Autism in girls and women

At the National Autism Show in June 2021 there was a particular focus on understanding and recognising autism in women and girls. Historically, autism studies investigated behaviours typically seen in men and boys, which then underpinned modern day diagnostic criteria. Initially, clinicians thought that ten times as many males were affected by autism compared to females. However, more recent studies estimate that the ratio of boys to girls with autism might be closer to 3 to 1, although the true figure is still unknown. Jennifer Cook, Siena Castellon and Dr Temple Grandin talk about their experiences on the autism spectrum.

Understanding autism in women and girls

Jennifer Cook is an autism consultant, international speaker and author of the “Asperkids” series. She spoke to us about why the diagnosis of women and girls might lag behind the true picture. “We are all on the human spectrum,” said Jennifer. “And yet everyone who recognises themselves in the autism characteristics I describe thinks they are the only one. I find there are scores of people who think they are the only one, when clearly that is not true.” Jennifer was relieved by receiving her own autism diagnosis at 35 as she had always felt ‘not quite’ in everything.

Jennifer finds that spectrum minds are more associative and less process-based. Just like boys with autism, girls have special interests, but these might not fit the more stereotypical diagnostic areas such as trains and cars. Girls’ special interests can often be more mainstream, such as anime, fashion and fiction – it is more the intense degree to which girls follow them that is associated with autism.

Autistic girls don’t act out, as boys often do, as much as they act in. They direct their anger at themselves not outwards to others, which can lead to self destructive behaviours such as eating disorders. Autistic girls might struggle with female friendships, as they are based on storytelling, might interrupt out of turn and don’t naturally take other people’s point of view. However, it is not true that autistic people do not have empathy. One type of empathy is stepping into some else’s perspective without having it explained, which people with autism may not do naturally. Once the other person’s perspective is pointed out, autistic people are very empathetic.

Jennifer finds that autistic girls tend to memorise information on social rules and sexual expectations to compensate for not picking these up instinctively. They often try incredibly hard to live up to people’s expectations, leading to issues with perfectionism. “For me, biographies are a favourite way to ‘learn how to be’. We have a missing sense of self because we don’t see ourselves very clearly,” explained Jennifer.

Perfectionism and a need for artificial control can lead to eating disorders and for Jennifer these are a big red flag. Autistic women and girls are more likely to manage anxiety, depression, trauma and low self-esteem through self harming behaviours such as cutting and skin picking.

Girls might also find less detectable ways to limit or avoid eye contact, such as looking at the space between people’s eyes. They might also engage in ‘show womanship’ instead of spontaneous or one-on-one interaction, for example by pursuing careers in teaching, narrative presentation, law or performance or have a hyperfocus on one best friendship that’s all or nothing. All of these behaviours can be strong indicators of autism in women and girls but are not fullly included in the diagnostic tools available to clinicians.

Education and autism

Lisa Camilleri and Naj d’Silva from Holmewood School spoke about providing specialist schooling for girls with autism. Initially, they had very few girls in their school compared to boys but have been gradually growing their female population. Setting up a Girls Club has helped girls to find their own identity within a school with a high percentage of boys.

While they have focused on supporting their female cohort, Lisa and Naj are also very aware that gender identity and sexuality are more varied among autistic people than in the general population. Some studies show that autism is more common among people who do not identify as their assigned sex than it is in the general population, perhaps 3 to 6 times as common (Warrier V et al 2020).

Lisa and Naj see first hand that autistic girls are diagnosed later in life and have greater emotional and mental health challenges. Autistic girls rely more on the intranet for friendships and have higher social anxiety. They struggle with how to respond to and resolve social conflict and find that close intense friendships can become all consuming. Sadly, there are also higher levels of assault for autistic girls making them highly vulnerable.

Autism and the impact on self esteem

Siena Castellon is author of The Spectrum Girl’s Survival Guide. Siena was diagnosed with autism at 12 and felt she was seen as eccentric, shy and aloof. She was sensitive to noise, touch and texture and felt rejected and ostracised by other children. Autism still seems to be perceived as a mostly male condition and for girls an autism diagnosis is seen as less valid or debilitating.

“If your autism is denied by others, it might be meant as a compliment,” said Siena, “but it really isn’t. The reality is that after diagnosis, for me nothing really changed. My diagnosis did not improve my life or stop the bullying.”

