Autism and ADHD in Girls and Women: One or the Other, or Both?

This presentation will focus on the unique challenges and trajectories experienced by girls and women with autism, ADHD or both. Presentation and moderated Q & A with Meghan Miller, Ph.D., Assistant Professor, Department of Psychiatry and Behavioral Sciences and UC Davis MIND Institute. Part of the 2020 SUMMER INSTITUTE ON NEURODEVELOPMENTAL DISABILITIES

[rahbeeuh]

Timestamps that may be helpful

Overview of ASD & ADHD
1:25 – 4:13 *ASD*
4:14 – 4:57 *ADHD*

4:58 – 19:48 *When* *ASD* & *ADHD* *co-occur*

19:49 *Girls* & *women* *with* *ASD, * *ADHD* *or* *both*– *what* *do* *we* *know?*
22:35 *Girls*/*women* *with* *ASD*
27:19 *Girls*/*women* *with* *ADHD* *compared* *to* *girls* *without* *ADHD*
30:19 *What* *do* *we* *know* *about* *girls/women* *with* *ASD* & *ADHD*
31:30 *Protective* *factors*
33:20 *Challenges* & *future* *directions*
35:00 *Thank you!*
35:10 *Questions*

[purplemind]

Great content. But it would have helped to show time stamps for us with concentrations problems;)

[Octoberstorm]

Did anyone else peak in their academics super young with ADHD? I would get perfect scores on tests as a kid but right around age 11-18 I went from talented and gifted/honor society to skipping tons of school and making Cs. Got suspended from college for failing. For years I wanted to do school work and loved learning but i couldn’t understand how I was so “lazy”. It’s less embarrassing now that I am diagnosed

[laurenrobinson]

As a future neuroscience researcher I will do us justice. The research needs to be left to us simply because looking at and comparing symptoms can never top truly experiencing and understanding them. Our minds are different and I will prove it.

[janlaag]

I moreover can't help but clarifying that too many official studies are still made by "experts" that have no personal involvement with the subjects, they are very often neurotypicals with no other understanding than being experienced in external observations filtered on their own models of interpretation so that despite the fact that they are the ones that are officially recognized, this very same people tend to be the less likely to have an actual valid expertise.

[Solarislun]

I'm 38 years old and didn't get an ADHD diagnosis until I was 19, this makes sense since most people at the time though you had to be physically hyperactive and I wasn't. When I was 27 I was in therapy and being medicated for ADHD and expressed my concern that I was on the spectrum because x, y, z... and the Dr. laughed at me. He said because I could talk to him and look him in the eye there was no way I could be on the spectrum.

I still think I am! I have never attempted to pursue a diagnosis since, honestly I'm afraid of being shot down again. This information is so helpful and validating!

[amaaachn]

In my experience, the difference between diagnosed and undiagnosed folks is economic status. Rich kids have adhd/asd, poor kids are just mean and lazy 😒

[Moana_moo]

As someone with adhd i didn’t really had significant academical problems until highschool. Like i used to make careless mistakes in tests but i mostly had good grades but since highschool i feel i can’t put up with it. And well with friendships those were always a problem...

[melissasaal]

As of read/listened many adult womens ADHD stories I feel like the actual questionnaire and process for testing isn't that great. many important points (reoccurring in most womens stories) are left out and not talked about at all among medicals dealing with ADHD patients. for example that you must have had difficulty learning and focusing before the age of 12. For many that are seeking diagnosis later in life they might not remember what people did/said what you did in that time. Also In younger years regarding learning difficulty, many subjects are really easy and when you are fortunate enough to have a teacher that can make everything interesting then it's even harder to spot. Many smarter girls just wing it in earlier education and the problems start to arise later. For example hyperfocus on subjects and if they have curious nature they just pick things up along the way, homework is quite less and fast to do (overcompensating starts later when the exercises get harder and need more time and attention). So they take 2 hours instead of 1 that it would take others of the same intelligence.When it gets even harder ie. subjects they don't care about or bigger projects, long essays then they just learn to overcompensate or give up (because the work in itself for a normal person would take 5hours and for ADHD it would take double). and put much more effort and time into for example studying something. Afterwards talking to peers they often feel confused of how others seem to have so much free time and energy to live regularly great lives (they don't have to waste time re-reading and re-focusing). But at the same time from the outsiders viewing the person everything seems okay (they don't know how much time or energy was spent to keep it together or to hand in that work etc). I think the questionnaires and formal information regarding ADHD should be upgraded. In my country psychiatrists and psychologists seem to think that it's mostly a children's problem and if you are somewhat smart (and seem to be doing well even though you are really just overcompensating and hiding parts of your life) than you cannot simply have ADHD. Sad

