highs & lows: ‘anatomy of a myth’

It was ‘Global COOLING’ in the 70’s, now ‘Global WARMING’ – what should be called a true Climate Change discourse’s rollercoaster, with the collaboration of the so-called media.

Girls and Asperger Syndrome: an article

[Firstly posted on Facebook, thanks to Sharon]

THE GENDER GAP IN ASPERGER SYNDROME: WHERE ARE THE GIRLS?
(by Lee A. Wilkinson)

A Case Study Published in:
TEACHING Exceptional Children Plus – Volume 4, Issue 4, March 2008

Copyright © 2008 by the author. This work is licensed to the public under the Creative Commons Attribution License

Although there has been a dramatic increase in the recognition of autism spectrum disorders over the past decade, a significant gender gap has emerged in the diagnosis of milder forms, such as high functioning autism and Asperger syndrome. Statistics indicate that while boys are being referred and identified in greater numbers, this is not the case for girls.

Girls are also diagnosed at later ages compared to boys. In this article, the author discusses possible explanations for the under identification of girls with high functioning autism and Asperger syndrome. A case vignette is used to illustrate the gender differences relevant to the understanding and timely diagnosis of girls with this autism spectrum condition. Asperger syndrome is an autism spectrum disorder characterized by problems in social relatedness, empathic communication and understanding, and circumscribed interests in the presence of generally age appropriate language acquisition and cognitive functioning (Volkmar & Klin, 2000).

Students with Asperger syndrome often experience problems related to their social deficits and are at risk for academic underachievement, school drop-out, peer rejection and internalizing problems such as anxiety and depression(Safran, 2002; Wilkinson, 2005). Although there has been a dramatic increase in the number of children diagnosed with autism spectrum disorders over the past decade, a significant gender gap has emerged in the identification of milder forms, such as high functioning autism and Asperger syndrome. Statistics indicate that while boys are being referred and identified in greater numbers, this is not the case for girls (Attwood, 2006; Ehlers & Gillberg, 1993; Wagner, 2006).

For example, referrals for evaluation of boys are ten times higher than for girls (Attwood, 2006). Girls are also diagnosed with autism spectrum disorders at later ages relative to boys (Goin-Kochel, Mackintosh, & Meyers, 2006). This gender gap raises serious questions because many female students with Asperger syndrome are being overlooked and may not receive the appropriate educational supports and services. The consequences of a missed or late diagnosis include social isolation, peer rejection, lowered grades, and a greater risk for mental health and behavioral distress such as anxiety and depression during adolescence and adulthood.

Why are fewer girls being identified? Why do parents of girls experience a delay in receiving a diagnosis? Are there gender differences in the expression of the disorder? Answers to these questions have practical implications in that gender specific variations may have a significant impact on identification practices and the provision of educational services for children with autism spectrum disorders (Thompson, Caruso, & Ellerbeck, 2003).

Although few studies have examined gender differences in the expression of autism, we do have several tentative explanations for the under identification and late diagnosis of girls with Asperger syndrome. This article discusses these possibilities and provides a case vignette to illustrate the gender differences relevant to the understanding and timely diagnosis of girls with Asperger syndrome.

Gender Roles

Gender role socialization is critical to understanding why girls with Asperger syndrome are being under identified (Faherty, 2006). Since females are socialized differently, autism spectrum disorders may not manifest in the same way as typical male behavioral patterns (Bashe & Kirby, 2005). For example, girls might not come to the attention of parents and teachers because of better coping mechanisms and the ability to “disappear” in large groups (Attwood, 2007). Girls on the higher end of the spectrum also have fewer special interests, better superficial social skills, better language and communication skills, and less hyperactivity and aggression than boys (Gillberg & Coleman, 2000). Likewise, girls are more likely than boys to be guided and protected by.

When I think of my earliest years, I recall an overwhelming desire to be away from my peers. I much preferred the company of my imaginary friends- -Liane Holliday Willey (1999)

Same gender peers have special interests that appear to be more gender appropriate (Attwood, 2006).

These characteristics lessen the probability of a girl being identified as having the core symptom of autism spectrum disorder: an impairment in social skills. In fact, it may be a qualitative difference in social connectedness and reciprocity that differentiates the genders (Attwood, 2007; Kopp & Gillberg, 1992). As a result, parents, teachers, and clinicians may not observe the obvious characteristics associated with the male prototype of higher functioning autism spectrum conditions such as Asperger syndrome (Kopp & Gillberg, 1992; Nyden, Hjelmquist, & Gillberg, 2000).

  • Although girls may appear less symptomatic than boys, both genders share similar profiles. Research suggests that when IQ is controlled, the main gender difference is a higher frequency of idiosyncratic and unusual visual interests and lower levels of appropriate play in males compared to females (Lord, Schopler, & Nevicki, 1982). As a result, the behavior and educational needs of boys are much more difficult to ignore and are frequently seen by teachers and parents as being more urgent, further contributing to a referral bias (Kopp & Gillberg, 1992).
  • Over reliance on the male model with regard to diagnostic criteria contributes to a gender “bias” and under diagnosis of girls (Kopp & Gillberg, 1992; Nyden et al., 2000). Clinical instruments also tend to exclude symptoms and behaviors that may be more typical of females with autism spectrum disorders.

Conclusion and Recommendations

Asperger syndrome may have a different profile in girls than boys, which in turn, might not be recognized as an autism spectrum disorder (Thompson et al., 2003). While the gender gap in Asperger syndrome has yet to be empirically investigated, if girls do process language and social information differently than boys, then clinical and educational interventions based largely on research with boys may be inappropriate.

