A comparison of the presentations of males and females with autism spectrum disorder and those narrowly below the diagnostic threshold.
Joanna M Tsirgiotis, Robyn L Young, Nathan Weber
PMID 37606218WHAT IT FOUND
Girls and boys assessed for autism differed in reported behaviours: boys were more likely to meet the restricted-interests criterion, while girls more often had parent-reported facial expression differences and unusual made-up words.
Key findings
01Males were more likely than females to meet the restricted-interests criterion: non-ASD males had a 1.7-times higher probability than non-ASD females, and autistic males had a 1.3-times higher probability than autistic females.
02Speech stereotypies differed by sex/gender: repetitive speech was more likely in males and neologisms were more likely in females.
03Among children who received an ASD diagnosis, males were more likely than females to have atypicality reported by teachers across both social communication and restricted/repetitive behaviour domains.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
All data came from one private clinic and seven diagnosticians, so the findings may not apply to other assessment settings. Only children who had already been referred for specialist assessment were included, so girls whose traits were never referred or were explained in other ways are not represented. Teacher report was missing for many children: it was available for 71.6% of children overall, 64.3% of females and 77.4% of males. Specific behaviours were coded as present or absent, so the study does not show how severe each behaviour was or how much it limited daily life. Standardised cognitive information was available for 70.4% of females and 59.7% of males, and incomplete cognitive assessments were prorated in 19.6% of cases.
Declared interests
The article was prepared from the first author's doctoral dissertation and was supported by an Australian Government Training Programme Scholarship and the Hamish Ramsay fund.
The easy way to misread this
Do not conclude that girls are underdiagnosed because the study only included children who had already been referred for specialist assessment. It cannot show how many girls in the wider community have undetected ASD.