女性自闭症及阿斯伯格综合症诊断不足

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女性自闭症及阿斯伯格综合症诊断不足翻译：zhongyuwoxin | 2010-02-16 14:04:00 | 阅读0 | 来源

时代报  2010年2月6日
David Rose, Health Correspondent and Rachel Carlyle

研究人员认为：自闭症和相关症状在女性身上往往诊断不足，有很多病例往往和进食障碍或者其他问题产生混淆。
社会孤立，交流障碍或者执迷于某种事物，或者令人费解的数学问题，自闭症先前被认为属于男性特有的问题。
超过80%的自闭症诊断病例都是男孩，阿斯伯格综合症（较轻度的情况下）男女比率达到大约15：1。但是，研究人员将会在英国第一界学术会议上提出这个论点，会有比想像中更多得多的女性其实应当被诊断为属于自闭症谱系，虽然医生和家长没有能够发现或者错误解读一些症状或者征兆。
那些在自闭症谱系较轻一端的病例，虽然没有语言障碍，有较高的智商但是却难于解读这个世界和它复杂的社会规则，尤其会被认为诊断不足。


“相对有自闭症的男孩，女孩很少有言语迟缓问题，所以在他们还是蹒跚习步时就被盖棺定论为正常，但是他们的自闭症就可能被忽略了。”Richard Mills ，自闭症研究的研究总监，本月组织该会议的慈善组织者认为，“自闭症女孩在幼年的时候在表面上比男孩更能表现得社会化。”

男孩们通常在5-7岁获得自闭症谱系的诊断，然而，女孩们通常是在青少年或者更大的时候，如果他们最终能获得一个正确的诊断。

Dr Mills即将于今年发表的研究表明，尽管女孩们被诊断为自闭症它也无法得到改善。在一个英国精神病院关于60个病人的研究案例里，通过例行检查没有人显示有自闭症症状，后来其中有11个得到了确认。

“事实上总是因此作出了其他的诊断--人格障碍或者也许是精神分裂，” Dr Mills说：“这个也许是因为大多数测试是与男性自闭症特征相关的。”

去年一个关于7500个英国成人的调查显示，大约有600，000英国人有自闭症谱系问题，但是这个比率男性（1.8%）远远高于女性(0.2%)。

现在还不清楚有多少女孩没有得到诊断的案例，但是慈善团体和患者组织说越来越多的成年女性在联系他们，通过电视或者关于自闭症的文章开始意识到她们自己有自闭症特征，而且终于明白她们为什么会“怪异”的原因并感觉到宽慰。Dr Mills相信因为大家都认为自闭症在女孩中比较少见，医生们就不大会考虑到它。“我和这些女孩们的家长谈过，他们说从医生的第一反馈就是，“她是女孩，不大可能是自闭症”不仅仅是全科而且是儿科学医生的观点。”

另一个诊断障碍是女孩比较善于隐藏症状，比如语言障碍，因为她们本来语言方面发展就胜过男孩，比较少产生麻烦而且能够更好地补偿她们的问题。女孩也很少象自闭症男孩一样终生执迷于收集某种事物。

Janet Treasure, 伦敦King's大学精神病学院关于饮食障碍的专家，她说在自闭症谱系中的女性经常关注于减肥或者控制热量，这些成为了她们的强迫行为。但是，有饮食障碍的女性中，大约5个当中有一个会被认为属于自闭症谱系。

由Treasure教授领导的一个对150个有严重厌食症或者贪食症的女人的研究表明，高达60%的病例发展出自闭症的精神征兆。”那些严重体重偏低且身体状况不佳，饮食模式严重紊乱的，其认知和情绪风格与自闭症有很多类似的地方，’她说“她们可怜的神经问题意味着她们不能看到更大的视野，她们过于注重细节而且思考问题僵化，很难适应环境。”

大多数女人会因为体重增加而减少这些心理症状，但是“有自闭症的女孩会有很高的陷入一种行为模式从而引起恶性循环问题的风险”，Treasure教授说，“人们去注意并且阻止它就非常重要。”

