Early Years – pre-school, nursery and playgroup

At the risk of stating the obvious, a child spends a large proportion of their waking hours at school. School is not home. School does not have Mum/Dad/carer/family in it. Nor does it have a perfectly colour-co-ordinated, unplayed-with collection of My Little Ponies, or X-Men, for that matter. School has people in it: lots of them. As Rudy Simone puts it, ‘Most of the Aspergirls said the same thing […] school was boring and they were bullied’  

For the child with Autism Spectrum Disorder (ASD) school constitutes a lack of control in all aspects of their world and hence can be a place of great trauma and anxiety. It is a constantly social environment. It can also be a place of knowledge, usefulness and structure. The extent to which the experience is positive or negative for the child is often a result of the understanding of her ASD by those in authority and their willingness to help her out. For girls, the aforementioned late, or non-existent, diagnosis and limited understanding of the female presentation (‘She’s quiet: she’s fine’) can mean that the school experience is often far from positive, as we shall hear. Eileen Riley-Hall, in her book Parenting Girls on the Autism Spectrum (2012), presents a whole chapter outlining education options and processes in both the US and the UK, which covers the practicalities and considerations with far more skill than I can here.

As we progress through this book and look at adult outcomes for women with ASD, we will see that intelligence does not necessarily lead to a conventionally successful outcome. Many women with ASD have to find their own rocky path to their own version of success, which may come later and in a different form to anything anyone could have predicted from that bright, quiet, bookworm of a girl.

On the whole, the girls and women with ASD who participated in the research for this book – particularly those diagnosed in adulthood – had a rotten time in their school years due to a lack of early diagnosis, support and any understanding of their perception of the school experience. This knowledge is useful in enabling us to identify how they felt and what went wrong for them and to put measures in place to prevent other girls with ASD from having the same experiences. This is a hope shared by one mother for her daughter:

It was a long road to get A recognised as being on the spectrum. Once support is in place, the difference is remarkable; I am almost envious and wish that I had had this understanding. It is my mission that she will not end up like me. Her home will be her haven, she will find love, understanding and support from her parents and I will insist that her school does the same. All of her desires and interests are supported; I cannot bear the thought of her feeling frustrated like I did. I look back and wonder what I could have been had my interests been indulged. (Mother with autism, who has a daughter with autism)

It is sometimes not until a child begins some form of formal education that their ASD starts to become apparent. All children have their own quirks and preferences, which are met and managed within the home and the family, and it may not be until the child is required to tolerate a large number of other children plus a few strangers for several hours a day that problems arise. She may have been an active helper to her mother at home, polite and talkative to visitors, relaxed and outgoing with her family and happy organising her toys and collections; a child who shows no signs of visible stress, because there probably wasn’t any. When asked about their experiences of their children starting pre-school, parents report:

Starting school was awful. Up until this time she was a happy, lovely little girl. The anxiety she feels is very upsetting. To be honest, I think she has resigned herself to school. I will consider home school when she is older if she finds it too difficult; the damage it could cause her is something I know only too well. (Parent of girl with autism)

Dreadful. It was then that we started to really see the differences. (Parent of girl with autism)

Some children have no concept of why they are going to this new place. It may seem obvious to us that this is simply ‘the way things are’ after a certain age, but this assumption cannot be made for a child with ASD. We may assume that the socialising aspect of play settings is beneficial to the child. This is an almost universally held belief, particularly in the case of girls. The child with ASD may disagree. It may be that for some children with ASD there really is no point or functional benefit in them attending a group play setting and that the distress caused outweighs any possible benefit gained. This notion is difficult for many parents to acknowledge as they believe that being alone cannot be good for the child; but for many children and adults with ASD, being alone is the best thing of all.

