G., Råstam, M., Turk, J., & Gillberg, C. (2005). Childhood onset neuropsychiatric disorders in adult eating disorder patients. European Child and Adolescent Psychiatry, 14(8), 431–437. https://doi.org/10.1007/s00787-005-0494-3.
Werling, D. M., & Geschwind, D. H. (2013). Sex differences in autism spectrum disorders. Current Opinion in Neurology, 26(2), 146–153. https://dx.doi.org/10.1097/WCO.0b013e32835ee548.
Westwood, H., Mandy, W., & Tchanturia, K. (2017). Clinical evaluation of autistic symptoms in women with anorexia nervosa. Molecular Autism, 8(12), 1–9. https://doi.org/10.1186/s13229-017-0128-x.
Westwood, H., Mandy, W., Simic, M., & Tchanturia, K. (2018). Assessing ASD in adolescent females with anorexia nervosa using clinical and developmental measures: A preliminary investigation. Journal of Abnormal Child Psychology, 46(1), 183–192. https://doi.org/10.1007/s10802-017-0301-x.
WHOQOL Group. (1998). Development of the world health organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28, 551–558.
Wilkinson, L. (2008). A childhood disorder grows up. The Psychologist, 21(9), 768–770. Retrieved from: https://thepsychologist.bps.org.uk/volume-21/edition-9/childhood-disorder-grows.
Wilson, C. E., Murphy, C. M., McAlonan, G., Robertson, D. M., Spain, D., Hayward, H., … Zinkstok, J. (2016). Does sex influence the diagnostic evaluation of autism spectrum disorder in adults? Autism, 20(7), 808–819. https://doi.org/10.1177/1362361315611381.
Wolff, S. (2004). The history of autism. European Child and Adolescent Psychiatry, 13(4), 201–208. https://doi.org/10.1007/s00787-004-0363-5.
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52(1), 30–41. https://doi.org/10.1207/s15327752jpa5201_2.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Pearlman-Avnion, S., Shlain, R. (2019). Adult Women on the High-Functioning Autism Spectrum. In: Lowinger, S., Pearlman-Avnion, S. (eds) Autism in Adulthood. Autism and Child Psychopathology Series. Springer, Cham. https://doi.org/10.1007/978-3-030-28833-4_5
Download citation
DOI: https://doi.org/10.1007/978-3-030-28833-4_5
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-28832-7
Online ISBN: 978-3-030-28833-4
eBook Packages: Behavioral Science and PsychologyBehavioral Science and Psychology (R0)