Disentangling the adult diagnosis of Autism and behavioural phenotype in assigned female at birth individuals

Early diagnosis of ASD can improve quality-of-life by improving access to supports and services, reducing judgement and self-criticism and creating a positive self-identity (Ruiz Calzada et al. 2012; Russell & Norwich 2012; Wong et al., 2015). ASD has a higher prevalence rate amongst males than females, with some research indicating that females are often able to “camouflage” their core symptoms, delaying diagnosis (Hull et al., 2017). Generally, when compared with males, assigned female at birth (AFAB) individuals are at an increased risk of going undiagnosed and must often present with more severe symptoms in order for their ASD to be recognised (Kreiser & White, 2014). One potential explanation for later diagnosis is individual differences around resilience, a protective factor, as well as the potentially moderating impacts of co-occurring conditions which may mask or disguise the traditional behavioural characteristics of ASD, such as a highly co-morbid condition, attention deficit hyperactive disorder (ADHD). This research will explore the gender differences in both ASD presentation and age of diagnosis in an adult population and will seek to identify the potential barriers to early/childhood detection of ASD, as well as the different factors involved specifically in the higher proportion of late ASD diagnoses within females/AFAB individuals.

Inclusion:

• Participants must be aged at least 18 years or older.
• Participants must speak English.
• Participants must have access to a smartphone/tablet/computer etc., in order to complete the online survey.
• Participants should have previously received a diagnosis of Autism Spectrum Disorder, or suspect that they may receive a diagnosis should they seek one

Exclusion:

• Participants under the age of 18 years old (0-17) are excluded.
• Participants with co-occurring intellectual disability.

Participants will be invited to complete an online survey through online platform Qualtrics, which will take approximately 10 to 15 minutes to complete. The survey will first comprise of a brief demographic questionnaire, confirming the participants gender identity, whether they had received a diagnosis of Autism, and the age at which this diagnosis occurred. Participants will then complete the following standardised measures including the AQ-10, an autism screening measure, measures of potentially co-occurring conditions, attention deficit hyperactive disorder (ASRS), depression and anxiety (DASS-21), eating disorders (EAT-26) and individual levels of resilience (CD-RISC).

Having reviewed the existing literature around gender differences in autism presentation and symptomology, and the disparities in ease of access to diagnosis and supports, it is evident that this study’s research aims, would contribute significantly to the scant current research on adult women/AFAB individuals who receive their autism diagnosis later in life, and support emerging theories in this area. Additionally, this research will aim to have clinical implications, specifically around the identification, screening and assessment of adult AFAB populations and how these processes may better support them.