1. Advocacy for adults with ASD
and the gender imbalance
By: Nicole Jinn
September 15, 2016
1Nicole Jinn

2. Overview
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3. Part 1: Advocacy for adults
with HFA
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4. BC Government’s lack of action
 Services by BC Ministry of Health exclude adults diagnosed with
HFA (and ASD in general) – e.g., Thrive program at Open Door Group.
 BC Ministry of Social Development and Social Innovation directed
me to Community Living BC’s Personal Supports Initiative (PSI)
program.
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5. CLBC’s Personal Supports Initiative (PSI) –
created in Aug 2008 (delivered in Feb 2010)
Original – CLBC had committed to the
program before they received the funding
 Never launched
 IQ ≥ 70
 Adaptive functioning below 70
(= 2 standard deviations below
the mean)
Implemented – CLBC had to make the
eligibility fit the economics
 Launched – CLBC received 10
million from BC Liberal Gov’t
 IQ ≥ 70
 Adaptive functioning below 55
(= 3 standard deviations below
the mean)
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6. Problems with CLBC’s PSI eligibility criteria
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7. Current state of services among prominent
autism organizations in BC
 Autism Community Training – funded by government only to work
with children with ASD.
 Autism Society of BC – No adult services yet in Vancouver, and
primary target audience of all events and services still is children that
have ASD (and their families).
 Canucks Autism Network – targeted for teens and young adults
with more severe cases of ASD, who are almost all male!
 PALS Autism School – offers adult program, most likely for those
with more severe cases of ASD, and waiting list is very long!
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8. Current state of autism-related
employment services in BC
? Pacific Autism Family Centre – opening in October 2016.
? EmploymentWorks Canada – launched on April 11, 2016 and first cycle
finished at the end of June 2016; second cycle is close to completion.
? Inclusion BC: Ready, Willing & Able and BC Partners in Workforce
Innovation – connecting people with diverse abilities, including HFA,
to employment opportunities.
? Coast Clubhouse (by Coast Mental Health)
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9. Current state of autism-related
employment services in BC (cont’d)
? YMCA Youth BEAT Program
? Gastown Vocational Services (GVS)
? Focus Professional Services – training only adults that have HFA to
deliver Software Testing and Data Quality to various client
organizations.
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10. Key barrier: Accessibility of services
for adults in BC that have HFA
 EmploymentWorks Canada and Focus Professional Services – the
only two services geared specifically for adults that have HFA –
require a pretty high level of skill in emotion regulation and anxiety
management.
 YMCA Youth BEAT and GVS require a strong and established support
network in place before entering into the program.
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11. Key barrier: Finances ($)
 PosAbilities, CBI Consultants: fee-for-service.
 Services not covered by government: psychologist, speech-language
pathologist, coach, counsellor.
 No funding at all for adults 19+ years old for those that are not
eligible for CLBC services.
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12. Amplified difficulty in developing
important skills
The following skills are not to be taken for granted:
 Emotion regulation / Anxiety management
 Interpersonal skills to work effectively in (large) groups
 Establishing and maintaining a strong support network
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13. Autism Canada
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 Autism Canada ASD Advisory Committee:
http://autismcanada.org/about-us/board-advisors/asd-advisory-
committee/
 Facebook page: Autism Canada ASD Central:
https://www.facebook.com/groups/1710172265882835/

14. Federal Accessibility Legislation initiative
 Will result in a Canadians with Disabilities Act (CDA).
 http://www.esdc.gc.ca/en/consultations/disability/legislation/index.
page#h2.3
 Autism Canada has a team of people preparing to provide a synopsis
or communication piece to assist adults with ASD that are interested
in participating in Minister Qualtrough’s engagement initiatives.
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15. Part 2: The gender imbalance
Making sense of the (high) ratio of males:females officially diagnosed
with ASD – especially HFA
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16. History
 Kanner 8/11 were male
 Asperger 4/4 cases he wrote in detail were male
 These early male-centred behavioural, clinical, and symptom
descriptions may have led to an underrepresentation of females in
research, which in turn led to a male-biased understanding of ASD
(Lai et. al., 2015)
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17. Lack of research on
females with HFA
Plausible reasons:
 Symptoms more visible and
easier to detect among males
 A female-specific manifestation
of autistic strengths and
difficulties does not fit the current,
male-centric* diagnostic criteria
* due to overemphasis on males and
underrepresentation of females
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18. Less and Later
“In the absence of intellectual impairment
autism spectrum disorder (ASD) is diagnosed
both less and later in females” (Hiller et. al.,
2014 p. 1381)
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19. Need for research on females with ASD
Dr. Kevin Pelphrey, psychologist at Yale
University's Child Study Center:
“Everything we thought was true of autism
seems to only be true for boys.”
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20. Major sources of misdiagnosis in females
 Anorexia
 Attention-Deficit/Hyperactivity Disorder (ADHD)
 Bipolar II
 Borderline Personality Disorder (or other personality disorders)
 Depression
 Post Traumatic Stress Disorder
 Gender dysphoria (formerly Gender Identity Disorder)
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21. How does HFA manifest in females?
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Domain Characteristics More Often Present in Females Than
in Males
Social interaction Greater awareness of the need for social
interaction
Desire to interact with others
Tends to receive less tolerance and more
expectation from others because she appears
more socially adept – often perceived as “just
being shy”
Better at mirroring others (copy, mimic, or mask)
in social interactions, so may mirror many
different types of personalities
Tendency to “camouflage” difficulties by masking
and/or developing compensatory strategies

22. How does HFA manifest in females?
(cont’d)
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Domain Characteristics More Often Present in Females Than
in Males
Social interaction Difficulty in distinguishing between friends,
acquaintances, and enemies
Communication skills Better linguistic abilities developmentally
Restricted, repetitive patterns of behavior,
interests
Restricted interests tend to involve people/animals,
which may be less recognized as related to autism
Other Tendency to be perfectionistic, very determined
Emotional instability – adult females are more
prone to both temper and crying meltdowns, even
in public; sometimes over seemingly small things
due to sensory or emotional overload

23. What do you think is the true ratio of
males:females officially diagnosed
with HFA (or ASD)?
My email: nicole.jinn@gmail.com
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