Interview with Dr Judith Gould: women and girls

Dr Judith Gould is the Lead Consultant at The NAS Lorna Wing Centre for Autism and retired as Director of the Centre in 2015.  She is a Chartered Consultant Clinical Psychologist, with over 40 years experience, specialising in autism and learning disabilities.

Dr Judith Gould kindly agreed to be interviewed for Network Autism when she attended the NAS Women and Girls Conference in September last year. We asked Judith a series of questions: you can view the full interview or clips of the individual questions below.

Full interview

Individual question clips

1. Can you tell us how your interest in women and girls with autism started?

2. How does autism differ in presentation between females and males?

3. Do you feel girls and women with autism are at increased risk of eating disorders?

4. Can you tell us how the understanding of women and girls with autism has developed over the last 10 years?

5. What are the key areas of difficulty facing women and girls on the autism spectrum?

6. What do you feel are the areas of support that are most needed for women and girls?

Author: Dr Judith Gould

Date added: 5 January 2016





Thu, 08/03/2018 - 18:53

"missed diagnosis"

What is really important is that everyone realises this includes diiagnostic failure following an ASD assessment.  This is happening.  It's not only females in mental health services being treated for the wrong conditions.

There is an issue with some clinicians failing to recognise female presentation of ASD and subsequently refusing to accept they have made a mistake.

Nobody is talking about this.  Everything centres around either misdiagnosis or diagnosis not being picked up whilst the person is in mental health services for other issues or through misunderstanding the cause of their issues.

We need to be talking about clinicians, some who believe themselves to be experienced in female presentation of ASD, putting reputation before patient care and failing to acknowledge the wrong outcome of an ASD assessment.

The NHS has a culture of covering-up which is well-known now, through cases such as Connor Sparrowhawk ( and which goes across the board. There is no redress with this, as patients requesting 2nd opinion are usually blocked as the original clinician's opinion is trusted.  Regulatory bodies and ombudsmen either pass the parcel, sending people on a merry-go-round ("we don't investigate individual cases") or assist in the cover-up.

Then there is the issue of the NHS refusing to recognise entirely valid private ASD diagnoses.

Why?  This is why:

"Autism is the most costly medical condition in the UK"

6. creating a direct link between a clinical decision over diagnosis and a recommendation for support could affect clinical impartiality. In the UK we are aware of situations where clinical professionals have felt under pressure from their employers to under-assess needs in order to ration limited resources.

"The medical insurance companies and other agencies will save money," Attwood said. "I can't say that this has been the driving force of the change; all I know is that this is the highly probable outcome. With fewer people being diagnosed, it's going to be less expensive for the agencies that support such individuals - either government or private."

So Dr Gould and other high-profile clinicians need to speak out and the National Autistic Society needs to pressure the Government to protect autistic adults (and children) in this position and write procedures that must be followed in the event missed diagnosis occurs.  Too much is currently left to clinical opinion as a final outcome upon which NHS trusts rely to block further opinion and reject people's autistic neurology.  A private ASD diagnosis is also just as valid as an NHS one and there is no justification for any NHS department or other public body, to refuse to recognise it.


Thu, 08/03/2018 - 18:57

In fact the NHS' own rules state that private diagnoses must be accepted:

"Private consultations

If you’ve had a private consultation for tests and diagnosis, you can still have treatment on the NHS. Your position on the NHS waiting list should be the same as if your original consultation was on the NHS."

There is also nothing in NHS NICE Guidance that states any of the guidance applies only to NHS clinicians.