Sex differences in age of diagnosis of autism spectrum disorder: Preliminary evidence from Uganda.
Emmanuel Bonney, Catherine Abbo, Collin Ogara and 2 others
PMID 34826197WHAT IT FOUND
In Ugandan clinics, girls were diagnosed with autism at an average of 7.75 years, compared to 6.60 years for boys.
This delay suggests clinicians should screen girls more aggressively for social communication differences, as cultural expectations may mask their symptoms.
Key findings
01The mean age of diagnosis was significantly later for females (7.75 years) than for males (6.60 years).
02Nearly half of the children diagnosed with ASD had at least one co-occurring condition such as ADHD, epilepsy, or speech delays.
03Females were less likely than males to receive a diagnosis before the age of four.
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
This was a retrospective chart review, so it relied on existing records which had missing data for some children. Diagnoses were made using clinical judgment and DSM-5 criteria without standardized tools like the ADOS, which may affect accuracy. The study did not include cognitive or socioeconomic data, so it could not account for how intellectual disability or poverty might influence the age of diagnosis. The sample came from two specialized clinics in the capital city, so results may not reflect the broader Ugandan population.
Declared interests
The authors declared no conflicts of interest. The study was supported by the National Institutes of Health (N.I.H.).
The easy way to misread this
Do not assume that later diagnosis in girls is solely due to biological protective factors or better camouflage. The authors note that cultural expectations in this setting may lead parents and clinicians to underestimate social deficits in girls, delaying referral. This is a finding about access and perception, not just symptom severity.