Autistic girls often ‘mask’, which means hiding their autistic traits – effectively changing their personality and behaviour to appear ‘normal’ and be socially accepted. This might include observing and copying others’ behaviour, assuming the personality of someone they like or preparing and memorising a script for conversations. Girls might also suppress their stimming behaviours or special interests.

Masking can be a double-edged sword. Girls develop a repertoire of personas for different situations that they copy from TV or film but might end up losing their own identity or sense of self, damaging their confidence and self-esteem.
“Having to hide your true personality in order to be liked makes you feel worthless and unworthy,” warned Siena. “Masking can be devastating to mental health. It takes a lot of effort, self-control and concentration and sometimes leads to burnout. Autism can feel like a constant state of panic and alertness.” Siena finds it helps to recharge her social battery by taking breaks from social contact and to use alone time to calm the senses.

Siena experiences alexithyma, a personality trait which causes difficulties with identifying feelings, describing what you are feeling and identifying the differences between emotions and the physical sensations that go with them. This is exacerbated by the greater expectation on girls to be emotionally in touch with their feelings. In fact, autistic girls might express their emotions clearly but in a non-typical way, without using the expected vocal or facial expressions. Siena also has difficulties with interoception, understanding whether she feels hungry or thirsty, tired or frustrated.

“We remain unseen and undiagnosed,” said Siena. “However, we are starting to come out of the shadows so that future autistic girls will be able to reach their potential.”

Dr Temple Grandin is a world renowned autistic author, speaker, activist and Professor at Colorado State University. She spoke with Helen Ellis, Equality, Diversity and Inclusion Co-ordinator at the National Autistic Society about her own life and highly successful career as an animal behaviourist and a person with autism.

According to the National Autistic Society, around 22% of autistic adults are in employment. Dr Grandin feels that children do not experience practical activities in the way they did when she was growing up, for example working with tools. For her, this is where great job opportunities can come from. Practical approaches led to her own highly successful career in animal behaviour.

In handling social interactions at work, Dr Grandin’s tip is to treat everything on social media and email as public. It is better to take people to one side to have difficult conversations to limit confrontation. For her, workplace manners etiquettes used to be clearer and are now more difficult navigate.

As many work roles are shifting to a dependence on online communication, it remains to be seen whether this will support or hinder people with autism. With employment figures so low, there is clearly a huge seam of untapped talent in the autism community. Due to late or missing diagnoses of women and girls, there are also many females remaining undiagnosed and unsupported in both education and employment. Understanding better how autism affects females compared to males and what this means for helping them to achieve their best is an area where there is still a long way to go – but with so much to be gained.

Book Review: “Invisible Women: Exposing Data Bias in a World Designed for Men” by Caroline Criado Perez

I first became aware of Caroline Criado Perez through her campaign to keep a woman on the reverse of UK bank notes, after Elizabeth Fry was replaced by Churchill on the five pound note. This campaign was memorable firstly due to her success – Jane Austen now appears on the reverse of the £10 note – and secondly, from the deluge of threats, hate mail and acrimony she attracted through Twitter as a result. At the time, Twitter did almost nothing about this – the situation is (only) slightly better today due the changes they have made to the way abuse is reported.

Undeterred, Criado Perez published “Invisible Women: Exposing Data Bias in a World Designed for Men” in 2019. Her book is rather neatly summed up by the quote from Simone de Beauvoir she includes in the frontispiece:

“Representation of the world, like the world itself, is the work of men; they describe it from their own point of view, which they confuse with the absolute truth.”

The gender data gap

Criado Perez’s aim is to flag up the huge data gap that exists about the lives of half of humanity. She dubs this the ‘gender data gap’ and it crops up again in again in almost any context you can think of – medicine, product design, protective equipment, town planning, governance. The silence of women’s voices in these areas leads not just to irritations, such as too-cold offices or phones that don’t fit your hand but also to life threatening situations. From stab vests that don’t fit female police officers’ bodies, to cars that are 47% more likely to seriously injure women drivers, to medicines that do not work for women, or actively make them sicker, the assumption that the average male represents the average human is causing unnecessary harm.

