Asking the right questions
Finally, a female-friendly autism assessment questionnaire is available in the UK. After more than twenty years of the male-biased AQ50, we can put those questions about noticing car number plates, being fascinated by dates and lacking imagination behind us.
Women who want to know if autism could be the reason for their difficulties fitting into the world can now access a set of questions tailored to their likely presentation.
The questionnaire is in The Female Profile of Autism: A Guide to Clinical Assessment, by Isabelle Hénault and Annyck Martin, out this month from Jessica Kingsley Publishers. The book, a translation of one published in French in 2021 for a Canadian audience, costs a fairly steep £22.99, but it could be well worth the investment.
As the title suggests, it’s primarily intended for clinical professionals to increase their understanding of female presentation, which is in itself a good thing. Internet forums are awash with women devastated by medical professionals who ruled they couldn’t be autistic because they had friends, a partner or a career, could make eye contact, weren’t stimming madly or were too articulate.
Despite the received wisdom that autism is a predominantly male condition – a position still held by the NHS – psychologist Hénault points out in the introduction, ‘Clinically we are now seeing a ratio of two men to one woman, or even one to one.’
Required reading
The Female Profile of Autism should be required reading for all those ‘professionals’ who haven’t yet caught up. The Questionnaire for the Diagnostic Assessment of Autism in Females (QDAAF) it contains was developed and reviewed by a multinational team of clinicians specialising in the diagnosis of girls and women. As a result, it’s a significant improvement on the outdated AQ50 generally used.
The list of open-ended questions would also be a useful starting point for any woman who thinks she may be autistic. It covers childhood, social interaction, cognition, relationships, sensory aspects and perception. There’s even a section on how you feel about animals, as so many of us report relating better to them than to our neurotypical peers.
Because this isn’t a box-ticking exercise, there isn’t a crib sheet of ‘right’ (autistic) and ‘wrong’ (neurotypical) answers, but there is a helpful section detailing typical autistic responses, which should be enough to give a clear sense of whether autism is at play.
Alongside Hénault’s chapters outlining significant aspects of female autism, there are several by Martin, a neurodivergent artistic and literary practitioner, describing her own experience. Although a little dry, these, too, will be useful reading for professionals and lay readers alike. I found myself nodding along as she talked about her sensory overwhelm, focus on detail, difficulty processing her emotions, dislike of using the phone, and issues with physical activities and motor coordination.
What’s in a name?
If, like me, you dislike the label Asperger’s, you may find your blood pressure rising as you read. Although Hans Asperger, the psychiatrist who gave his name to this presentation of autism, is known to have participated in the Nazi eugenics programme, the label remains in use in North America. It’s less common to come across it here now, and it would have been nice if this could have been acknowledged in the UK edition.
Having said that, with no sign of the long-promised AQ-f female-specific questionnaire developed in the Netherlands becoming widely available, The Female Profile of Autism and the QDAAF are welcome arrivals on this side of the Atlantic.