Evaluation of sex differences in preschool children with and without autism spectrum disorder enrolled in the study to explore early development.
Lisa D Wiggins, Eric Rubenstein, Gayle Windham and 9 others
PMID 33610079WHAT IT FOUND
Preschool boys and girls with autism symptoms scored almost identically on behavior, development, and screening tests.
Small differences in restricted interests were not clinically meaningful. Screening tools appear equally sensitive for young children of both sexes, so do not assume girls present differently at this age.
Key findings
01There were no statistically significant sex differences in behavioral or developmental functioning scores for children classified with ASD or those with subthreshold ASD characteristics.
02While males showed slightly more restricted and repetitive behaviors on diagnostic instruments, the effect size was so small it was not considered clinically meaningful.
03There were no significant sex-based differences in parent-reported developmental diagnoses (such as language delay or ADHD) given before the study enrollment.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study only included children who already showed signs of risk or had a prior diagnosis, so it cannot speak to girls who are completely missed by screening. Most children in the sample had co-occurring intellectual disability or language delays, which may mask subtle sex differences that appear in higher-functioning children. The findings apply to preschool-aged children; sex differences in restricted interests and social camouflaging may emerge later in school-age children.
Declared interests
The study was funded by the Centers for Disease Control and Prevention (CDC).
The easy way to misread this
Do not conclude that sex differences in autism presentation do not exist. This study focused on preschoolers with significant symptoms or delays. Other research suggests that differences in restricted interests and social masking become more clinically relevant in school-aged children and adolescents.