Female-specific concerns that men (mostly) fail to factor in crop up repeatedly in the many areas that Criado Perez examines, but fit into three themes: the female body, women’s unpaid care burden and male violence against women. Males of course do experience violence, lots of it, but as Criado Perez says, “…it manifests itself in a different way to the violence faced by women.” Facilities such as suburban housing centres, travel networks, homeless shelters and refugee camps are usually planned by men, and do not take into account the types of activities women need to engage in, nor do they keep them safe while they do them.

There are multiple examples in the book of how women are missing from our data. Data is not only not collected about women, when it is collected it is then not disaggregated by sex. For example, few medical studies or trials specify the sex of the participants. When they do, participants are usually overwhelmingly male. If the sex of the participants is revealed, the results are not always then separated by sex. Even tests on animals or single cells are not often carried out on male and female animals or cells, even though research shows the results are likely be different between sexes. The most common adverse drug reaction in women is that the drug simply doesn’t work, putting their health and sometimes their life at risk as a result. It is likely that many drugs only make it to market because they are effective in men in early trials – anything that might have been a good treatment candidate for women alone is screened out at an early stage because it is not effective in men. And that is before you even address the woeful lack of research into conditions that principally affect women, such as period pain or endometriosis.

A scarily prescient section in the book describes how a lack of sex-segregated data can impact during a pandemic. We know from previous coronavirus epidemics, such as SARS, that symptoms can be more severe in pregnant women. During the last SARS outbreak in 2002-2004 in China, pregnant women’s outcomes were not consistently tracked. “Another gender gap that could so easily have been avoided, and information that will be lacking for when the next pandemic hits,” writes Criado Perez. Here we are, in the middle of the worst pandemic most of us can remember, still without this information. Is data being collected now on outcomes for pregnant women, or will we remain in the dark for the next one, and the one after that?

Gender blind is not always gender neutral

Another gender data gap exists where supposedly ‘gender blind’ neutral policies have an unintentionally discriminating effect against women. For example, US academics in the tenure track system have 7 years to achieve tenure. The years between completing your PhD and receiving tenure, ages 30 to 40, are when most women are likely to have their children. The result is that mothers with young children are 35% less likely than fathers to get tenure track jobs. A ‘gender blind’ policy to give all US parents an additional year to achieve tenure actually decreased mothers’ likelihood of being successful compared to fathers. The extra time gave fathers an advantage over their male peers, while the bulk of childcare and recovery from birth fell to mothers and comparatively decreased their chances.

We are seeing the same phenomenon appearing during the COVID-19 crisis – while everyone attempts to work from home and take on home education, according to Nature, women seem to be publishing far less compared to their male peers. The crisis seems to be gifting additional time to male academics to write up their research and submit grant applications, while at the same time robbing female academics of their chances, as they spend extra time caring for families, home-schooling and prioritising their students ahead of their own research interests.

The burden of unpaid care work

Academia is just one area where women do far and away the greater share of unpaid care work, to the detriment of their careers and to national productivity (GDP). A study of working patterns during the COVID-19 lockdown by the Institute for Fiscal Studies and University College London in the UK shows that due to the disproportionate childcare and housework burden, in households with home-working mothers and fathers, men have three times the uninterrupted work time that women do. 

Even in normal times, the world cannot function without this care work – looking after children, elderly relatives, the vulnerable and disadvantaged. The vast majority of this work is unpaid and is carried out by women on top of their hours of paid work. They fit in multiple extra, short trips every day to support this unpaid work, dropping off children, doing shopping, seeing relatives. These journeys are poorly supported by the radial transport networks designed, largely by men, to serve the traditional daily commute from home to office. As we ‘clap for carers’ every Thursday to express our sincere and heartfelt gratitude for what care means during an international crisis, we shouldn’t forget that the caring burden is a daily reality for most women. For the moment, many of our commuter transport systems are empty. Post COVID-19, should we really go back to investing more and more money in systems that whisk us from home to office, but leave local neighbourhoods under-funded and under-served?

