SLPOtherJournal of autism and developmental disorders2019

Brief Report: Sex/Gender Differences in Symptomology and Camouflaging in Adults with Autism Spectrum Disorder.

Rachel K Schuck, Ryan E Flores, Lawrence K Fung

PMID 30945091

WHAT IT FOUND

In 28 adults with autism, women scored higher on camouflaging than men.

Self-reported symptom scores were higher, but not after the study's stricter check. Camouflaging linked to less positive emotional expression in women, not men.

Key findings

01In the 28 adults with ASD, women had higher camouflaging scores than men (mean 0.34 versus 0.03).

02Self-reported ASD symptoms were higher in women, but the difference did not remain after the study's correction for multiple comparisons.

03In women, higher camouflaging scores were linked to lower overall emotional expressivity and lower positive emotional expressivity; in men, no such links appeared.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The sample was a convenience sample and was small: 62 adults were recruited, and the analyses focused on 28 adults with ASD, including 11 females. The study was underpowered to detect small differences. It was a post hoc analysis of data from two studies, not a study designed primarily to test camouflaging. Camouflaging was measured by subtracting standardized ADOS scores from standardized AQ scores, and the authors describe camouflaging as still a crude concept that has not been extensively researched. Sex/gender was recorded as male or female only, so non-binary and transgender experiences were not captured. The emotional expressivity findings were exploratory and did not receive the stricter correction, so they need replication. All symptom and expressivity measures were self-report, and parental report was not used for all participants. Correlations cannot show that camouflaging causes lower emotional expressivity.

Declared interests

All authors declared no conflicts of interest. The supplied text does not state who funded the study.

The easy way to misread this

Do not conclude that camouflaging causes reduced positive emotional expression or that all autistic women camouflage more than autistic men. The sample was small and exploratory, the camouflaging score was derived from AQ and ADOS rather than a direct camouflaging measure, and the emotional expressivity links were not corrected for multiple comparisons.

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