Whitlock, Alana; (2019) An investigation into the diagnostic bias in primary school teachers against girls with Autism Spectrum Disorder. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

This thesis comprises of three parts, with an overall focus on the diagnostic bias against females with autism. Part one provides a conceptual introduction to the topic through a narrative review and synthesis of the previous relevant literature. It considers the pertinent theories aimed at explaining the higher rates of autism diagnoses in males, before focusing on one specific theory – the presence of a female autism phenotype – in more detail. It presents a synthesis of the key literature which has investigated and evidenced this presentation, and attempts to deduce the ‘true’ higher male prevalence from possible diagnostic bias. It outlines current gaps in research, before providing a rationale for the empirical study of the thesis, and a justification for the methodology used. Part two is an empirical paper examining whether primary school educational staff, in their role as gatekeepers to autism diagnosis, show a bias against females with the condition through an over-recognition in males and a lack of understanding of the female presentation. Primary education staff were presented with vignettes depicting children with different mental health conditions, including both the male and female autism presentations, and asked to rate the likelihood of the child having the different diagnoses and the likelihood of them seeking support for that child. Gender was also manipulated on the vignettes, with half of the respondents receiving female-gendered vignettes, whilst the other respondents received identical male-gendered vignettes. Results indicated that respondents showed a bias against females with autism; female-gendered vignettes received lower estimations of autism and support seeking than male-gendered, regardless of the presentation described, and the female autism presentation received significantly lower estimations of autism and support seeking than the male autism presentation. The findings have potential implications for the recognition of females with autism in the future, as well as training for education staff in this area. Part three provides a critical appraisal of the research process overall. It reflects on the challenges faced and an evaluation of the decisions taken in regards to methodology and respondents. Finally, a reflection is provided on the experience of engaging in a joint project. This was a joint project with fellow DClinPsy student Kate Fulton (Fulton, 2019). See Appendix A for a breakdown of contributions.

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