Girls with autism spectrum disorder : missed diagnosis or misdiagnosis?

Abstract

This research investigates the possibility of females with Autism Spectrum Disorder (ASD) going initially missed or misdiagnosed in Malta. Potential reasons behind these diagnoses and the effects that they have on the individual were also explored. A literature review was conducted in order to gain a thorough understanding of the subject and to note gaps in areas of research. This study was qualitative and used semi-structured interviews as tools for data collection. Interviews were conducted with a group of 19 professionals who are involved in assessing and diagnosing individuals with ASD, and four mothers of females with ASD (fASD). These interviews were transcribed and analysed using a thematic approach. Through this analysis, themes were identified and discussed in view of reviewed literature. Results evidenced that initial misdiagnoses of fASD are uncommon in Malta, while missed diagnoses were acknowledged to occur locally. The most predominant factors identified as contributors to such diagnoses were: being high-functioning; the ability of females to mask their impairments; females‘ social inclination; professionals‘ hesitance and time constraints; and a general male-bias in diagnostic methods and clinical expectations. Repercussions with regards to missed diagnoses and misdiagnoses in fASD were generally related to a poor prognosis. However some professionals insisted that a misdiagnosis may not be detrimental to a child‘s prognosis as she is likely to be receiving intervention irrespective of the nature of the diagnosis.