I was distraught and in tears and didn’t want to go. I didn’t see the point. I would regularly vomit in the car on the way to pre-school. (Woman with autism)

Capacity can become stretched for the first time in the child’s life and very different behaviours may be observed. For the child herself, the world has suddenly changed beyond all recognition and has potentially become very frightening; she has had to leave her home (her sanctuary) and in its place there is this cacophonous, labyrinthine, stranger-filled abyss. In the responses to my questions, there was a marked difference between those who were diagnosed in adulthood, who had to navigate school without a label or any adjustments, and those who are still children with a diagnosis and receiving support (although this may have been hard fought for by their parents and initially traumatic for the child).

The transition to pre-school was very difficult. She became upset and didn’t want to go in […] The manager asked me to stay every day for three weeks and then I gradually stayed for less and less time. [The manager] said that she had never had a child who reacted like this for such a long time. The transition to primary school was much better. We knew that she probably had autism at this stage, and a comprehensive transition plan was put into place. She settled in quickly and enjoyed it. (Parent of girl with autism)

Eileen Riley-Hall (2012) advises parents to take a photograph of their daughter to any meeting to discuss her education in order to remind everyone present that she ‘is a person, not just a program to be created in a cost-effective manner’ (p.49).

The adult-diagnosed women’s recollections are, in the vast majority of cases, negative and painful to read: ‘dreadful’, ‘awful’, ‘horrific’, ‘distraught’ are the words they use. For parents of children who have managed to get support in place, the story is remarkably different and positive. Comparing these experiences lends huge hope and support to the idea that knowledge and a change in attitude can make a real difference for the daily experience of the child with autism. The tales of late-diagnosed women give insight into a world that we should not be subjecting a child with ASD to in the present day.

I remember early on […] crying and hiding behind a door when we walked from one classroom to a new classroom and I was unaware of what was going to happen. (Woman with autism)

My mum says I hated nursery. She never managed to leave me there for a full day as the teachers often had to call her because I was crying so much. (Woman with autism)

Horrific, traumatic experience, which sadly never improved. (Woman with autism)

The school environment was stressful and hectic and full of people who seemed to hate me for no reason. (Woman with autism)

Many of the comments and experiences here could apply to both boys and girls, but some are more indicative of the female profile and of others’ expectations of girls’ behaviour and social abilities, which these girls may not be able (or aspire) to match up to. It is difficult to convey just how deep-seated and a core part of society these gender expectations are, and how hard it is to consciously recognise these girls and be willing to view them as different but equally acceptable just as they are.

There are many books on educating children on the autism spectrum, with tips, tools and techniques that go into great depth. I will touch on a few here, but my main purpose is to illustrate the female experience in a school setting. The intention is not to frighten professionals or parents of young girls with ASD into seeing the horrors that lie ahead; rather, it is to prevent these experiences happening to future generations of girls. The headings below are not consistent across each educational setting as different aspects cause different levels of difficulty at different stages. I would advise that reading through all settings might be worthwhile to get a picture of potential issues in education as a whole rather than just isolating one age group. Any child or adult with whom you are working will either have already experienced much of what is discussed through these sections, or has yet to do so as they move forward through the education system. Either way, a holistic consideration of the impact of their past and potential future should enable any professional to better consider appropriate educational measures to be put in place.

Early Years – pre-school, nursery and playgroup

Physical environment

This is a young girl’s first experience of spending significant time with people other than her family and in an unfamiliar environment. In the UK, these Early Years experiences may sometimes take place in a building that is not built as a place of learning and that is used for many functions throughout the day – a church hall, Scout hut or leisure centre, for example. The rooms are often large, old and have strange acoustics. Furniture and equipment have to be set out and packed away at the start and end of each session and that can mean that materials and space may be limited and not very adaptable. The impact of these factors on a child with autism may be that they experience stress around the sensory environment in terms of noise and acoustics, but also in terms of a lack of consistency about the layout of the space. I have worked with children (and adults) who cannot tolerate furniture being moved in a classroom without their presence; for them it is like entering an entirely different place and requires them to entirely reconfigure their understanding of where they are every time they enter the room. Something as simple as this could result in anxiety and so-called ‘challenging behaviour’.

