Sex Differences in Autism: Examining Intrinsic and Extrinsic Factors in Children and Adolescents Enrolled in a National ASD Cohort.
Emily F Dillon, Stephen Kanne, Rebecca J Landa and 8 others
PMID 34859339WHAT IT FOUND
Girls with autism in this large cohort were diagnosed four months later than boys, even though parents' first concerns began at the same age.
Parents more often first noticed motor delay in girls and speech delay in boys.
Key findings
01Females were diagnosed four months later than males, and child sex was the largest predictor of age of diagnosis.
02Parents of females more often reported motor delays as their first concern, while parents of males more often reported speech or language concerns.
03Females scored lower on the parent-reported SCQ than males, but the paper says both groups were well into the affected range.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for SLPs
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What it does not show
The sample was mostly urban (87.1%), white (77.8%), and described by parents as functioning below age expectation (76.4%), so it may not represent rural, minority, or higher-functioning children. IQ data were missing for more than half of families, so intelligence findings are interpreted cautiously. Only children already diagnosed with ASD were included, so girls who were missed or remain undiagnosed were not studied. All data were parent-reported, so differences may reflect parents' perceptions, expectations, or reporting rather than directly observed behaviour. The study is cross-sectional and cannot explain why females were diagnosed later; it cannot separate family delay, clinical delay, or presentation differences.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not conclude that autism is milder in girls because parent-reported symptom scores were lower. The paper says both groups scored well into the affected range, and the difference was not clinically significant.