活动组织者很担心缺乏诊断可能会引起灾难性后果。低自尊会引起自我伤害甚至自杀，社交幼稚可能会引起被欺凌或者性侵犯。

Mark Lever, 国家自闭症组织的主席说：“我们极度关心许多有自闭症的女人们也许没能得到诊断。很多事实告诉我们得到诊断似乎是一个不可逾越的障碍而且她们不得不奋力争取才能得到她们极度需要的帮助，支持和服务。”

“自闭症是一个严重的，终生的且残障的状况，而且如果没有得到正确的支持可能会对个人及家庭产生严重的后果。

自闭症和阿斯伯格综合症
--自闭谱系障碍（ASD）是发展类障碍，每个孩子可能都有所不同，程度由轻到重。他们的症状分为三大类：
----社交障碍，比如缺少对人们感觉的理解和意识。
----沟通技巧障碍，比如语言发展迟缓和无法开始或者加入谈话。
----不同寻常的思想和行为，包括刻板动作。孩子会因为刻板模式被打断而觉得沮丧。
--目前看来自闭症谱系障碍（ASD）是无法治愈的，但是有一系列的训练方法可以改善症状。
--自闭症谱系障碍（ASD）有三种主要类型：自闭障碍（也被称为“典型自闭症”）；阿斯伯格综合症（影响社会交往的轻度症状）；和广泛性发展障碍（两种类型的症状皆有的孩子们）
--在过去，许多有ASD的孩子们也许被贴上了“动作迟缓”或者“害羞”的标签。
--Kim Peek,最著名的自闭症专家，电影“雨人”以他为原形而创作，在今年12月过世，时年58岁。他可以一天读8本书，10秒钟读一页。

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刚刚翻译完的一篇文章，感觉很适用，有些观点和我自己的想法很类似，很有认同感，所以赶紧翻出来
有一些不太确定是否翻得正确，所以还请大家帮忙看看，谢谢啦


From The Times
February 6, 2010

Autism and Asperger syndrome underdiagnosed in women, researchers say


David Rose, Health Correspondent and Rachel Carlyle
20 Comments
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Autism and related conditions are being underdiagnosed in women and teenage girls, with many cases being confused with eating disorders or other problems, researchers say.

With symptoms such as social isolation, communication difficulties or a fanatical interest in categorising objects or obscure mathematical problems, autism has previously been seen as a male preserve.

Up to 80 per cent of diagnosed cases of autism are in boys, with the proportion rising to an estimated 15 male cases for every female with Asperger syndrome, a milder form of the condition. However, researchers due to speak at Britain’s first academic conference on the issue will suggest that many more girls are on the autistic spectrum than previously thought, with doctors and parents failing to notice or misinterpreting the telltale signs.

Cases at the less severe end of the spectrum, where sufferers do not have speech problems and can have high IQs but have difficulties interpreting the world and its complex social rules, are thought to be particularly underdiagnosed.


“Girls are less likely to have language delay than boys with autism, so all the right boxes get ticked when they are toddlers and their autism can get missed,” said Richard Mills, research director of Research Autism, the charity that is organising the conference this month. “Autistic girls are also more likely to be outwardly social when they are younger whereas boys are less so.”

Boys commonly have autistic spectrum conditions diagnosed aged 5 to 7, whereas girls are usually adolescent or older, if they receive a correct diagnosis at all.

Dr Mills’s own research, due for publication this year, suggests that even when girls are screened for autism it is not picked up. In a study of 60 patients at an English psychiatric hospital, none had an autistic condition diagnosed after routine screening, despite 11 later being shown to have been confirmed cases.

“What was happening was that other diagnoses were being made — personality disorder or perhaps schizophrenia,” Dr Mills said. “This is possibly because most tests were developed around male characteristics of autism.”

Last year a survey of 7,500 British adults suggested that about 600,000 people in Britain suffer from an autistic spectrum condition but that rates are far higher among men (1.8 per cent of the population) than women (0.2 per cent).