Teaching and support staff

Early Years settings are often partly staffed by volunteers, who may have limited or no knowledge or experience of ASD – particularly as it is often not diagnosed in this age group unless there are significant verbal or global developmental indicators. In contrast, they may have plenty of knowledge about how they expect a neurotypical child of this age to behave. These general expectations of what is typical can put pressure on the child to conform in ways that are unmanageably difficult for them, but nobody knows why they become so distressed. A requirement to sit on an itchy carpet, touch wet sand or hold hands with another child may make the setting unbearable for a child with ASD.

They insisted on tying my hair up and I found this very painful. Until recently when I read about autistic people having scalp sensitivity, I blamed them for being horrid and pulling my hair so painfully. (Woman with autism)

Training and awareness for staff working in these settings is crucial in ensuring early positive experiences for young girls with ASD, even if the ASD is only suspected by the parent at this stage. Diagnosis is unlikely to have taken place for many of these girls at this age, but early signs of difference should be accommodated, regardless of official recognition. It may only be possible to make limited adjustments to the environment due to factors outside the Early Years organiser’s control, but small measures can make a huge difference; a quiet space being made available with headphones, being permitted to hold a teacher’s belt rather than her hand, wearing rubber gloves while playing in the sand pit, a beanbag and a favourite toy are strategies that might provide a small respite and reduce anxiety for a child who is feeling overwhelmed or overloaded.

Communication and structure

Early Years settings can be quite fluid and flexible in their schedules, which may cause additional difficulties for the child with ASD who does not know what is going to happen unless explicitly told. Some children become distressed at their parent leaving them at playgroup or school because no-one informed them that the parent would return. Without the benefit of imagination, the child may assume that she will never see her parent again, which makes the level of distress understandable in that context.

Some level of predictability and timetabling might help a child with autism to cope with knowing what to expect each day and how and when it will start and end. Explicit and visual reassurance can support the child in managing her own anxious feelings.

At playgroup, she seemed to find unstructured play unsettling. Was often telling the adults that they were wrong, e.g., spelling or simple facts (usually correctly!). Was seen as aloof and a bit posh! (Parent of girl with autism)

A pictorial schedule of the day pinned to the wall might provide evidence of certainty and the child can be encouraged to learn where to find the information she needs on it. This may also give the child the chance to look forward to certain activities and encourage her to attend – particularly if these can be tailored to meet the child's interests. Being told that tomorrow she will be able to look at pictures of cats and draw cats – if cats are her ‘thing’ – may help a reluctant child to feel motivated to attend. In terms of other motivators, it may be that social ones don’t work. As we shall see below, other children were often the cause of difficulty and apprehension about attending school or nursery. Attempting to persuade a girl with ASD to go to playgroup in order to ‘play with her friends’ might remind her of the horror of sharing toys and reduce her to tears and panic. For many children with ASD, free playtime is the hardest time of all to manage. Identifying the motivators that are meaningful to her – interests, favourite carer, specific toys, biscuits at breaktime and chocolate on the journey home if she makes it through the day – is most likely to achieve success.

School

The transition from an Early Years setting into school can be quite a shock for a child with ASD. A uniform with all of its required sensory tolerance may be insisted upon; the length of the school day may increase two-fold and the afternoon nap is a thing of the past. Although some children with ASD embrace the clear rules, structure and boundaries that school imposes, since these things provide routine and hence a sense of safety and relief, others find the number of people and the length of the school day extremely difficult to manage. Good preparation for this, prior to the child starting school, is essential to ensure that the child understands what school involves and has some idea of the environment that she will be spending her days in.

