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Contents Foreword 13 Acknowledgements 14 Author¿s notes 16 Chapter 1 . What do we currently know about girls and women with autism spectrum disorders? 18 Asking the question¿ 18 What families have shared 19 What we know and don¿t know about girls with autism spectrum disorders 20 Epidemiology and the puzzle of diagnostic rates 21 Same disorder, different faces? Sex differences in symptom presentation 22 Summary of differences in clinical presentation between girls and boys with ASDs 26 Diagnostic implications of sex differences 28 Interventions and supports 31 What causes sex differences in autism spectrum disorders? 33 Sex differences in other developmental disorders 37 The importance of understanding typical developmental sex differences 38 Clinical programs: Are they out there? 40 A window of knowledge: Personal stories by women with ASDs 41 Routes to a diagnosis for females and their families 44 I¿m still not sure what her diagnosis is¿ 46 Resources 48 Chapter 2 . Approaching adolescence: Anticipation, anxiety, adaptation and¿ acceptance? 51 Adolescence: The wild ride 51 Developmental tasks 52 Physical development 53 Social development 55 Personal identity 56 Adolescence x Autism = A2? 60 Specific challenges of adolescence 61 Precocious puberty 61 Seizures 62 Depression 63 Anxiety 64 Body image and disordered eating 67 Hygiene problems 68 Behaviour problems 69 Sexuality and masturbation 71 Your ¿Teaching Toolkit¿: Guidelines and techniques 72 Lessons from Nemo 79 Resources 81 Chapter 3 . Puberty or ¿Do my parents know you¿re here?¿ 86 Are you ready? 86 Mixed feelings about the start of puberty 87 Taking the plunge 88 ASDs and adjusting to puberty 89 When does puberty start? 90 Foundational skills 93 Wearing clothes in public places 94 Proper attire 96 Private topics 98 Private behaviours 100 Personal hygiene and grooming 100 Visuals, Visuals, Visuals: Supporting your daughter¿s hygiene and grooming skills 104 Teaching your daughter the ¿why¿ behind personal hygiene 106 Respecting privacy 108 Navigating pubertal change 109 Talking about change 112 Normalizing change 113 Finding teaching materials 114 Managing the locker room 116 Hormones and emotions 119 Resources 121 Chapter 4 . The red spot: Periods, pads and pelvic exams 126 Goal one: Finding your positive tone 127 Overcoming the cultural taboo 128 A happy period 128 How to throw a period party 129 Goal two: Providing accurate information 131 Learning about body parts 133 Explaining menstruation 135 Teaching tips for menstruation 137 Goal three: Practicing skills ahead of time 139 Being attuned to her body 141 Goal four: Preparing for the first period 143 Successful management of menstrual hygiene 144 Cycle awareness 144 Regular menstrual hygiene 146 Prepare yourself, and your daughter for (sigh) PMS 152 The great debate: Pads, tampons, or both? 156 The gynaecological exam 159 Aiming for independence 163 Resources 164 Chapter 5 . Feeling good inside and out: Self-perception and self-confidence 167 Part I: Your daughter¿s external sense of self 168 Body image and physical appearance 169 Issues with eating: From complications to disorders 172 Weight management 176 Fitness and exercise 177 Choosing the right activities: What kind of fitness is best for your daughter? 178 Building a healthy self-image 182 First bras and beyond: The world of intimate wear 183 Getting ready for the first bra 184 Choosing the right bra 185 Why do women have breasts and wear bras? 187 Fun with fashion and personal style 188 What are other girls her age wearing? 189 What does your daughter like to wear? 190 Developing a personal sense of style 196 Part II: Your daughter¿s internal sense of self 198 Creating success experiences 200 Developing independence, self-reliance, and responsibility 201 Promoting self-knowledge and self-awareness (¿Who am I?