It is unclear how many cases in girls are not being diagnosed but charities and patients’ groups say that a growing number of adult women are contacting them, having recognised themselves in autistic characters on television or through articles about autism, and are relieved finally to discover why they are “different”. Dr Mills believes that because it is assumed that autism is rare in girls, doctors are less likely to consider it. “I have spoken to parents of girls who have said that the first response from the doctor has been, ‘She is a girl, it is highly unlikely to be autism’. Not just GPs but paediatricians too.”

A further barrier to diagnosis is that girls are often better at masking the symptoms, such as difficulties with language, because they tend to be more advanced than boys, less disruptive and able to compensate better for their problems. Girls are also much less likely to have an obsessive lifelong interest in collecting facts, as boys with autism commonly do.

Janet Treasure, an expert on eating disorders at the Institute of Psychiatry, King’s College London, said that women or girls on the autistic spectrum often focused on diet or calorie control, which became their obsession. About one in five women with an eating disorder is thought to be on the autistic spectrum.

A study led by Professor Treasure on 150 women with acute anorexia or bulimia suggests that up to 60 per cent also develop the psychological signs of autism. “Those who are severely underweight and unwell, with serious disruption of eating patterns, share a lot of the cognitive and emotional styles common to autism,” she said. “Their poor nutrition means that they can’t see the bigger picture, they focus on detail and have a rigid way of thinking, finding it hard to adapt.”

These psychological symptoms were lessened when most of the women gained weight. But “girls with autism are at high risk of getting into a pattern of behaviour that can cause a vicious cycle of problems”, said Professor Treasure. “It is important that people notice and try to stop it.”

Campaigners are worried that the lack of diagnosis can have catastrophic effects. Low self-esteem can cause self-harming and even suicide, and social naivety can lead to bullying and sexual exploitation.

Mark Lever, the chief executive of the National Autistic Society, said: “We are extremely concerned that many women with autism may be going undiagnosed. So many tell us that trying to get a diagnosis feels like an insurmountable hurdle and they have to fight tremendous battles to get the help, support and services they desperately need.

“Autism is a serious, lifelong and disabling condition and without the right support it can have a profound effect on individuals and families.”

Autism and Asperger syndrome

— Autistic spectrum disorders (ASDs) are developmental conditions that can vary from child to child, and from mild to severe. Their symptoms are grouped into three broad categories:

— Problems with social interaction, such as a lack of understanding and awareness of other people’s feelings.

— Impaired communication skills, such as delayed language development and an inability to start or take part in conversations.

— Unusual patterns of thought and physical behaviour, including repetitive physical movements. The child can become upset if the routines are broken.

— There is currently no cure for ASD, but there are a range of treatments that can improve the symptoms.

— There are three main types of ASD: autistic disorder (also known as “classic autism”); Asperger syndrome (milder symptoms that affect social interaction); and pervasive developmental disorder (children who have some symptoms of either).

— ASDs are uncommon but not rare. In England it is estimated that 1 in every 100 children has an ASD.

— In the past, many children with an ASD may have been labelled as “slow” or “shy”.

— Kim Peek, the most famous autistic savant and inspiration for the film Rain Man, died aged 58 in December. He could read eight books a day, taking just ten seconds to read a page.

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related comments:

http://www.timesonline.co.uk/tol ... /article7017168.ece

Stef Heathcote wrote:
Would anyone know where is the line between shy and mild ASD? What is the measuremnet of how many time a little girl can choose to sit on her own and this can be ok and at which point I start worrying and seek help? We are all different - learing social skills is not always easy, but sometimes is hard and sometimes is completely allient, I just don't know how to recognize the difference...Can anyone help, please?....
February 18, 2010 11:58 AM GMT on community.timesonline.co.uk Recommend?  Report Abuse  Permalink  

  ally drysdale wrote:
hello, like Miranda I have at last received a diagnosis of AS- at age 48 ! It is a relief to know there are reasons why I am like I am. I have also had the label of bad parent,eccentric etc. I am susceptible to anxiety, depression. I have many difficulties but for years have managed to hide them, although relationships with men didn`t go so well, which was a good indication of AS ?
I have been criticised for commenting on the new DSM V discussion, as the american psychiatrists are looking at dispensing with AS as a diagnosis. personally I find AS is helpful as a diagnosis but other people think it limits the support individuals will get from the local authority. There will still be individual assessments and the `high functioning` people will probably still be left out in the cold. I was lucky to be assessed and it was only possible because I am on a degree course and my way of learning is certainly different, so the disability advisor referred me for assessment.
Yes, there are many women out there that are undiagnosed and struggling but what are we going to do about it ?
February 15, 2010 6:34 PM GMT on community.timesonline.co.uk Recommend? (1)  Report Abuse  Permalink  

