ASD mother - boys child presenting more like a "fmale" profile

[BeyondPurpleTulips]

will have to do this in bits as it keeps crashing and is driving me crazy!

So, we know autism is under diagnosed in girls due to even professionals being unaware of the "female" profile/biased towards the "male" profile

While it was my own Dcs behaviour that prompted my own diagnosis when they were younger, I have always said that I would not seek diagnosis for them until it became an issue/they struggled. They are home Ed and I have adapted around them using an autistic framework. If that makes sense - I'm trying not to type six tonne of text.

DC2 (the one who prompted investigation into asd) is very stereotypically "male" autistic, whereas his brother is much more like I was as a child.

My question was, does anyone here have experience of diagnosis of a boy with a more typically "female" presentation of autism?

Obviously "male" and "female" here are in quotes as they're afaik influenced by gendered behaviour rather than sex, and hence my worry is that - with assessors already less aware of "female" presentation in girls - will they be even less aware of this presentation in boys? Will they affect his assessment with their own bias?

I am worried that it will be missed by them thinking a) this is what autism (male) looks like or b) this is what autism in girls look like, and he is not a girl.

Of course the other issue - and one that maybe more of you can help with - is I'm paranoid that they will blame all of his behaviour on watching me as he has grown. ☹️

I am asking here on purpose (rather than the more child-specific area) as I was hoping to find someone who is autistic themselves and recognised themselves in their child - rather than just someone whose child has asd but they themselves don't.

Can you give some specific examples of what you mean male/female presentations in terms of your dc.

My ds is good at masking, and passed under the radar in school. He’s witty, and charming when you meet him first. There we are many times when I doubted the diagnosis. He was described in his report as having a “subtle presentation”. But they were in no doubt about him being autistic. No one, in 13 years (gp/HV/nursery/school/clubs) has ever approached me with a concern that he might be nd.

would that be similar to your situation?

Yep of course. Well masking when anywhere but at home is definitely a factor (including at his dads), then suffering more at home. He also has a tendency to internalise his feelings, so more frequently suffers in an anxiety/depression manner rather than exploding. He is very superficially sociable (whereas his brother isn't interested in people at all), and will try to but now he is older he feels he is not connecting properly with people as he doesn't know how (his words). He gets upset about his lack of friends. His "special interests" tend to be those that are less associated with autistic males - obsessive interest in particular tv programmes, rather than rollercoaster stats (his brother).

There's definitely more that I haven't included, but I'm recovering from covid and my brain is frazzled so I'm forgetting things!

I think you're probably worrying unnecessarily. Whilst it's true that autism was significantly underdiagnosed in the past, the new diagnostic criteria aren't divided into "look for these issues in boys" and "look for these issues in girls" but rather there's a number of broad categories where issues might present in a very wide spectrum of ways and the examples of the sorts of things that might be relevant includes things that are both "typical male profile" and "typical female profile" but the professionals know that there are millions of different ways that autism can present.

I was diagnosed with autism before my DS was. He comes across as functional in a lot of ways and masks a lot, and many of the more noticeable traits that show he has autism are more resonant of the 'female' profile but I don't think that has affected anything.

That's reassuring, thank you.

Just spoke to a professional (via a charity) who is helping with his MH at the moment, and she said there are enough "flags" to recommend an assessment.

So now I'm currently weighing up whether to try to explain to the GP, or do I self refer to cahms..? And then if I self refer, do I just ask for a referral, or lay out a figurative PowerPoint of my reasoning...?

yes, I'm over thinking it again 🤔