Many parents have to fight particularly hard for a diagnosis for their daughters whilst overcoming ignorance from the medical profession about how autism presents in girls, with one doctor even stating that "girls don't get autism":
"Annette Lewns has more experience than most of the different ways in which boys and girls with autism are treated. Her 14-year-old son, Ryan, was diagnosed when he was three and a half. But doctors refused to diagnose her 12-year-old daughter, Rachel, until she was nine.
"What angers me is that for years I was dismissed by doctors purely because Rachel was a girl. Ryan was spotted very quickly because the autism symptoms that doctors look for are so male-orientated," said Lewns. "But Rachel's autism was hidden unless you knew where to look for it.
"Rachel could express herself, she had a couple of friends and understood emotions if someone was at an extreme: really upset or really happy. But you didn't really have to look too hard to see she didn't genuinely understand emotions or relationships: she was just mimicking scripts and scenarios from TV."
"The doctors failed time and time again to see through her coping strategies. I fought for years but I was confronted with a wall of disbelief and scepticism. They were simply unable to understand that a girl might present differently to a boy."The idea that autism is a boy's disorder stemmed from a number of researcher’s including Simon Baron Cohen's theory that autism is an 'extreme variant of male intelligence' due to the apparent larger incidence of autism in males. Unfortunately, this theory has blinded many to the bigger picture as well as generating gender discrimination cases such as the above.
Fortunately, since this disparity has been recognised efforts have been made to study more closely the effects of autism and Aspergers in girls. The human givens approach added to this line of enquiry with Caetextia theory, which explains how the same disorder can present differently in girls than in boys and suggests that the prevalence of Asperger's Syndrome in women is grossly underestimated.
Below is an extract from the book, Godhead: The brain’s big bang where the authors’ explain the origin of creativity, mysticism and mental illness, which anyone wishing to understand more about Asperger’s, autism and psychosis should read:
Left- and right-brained caetextia
As the intelligence system evolved in humans, our higher cortex became more complex and its left and right hemispheres developed specialisations for different processes. While maintaining the ability to interact with and complement each other, the hemispheres developed exponentially to support rational and contextual thinking. Human language and thought, for example, are primarily ordered through the left hemisphere, which sequences and structures information moment by moment in a way that fosters reason. But our logical thinking is informed, and also coloured, by associative thinking and imagination, both faculties that primarily involve the right hemisphere. Whereas previously we had relied on instinctive responses to keep us safe, once the cortex developed in modern humans we were able to consciously review feelings and not just act on them. In other words, we could investigate what was going on around us with a more refined reasoning ability.
But when people are missing the mammalian parallel processing template for handling multiple streams of information, they are forced to try and resolve problems by other means. If a person is left-brain dominant, we see Asperger’s behaviour as traditionally recognised: literal, logical, analytical reactions with difficulties in communication and empathy because of a severely diminished ability to think contextually. This happens because the left neocortex is itself ‘autistic’ – it doesn’t have access to the feelings and metaphors that create context.
Such people are easily stressed by sensory overload, which often produces intense outbursts of autistic anger and more desperate attempts to try and control everything around them so as to minimise the unpleasant feelings they are having. But if a person is right-brain dominant and is missing the template for mobilising context, we suggest that caetextia may express itself through an undisciplined and very strong imagination. The right brain looks always for associations, so, without a strong left-brain to moderate the myriad associations that the right brain makes, a person with caetextia cannot discipline them and check them out. The associations made are unlikely to be the right ones because, without access to a personal emotional history, they are not anchored in reality. The constant, undisciplined association-making can lead not only to inappropriate but also often quite bizarre thoughts, speech and behaviour.
Right-brained caetextia is caused by a lack of instinctive feelings to moderate the person’s thoughts and behaviour, leaving the mind to run free, making directionless, random associations. Because a right-brained caetextic person is more emotional, it may seem odd to suggest that their condition is due to a lack of instinctive feelings, but it is the lack of the instinct to discipline emotional associations that gives rise to problems. Scientists researching decision-making have determined that it is emotion, fired by imagination, that prioritises decision-making – not logic: “Emotions arise when events or outcomes are relevant for one’s concerns or preferences and they prioritise behaviour that acts in service of these concerns” (our italics).