She finds school emotionally draining […] she would often ‘explode’ the minute she left the school gate and I learned that it was best not to speak to her at all while we walked home because any conversation would lead to meltdown. (Parent of girl with autism)

It is necessary to remember that the girl with ASD may not appear to have any difficulties; she may be the ideal child, helpful and polite. This may be the case at first, but as she gets older and additional demands are made of her, both socially and educationally, the mask may start to slip. (It has been shown that increased demands in both of these areas contribute to increased anxiety in girls with ASD (Stewart 2012)). And, as we have seen, when the mask slips, something that looks like mental health issues can be revealed; however, careful observation may lead to the conclusion that changes in a girl’s behaviour are simply the result of an inability to maintain the neurotypical persona that she has learned to create.

An important thing to note, and that has been seen in this research and elsewhere (e.g., Stewart 2012), is that girls with ASD want to do well, comply and not get into trouble. As professionals, if we always keep in mind that when a girl is doing something that on the face of it appears rude, diffident or downright obstructive, she is, in fact, trying her hardest to do the right thing, regardless of how it might appear, we can support her by understanding what she is trying to say or do and teach her a new way of doing it in the future.

Breaktimes and social interaction

For many children with ASD, breaktime is the most difficult part of the school day. The structure of the lessons is gone and the entire population of the school is released into the playground, our girl included. Suddenly, social abilities reign supreme and an understanding of the complexities of relationships, negotiation and rules of play is required. It would be fair to say that our girl with ASD may well return to the classroom after a ‘break’ more exhausted than she was when she left it. This is an extremely important point and one that must be considered in reflecting on behaviour, performance and general well-being at school.

[The playground] was noisy, unorganised chaos. I went home for lunches and avoided busy [areas] at playtime. (Woman with autism)

I wanted to stay in and read a book, but was not allowed. I spent most playtimes alone. (Woman with autism)

I would stand by the punishment wall (a place where kids were sent to stand if they had done bad things) every playtime of every day, and do nothing but stand there during that time. (Woman with autism)

Playtime remains difficult for A. We asked the school to give her more supervision, access to a quiet area indoors, a place for her to eat her lunch outside the dining hall at times of high anxiety as these things are very hard for her. (Parent of girl with autism)

As girls get older, their friendships change, and they move away from toy-based, pretence games to more sophisticated people and personality-based relationships. Girls talk about other girls (and boys); their relationships are subtle and nuanced, and allegiances are forever changing. Girls with ASD struggle increasingly with age to, first understand why this change has occurred – they were quite happy as things were – and, second to be able to continue to hold their own in this new social arena (Riley-Hall 2012). School breaktime is the primary location for this new terror – and it happens three times a day. This is supposed to be the part of the day that is ‘fun’! For parents, the expectation may be that seeing friends after school is a natural thing for their child to want to do. The parent of one girl explains beautifully the perspective of her daughter with regard to socialising after school:

We rarely had playdates in the first couple of years because she said, ‘I’ve been at school with people all day – why would I want to see them again now?’ (Parent of girl with autism)

Learning and teaching style

Many of the women and girls who participated in this book were precocious early talkers, often with extensive vocabularies. This does not mean that learning came/comes easily to them, on account of the neurotypical system they were/are expected to adhere to. We must not forget that, even in a learning environment, social requirements are always present, which means that our girl with ASD has to work doubly hard to make sense of both the social and the academic elements.

I had little interest in other children and would much rather have been left alone with books to study by myself or just have one-to-one lessons. Being around the other children was a huge impediment to my learning, well-being and mental health. (Woman with autism)

Due to my constant daydreaming and struggles following spoken instructions, I had a lot of trouble with learning. (Woman with autism)

I was pretty good academically; my biggest difficulty was probably with my own arrogance and I felt I was superior to not only the other kids but to the teacher. (Woman with autism)

We know that individuals with ASD find life easier if there is some structure and predictability about what’s coming next. It means that anxiety is reduced and therefore the capacity and ability for learning are increased. School is often full of rituals, routines and structures. Unfortunately, many of these make little sense as they may have a social or compliance basis rather than a logical one. They may also be imposed without any contextual explanation to enable the child to learn why these social behaviours are beneficial and/or necessary. Being reprimanded for doing something that you didn’t know you had to do and why you had to do it – and hence are unlikely to understand the context of when to do it next time – causes anxiety. Knowing that you will undoubtedly get something ‘wrong’, but are not sure what or when, is perhaps why children with ASD can develop school phobia.

