Does ASD in girls always involve social/communication impairment?

[nickEcave]

I'm posting this after reading the thread from someone asking if it's possible to have ASD but be fine in school. I didn't want to hijack that thread but I am grappling with the same kind of issues with my 8 year old daughter. She has always had sensory issues, hates transitions, gets really anxious when its time to leave the house and has meltdowns at home but completely controls them at school. I saw her class teacher at parents evening yesterday and told her how some mornings DD cries all the way to school because she can't bear the feel of shoes and socks and the teacher was astounded and said she's never seen any sign of this.

DD also has no problems with social interaction - she will talk to anyone and has always had friends at school so this has always stopped me from thinking she could have ASD. I have read about Sensory Processing Disorder, which seems to more closely fit her problems but I understand you can't be diagnosed with that as a stand-alone condition in the UK.

I feel that we've been managing DDs sensory and anxiety issues quite well during the primary years but I am dreading the transition to secondary and wonder if trying to get her assessed would help. However I don't see how we would get an assessment as the school simply does not see the behaviour that we see at home.

[AmaryllisNightAndDay]

It doesn't always involve obvious communications impairment. And yes, a girl can be outgoing and still have an ASC.

You might find Tony Attwood's video on has some helpful insights for thinking about your DD.

[LightTripper]

For my DD the social aspect is probably the most obvious, but I have a friend with two DDs on the spectrum and one of them is very social and has lots of friends but big sensory issues. The other is more like my DD (less sensory issues but more shy/quiet type - finds social interactions overwhelming).

I find it helpful to think that ASC can involve sensory aversion or sensory seeking (or both at different times) - so if you think about sensory feedback from social interactions that can be quite compatible with being an extrovert or an introvert.

It may also be watching some videos by autistic adults like Purple Ella (and her friend Ros on the "Autism in Company" videos) and Katie at Invisible i. Sarah Hendrickx has several talks up and was a stand up comedian for part of her career although she also talks about finding more casual social interactions very difficult: so ASC doesn't always present the way you think it would.

[buttertoff33]

ASD is a form of a social communication disorder. having difficulty with social communication is intrinsically part of ASD.

However, if you DD is fine in school, she may actually not be. Is is possible that she is just masking? Very common in HF girls. She might just 'appear' fine.

Sensory processing disorder is a dx in the UK. where did you read it is not?

[Legofriday]

My child had to leave school at 6 so I don't know how she would have fared socially later, but she had friends and had no social issues at school really. She had lovely friends. ☹️

And she's autistic.

[drspouse]

Sensory processing disorder is not diagnosed on the NHS in most areas.
It is generally thought of as a symptom of another disorder e.g. our DS has ADHD, the consultant says he's unlikely to meet the criteria for ASD but has quite a few sensory issues.

[hazeyjane]

Sensory processing disorder is a dx in the UK. where did you read it is not?

We were told ds couldn't be diagnosed with sensory processing disorder here, despite having obvious sensory issues.

[buttertoff33]

ok, I stand corrected - I have a friend whose child has this as a stand alone dx (in the UK) but got that years ago.

[BlankTimes]

Sensory processing disorder is not diagnosed on the NHS in most areas

It used to be, 15 or so years ago it was called Sensory Integration Dysfunction and was diagnosed and treated by Occupational Therapists who used Jean Ayres' research. It's had a couple of name-changes in the interim and is currently called Sensory Processing Disorder.

Over the last few years, from reading the comments on these boards, it seems as though a lot of areas in the UK do not have this diagnosis and treatment available as part of the OT system and people are advised to find sensory OTs in the private sector.

However SPD is being considered as part of the diagnostic criteria for autism because so many autistic people have sensory issues which impact daily life.

As far as I'm aware, this is as far as it's got at present
"With regards to the described characteristics of autism, the ICD-11 also includes the same two categories as the DSM-5: difficulties in interaction and social communication on the one hand, and restricted interests and repetitive behaviours on the other. It thus removes a third characteristic listed in the previous edition of the ICD, related to language problems. Both classifications also point to the importance of examining unusual sensory sensitivities, which is common among people on the autism spectrum
more at www.autismeurope.org/blog/2018/06/21/world-health-organisation-updates-classification-of-autism-in-the-icd-11/

[drspouse]

The consultant we saw for the ADHD diagnosis said it's a possibility with most neurodevelopmental disorders.

[Tmara]

I could have posted this about my dd! Just about to go to work so will write more later x

[jackparlabane]

This could be my dd (or me). No problems communicating within the rules of a classroom, has a gang of friends and she knows everyone, but increasingly she doesn't understand the complex rules of playground interaction and popularity contents, despite grasping that there is a popularity contest and therefore she Must Win.

Increasingly losing it at home and lashing out at her brother and parents (but not stepbrother, who is autistic and increasingly violent) - brother is autistic too but curls up and hides at a raised voice, never mind violence. It's hard to tell what might be dd's own issues vs copying her brothers and aunt (all ASD), and both parents are on waiting lists for ASD assessment - so in short we're not experts on social interaction either.

[Tmara]

My daughter is the same age and you've pretty much described her! School see no issues, I've mentioned masking at school and that then all hell breaks loose at home, but school just can't imagine her being like that. She wants to be popular with other children and the teachers, she's very sociable, has good eye contact etc, so we were told by a Dr she couldn't possibly have ASD. She has many sensory issues, anxiety, worsening meltdowns and anger at home, very narrow set interests that become obsessions, she's like this with certain friends too, she almost wants to become them. She's always been an outwardly happy smiley chatty child since interacting with people started at nursery and has always made friends easily. BUT I'm now seeing some subtle changes as she's getting older, she's definitely not finding it as easy to make and keep friends like she always has done til now. I can see that the other 8/9 year old girls in her year are more into just hanging out and chatting now, whereas dd still likes what they probably think are babyish games like playing schools, families, tag and hide and seek, basically role play games and games with running and hiding rather than interaction and being yourself. So I'm wondering if some traits can come out more as they get older? I think we have no option but to have her assessed privately, as the school and GP just don't see what we do at home.

[LightTripper]

Tmara from what I've read that can definitely be the case. I think autistic kids are often a couple of years behind socially, so they can go through phases when they seem fine socially (because being a couple of years behind when everyone is 6 and your interests are more 4.5ish still means pretending to be unicorns and galloping about), but harder when everyone is 13 and starting to get into boys and makeup and you are still internally 10 and want to do stickers and colouring. So I'm kind of expecting with DD that there will be times (like now) when she's doing fine and having fun playing with friends (just needs a bit more down time than the others), but other times when they've made a leap that she hasn't made yet when it's all more difficult.

FWIW (and I don't know if I'm autistic or not but see a lot of me in my daughter who is diagnosed) I can definitely now see that I was immature growing up and wasn't interested in the same things my peers were, but by the time I was a student those differences became much less important/noticeable. I was still seen as "young" and probably a bit naive, but I had nice friends who looked out for me and liked my enthusiasms and my niceness (i.e. lack of ability to play the social one-upmanship games) and all was well.