Both right- and left-brained caetextia result in black-and-white thinking and, of course, when heavily stressed, we can all become temporarily caetextic: prone to black-and-white, crazy, irrational behaviour and faulty reasoning. As one excited boy described an emotionally arousing sporting event, “People were running about all over the place, the boys in shorts and the girls in hysterics.”
There is a widespread contention that Asperger’s is linked to gender. However, the notion that it is overwhelmingly a male condition, with the male-to- female ratio ranging up to 15:1, is not consistent with our clinical experience. As psychotherapists we see more females than men with this condition and, even taking into account that more women than men come for therapy, we believe that the prevalence of Asperger’s syndrome in women may be underestimated.
We would suggest that females are more likely than males to suffer specifically from right-brain caetextia, and that clinicians are not yet recognising this expression of Asperger’s syndrome. This could be because, although in right-brain caetextia we see the same inability to track multiple foci of attention and think contextually, such people have ready access to emotions in a way that left-brain dominant caetextics, who, in our experience, are predominantly male, do not.
Right-brain caetextics, for instance, can become emotional in an instant and very easily cry or express extreme anger at the slightest upset. This accessibility of emotion, generally much more common in women, disguises the caetextia. However, they are just as poor at interpersonal intelligence as those diagnosed with Asperger’s syndrome and have difficulties around their sense of identity. They also lack empathy and cannot see how inappropriate their behaviour or beliefs appear to others.
Confirmation that our description of right-brained caetextia is plausible has come not only from psychotherapists working with difficult ‘stuck’ patients, but also from individuals who have read our caetextia website.
Nicolle from the US, for example, wrote to us as follows (and kindly gave us permission to publish her letter):
“I have just stumbled across your site after Googling ‘right brained aspie?’ I want to say ... THANK YOU! I can’t believe it, after all these years I have FINALLY discovered what it is I really have. I am a 36-year-old female who has struggled my entire life with all the symptoms and issues that you describe. I was recently diagnosed as being on the high-functioning end of the autistic spectrum by a wonderful and very experienced psychiatrist who specializes in autism. Prior to that I have collected a number of labels by inexperienced and ignorant medical professionals who had their heads stuck in a bucketful of stereotypes. Avoidant Personality Disorder, Borderline Personality Disorder, Generalized Anxiety Disorder. Despite fitting some of these symptoms I always knew there was more to it than that and they didn’t describe or explain much of my other difficulties.
When I got the Asperger diagnosis, I was elated but also puzzled as all the aspie people I know, including my classic left-brained aspie husband, were very different from me, being highly intellectual and very logical. Although I shared much in common with them in other regards such as sensory problems etc, I have been wondering what it is and came to the conclusion it must be because I am a right-brain dominant aspie and have some co-morbid bipolar, hence the Internet searching and discovering your site explaining ‘caetextia’, which I have not heard of before. I have chronic fatigue syndrome. I know this but cannot get any doctor to listen to me and it is difficult to diagnose.
I have been battling this all my adult life and also struggle with autistic inertia. My mother has undiagnosed autism as she is exactly like me. She is diagnosed with fibromyalgia and is extremely volatile. I also have a son who is diagnosed with AS and he is a lot like me. I have many behaviors which I cannot help and don’t even understand why I do the things I do; I know some of it is how I manage my anxiety and now I see after reading about caetextia that there is a lot more to it than that. It has confirmed all my suspicions about myself that I have not been able to put into words.
Sorry to harp on, I just think you have cracked it and most professionals have no knowledge of this and how autistic women present, especially when they are very right-brain dominant. You’ve given an explanation for my entire life and behavior. I’ve been accused of being lazy, crazy, bad, selfish…the list goes on. I hope the medical community wakes up to this. So many of us are suffering in the shadows.
Thank you again: now I know what it is I am dealing with, I hope I can learn to manage myself better.”