Building bias into the system

While we might be able to understand the presence of bias in humans, it can be tempting to rely on machines to fix the problem. Surely computers are neutral, with their artificial intelligence and gender blindness? Unfortunately, Criado Perez explains why this is not the case, because a large gender gap exists here as well. She describes how women are hugely under-presented in image and speech datasets. Speech recognition technology in smart speakers, phones, medical devices and cars are trained on male voices and struggle to respond accurately to women’s voices. Not only that, the images and text databases that AI systems train on are just as biased as humans, which is not surprising as they are generated by humans. So not only are datasets lacking in data from half the human race, the information that is in those datasets is biased towards gender stereotypes in the same way that humans are unconsciously biased. I encountered more research on this area at the Gender Summit in 2019. This has a real impact on outcomes for women when CV selection systems and even medical diagnostics are becoming increasingly automated using AI.

An individual perspective

If I have a criticism of Criado Perez’s book, it would be that the experiences of one person are sometimes used to make a point about the invisibility of women in general. Anecdotal evidence is still evidence, but does that person represent many? On the other hand, the whole point is that bulk data is lacking in many areas for all the reasons outlined above, so perhaps it’s understandable.

I found reading this book an eye-opening but ultimately rather sobering experience. Getting into a car to drive, will I feel as safe having read it? I certainly won’t stop feeling absurdly irritated by the smart speaker at home that responds instantly to my husband’s voice but stubbornly ignores mine until the third or fourth attempt. I’ve lost count of how many times I’ve nearly dropped my new phone trying to use it to take a photo one handed. As a materials science student at university, the protective equipment we used for welding or casting metals practically drowned me – it seems unlikely it made me safer if I could hardly move without tripping over it. Who knows how many times my CV didn’t make the cut for a science job due to skewed AI algorithms? I need to work flexibly and part-time to fit round my roles as mother of a special needs child, school governor and fundraiser for the National Autistic Society .Realistically, this limits my career options. Minor points on their own perhaps, but over a lifetime they add up, they really do.

Read this book – it will certainly make you think.

Positive Coping in a COVID World

As it is Mental Health Awareness Week (18 – 24 May), there have been a slew of well-being focused events at work lately. AXA Health Care spoke to us about ‘positive coping’. Those displaying positivity seek out pleasurable and meaningful activities during changing and challenging times. The great thing about positivity is that it can be shared with teams and family.

Any situation leads to thoughts, emotions, behaviours and physical sensations and these will be unique to you, even if the situation is the same for all.

AXA highlighted “5 Ways to Wellbeing” – connect, give, keep learning, take notice, be active. There are plenty of obstacles to wellbeing that can get in your way, including your thoughts, lack of time, less autonomy, varying emotions, other responsibilities such as home schooling and priority management.

The reactions to change and adversity that people experience are many and varied, including fear, shame, feeling drained, anger, anxiety, a racing heart, catastrophizing and uncertainty. It’s important not to judge yourself negatively on your reactions based on the reactions of others; conversely, don’t judge others based on your own reactions.

Traffic light behaviours and self protection

Positive coping strategies typically involve taking a conscious and direct approach to problems. You can use a traffic lights technique to help monitor your reactions. Write down and then look out for behaviours that are positive (green), warning signs (amber) or unhelpful (red) for you. How do you know when you are starting to move into the red zone?

Make sure you protect yourself – stay informed but don’t delve too deeply into areas that make you anxious. For me this means staying off Twitter and being judicious with watching news updates. Write down your core values, the ways of being you hold most important such as accountability, uniqueness, autonomy, reliability. Ask yourself how you can preserve these during challenging times. Focus on your strengths, like creativity, patience and kindness, as these will give you purpose and hence lead to positivity.

Another trick is to identify the resources you have used in the past to overcome challenges. You could use a time line tool to rediscover these. When have you encountered difficulties in the past, what skills did you learn from the experience and what does this say about you? Examples could include changing job, moving house, as well as more recent shifts such as switching to home working or trying to home school. One skill we are all honing at the moment is the ability to multi-task!

What you do in challenging times is important, so identify those small (or not so small) achievements each day e.g. reading a book. You can separate these out into the routine e.g. cooking, the necessary e.g. paying bills, and the more pleasurable e.g. socialising, hobbies, gardening. Try to do some of all these each day if you can.

Positive coping strategies

AXA recommended a few positive coping strategies to choose from:

Self management using the 6Ps – Plan; Perfectionist e.g. be flexible and realistic; Pass it on e.g. can someone else do it, Put things off e.g. does it have to be done now; Proactive e.g. plan ahead; Prioritise – is it A (essential), B (better done today), C (could do it today), D (don’t do today)

Self compassion – how would you treat a friend in this situation? Try to forgive your mistakes, write a positive letter to yourself, try out positive self-talk and tell yourself what you love about yourself.