  Miranda March wrote:
I agree with all the other comments other people have written. I have only just been diagnosed with high functioning autism at the age of 47 years. I have struggled all of my life to this date and no-one took my mother's concerns seriously when she tried to gain help after raising concerns about my development. I agree that girls are clever in masking their differences and have very often learned to cover up their difficulties because by their very nature they are more sociable than boys. However, I have never been sociable and have always been acutely shy. I have also struggled to gain a diagnosis for my own son. This took 15 years and it almost destroyed me owing to the fact that I wasn't believed which made me so angry. My son's headmaster stated I was responsible for my son's problems because he said I was eccentric. I am furious that women are seen in this way whether they have a diagnosis or not. To all the parents who feel that something is amiss with their daugher or son's development please follow your instincts and do not give up hope because you will be taken seriously if you follow your innermost voice.
February 11, 2010 1:51 PM GMT on community.timesonline.co.uk Recommend? (2)  Report Abuse  Permalink  

  Jacqui Footman wrote:
Pam Mason, as an adult at least you have the support of the new Autism Act, which commands that services for adults must be provided.
I am going through hell atm trying to get an assessment for my 13yr old daughter - so many eg school doctor and paediatricians don't recognise her as obviously ASD and our local specialist service recently closed to new referrals with a waiting list of 11.5 months. She is suffering so badly at school having returned after 18mths illness (glandular fever/MECFS). Signs of ASD are clear now she has to reintegrate socially but were masked at primary school. People tend to think I am just an over fussing mother and she will get over it once she gets used to school again. She is having a terrible time but can't express it to anyone else, help!
February 9, 2010 8:11 PM GMT on community.timesonline.co.uk Recommend? (5)  Report Abuse  Permalink  

  Rhys Jaggar wrote:
I'm still of the strong belief that, at the milder end of the spectrum, this is not a 'disease' or a 'condition' but a 'different wiring'.

I'd lay strong odds that the 'traditional path' from 0 - 18 might be totally wrong for some autistics and that 18 - 0 might be closer to the mark. By that I mean with good education you go from obsession with routine toward free thought, with 'normal' children going from innocent spontaineity toward systematising and organising.

Would that be a problem if mentored properly??
February 8, 2010 4:30 PM GMT on community.timesonline.co.uk Recommend? (2)  Report Abuse  Permalink  

  Carrie Brown wrote:
I am beginning to wonder if I have mild Asperger's. For a while, I wondered if my dad has high-functioning autism, but I started noticing some of the symptoms in myself. As a child, I was labeled "shy" and was diagnosed with social anxiety in my teens. I was also diagnosed with adult ADD. I struggled a lot with social awkwardness.
February 8, 2010 5:35 AM GMT on community.timesonline.co.uk Recommend? (4)  Report Abuse  Permalink  

  Rory Davis wrote:
Alyson Bradley, so, professionals fail to make diagnosis and this is a problem.

But everyone is unique individuals.

Do you want to be categorised on not?
February 7, 2010 1:17 PM GMT on community.timesonline.co.uk Recommend? (1)  Report Abuse  Permalink  

  Pam Mason wrote:
It seems to me that there are two distinct and very separate problems here. First we have the needs of parents whose young children are newly diagnosed. Great that they are getting help. But those of us who are adults, who have struggled through life with an intolerable invisible burden, are entirely different. I was 47 when I was diagnosed. I want children helped because I don't want them to go through what we went through. But I want us adults to be helped too.