It is thought that girls with ASD are more likely to suffer in silence (Wagner 2006) and that their ‘shy’ profile means their learning difficulties go unnoticed. These girls may just be seen as poorly performing students. The desire to fit in and not be seen as stupid by their peers may explain a reluctance to raise their hands to answer a question or to stand out in any way.

She is a perfectionist […] she would not put up her hand or answer a question for many years in case she was wrong […] She generally sits at the back saying very little but still manages to produce excellent work. (Parent of girl with autism)

She won’t speak to a teacher because she ‘doesn’t want to bother them’ and ‘might get shouted at’. This is a problem because she will never ask if she doesn’t understand. (Parent of girl with autism)

Subjects

Among those women questioned, art and English topped the list of favourite subjects at school. These are not the typically expected ‘male’ ASD topics (usually involving maths and IT), which may add to the difficulty in considering an ASD diagnosis for a literary and creative girl. Many were voracious readers and most happy when engrossed in a book during the school day. They also enjoyed drawing and colouring – perceived as typical female pursuits. Gathering factual (or fictional) information in a solo world appears to be more enjoyable than gathering social information in the real world for these girls, and their knowledge of chosen subjects can be extensive. My personal experience was of being constantly described as ‘lazy’ by teachers for never achieving an ‘A’ grade despite being a gifted-level student with precocious early speech. I have always said that I knew the answer, but I didn’t know the question. It was other people’s language I had trouble with, not my own. Language processing (verbal and written) made much of learning inaccessible, but I was fortunate to be able to scrape through using intellect and logic, which has its limitations. This remains the same in my adult life.

Girls with ASD, like their male peers, can show unusual, uneven learning profiles, where instead of having a fairly consistent profile of ability, they exhibit extreme subject area peaks and troughs. The causes of this can be a combination of:

•the cognitive profile of autism itself

•the nature of the subject being taught

•the individual’s natural processing style and ability

•the teaching style

•the level of interest and motivation that the student has in the topic.

All or some of these elements can combine to create a greater or lesser ability in certain subjects. If the subject content is inaccessible, due to either its nature or the way in which it is taught, a student with ASD is more likely to switch off and feel incapable of engaging. The logical nature of those with ASD leads some to conclude that if they know they are going to fail at something, why bother to even try?

I saw little point in doing any subject I wasn’t good at as it seemed a waste of time and just an exercise in futility and self-humiliation. (Woman with autism)

Something as simple as considering a different teaching approach or explaining a broader contextual reason for the purpose of the topic can bring about a change in attitude and performance in certain subjects.

Teaching staff

Research has shown that teachers are less likely to notice and/or report difficulties with adapting in girls with autism than boys (Mandy et al. 2012), perhaps due to the invisible presentation in girls and the perception of ASD as a male condition. Girls with ASD have been found to exhibit less restricted, stereotyped behaviours, which are a known visible sign of potential ASD. It may well be that if a teacher does not notice any such behaviour, they may not be open to the possibility of ASD. Teachers rarely have sufficient knowledge of autism, even less so its presentation in girls (Wagner 2006). Constant misunderstandings from teachers were a common theme in the responses of my participants and have also been identified as a concern elsewhere. Catriona Stewart states that:

As they worked to establish a system of rules that allowed them to function (i.e. systems of behaviour relating to logic, sustainability, cause and effect, predictable outcomes, fairness), the girls were expected to function in a world of people whose behaviour did not adhere to them. (Stewart 2012, p.42)

I did well in school but did not speak a lot and ended up in detention for really [trival] things like not talking. (Woman with autism)

She tells me how she was sent to the Principal’s office because she had kicked someone under the table. She says she didn’t know why she was there or what she had done – she was just swinging her legs. (Parent of girl with autism)

