Are Females Inherently Protected from Developing ASD?

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It was an average of several estimates I've seen. Here's one source:



http://www.nytimes.com/2007/08/05/magaz ... d=all&_r=0



http://www.plosone.org/article/info%3Ad ... ne.0020835

I think the sex ratio in LFA of around 2-1 or 4-1 is probably likely the sex ratio of autism overall and that the girls who go undiagnosed are mostly in the HFA category. I say this for two reasons 1) I bet only HFA girls can successfully mask their symptoms and 2) the sex ratio among HFA is much more unbalanced than LFA, so it makes sense that most of the undiagnosed girls are in that category.

So, what I'm trying to say is that, yes, many girls with HFA go undiagnosed (maybe well over half of them, in fact), but this doesn't change the fact that even accounting generously for undiagnosed HFA girls, boys are still at least 2 x more likely to get autism -- of all types. And I think this matches many developmental disabilities generally. The Y chromosome has specific weaknesses, which is why more boys than girls are born -- to allow for the fact that more boys than girls die of various causes, or get taken out of the gene pool for various reasons, including developmental disabilities.

I think a 2-1 sex ratio overall is a very reasonable estimate that generally allows for many, many undiagnosed HFA girls.

Yes, I am very familiar with that statement from Gillberg, and this ratio is close to the 2 to 1 male to female ratio that Atwood describes as his best guess from clinical experience, as identified in my last post, specific to Asperger's syndrome.

My point was that the 9 to 1 ratio is evidence of social-cultural adaptation not evidence for a higher actual ratio of male to female ASD. That social-cultural adaptation also includes the biases of professionals as an adaptation to their social-cultural environment specific to what they have seen in research results over the course of decades, specific to this issue. It seems to be a self-full filling prophecy in that respect, overall.

People like Gillberg, Cohen, Atwood, Wing, Frith, and Gould, are striving to make the message heard that there are other factors involved beyond the current diagnostic criteria, diagnostic features, and even associated features of Autism Spectrum Disorder(s), beyond what is currently related at large in the world specific to ASD, that does not take many of these variant issues specific to females on the spectrum into account.

They are the pioneers once again, in a new area of discovery, as they were when the diagnosis of Asperger's syndrome was first described, that is very important at this point in time to females on the spectrum. I have probably linked that Gillberg video 10 times in the last 2 weeks in various areas of the internet. Here it is again. One of my favorites. And one of only 2 or 3 things I have bookmarked on my browser..

Gillberg and all his colleagues listed above are professionals that are at the top of the list of effective allies to those in the autism community, beyond what is sometimes recognized, in the Autism Community.

I was hoping to design this Op as a rhetorical statement applicable to specific subgroups of the spectrum that are potentially not equally applicable specific to the topic research from the Boston source on twin studies, that seems to make a generalized hypothesis for the full spectrum..

http://www.youtube.com/watch?feature=en ... e-iik&NR=1

Thanks for the second link, it is the Simon Baron Cohen research that I was referring to in the topic post.

The 1.95 to 1 ratio is from a Fombonne study in 2005, specific to co-morbid intellectual disability, but not to language delays in general on the spectrum. As you describe the first link from 2007 still identifies "classic autism" at a 4 to 1 ratio, which is not restricted to individuals assessed with co-morbid intellectual disability on the spectrum. It is a fuzzy area of what is identified as "low functioning" autism, but it is not limited to individuals with co-morbid intellectual disability or language development delays.

The research I linked in the topic post suggested in general females are protected against language development delays specific to high levels of prenatal testosterone, but the research specific to this issue and the spectrum is ongoing by the same research team in Australia.

This research you linked by Cohen was specific to matched IQ level male and females adults identified with high functioning autism.

This research validates many of the anecdotal accounts identified by females on the spectrum in online autism communities, including sensory difficulties that are generally greater than what males report, the ability to and desire to mask symptoms, non-verbal learning disorder type symptoms, and the ability to talk and/or write excessively to mask symptoms, with pragmatic type language difficulties.