All too often this debate is framed as though AS was a childhood illness. It isn't. Well done for parents for being so vocal. But it's time we AS adults were given an equal hearing.
February 7, 2010 11:39 AM GMT on community.timesonline.co.uk Recommend? (14)  Report Abuse  Permalink  

  Erin Monk wrote:
I'm currently raising a wonderful little boy with autism. Although I do not have it, I can see a lot of the traits in myself, especially as a child (obsessiveness over certain narrow topics, extreme shyness, extreme sensory issues, learning difficulties, anxiety disorders, eating issues, auditory processing disorder, etc). I do not have the trademark difficulties with socialization that a person with autism has, therefore I am pretty sure that I am close to the spectrum but definitely not on it. I do wonder if the same "causes" of autism in males also present in females with a similar frequency, just with a different expression.
February 7, 2010 1:18 AM GMT on community.timesonline.co.uk Recommend? (2)  Report Abuse  Permalink  

  Selina Postgate wrote:
Lucy Brown, reading through my reply to your post I realise I may have come across as rude and uncaring (as we autistics frequently do, having limited social understanding). I was not condemning you for trying psychotherapy for your daughter. She is lucky to have a family who have worked so hard to meet her needs.

With regard to a formal diagnosis, this would entitle your daughter to a variety of disability supports while at university, such as mentoring, library assistance and recording equipment, which might make her time there easier and more pleasant. Legally speaking at least, a disability should not affect her employability, and again it could entitle her to free support under the "Access to Work" scheme, which might make her working life more successful and less stressful. In the long term an Asperger's diagnosis might be very helpful and protect her from inadvertent abuse if she ever develops psychiatric problems or decides she does need social care support.
February 6, 2010 11:49 PM GMT on community.timesonline.co.uk Recommend? (2)

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Deb Gardner wrote:
Probably more women do go around with it. But generally I think more men have it than are actually diagnosed. They are generally more tunnel visioned about matters, they go train spotting, plane spotting. Yes I think a lot of men are autistic.
February 6, 2010 5:34 PM GMT on community.timesonline.co.uk Recommend? (3)  Report Abuse  Permalink  

  Selina Postgate wrote:
Lucy Brown, as your daughter is reaching or has reached adulthood, the choice of whether to pursue diagnosis must of course now be hers.

I would like to point out though (from bitter experience, having spent countless hours in therapy and counselling trying to "cure" myself of what turned out to be autistic traits) that the neurological differences that make some of us autistic (and I include Asperger's) are hardwired.

Psychotherapy is useless, even counter-productive, unless the therapist both accepts that the client has an ASD and understands the consequences of this for the client's psychological make-up. Unfortunately there are not many therapists yet who do have the necessary knowledge and experience, particularly when it comes to working with autistic women.
February 6, 2010 2:54 PM GMT on community.timesonline.co.uk Recommend? (10)  Report Abuse  Permalink  

  Lucy Brown wrote:
I have a daughter, who had various diagnosis: some traits of Asperger's, no traits of Asperge's, anxiety; NHS psychotherapy, private psychotherapy... but nothing helped. I have an impression that nobody knew how to deal with her problems: low self esteem, shyness, social interaction, obsession about people. She is very intelligent, with very high IQ, hard working, at one of the best universities. She does not cause problems for others, but generally unhappy. As an young adult now refused any help from NHS, because "she is coping well". Is it worth pushing for diagnosis of Asperger's syndrom,for a highly functioning girl? It can only reduce her prospect of employment and does not guarantee any real help from social services. A caring family is the best support.
February 6, 2010 1:43 PM GMT on community.timesonline.co.uk Recommend? (11)  Report Abuse  Permalink  

  Frank Taylor wrote:
Our daughter who is three has been diagnosed with aspergers we didn't find any problems where support from our doctors was concerned and we were given a referral date to have our daughter tested very quickly.
As she is so young she is going to be retested every year, this is to assess her progress as she is still only a baby really.