[miacara]

Learned shame is a huge factor in children- particularly females, not presenting ‘obviously’ as having ASD or ADHD. When children with these disorders are punished or marked as pathological by the authority figures in their life, they learn how to mask their symptoms through pattern observation. Tying in the fact that these disorders are extremely hereditary, it’s not too far off to assume that undiagnosed parents are particularly sensitive to their children’s poor behaviors because it triggers their sensory issues, or emotional regulatory issues, leading to more shame and undiagnosed children.

[rather_be_known]

Quick correction that is vitally important. At 3:56 criteria C for ASD is listed incompletely. Dr. Miller forgot the last part which states "(but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life)."

[kelleyl]

Prevalance = how the symptoms present in ways that negatively impact others around them. Boys are more likely to have outward behavioural issues which lends to them being referred for Dx. Girls tend more toward PI, which does not impact others and, subsequently, does not result in being referred for Dx. The rates are likely closer 1:1, but referrals are much more likely for those who cause distractions to family/classroom, regardless of how significant their actual symptoms are. Furthermore, the egregious lack of understanding of HF ASD (aka Aspergers) in girls has led to a large disparity in Dx between genders. This is why Dx for girls (those with HFASD/ADHD) happens in adolescence or early adulthood post breakdown/attempted suicide.There are high rates of ED, self harm and suicidal ideation in girls with both; however, the profile of these girls are still not recognized largely for what they are. I am hopeful since many in the field are now finally learning what HF ASD looks like in girls, but we are so far behind still. Note, that it took more time than it should have for researchers to realize that ASD female brains look like NT male brains, for example. This all being said, it's NT individuals who lack theory of mind.

[maritvandenhurk]

I have inattentive type, but also relate to talking loads, interrupting and having trouble waiting for my turn(or even not raising my hand in class and just blurting it out). Teachers have been so mad at me for that...

[janlaag]

Asds use a lot of conscious reasoning in areas where nts just have it "pre-wired" and so intuitive, this means that in coping with social environments asds are already much more inclined to mental exhaustion which will clearly affect the capacity for attention, memory, and others cognitive functions.
By constantly living into stressful environments asds are inclined to develop adhd as a consequential complication.

[cxSMILEYx]

Has there been work looking into the effects of complex trauma on women/girls with ADHD and/or ASD and trauma-related disorders such as PTSD and DID? I ask because my family has a lot of mental illnesses in the family and I underwent a lot of complex trauma and my older brother, who also went through a lot, was diagnosed with ADHD and medicated for it when he was 5 years old. As an adult he still suffers w a lot of the typical hyperactive symptoms whereas for me, my symptoms were most characterized by social anxiety, generalized anxiety and depression all of which I have been recently diagnosed with along with PTSD. Upon finally starting trauma therapy I noticed that as a child I started reading/writing earlier than my peers and also had issues with making friends and keeping friends. Granted there was a lot of confusing trauma happening at the same time but I feel those effects today with difficulty forming and maintaining friendships (except for my longtime boyfriend).

So, what I’m getting at is I think I may have always had some time of adhd and/or be on the spectrum on top of having adopted a lot of dissociation coping mechanisms to the point of also having a dissociation disorder.

[livb]

Someone still saying (in the beginning) that the ratio is 4/5-1 boys - girls? 🤔 I thought we moved past that long ago? Is it even worth listening to this, I wonder

[nataley]

I found this super interesting and relatable. Thank you for your hard work, it's sad to see there aren't many studies for women affected by autism and ADHD.

[OlympiaSophie]

Great discussion and definitely needed. I think many of us question this when hearing terms such as ADHD and autism

[SamanthaGJones]

I have an official ADHD diagnosis with alot of comorbidities such as OCD, GAD, ecc…I think (I’m 99, 9% sure) I’m on the ASD spectrum, too, but the doctors who made my ADHD assessment said no. But I’m sure I am. Can’t explain any further. The place where I got diagnosed is an ADHD center, so I think I’ll go make an ASD assessment in a specialized center. Unfortunately here in Italy we have much work to do about mental health awareness, especially about ADHD. I’m 35 years old and got diagnosed last year!!! A lifetime feeling like an alien, but better late than never… 😰

[melissasaal]

Sad. This video is new but info is old at places women are as likely to have it as men, just underdiagnosed.