I came into this project with a fairly firm idea of what I would find. I thought the shift from the old pervasive developmental disorders chapter in DSM-IV-TR to the single autism spectrum diagnosis in DSM-V had probably stripped out some of the gender detail. That loss, I believed, helped explain why so many women and girls still go unrecognised. It felt neat. It felt researchable. The start itself was delayed. I had to leave St Andrews for medical reasons and spent the first part of the summer at home recovering. I regretted not being able to participate in social events and learning activities. Luckily, I got to spend the last few weeks with the group and establish relationships with the other Scholars, and I am looking forward to having more of those opportunities.
Even after I returned the recovery continued in the background. Concentration came and went. Some days a couple of pages felt like real progress. Other days the same paragraph sat open for half an hour while my mind drifted.
Most of the work was reading. Twenty peer-reviewed papers plus the two manuals. I would open a new study or another section of the diagnostic text and try to stay with what it actually said about criteria, about sex differences, about how girls present. A few of the papers pulled me in more than others. Hiller’s comparison of already-diagnosed high-functioning girls and boys stayed with me. It showed how the same broad criteria could be met in quite different everyday ways, and how teachers still reported fewer concerns for the girls. Loomes et al. put a clear number on the recognition gap: screening studies identify more girls than studies that wait for clinical diagnosis. Whitlock’s vignette study with primary educators made the school gatekeeping point especially sharp. Other papers were slower going. Dense methods sections. Tables that needed re-reading. Progress stayed uneven.
What became clear after a while was that my opening assumption did not hold. DSM-IV-TR never set out separate must-meet criteria for females. The sex-related comments were short and mostly about rates. DSM-V-TR actually said more on the topic. It also named under-recognition of women and girls. It noted later average age at diagnosis. It described subtler social presentation and the possibility of masking. The diagnostic algorithm itself stayed the same for everyone. The description of how those criteria can look in practice simply grew longer.
Under-recognition is real and the papers still point to it. But the better explanations seem to originate elsewhere such as differences in how traits show up, instruments that were largely developed around male samples, teachers who notice the quieter female presentation less readily. The manuals did not delete girls from the picture. If anything, the later text makes that picture a little easier to see.
There is another silence that kept catching my attention. The studies talk a good deal about who gets identified. They say almost nothing about what happens after the label arrives or fails to arrive. How many treatment hours does the girl need? What kind of education plan can help? Can support actually stick and the female lead a better organized life with more learning and less dysregulation? That gap feels important, especially when identification numbers keep climbing.
Working at a slower pace while still recovering changed how I handled the material. There was less temptation to rush toward the conclusion I had brought with me. The weekly workshops and the knowledge that a poster and essay still had to be finished kept the project moving on the flatter days.
Looking back now that the research period has ended, I am still thinking about what this summer shifts in the way I approach a research question. Holding a clear prior concept can give you energy to start. Watching that prior assumption loosen under careful reading is a different kind of useful, although it was hard to wrap my head around it at first. Having said that, being open and able to change your opinion or conclusion must also be an important part of becoming a good researcher, or at the very least, a good reader. The next step is to turn the review into the final essay and poster so the findings can be shared more widely.
If you are in the middle of your own Laidlaw project and the pace feels slower or the results less tidy than you expected, I would be glad to hear how you are managing it.