We were playing a game where everyone stands in a line with their feet apart, and the person at the front rolls a ball through everyone’s legs to be caught by the last person in the line, who runs to the front […] The teacher pulled me out of the line and shook me in front of everyone, and I never did understand what for. (Woman with autism)

Teachers are predominantly female and perhaps, given their people-focused, flexible, communication-based career choice, may be quite different in personality from their young, female charges with ASD. When one considers the difficulties that these girls can have with their female peers, it shouldn’t surprise us that they have similar problems with the grown-up versions of those peers, who may become teachers! It is also important to remember that relationships are reciprocal, so it is not simply the case that the girl with ASD doesn’t understand and relate well to her more intuitively communicative teacher; it is equally the case that the teacher may not feel that she has ‘connected’ with this unusual (especially so for a ‘girl’) child. The standard reciprocal ‘positive strokes’ may not be there and the teacher may be confused by their feelings about this girl. Children with ASD may also be highly knowledgeable in certain subjects and, not perceiving the invisible social rules of hierarchy, may quite confidently correct or interject when a teacher is speaking. This can be perceived as a deliberate attempt at insult by a teacher, whereas the girl is simply presenting empirical facts and has no agenda to cause emotional harm or any understanding that she may be doing so.

As professionals, it is essential that people self-reflect and separate their – often strong – personal feelings towards a person from their professional duty to do the right thing for that individual. I am not aware that teacher training programmes include this type of practice, but it is my belief that they should. It may be that the teacher is not even aware of why this child upsets them so much as it can occur on an subconscious level. People who are very emotionally intuitive can sometimes take the behaviour of this type of girl personally and assume that she is deliberately trying to make life difficult. The insights from girls and women with ASD reveal that this is seldom, if ever, the case. Mostly, they are desperate to get it right and gain approval and acceptance, but despite their best efforts, they often appear to do the one thing that causes a teacher to react very badly to them at times.

They [teachers] didn’t like me, thought I was lazy, and often accused me [of] being an attention-seeker, when all I really did was actually avoid everyone. (Woman with autism)

Some [teachers] felt her rude/insolent when she showed high levels of knowledge and intelligence. (Parent of girl with autism)

They [teachers] seemed to think I was choosing to be different and to have social difficulties […] One teacher bullied me terribly and used to reprimand me for not giving him eye contact. (Woman with autism)

It is worth noting that there is often an expectation that girls will be better than boys at social niceties and so may be judged differently – and sometimes more harshly – when they fail to behave in a ‘nice’ way on occasions where their intentions may have been misinterpreted. The following is a good example of this:

I wanted to surprise my friend by taking her outside and getting her to feel the rain in her face. She was still in the classroom so I covered her eyes and took her out of the class, walking blindly while telling her it was a surprise. As we walked down onto the patio she tripped, fell on a muddy patch, and her uniform got dirty. A teacher noticed and came over. She called me a ‘nasty, ugly girl’. I was not given the chance to explain, nor had I the verbal skills to interrupt and explain what I had intended to do. I had had no malicious intent whatsoever. (Woman with autism)

Physical environment

For a lot of school, we sat alone at desks, not in groups. This was perfect for me. (Woman with autism)

For many young women with ASD, the physical environment of mainstream school is extremely stressful (Stewart 2012) and this gets worse as they grow older. School dining halls are notoriously overwhelming for children with ASD, mainly because of the noise (cutlery, scraping chairs, banging plates, incessant chatter) but also because of the smell, visual overload and social elements (where shall I sit?). This stress can be exacerbated when there is the requirement to navigate the complex female social world of working out allegiances and non-verbal signals. One girl did not eat at lunchtime because the dining area was intolerable for her (Stewart 2012), leading to potential health issues.

Education in adolescence and beyond

The main problem for young women with autism at school during the teenage years is their social relationships and ability to be around other people for extended periods of time. The challenges of earlier childhood school remain but are exacerbated by an increased awareness of the difference between them and their peers. Spending time surrounded by teenagers at school is a constant reminder of these feelings of difference, and it is unavoidable.