We don't ignore men when they suffer from breast cancer, so why are people ignoring girls who have autism?
February 6, 2010 1:01 PM GMT on community.timesonline.co.uk Recommend? (7)  Report Abuse  Permalink  

  Adele Williams wrote:
John Bald wrote:
>>I am currently working with two children, a boy and a girl, who have both been "diagnosed" as having Asberger's, and who are both perfectly capable of normal behaviour, work and concentration when treated with normal consideration and politeness. Asberger's is too easy a diagnosis for a lazy psychologist who is not prepared to get to the underlying causes of children's behaviur. In one case, the problem was sensitivity to light that led to the person being unable to learn to read, and the behaviour was caused by frustration at this. Perfectly understandable, and now fixed.
>>
First, it's Asperger not Asberger.
Second, the diagnosis should lead to exactly what you suggest: an understanding of the issues underlying difficulties that people may experience with schoolwork, employment, relationships etc. Sensory issues like the one you describe are common in AS--even though they are not part of the current diagnostic criteria--as all experienced clinicians know. Adjusting the environment and changing our own communication, teaching, and work styles is the key to success, because there is no "treatment" for AS.

It's good to see some solid research, following on from Gillerg's study on AS and eating disorders. Most of the adult women ith AS I have met have been through horrific experiences due to misdiagnosis with schizoaffective disorder, personality disorder, or schizophrenia. The drugs currently given to people with these conditions cause health problems for those who should not be taking them, including inability to think, massive weight gain, movement disorders, etc., while not helping the condition at all. Appropriate education and social care, on the other hand, helps people make good lives for themselves!
February 6, 2010 12:42 PM GMT on community.timesonline.co.uk Recommend? (8)  Report Abuse  Permalink  

  Andy Davis wrote:
My local health and education authorities are quite good. Indeed my daughter has had a Statement of Special Educational Needs since she was 4 because of her language development etc (it's quite unusual to have one so early).

But it's only now, when she is nearly 12 that she is going through the testing regime for an ASD. We, her parents have recognised it for years but overcoming the inertia of "Girls don't suffer from ASD" has been an uphill struggle from start to finish - and as I say this is with reasonably good authorities.

What it must be like for children and adults in less than good authorities must be a living nightmare. So on behalf of them I am very glad that the whole issue is being revisited.
February 6, 2010 12:33 PM GMT on community.timesonline.co.uk Recommend? (7)  Report Abuse  Permalink  

  Alyson Bradley wrote:
The process of self discovery is exhausting and does not help when those around us start to question us, I needed a diagnosis because I knew their is no way my husband and others would of accepted that I was without that, because until we are sure... it can seem like being lost in a void with no where to turn and easier to try and go back before its official which is scary at first, but for me now their is no compromising as now I know for sure, I can not go back and allow my life to only exist in parts, exist for others, no more pretense.

Their are many badly informed professionals out their and they make us question self, which can be a huge stress, here in NZ many doctors do not always diagnosed adults and feel the same in world wide in parts.... its like they want to see where we have issues and change that, so wrong as when we are so desperately trying to look for answers, it does not help having doors slammed in our faces, and making us question what we know.

Their is no specrum none spectrum really we are all unique individuals, but for some of us that bit more different, but the more we get to know self the easier it is not only for us, but those we care about... I do feel grils re accepted if they're quiet and non-active, are we better at disguising our differences.? Asperges Parallel Planet
February 6, 2010 6:10 AM GMT on community.timesonline.co.uk Recommend? (6)  Report Abuse  Permalink  

  John Bald wrote:
The problem is not under-diagnosis, but accurate diagnosis. I am currently working with two children, a boy and a girl, who have both been "diagnosed" as having Asberger's, and who are both perfectly capable of normal behaviour, work and concentration when treated with normal consideration and politeness. Asberger's is too easy a diagnosis for a lazy psychologist who is not prepared to get to the underlying causes of children's behaviur. In one case, the problem was sensitivity to light that led to the person being unable to learn to read, and the behaviour was caused by frustration at this. Perfectly understandable, and now fixed.
February 6, 2010 5:23 AM GMT on community.timesonline.co.uk Recommend? (8)  Report Abuse  Permalink  

  ROBERT BOYD wrote:
Your right all women have it!
February 6, 2010 12:54 AM GMT on community.timesonline.co.uk Recommend? (2)  Report Abuse  Permalink  

  Selina Postgate wrote:
It took me five years and a complaint to the Healthcare Commission just to get an NHS referral for an assessment for Asperger Syndrome. When I was finally seen privately, after a further two-year wait in vain for an NHS-funded assessment, the well-known and highly-respected clinical psychologist who assessed me told me my Asperger's diagnosis was "quite unequivocal".

