Autism ‘may be missed in girls’

Girls may show different symptoms

Girls with mild autism are less likely to be identified and diagnosed than boys, a study suggests.

Researchers examined 493 boys and 100 girls with autistic spectrum disorders.

They found the girls showed different symptoms, and fewer signs of symptoms traditionally associated with autism, such as repetitive behavior.

The researchers, who presented their work to a Royal College of Psychiatrists meeting, said this might mean cases among girls are missed.

“We shouldn’t assume autism or Asperger syndrome will look the same in both sexes Professor Simon Baron-Cohen University of Cambridge

Autism is thought to affect four times as many boys as girls – but the latest study suggests this might not be the case.

Most of the children featured in the study had been seen at the Social and Communication Disorders Clinic at Great Ormond Street Hospital in London. Additional cases came from Sunderland and Finland.

All the children were classified as “high-functioning”. They did not have classic autism, but did have difficulties with socialising and communication.

Relationship obsessions

The researchers, who have yet to publish their research, found that the girls were more likely to have obsessional interests centred around people and relationships.

However, these interests were more likely to be acceptable to their parents, and therefore tended not to be reported to doctors.

Characteristics such as shyness and over-sensitivity, common to people affected by autism, are sometimes deemed to be typically female traits Judith Gould National Autistic Society

In addition, these types of obsessions were less likely to be discovered using standard diagnostic questionnaires.

The investigators said more research was needed to analyse how autism spectrum conditions manifest differently in the sexes.

Professor Simon Baron-Cohen, an autism expert at the University of Cambridge, agreed.

He said: “This is an important clinical issue and there are too few studies addressing it.

“We shouldn’t assume autism or Asperger syndrome will look the same in both sexes.

“There may be many factors leading to these conditions either being underdiagnosed or misdiagnosed in females, or leading females to require a diagnosis less often.”

Judith Gould, of the National Autistic Society, said: “We hear from many women who have been diagnosed later in life.

“The way autism is presented in women can be very complex and so can be missed.

“It might be that due to misconceptions and stereotypes, many girls and women with autism are never referred for diagnosis, and so are missing from statistics.

“This may mean that many women who are undiagnosed are not receiving support, which can have a profound effect on them and their families.”

Ms Gould said it was also possible that girls were better at masking difficulties in order to fit in with society.

“Characteristics such as shyness and oversensitivity, common to people affected by autism, are sometimes deemed to be typically female traits.

“However if a boy were to display such characteristics, concerns may be raised.”

Diary: Sierra Leone slum clinic

Courtesy BBC

Staff at a clinic in the coastal slum of Kroo Bay, in Sierra Leone’s capital, Freetown, are keeping a diary of their working lives for the BBC News website.

Here, Adama Gondor, who runs the clinic, talks about the challenges of its malnutrition programme and renovation works on the clinic building.

Every Friday we distribute a corn-soya blend with oil and sugar mixed in for making porridge.

Every Wednesday we distribute plumpy nut – a peanut-based paste with all the nutrients a malnourished child needs, which comes from the World Food Programme.

We started more than three months ago and have now started to discharge our first patients.

First we had 60 in the programme, now we have 102. When we discharge we admit new ones.

[Parents] beg me not to discharge their children, they need the food for survival

We’re often low on food. I think we didn’t expect to find so many malnourished children.

It is because everything is expensive now. People cannot afford to buy food and the nutritional status of people has dropped.

If a mother who is breast-feeding is not eating properly, how can she have a healthy baby?

The plumpy nut is for severely malnourished children and at the moment we have 17 children who fall into that category.

Every day now, food prices is all people talk about.

It is poverty and rising food prices that are making people suffer here in Kroo Bay.

We are seeing many more cases of malnutrition – even though the children we treat are gaining weight from the food we give them.

We only discharge them when they are 85% of their ideal weight for three consecutive weeks.

It is difficult to discharge the children because the parents often get upset, they want the food which is a real supplement to what they can afford, they have come to rely on it.

They beg me not to discharge their children, they need the food for survival.

I try and explain that their children are no longer dangerously malnourished and other children need the food, and they leave sad and sluggishly.

It is so hard to discharge them, children here are vulnerable, they need good food.

Rebuilding

About a month ago, reconstruction work in the clinic started. It is very exciting.

We are really happy knowing that in four or five months we will have a new, extended clinic.

The clinic is being extended and fixed

Now we are getting three wards and an under-fives area. In the wards we’ll be able to admit patients for up to 72 hours.

The construction workers have just completed the foundations. On top of the new wards they’ll put an extra floor which will be my staff quarters, meaning I can always be on call for serious cases.

So far all the work is in the hall and although it is loud and dusty, it is not bothering us because we really want the clinic to change and be clean and hygienic.

The work is being done by Save the Children in collaboration with Concern, and I want to say thank you to all the people who have donated.

We really appreciate them sharing their earnings. We sincerely hope they’ll continue helping us – once the clinic is finished we’ll need drugs and equipment.

The Kroo Bay clinic staff are keeping a joint diary

Save the Children is running an interactive website where Kroo Bay residents answer questions about their lives. Visitors will be able to access 360-degree images of the site, and catch up with the latest news from the slum through regular “webisodes”.