¿) 203 Developing and expanding your daughter¿s interests 205 Self-regulation and emotional understanding: 207 Fostering mental health 210 Depression 211 Anxiety 212 Self-injury 214 Mental health interventions 215 ¿The talk¿: Teaching your daughter about her ASD 218 What having an ASD means to your daughter 221 Self-determination and self-advocacy 221 Disclosure 222 Identification with other girls 223 Parent modelling of self-esteem: 224 Resources 226 Chapter 6 . The social landscape of adolescence: Friendships and social status 231 The age of friendships 231 Encouraging friendships 232 Maintaining friendships 234 Friendships for less verbal girls 235 Understanding friendships and developing friendship skills 238 Standardized assessment of social skills 242 Stages of friendship 244 Sharing and turn taking 248 Be aware of your daughter¿s friendships 249 Emotional communication 250 Popularity and social status 251 Specific challenges for girls with ASDs 253 Relational aggression 253 Possessiveness 256 Talking on the telephone 258 Finding your daughter¿s social compass 261 Resources 263 Chapter 7 . Healthy sexuality for girls with ASDs 266 Defining sexuality: Finding a common meaning 266 Sexual attitudes and values 269 Sexual myths 270 Your roles as a parent 272 Bill of healthy sexuality rights for girls with ASDs 276 Why is sexuality education important for your daughter? 276 Sexuality education for girls with ASDs 278 Challenges faced by girls with ASDs 278 Social challenges 279 Communication challenges 280 Behavioural challenges 280 Sensory challenges 281 Cognitive challenges 282 Mental health challenges 282 What does sexuality look like for typically-developing girls? 283 What does healthy sexuality look like for females with ASDs? 287 Your daughter¿s sexual education plan 289 General guidelines for teaching sexuality 291 How do girls with ASDs learn about sexuality? 292 Creating a basic sexuality education plan 294 Boundaries: personal space, touch, and affection 297 Sexual arousal and masturbation: What¿s normal for your daughter? 303 Communicating with your daughter about arousal and masturbation 304 Difficulties that might arise 306 Romantic feelings and being ¿interested¿ in someone 307 From romantic interest to dating 311 Safe and supported dating 316 What about intercourse and intimate sexual activity? 320 Your school¿s sexuality education curriculum: To participate, or not? 324 Gender identity and sexual orientation 326 How can I support my daughter? 329 Providing reading materials for your daughter 330 Resources 332 Chapter 8 . Keeping girls safe: Promoting personal safety in the real world 338 Abuse and developmental disabilities 339 Abuse and autism spectrum disorders 340 How to keep your daughter safe: Abuse prevention strategies 344 Social skills 345 Social communication 345 Emotional awareness 346 Sexuality education 347 Privacy awareness 348 Personal space, touching rules, and boundaries 348 Permission and ability to say ¿No¿ 350 Safety in the curriculum 354 Sexual harassment and bullying at school 355 Harassment prevention strategies for you and your daughter 358 What are the signs of abuse? 358 Building a safety circle 362 Steps to Safe Reporting 363 Reacting to abuse 364 Respecting others¿ boundaries: Keeping your daughter, and others, safe 365 Consent to sexual activity 369 Online safety: Protecting your daughter on the internet 371 Dealing with the dangers of being online 374 What you can do as a parent to keep your daughter safe 377 Resources 381 Chapter 9 . Our Journey: A Mother and her Daughter with Asperger's Syndrome 386 Our Journey ¿ B.D. (¿Before Diagnosis¿) 390 Our Journey ¿ A.D. (¿After Diagnosis¿) 404 Bullying ¿ The Nightmare that was Middle School 409 High School ¿ The Highs, the Lows and the In-Betweens 421 The ¿Here and Now¿ 429 Thoughts on Being a Female Adolescent with Asperger¿s Syndrome 431 Thoughts on Being a Mother of an Adolescent Daughter with Asperger¿s Syndrome 432 Conclusion: Embracing change 434 References 437
Library of Congress Subject Headings for this publication:
Autism in children.
Autism in adolescence.
Girls -- Mental health.