Many of the issues identified in this peer reviewed research by Cohen were previously identified by Atwood in his clinical observations, over the course of two decades coming across a substantial number of females diagnosed on the spectrum during that period of time, to make these differential observations, that historically have not been easy to access or assess, because of lower demographics of females observed in the clinical environment, overall among clinicians and in research.

But, the research also makes it clear that some of these issues of masking symptoms are common among males as well, in adulthood.

The quotes taken from the article below are in reference to some of these issues:





If there is a greater relationship with non-verbal learning disorder symptoms and females as opposed to males on the spectrum, that in itself could be a big part of the reason why males are diagnosed earlier than females if the females are diagnosed at all on the spectrum among females with the language delays potentially associated with pragmatic language impairment, hyperlexia, or what seems to be described here as potential symptoms of non-verbal learning disorder may be completely missed in CDC studies at the age of 8. Although this sample as identified is small.

I think your opinion here makes sense and the 2 to 1 ratio is close to what both Gillberg and Atwood are indicating that while I haven't heard them specifically quoted, I think it is more than likely that Cohen, Frith, Wing, Gould, are generally in agreement in this ball park of estimated true ratio as well.

However, again, I think it is going to be an uphill battle in the US, to get professionals to listen to Atwood, Cohen, Wing, Gillberg and Gould, as this does not even appear to be on the radar for the APA specific to the statement by Sue Swedo, I linked and the DSM5 criteria per strict requirements of social-communication impairments met over the course of a full lifetime, with RRBI's met by history alone.

Cohen's research here, suggests that it is particularly more likely that females will social-culturally adapt to social-communication impairments over the course of a lifetime. With additional potential much larger studies, conducted by Cohen and colleagues, the DSM and ICD committees may lend more of their ears to this issue in the future, perhaps in a version 5.1 or 5.3, etc. of DSM5 diagnostic features. The ICD11beta revision still has time for adjustments, which I would not be surprised to see, since the source is based in Europe, among all of these pioneers in this area of differential diagnosis of females on the spectrum.

This is troubling and I have seen reports that are much worse from reddit that are reflective of a much larger issue in culture. This is part of the sharing of information I was talking about, and yes it is far from limited to text.

This is more of a male specific issue but far from entirely a male issue, as there is the culture of participation generated by a culture of pornography that seems to be protected more than the gun culture, but it is now considered integral with freedom of speech.

With the process of neuroplasticity, one's view of the world becomes what one feeds their mind, no matter what one's fleeting conscious thoughts tells the rest of the brain occasionally through the course of the day.

But it's not just that, as it is one of the greatest sources of "natural" dopamine stimulation, by those that are inclined to be stimulated by the visual information, and an avenue of potential behavioral addiction. Trying to convince a young adult male of the real potential human consequences of instant gratification and the view of one's world changed through neuroplasticity per the avenue of pornography, is similar to trying to convince a primate that pressing the lever for the next hit of cocaine or even sugar, may eventually result in negative consequences.

It's primate nature, doesn't matter that much if the classification of homo sapiens is attached, when it comes to instant gratification powered by high level avenues of dopamine stimulation. And some people are more vulnerable to the effects specific to those more generally vulnerable to the disease of addiction.

Where pornography is more effectively policed on the internet, and filtered out, it itself, impacts the level of male participation in those avenues of internet participation. As one can imagine, if pornography was allowed on this website, the demographic would be completely different.

I've seen examples of what can happen on reddit that are the equivalent of virtual assault, for unsuspecting young females, attempting to have a conversation, that dare provide a picture of a young female face, and an issue more disturbingly with no age cut off for the potential result of virtual assault. With scores of identified males of all ages "socially bonding" for what can be a virtual style gang assault.

But perhaps the most disturbing aspect is a general reduction of basic human compassion for other human beings and I think this part of the issue is impacting males and females, specific to the opposite perceived sex, in general discussions across the internet, that are not directly associated with pornography, but may still be a lurking factor in the primate brain, both in males and females, in their perception of their social roles in the continuously changing culture.

In comparison it also makes violent video games seem like benign sources of stimulation, but the potential for behavioral addiction and the stimulation provided by an avenue of dopamine stimulation is still a potential powerful avenue for behavioral addiction, particularly among those more inherently vulnerable to the disease of addiction which is correlated with ADHD, and obviously a real concern specific to the spectrum because of the overall correlations that exist specific to that spectrum demographic.