Solution finder tool – identify the problem, write down all your ideas for solving it, list the pros and cons, choose one, plan it, implement it, review it, keep going or adjust

Immerse yourself in nature e.g. parks, gardens, pets

Diary writing to download events and process feelings, such as gratitude journaling, positive data journaling, positive future writing

Get creative to lose yourself in an activity and get into a ‘flow’ state e.g. arts and crafts, dancing, poetry, playing music

Just breathe – use breathing exercises to get into the ‘rest, digest, restore and repair’ zone. Try this one: https://www.youtube.com/watch?v=-6jDjBSGRVY

Progressive muscular relaxation – tense hands, arms etc one by one then relax

Humour – share jokes, movies, clips, memes

Create a happy box – this should engage your senses: sound e.g. music; touch e.g. fabric; sight e.g. photos, books; taste e.g. foods; smell e.g. candles, handcream. Also add the contact details for a person or organisation you can reach out to if these don’t restore you.

Ways to achieve a positive or balanced mindset

Catch the catastrophes – we are drawn to catastrophizing and worst case scenarios, when even the unlikely scenarios can start to feel inevitable. Write down…

• What is the worst possible outcome? (But don’t get too hung up on those!)
• What is the best possible outcome?
• What is most likely outcome e.g. what is the evidence for that?
• Plan for the most likely outcome

Helicopter view – take a step back from your opinion, is there another way to look at something which is not so up close and personal?

Worry tree – if this is not something you can control, let worry go e.g. write it down on paper and throw it away. Have a ‘worry time’ at a specific time of day when you will worry about things, then park them until the next worry time.

Tips for tolerating uncertainty:

• acknowledge worries;
• pause and try not to react;
• pull back;
• let go i.e. a thought or feeling is not a fact, imagine it floating away in a balloon
• explore and remember that right now all is well, focus on your 5 senses to bring you back to the here and now

Remember to help others, if you can- communicate regularly, show empathy, reassure and most importantly ask for help when you need it.

The Good Mood Café with Jenny Swain

I also attended a ‘Good Mood Café’ by Jenny Swain  aimed at parents and carers. She asked us to associate a good mood with a sound, like bird song, waves or for a parent, the blessed silence of contented / sleeping children!

In a household, even at the best of times we will be juggling lots of different moods in family members and these tend to feed off each other. If we focus on how to lift our own mood first, then we can see the domino effect on others around us, akin to putting on our own oxygen mask first.

Mental Health is a continuum, from optimum mental wellbeing to poor mental wellbeing. This is just as true for those with no diagnosable mental health conditions as well as people with serious diagnosable mental health issues. It is very possible for us all to move between the quadrants, day-by-day or over weeks, months or years. Which quadrant do you feel that you are in at the moment?

Jenny also recommends self compassion. To counteract depression and self hatred, practice self care.

• Tell yourself that the task was very hard and lack of success is not total failure.
• Not everything is our fault. Most people have normal, average lives and very few beat the odds to show ‘brilliance’ – don’t compare yourself unfavourably.
• Luck is involved in most success and failure, and this is not in your control.
• Remind yourself you are not entirely to blame for everything that happens in your life, or indeed in the lives of your family.
• You are not only your achievements – rehearse the voices of those who have been kind to you, especially when you were young
• This too shall pass – reduce expectations to zero in a crisis and take some rest

The School of Life has a great video on self care: https://www.youtube.com/watch?v=-kfUE41-JFw

Rumination or over focus on what causes us distress is our enemy, so try to get out of internal loops of negative thinking – “I can’t cope, why can’t I cope, I should be able to cope” and so on. Switch focus to something external to yourself. For example, what were you doing the last time you were outside, walking, relaxing or gardening? Freeze frame that moment and focus on your 5 senses at that point. Don’t forget that physical movements generate endorphins, so get your exercise!

Jenny left us with some challenges – you might want to try a few of these when you have a few moments.

