How to Recognize Autism in Women and Girls with Wendela Whitcomb Marsh | POP 717

A photo of Wendela Whitcomb Marsh is captured. Wendela Whitcomb Marsh is an award-winning author and board-certified behavior analyst specializing in autism. Wendela Whitcomb Marsh is featured on Practice of the Practice, a therapist podcast.

What does autism look like in women and girls as opposed to men and boys? What are three things every therapist should know about how autism presents in women? How do you know whether to test for autism in a client?

In this podcast episode, Joe Sanok speaks with Wendela Whitcomb Marsh about how to recognize autism in women and girls.

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Meet Wendela Whitcomb Marsh

A photo of Wendela Whitcomb Marsh is captured. She is an award-winning author and board-certified behavior analyst specializing in autism. She is featured on the Practice of the Practice, a therapist podcast.Wendela Whitcomb Marsh is an award-winning author and board-certified behavior analyst specializing in autism. After a career working with children on the spectrum, she took early retirement to write books and to provide autism assessments for adults. Her most recent book, Recognizing Autism in Women and Girls, was written to help therapists and diagnosticians look behind the mask to identify the subtle feminine characteristics of autism which are so well hidden.

Visit Wendela Marsh’s website and see also Autism PIPS.

Connect with Wendela on Facebook, Youtube, and LinkedIn.

FREEBIE: Check out this free PDF Checklist: When Your Client Says, “I Think I’m Autistic”

In This Podcast

  • Three things every therapist should know about autism in women and girls
  • How to know if you should consider autism as a diagnosis for your client
  • Providing treatment
  • Wendela’s advice to private practitioners

Three things every therapist should know about autism in women and girls

1 – It’s going to look different

Don’t go in with a closed mind thinking, “If they don’t look autistic then that can’t be it”. Have an open mind and be willing to say, “Oh, maybe you are autistic”. (Wendela Whitcomb Marsh)

Autism looks different in women and girls.

A common trait of autism is if a patient is often flapping their hands, but in women and girls, the equivalent of this could be to twirl their hair.

It’s still a repetitive behavior but they have tried to make it more socially acceptable when they notice people looking at them funny. (Wendela Whitcomb Marsh)

2 – Women and girls are more socially aware of how their autism presents in public.

Common traits may include:

  • Twirling hair
  • Bouncing a leg
  • Biting the inside of the cheek

3 – They teach themselves things that are natural to other children and adults

For example, looking at people in the eye, making the appropriate facial expressions, and learning how long to leave a pause in a conversation before starting to talk.

How to know if you should consider autism as a diagnosis for your client

  • Social communication: ask your clients about how comfortable they are with their social interactions.
  • Physical self-regulation: are there ways that the client moves their body to self-regulate or soothe themselves? It could be fiddling with an object that is nearby or rocking back and forth.
  • Have these symptoms always been present?

Providing treatment

The social responsiveness scale (SRS) 2 is primarily used to diagnose people with autism. However, when the SRS 2 test gives a severe score, it does not mean that the person has severe autism but that there is a greater likelihood that they have autism.

Adults who seek treatment for autism are often not going to have a high score on the SRS 2 test because they went through most of their lives not presenting their autism.

Furthermore, many women are only diagnosed as autistic in adulthood because the scales and symptoms have been designed for men and boys in the past.

Therefore, many women have been “masking” their autism for most of their lives, and it is exhausting.

Remember to listen openly [to your clients] … sometimes neurotypical people think, “you don’t look autistic so you’re not autistic” is a compliment which seems to imply that autism is bad, and it’s not. There’s nothing wrong with being autistic, just like there’s nothing wrong with being lefthanded. (Wendela Whitcomb Marsh)

Wendela’s advice to private practitioners

You are doing a terrific job! You have come into a line of work to help other people and you should acknowledge that. Take care of yourself as well.

Books mentioned in this episode:

Useful Links mentioned in this episode:

Check out these additional resources:

Meet Joe Sanok

A photo of Joe Sanok is displayed. Joe, private practice consultant, offers helpful advice for group practice owners to grow their private practice. His therapist podcast, Practice of the Practice, offers this advice.

Joe Sanok helps counselors to create thriving practices that are the envy of other counselors. He has helped counselors to grow their businesses by 50-500% and is proud of all the private practice owners that are growing their income, influence, and impact on the world. Click here to explore consulting with Joe.

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