And also where does one draw the line on a potential behavioral addiction as opposed to an RRBI, correlated with ADHD, resulting in the potential loss of interest in reciprocal communication with flesh and blood human beings.

There is no DSMIV criteria for a behavioral addiction, nor will there be a DSM5 criteria for a behavioral addiction. What could have resulted in the years of 1994 through 2000 when technically an RRBI was all it took for a spectrum diagnosis, because of an editorial error, is fairly obvious I think. With a greater potential of impact past CDC age statistics and potentially greater captured in the screening for the 7 to 12 year old demographic in South Korea per the 1 in 38 statistic, even after the the DSMIV error was corrected in the year 2000 with the DSMIV-TR.

While this tangent may seem completely off topic, I think it may be far from off topic, as the rates of female participation in both of these dopamine stimulating activities are increasing, this was not the same propensity in the 90's and early 2000's when the greatest peak of increase in autism was measured, along with loosely defined minimum requirements for a diagnosis, particularly with that 6 year editorial error in the DSMIV, per PDDNOS and an RRBI potential specific diagnosis.

So take video games and pornography out of the equation, along with that 1994 editorial error, and I think it is pretty obvious that behavioral addiction is at least a potential contributing factor that I left out of my group of contributing and underlying factors, in the topic post, in what may lead to a an ASD diagnosis, because it is in someways offensive to even mention behavioral addiction as a potential contributing factor to ASD in an online autism community.

But, specific to the topic of what may protect females from an ASD diagnosis compared to males over the last couple of decades, it is worth a passing thought, I think, although understandably a potential passing thought that can be hard for one to wrap their minds around, when it is an integral part of a person's life, that one may have nothing to compare it to in past experience.

I remember my friend's 6 year old child able to defeat adults in video games, that were in their 30's. He is not on the spectrum and excels in social interaction in his 20's, so it is obviously not a destiny for any spectrum disorder, but still a potential contributing factor for those that may be vulnerable to this as a contributing factor for what is observed as potential behavioral impairments in an ASD diagnosis, whether it is ADHD and the correlation of propensity toward the disease of addiction, or other general factors of the reward system of the brain, among other genetically determined inherent factors that may mix in with these environmental factors of culture.

A door to door population scan was done in two Amish countries that brought up a result of 1 in 271 in ages 3 to 17, in a preliminary study, as compared to a less extensive scan down strictly among the 7 to 12 age group in South Korea that brought the 1 in 38 result.

The preliminary study never made it to publication, and it has been speculated that it could not be published because of politically incorrect vaccine hysteria concerns. The Amish seem to have become off limits for research, but there may be more to study in this issue that may have nothing to do with technology and obviously nothing to do with vaccines, that may be overlooked because of politically correct concerns associated with the vaccine hysteria.

Interestingly, the Gillberg criteria, would not likely have picked up many individuals specific to a behavioral addiction, since 1989 when it was published, because of the inherent factors of communication impairment and neurodevelopmental motor skills difficulties that are mandatory in that criteria.

It appears that the DSM5 standards in this case as restrictive as they are in three mandatory elements of social-communication will reduce the potential influence of this potential contributing factor in what may lead to a diagnosis, beyond the potential recognition of a related RRBI, per past DSMIV less restrictive criterion elements in social-communication, particularly before the year 2000, when there was the technical potential for no requirement of observed social communication behavioral impairments at all, per the 1994 DSMIV editorial error in PDDNOS.

But given a much broader view of the issue, since there is no DSM5 disorder of behavioral addiction, where do these people fit in, in the future, if they were captured before in diagnosis on the spectrum, and don't gain needed support.

I don't think anyone cares to approach the issue in the research world, because of the issue with publish or perish, as this is an issue almost as politically incorrect to discuss as vaccines, even in the much larger world, outside of autism communities, otherwise behavioral addiction might have been taken more seriously in the DSM5 committee analysis, because it is considered an addiction as organically strong as substance abuse, per the American Society of Addiction medicine, that has a substantial amount of research to support that concern.