Challenges for achieving a good mood

• List 5 things you notice each day that make you feel happy
• Identify your 5 favourite tastes or flavours and the associations that go with it e.g. a holiday food
• Think about a favourite piece or style of music, then pinch your thumb and forefinger together to ‘anchor’ that good mood feeling in your mind
• Create a good mood play list of your favourite tunes
• Try a breathing exercise to promote calm e.g. “How to avoid becoming a lizard“

What can you do for 3 minutes or even 30 seconds a day to lift your mood?

Places to go for help

Mental health at work.org.uk: https://www.mentalhealthatwork.org.uk/
MIND: https://www.mind.org.uk/
WHO: https://www.who.int/mental_health/en/
NHS Choices: https://www.nhs.uk/oneyou/every-mind-matters/
CPSL Mind Qwell: www.cpslmind.org.uk/qwell
Learn.4mentalhealth: www.learn.4mentalhealth.com
Anxiety UK: www.anxietyuk.org.uk
Young Minds: www.youngminds.org.uk

Book review: “Quiet” by Susan Cain

This week I have been trying to make inroads into my ever-growing pile of books on equality and diversity. Motivationally speaking, it helps that reading lends itself much better to soaking up the spring sunshine than answering emails does.

A long standing tenant of my shelf has been ‘Quiet’ by Susan Cain. Actually, I ‘borrowed’ it from my husband’s shelf but I’ve had my eye on it for ages! The subtitle is ‘The power of introverts in a world that can’t stop talking’, which drew me in immediately as a self-identified introvert.

What is an introvert or extrovert?

The book takes a close, well-researched look at what defines an introvert or an extrovert, and examines the ‘Extrovert Ideal’ – the rise of the outgoing, energetic personality type as the ‘preferred’ way to live and work. Cain identifies that the introvert – extrovert scale is one of the few that most psychological models of personality agree on. The term ‘introvert’ can include a constellation of attributes: reflective, cerebral, bookish, unassuming, sensitive, thoughtful, serious, contemplative, subtle, gentle, calm, modest, solitude-seeking, inward-facing, shy, risk-averse, thin-skinned. Conversely, ‘extrovert’ can include: ebullient, expansive, sociable, gregarious, excitable, dominant, assertive, active, risk-taking, thick-skinned, outward-facing, bold, light-hearted, happy in the spotlight. Being identified as an introvert often has negative connotations, while extrovert is often seen positively, especially at school, college or work.

The ‘introvert-extrovert’ scale is of course not the only story, and people may not be exclusively at one end or the other, or may behave differently in different circumstances. Personally, I’m fine giving a talk to an audience, and in fact relish the opportunity, but find making small talk at parties with strangers frustratingly challenging. The ‘introvert-extrovert’ spectrum can also be coupled with other scales such as ‘openness to experience’, ‘conscientiousness’ and ‘neuroticism’ for a more nuanced picture.

As children, and often into adulthood, introverts are often (but not always) ‘high reactors’ to stimulating environments and seek out quiet spaces. Conversely, extroverts are often (but not always) ‘low reactors’ to stimulating environments and seek out ever more stimulation.

Relationships, socialising and personal characteristics – gregariousness is optional!

Human relationships make both introverts and extroverts happy but “gregariousness is optional” as Cain puts it. She recommends that introverts think of quality over quantity when it comes to friendship. For introvert-extrovert couples, it’s important to respect your loved one’s need for solitude (if they are an introvert) or socialising (if an extrovert) and come to a compromise to achieve balance.

When you encounter an issue, extroverts are apparently less upset than introverts if someone is angry or aggressive about it – extroverts see this as confirmation that the person is passionate about their cause, but an introvert will be put off by it.

So how do we spot an introvert or an extrovert among our friends, family and colleagues? It may not be that easy. Some people act like extroverts but behind the scenes, it costs them energy, authenticity and even physical or mental health to suppress their true, introvert selves. If someone seems aloof and withdrawn, they may still be keen to be social underneath, but in their own way.

Introverts tend to dislike large crowds and having multiple shallow, small-talk style interactions. They prefer conversations with smaller groups at a deeper level to discuss issues, feelings, thoughts and ideas. At a party, you will probably find them in the kitchen, in deep discussion with one or two others over the chips and dips, rather than schmoozing their way across the dance floor. For good mental health, introverts should carve out restorative niches to recharge after events that drain their energy. In contrast, extroverts should seek out stimulating spaces that energise them after solitary activities (important to know in our lockdown times).

