Sex differences in parent-reported executive functioning and adaptive behavior in children and young adults with autism spectrum disorder.
Emily I White, Gregory L Wallace, Julia Bascom and 6 others
PMID 28568910WHAT IT FOUND
Females with autism spectrum disorder were rated by parents as having more everyday executive function problems and worse daily living skills than males, even though IQ, autism symptoms, and ADHD symptoms were similar.
Key findings
01Parents rated females with ASD as having greater overall executive function problems than males, despite similar ASD and ADHD symptom ratings.
02Female mean scores exceeded the clinically significant level (T score>65) on 5/8 scales: Inhibit, Shift, Working Memory, Plan/Organization, and Monitor, while male mean scores exceeded it only on the Shift scale.
03Females showed significantly lower standard scores in adaptive daily living skills, while communication and socialization did not differ significantly.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The study compared groups at one time and cannot show why females had more executive function and daily living problems or whether these differences are unique to ASD. Executive function and adaptive behavior were based only on parent report, with no input from other adults, the participants themselves, or laboratory tasks. The sample was clinically referred and selected by diagnostic measures developed mainly from males, so females included may represent those with more noticeable problems and may not represent all females with ASD. The study used binary male and female categories and did not include transgender or gender nonconforming individuals. The adaptive behavior analysis used a smaller subset of 56 females and 130 males, and the confirmatory full sample included a significant age difference between females and males. The analyses were mainly exploratory, and the paper notes that norms from typically developing youth could mask ASD-specific sex differences.
Declared interests
Lauren Kenworthy receives financial compensation for use of the BRIEF.
The easy way to misread this
Do not conclude that females with ASD are less impaired because their communication scores were similar to males. Parent reports showed greater executive function problems and lower daily living skills in females, and the study cannot show whether these differences are caused by ASD, referral patterns, or parent reporting.