As a result, girls may receive less than optimal academic and behavioral interventions and not realize their potential. Further research is urgently needed to examine the similarities and differences between males and females to determine whether the diagnostic definition of Asperger syndrome is valid for both boys and girls (Attwood, 2007). If gender specific variations do exist, then the predictive validity of the diagnosis and developmental course may well differ between the sexes.

In the meantime, educators and school personnel should question the presence of an autism spectrum disorder in female students who may be referred for internalizing problems such as anxiety or depression. Additionally, when a girl presents with a combination of social immaturity, preservative or circumscribed interests, limited eye gaze, repetitive, social isolation, high levels of anxiety and attention problems, and is viewed as “passive” or “odd” by parents, teachers or peers, the likelihood of an autism spectrum disorder should be considered (Wagner, 2006).

Lee A. Wilkinson, PhD is a nationally certified school psychologist and adjunct faculty member at Nova Southeastern University with a practice and research interest in the identification and assessment of children with autism spectrum conditions.

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sobre a inveja (crônica)

Para entender-se um pouco do mecanismo insidioso que a inveja representa, um bom passo é assistir e observar a trama e os personagens de Amadeus (1984), do cineasta tcheco Milos Forman (um dos meus favoritos, diga-se de passagem) – ou, pelo menos, leia-se a peça original do prestigiado e premiado dramaturgo inglês Sir Peter Schaeffer, no qual o filme inspirou-se. A propósito, este mesmo dramaturgo teve outras duas peças suas adaptadas para o cinema, anteriormente: Equus (1977) e The Royan Hunt of The Sun (1970), cujo título em português não lembro, se bem que o mesmo era exibido (e eu assistia) nas sessões coruja da vida, no meu tempo de garota.

Falando da peça Amadeus lembro-me ainda que a mesma, nos anos 80, foi montada no Brasil, com Raul Cortez (1932-2006) no papel de Salieri. Não assisti a essa montagem, infelizmente; mas, com um ator do porte de Raul Cortez no elenco, deve ter sido fantástico, uma vez que o saudoso – e extraordinário – ator era garantia de bons espetáculos. E Equus também foi brindada com uma montagem brasileira na década de 70, na mesma época em que o filme homônimo foi lançado.

Não me perderei aqui em comentários sobre a a peça Amadeus – adaptada em clima mais light às telas – ou a obra do dramaturgo inglês como um todo, assim como as características mais marcantes de suas peças (constantes, aliás, em qualquer boa peça teatral que se preze): diálogos densos e igualmente densa caracterização psicológica dos personagens, entre outros. E, de mais a mais, em um país como o Brasil, Teatro é – apesar de alguns bons momentos, naturalmente – um terreno inevitavelmente ingrato. Por outro lado, enquanto Forman “amaciou” Amadeus para o público de cinema, as versões cinematográficas de Equus e The Royal Hunt… (que não são do mesmo diretor, veja-se bem) permaneceram mais fiéis às respectivas versões teatrais originais.

Apenas comento sobre Amadeus, the motion picture (não resisti), este mais acessível; afinal, qualquer locadora minimamente sortida deve tê-lo em seu acervo, disponível para aluguel. Se bem que, por tratar-se de um filme tão bom, desses de que JAMAIS enjôo, tratei de devidamente incorporá-lo ao meu acervo particular de DVDs. Com um detalhe: a cópia de que disponho é a chamada versão do diretor, com alguns cruciais minutos a mais que acabam por desvendar uma nova dimensão tanto ao próprio enredo quanto aos olhos do espectador atento – diferentemente da versão veiculada nos cinemas no ano de sua estréia nos cinemas, e por mim assistida à época.

Na trama – e aqui chegamos ao ponto -, toda uma psicologia da inveja é esmiuçada, e não apenas através do músico Salieri, mas também de toda a concorrência da corte austríaca daqueles idos do século XVIII, que via no talento de Mozart uma verdadeira ameaça, por assim dizer.

Na versão veiculada por ocasião da estréia do filme, o tom maniqueísta é mais forte: Salieri, esse “monstro” medíocre e certinho minando aos poucos, com seu olhar seca-pimenteira, a energia do genial e indisciplinado concorrente.

Porém, na versão do diretor em DVD aqueles preciosos minutos a mais desvelam uma dimensão mais humana dos dois rivais (ou “inimigos íntimos”?), de suas respectivas condutas – e, sobremaneira, motivações pessoais. Desta forma, entende-se porque Salieri passou a odiar Mozart e como este por seu turno não era, a despeito de toda sua genialidade, florzinha que se cheirasse. Pois, como o próprio cartunista Henfil ( 1944-1988 ) resumiu, certa vez: “Arte e caráter não têm nada a ver uma coisa com outra. Infelizmente, ou felizmente”. Humanos feitos do mesmíssimo barro, no qual misturam-se virtudes, defeitos e limitações, enfim.

Desta forma, assim como Salieri, lá no íntimo de seu ser, reconhecia a genialidade de seu concorrente, a inveja é, como bem definiu alguém conhecido meu, certa vez, uma admiração azedada: no fundo, o invejoso admite os méritos do objeto de seu sentimento deletério, embora não dê o braço a torcer jamais.

Portanto, digamos que retifico a moral de uma antiga fábula, a qual apregoava que “a inveja não admite o mérito”: admite, sim – embora, repetindo, não dê o braço a torcer, preferindo antes puxar o tapete.

Porque, em nossa humanidade limitada e mesquinha, acabamos por perturbadoramente enxergar-nos muitíssimo mais em Salieri, por mais que não o desejemos: todos somos um pouco como ele. Ele está em cada um de nós, como realmente somos. E ele é de fato como autoproclama-se, apoteótico, o “santo padroeiro” da nossa mediocridade.

…E o caminhão de gás, alheio a tudo segue, impávido, assassinando Für Elise.

UPDATE: trabalho de pós-graduação, feito em 2010

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