I was totally lost as a teen at school, I had no idea how to pull off fitting in and didn’t want to be like the others. I wanted school to be about learning exciting, interesting stuff and then the subject matter being what everyone talked about, but alas that wasn’t the case. School seemed to be one big social experience and the learning and subject matter were irrelevant to most people. (Woman with autism)

When things were fine the autism helped my education – memory, numerical skill etc. But when things went wrong people were quick to judge things as ‘hormonal/emotional problems’ or ‘attention seeking’ rather than listen to me try to explain the actual issues. (Woman with autism)

Sharing space was a problem. I didn’t care to be around others much and during the teenage years – at school, home and work – I was trapped with people, which was horrendous for me. I used to spend ages in the bathroom with the door locked as it was the only place I could be alone with my thoughts. (Woman with autism)

College

I had convinced myself that my high IQ and high academic achievement record meant I was strong enough to handle whatever came my way […] I was hit hard when I had to realise smarts were not enough to make it in this world. I was turned upside down when I had to admit I could not find anyone who saw things like I did. (Liane Holliday Willey 2014, p.63)

Liane writes of how she had an accepting group of friends at school and how she expected to find the same at college, but instead found herself floundering in a bigger, unknown environment. While being bullied often decreases as people get older, it can be replaced with invisibility, which feels like rejection, regardless of intent. College means starting over again, with the need to initiate new relationships, but these are more adult, and more socially nuanced than the last time that this had to be done at the start of school.

Some women in my survey found that college was easier than school as there is more freedom of movement, there are fewer classes per day and you are able to choose to study subjects that you excel at and enjoy. The more mature treatment of students at college suits some individuals with autism – those who like control and autonomy, and simply to be left alone. A few found kindred spirits in their tutors, who offered knowledge and an escape.

I found it much easier to deal with college. When you are at school you cannot be alone at lunch/breaktimes, but at college it’s seen as quite acceptable to go to the library, or study or sit quietly and read a book. (Woman with autism)

I spent a considerable amount of time chatting to one of my lecturers, who was, on reflection, obviously on the [autism] spectrum […] If it wasn’t for him, I don’t think I would have achieved my A-levels. His office was like a sanctuary for me. (Woman with autism)

University

The challenges of university for women with autism are largely similar to those of men with autism, and other writing focuses on these aspects in greater detail. For women, the specific difficulties remain the same as for other areas of life: social interaction with female peers, mental health problems as a result of difficulties coping with what is required of them and lack of diagnosis, and, therefore, lack of understanding or support of any kind. The key to a successful experience of university appears for many young women to be linked to social integration and acceptance. They may have the academic abilities to undertake the work, but the isolation and implicit rejection can make the difference between successful completion and dropping out. Personal relationship issues are discussed elsewhere, but might also be a contributory factor during this time.

When I went to university, I failed my first year. The other students were girly girls; I just did not fit in. I felt very lonely and missed tons of lectures and deadlines. They failed me but allowed me to re-sit the year […] Thankfully, I got together with a group of students. We were a bunch of misfits […] We had a great time – those three years were brilliant. I felt completely accepted in my circle of friends and successfully completed my degree, with a few deadline extensions! (Woman with autism)

I’m doing a distance learning course, so I don’t really have to interact much with people. The occasional presentation or Skype discussion I can cope with, although I’m very self-conscious about these and find them stressful. (Woman with autism)

My autism wasn’t diagnosed until after university. I feel that had I been a male child, it would have been picked up sooner […] At university, I was mentally ill and I struggled to cope socially too as I don’t drink and I don’t go to clubs or pubs. I didn’t speak to anyone other than my tutors for the first year and nearly left on several occasions. When I tried to interact with people or be open about my difficulties and distress, people just became exasperated and bored with me, like I was a nuisance rather than someone desperate for support. (Woman with autism)