Work, careers and advice for managers – the power of quiet

The key to success at work should be to play to your strengths. However, introverts may literally struggle to make themselves heard over louder, more outgoing colleagues – back to the ‘extrovert ideal’ again. Managers should remember that one third to one half of their staff are natural introverts, although they may not appear that way due to having developed extrovert work personas.

Ideally, introverts should use their powers of persistence, concentration, insight and sensitivity to focus on work that they enjoy and find meaningful. It’s especially important for introverts to pursue the jobs, pastimes and activities that they actually enjoy, rather than the ones they think they should prefer. I spent years early in my career trying to be successful in environments that valued vocal, outgoing, sociable personalities over quieter and more introspective ones (me). Eventually, I realised that I didn’t actually have to change myself to match my job – I could change the job to suit my personality better.

Of course, introverts can often behave in highly extrovert ways for causes they passionately believe in – they ‘lose themselves’ in the moment, carried away by their enthusiasm. Cain recommends finding training to help give you confidence in areas that you find daunting, such as networking and public speaking, to develop an extrovert persona for when you need it. She suggests making a deal with yourself on how many networking, social or other draining events you will attend before you allow yourself time out to restore. I do this all the time at conferences!

In the office (if you can remember what it is like to spend lots of time in one of those since COVID-19 reared its head), introverts do not appreciate open plan spaces or big social work dos. They find open plan offices over-stimulating and draining and may underperform in them if they don’t have quiet places to retreat to. It’s worth bearing in mind that extroverts find single offices and lots of solo working under-stimulating and may underperform in that environment too. However, introverts will under-perform more in noisy environments than extroverts do in quiet environments. Managers should remember that stimulating, communal spaces do more damage to introverts than quiet ones do to extroverts.

Cain showed that introverts slow down their decision-making in high risk situations; extroverts tend to speed up, which may compound mistakes in areas such as finance or banking. Introverts will think deeply, strategise, solve complex problems and foresee problems or risks ahead of time but can struggle to make their opinions heard over more extroverted colleagues. Managers should also beware of ‘Group Think’, when groups may align to the opinions of the more frequent or early speakers, who may not offer the best solutions. Ensure everyone solves problems individually first before getting together to discuss them and make sure the quieter, more reflective staff are heard without criticism or impatience.

Don’t equate eloquence and verbosity with intellect – there is no association between extroversion and having the best ideas!

Interestingly, research shows that proactive teams will perform better under introvert leaders, perhaps because these leaders are more inclined to listen to other people’s ideas and are less inclined to impose their own. However, passive teams may perform better under extrovert or charismatic leaders as they provide clarity on what is needed.

Children and education – the difficult early years

For those with introvert children, you may be frustrated that they don’t seem to enjoy the activities you think they should – birthday parties, sleepovers, team sports or family gatherings. You might feel that they are ‘missing out’ on the fun things in life and be keen to encourage them to fit in with their peers. Bear in mind that for some children these occasions can be painfully daunting and even damaging to their self-esteem in the long term. Of course, they don’t have to miss out forever. You can encourage introvert children to get used to new situations and people gradually in ways that make them comfortable – ideally start as young as possible. Encourage introvert children to socialise with a few close friends at first, rather than large crowds and always ask them before you set up social occasions or let them leave a bit early.

Try not to force it or you may cause a lifelong aversion or trample on the early seeds of confidence!

Parents should role model behaviours and let children know about similar struggles they may have had at school themselves. I often tell my younger son how shy I was at school but describe how much easier things got as I grew up (very nearly true!). Most of all, let introvert children be themselves and take pride in their originality, thoughtfulness and focus. Don’t make them be what you think they should be, or try to turn them into you.

At school, teachers should not forget to draw out their quieter students. Working in small groups rather than large ones will get the best out of them, especially if they are given a specific role such as note taker or rapporteur.

In particular, introverts may struggle at school as teenagers, when their talents for thinking deeply and developing ideas are not appreciated compared to the ability to easily vocalise and socialise. As a parent, it’s tough to watch them struggle through these difficult years, but comfort yourself with the thought that they are likely to be more successful later in life, when their ability to focus on long term goals and deal with delayed gratification will pay off.