Autism in girls
Are there really more Autistic boys than girls or does the diagnostic criteria for Autism Spectrum Disorder (ASD) hold a male-based gender bias leaving many girls missing the criteria and therefore not receiving a clinical diagnosis?
Well yes, currently but maybe not. Once assumed predominantly a male diagnosis, Autism is now commonly diagnosed in females as well. Research that once said the male-to-female ratio was 4:1, is now suggesting it's closer to 3:1. As more research is produced and we continue to understand Autism in females, the male to female ratio may shift even further.
Clinical understanding of Autism and how it presents has been based primarily on male observations, leading to the diagnostic criteria holding gender bias. As a result, some girls don’t meet the ‘typical’ criteria and therefore have gone undiagnosed or misdiagnosed. In fact, many girls are not diagnosed until they reach mid to late teens or adulthood. Sadly this can result in adverse impacts on mental health, overall wellbeing, education, and employment.
Autistic females have many of the same core autistic traits, but due to their ability to internalise their difficulties and do what is called “masking”, their autism is often missed when compared to their male counterparts. There are many traits associated with females and autism, here is a list of some of the more common ones:
She may mask or camouflage her personality and or autistic traits to fit in with her peers in the neurotypical world.
She may conceal her anxiety in public such as work or school but then meltdown or shut down once in a safe place such as her home.
She may be extremely empathetic, caring, nurturing and sensitive.
She may have sensory sensitivities to foods, fabrics, noise or temperatures.
She may struggle with change in routine or change of environment.
She may struggle socially and misunderstand social boundaries.
She may show extreme reactions, compared to the size of the problem.
She may interpret language literally.
She may have a special interest and be able to hyperfocus for hours when doing the activity (such as lego, animals, nature, books, art).
Autistic female clients in clinic
As seen above Autism in females presents in many different ways and no two Autistic females are alike. It's important to keep this in mind in clinical practice and focus on treating your client as an individual, finding and addressing the underlying root cause/causes, and using a holistic approach. This means supporting them Nutritionally but also emphasising the importance of lifestyle support, stress and anxiety reduction, self-regulation, self-acceptance, and referrals to other health practitioners where necessary.
From a Nutritional perspective, there is a lot we can do to support Autistic females. Below are a few examples.
Remove and Identify allergies and intolerances
Firstly identifying and removing any possible food allergies or intolerances because these can contribute to intestinal permeability and chronic gut inflammation. This can negatively impact the immune system and create digestive upset, mood imbalances, and behavioural issues.
Dairy (Casen), gluten, and soy can sometimes be the worst culprits here, but not always (remember everyone is different!). Removing these foods particularly the gluten and dairy for 6-8 weeks alongside additional gut support may help reduce symptoms.
Nutritional deficiencies
Understanding which Nutritional deficiencies are present is an important step for ascertaining what may be causing or exacerbating mood disorders, appetite, food habits, general behaviours, and sleep difficulties.
Deficiencies may be evident from physical examinations, the patients presenting signs and symptoms and tests such as hair tissue mineral analysis or in some cases pathology or urine testing.
Some common deficiencies include:
Zinc
Magnesium
B6
B12
Iron
Omega 3s
Vitamin D
Calcium
Nutritional supplementation
Diet can be challenging for some Autistic females. Some may have a limited variety of foods in their diet due to sensory or textural difficulties or food neophobia. In these cases nutritional supplementation may help to bridge the gap between nutritional deficiencies.
Food as medicine
Top foods for supporting Autistic females
Probiotics to support a healthy gut: natural or coconut yogurt, kefir, sauerkraut.
Prebiotics to feed the probiotics: leeks, bananas, oats, apples.
Zinc for neurological development and immune function: pumpkin seeds, hemp and sunflower seeds, chickpeas.
Iron for growth, development, and energy: Organic chicken liver, organic dried apricots.
Magnesium to calm the nervous system and for neurotransmitter synthesis: buckwheat, dark chocolate, nuts, seeds, quinoa.
Essentially fatty acids for a healthy brain and reducing inflammation: Oily fish, hemp and chia seeds.
The good news is that as Autism in girls is becoming more recognized, support systems are being established to help Autistic girls and women, wherever they are in their journey.
Interested in Nutrition?
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