This is not a trivial matter - I suffered a nervous breakdown and developed serious physical health problems whilst waiting, as until I was positively diagnosed with AS I was unable to obtain any of the social care support I needed to cope with daily living.

I know of numerous other women who have likewise been refused referral to experts for assessment for ASD, either by GPs or local mental health teams. Over the years these women's resulting mental health issues - often including hospitalisation - cost the NHS far more than timely diagnosis and appropriate social support would cost.
February 6, 2010 12:46 AM GMT on community.timesonline.co.uk Recommend? (14)

忠于我心

案例研究：女孩自闭症症状被忽视5年之久


Julia McGeady, 14岁，有一个自闭症的哥哥，但是尽管有这样的家庭问题，她的情况在好多年里还是没有得到诊断。

“我们倒是担心过这个问题，因为她的主要症状是在三岁的时候还不会说话，而且她也因为在幼儿园里脾气暴躁没有上幼儿园，“她的母亲，一个来自伦敦西部的前IT咨询师Teresa Abrat说，“关于自闭症的意识没有现在这么好，尤其对女孩。尽管我的儿子也曾经上过这个幼儿园，并且被诊断为自闭症，但他们也没有意识到她也许会有同样的问题。”

她的哥哥根本不会玩玩具。但是她会尝试-她会拿起毛绒玩具并试着给它们讲故事。在状态较好的日子里，她会尝试变得友好并有眼神交流，还会微笑，尽管她很少微笑。

“随着时间的变化，更多明显的症状变得紧急起来，但是它们和她哥哥的症状并不一样。”

“和她的两个哥哥有所不同，她的两个哥哥都对火车很着迷，她没有任何着迷的东西。”Julia的情况是在5岁的时候得到诊断的，在6岁的时候她转到一个专门收取自闭症孩子的学校，那里60个学生里仅有6个女孩，且根本没有和她同一个年龄段的女孩。“我真的觉得作为一个有自闭症的女孩更艰难，因为当人们听到自闭症这个词时，人们能想到的只是男人。”Abrat女士说。

“Julia现在也开始时尚起来，化妆，少年杂志和流行乐队--她是真的希望和其他同年龄女孩一样，但是对她们来讲她根本就不一样。”

Case study: Autistic symptoms of girl were ignored for five
years
http://www.timesonline.co.uk/tol/news/uk/health/article7017180.ece
Julia McGeady, 14, has an autistic older brother, but even with this family link, her condition was not diagnosed for a number of years.
“We were concerned because she was not speaking at 3, and she wasn’t coping at nursery, where she’d have major tantrums,” says her mother Teresa Abrat, a former IT consultant from West London. “The awareness of autism wasn’t as good as it is now, especially for girls. Even though my son had been through the nursery, and diagnosed with autism, it did not occur to them that she might have the same thing.
“Her older brother would not play with toys at all. But she would try — she’d pick up soft toys and try to make a story with them. On a good day, she would try to be sociable and would give eye contact and be smiley, whereas he rarely smiled.

“As time went on, more obvious symptoms began to emerge, but they were not always the same as her brother’s.

“Unlike her two brothers, who are both fascinated by trains, she does not have one obsessive interest.” Julia’s condition was diagnosed at the age of 5, and at 6 she moved to a school for children with autism, where there are only six girls out of sixty children, and none in her year group. “I really do think it’s harder to be a girl with autism, because when they hear the word autism, people think of men,” says Ms Abrat.

“Julia is now into fashion, make-up, teen magazines and pop bands — she’s really trying to be like other girls of her age, but it’s obvious to them that she’s not like them at all.”