Journal of Autism and Developmental Disorders

, Volume 37, Issue 1, pp 86–97 | Cite as

Sex Differences in Toddlers with Autism Spectrum Disorders

  • Alice S. CarterEmail author
  • David O. Black
  • Sonia Tewani
  • Christine E. Connolly
  • Mary Beth Kadlec
  • Helen Tager-Flusberg
Original Paper


Although autism spectrum disorders (ASD) prevalence is higher in males than females, few studies address sex differences in developmental functioning or clinical manifestations. Participants in this study of sex differences in developmental profiles and clinical symptoms were 22 girls and 68 boys with ASD (mean age = 28 months). All children achieved strongest performance in visual reception and fine motor followed by gross motor and language functioning. Sex differences emerged in developmental profiles. Controlling for language, girls achieved higher visual reception scores than boys; boys attained higher language and motor scores and higher social-competence ratings than girls, particularly when controlling for visual reception. Longitudinal, representative studies are needed to elucidate the developmental and etiological significance of the observed sex differences.


Autism Autism spectrum disorder Sex differences Toddlers Developmental profiles 



This work was supported by a STAART grant from the NIMH awarded to Helen Tager-Flusberg and Alice S. Carter (U54MH066398) and by M01 RR0053, a General Clinical Research Center grant from the National Center for Research Resources to the Boston University School of Medicine.


  1. Baron-Cohen, S., Knickmeyer, R. C., & Belmonte, M. K. (2005). Sex differences in the brain: Implications for explaining autism. Science, 310(5749), 819–823.PubMedCrossRefGoogle Scholar
  2. Baron-Cohen, S., & Wheelwright, S. (2003). The friendship questionnaire: An investigation of adults with Asperger Syndrome or High-Functioning Autism, and normal sex differences. Journal of Autism and Developmental Disorders, 33(5), 509–517.PubMedCrossRefGoogle Scholar
  3. Baron-Cohen, S., & Wheelwright, S. (2004). The empathy quotient: An investigation of adults with Asperger Syndrome or High-Functioning Autism, and normal sex differences. Journal of Autism and Developmental Disorders, 34(2), 163–175.PubMedCrossRefGoogle Scholar
  4. Bryson, S. E., Clark, B. S., & Smith, I. (1988). First report of a Canadian epidemiological study of autistic syndromes. Journal of Child Psychology and Psychiatry and Allied Disciplines, 29, 433–446.Google Scholar
  5. Carter, A. S., & Briggs-Gowan, M. J. (2006). Manual for the Infant-Toddler Social & Emotional Assessment (ITSEA)—Version 2. San Antonio, Texas: Psychological Corporation, Harcourt Press.Google Scholar
  6. Carter, A. S., Briggs-Gowan, M. J., Jones, S. M., & Little, T. D. (2003). The Infant-Toddler Social and Emotional Assessment (ITSEA): Factor structure, reliability, and validity. Journal of Abnormal Child Psychology, 31(5), 495–514.PubMedCrossRefGoogle Scholar
  7. Constantino, J. N., & Todd, R. D. (2003). Autistic traits in the general population: A twin study. Archives of General Psychiatry, 60, 524–530.PubMedCrossRefGoogle Scholar
  8. Fombonne, E. (1999). The epidemiology of autism: A review. Psychological Medicine, 29(4), 769–786.PubMedCrossRefGoogle Scholar
  9. Honda, H., Shimizu, Y., Imai, M., & Nitto, Y. (2005). Cumulative incidence of childhood autism: A total population study of better accuracy and precision. Developmental Medicine and Child Neurology, 47, 10–18.PubMedCrossRefGoogle Scholar
  10. Joseph, R. M., Tager-Flusberg, H., & Lord, C. (2002). Cognitive profiles and social-communicative functioning in children with autism spectrum disorder. Journal of Child Psychology and Psychiatry, 43(6), 807–821.PubMedCrossRefGoogle Scholar
  11. Krug, D. A., Arich, J., & Almond, P. (1980). Behavior checklist for identifying severely handicapped individuals with high levels of autistic behavior. Journal of Child Psychology and Psychiatry, 21, 221–229.PubMedCrossRefGoogle Scholar
  12. Le Couteur, A., Rutter, M., Lord, C., Rios, P., Robertson, S., Holdgrafer, M., & McLennan, J. D. (1989) Autism diagnostic interview: A semistructured interview for parents and caregivers of autisitic persons. Journal of Autism and Developmental Disorders, 19, 363–387.PubMedCrossRefGoogle Scholar
  13. Lincoln, A. J., Allen, M., & Kilman, A. (1995). The assessment and interpretation of intellectual abilities in people with autism. In E. Schopler, & G. Mesibov (Eds.), Learning and cognition in autism (pp. 89–117). New York: Plenum.Google Scholar
  14. Lingam, R., Simmons, A., Andrews, N., Miller, E., Stowe, J., & Taylor, B. (2003). Prevalence of autism and parentally reported triggers in a north east London population. Archives of Disease in Childhood, 88, 666–670.PubMedCrossRefGoogle Scholar
  15. Lord, C., Risi, S., Lambrecht, L., Cook, E., Leventhal, B., DiLavore, P. et al. (2000). The autism diagnostic observation schedule—generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–223.PubMedCrossRefGoogle Scholar
  16. Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism diagnostic interview—revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685.PubMedCrossRefGoogle Scholar
  17. Lord, C., & Schopler, E. (1985). Differences in sex ratios in autism as a function of measured intelligence. Journal of Autism and Developmental Disorders, 15, 185–193.PubMedCrossRefGoogle Scholar
  18. Lord, C., Schopler, E., & Revicki, D. (1982). Sex differences in autism. Journal of Autism and Developmental Disorders, 12(4), 317–330.PubMedCrossRefGoogle Scholar
  19. McLennan, J. D., Lord, C., & Schopler, E. (1993). Sex differences in higher functioning people with autism. Journal of Autism and Developmental Disorders, 23(2), 217–227.PubMedCrossRefGoogle Scholar
  20. Mullen, E. M. (1995). Mullen scales of early learning. Circle Pines, MN: American Guidance Service, Inc.Google Scholar
  21. Pickles, A., Bolton, P., MacDonald, H., Le Couteur, A., Sim, C. H., & Rutter, M. (1995). Latent-class analysis of recurrence risk for complex phenotypes with selection and measurement error: A twin and family history study of autism. American Journal of Human Genetics, 57, 717–726.PubMedGoogle Scholar
  22. Pilowsky, T., Yirmiya, N., Shulman, C., & Dover, R. (1998). The autism diagnostic interview-revised and the childhood autism rating Scale: Differences between diagnostic systems and comparison between genders. Journal of Autism and Developmental Disorders, 28(2), 143–151.PubMedCrossRefGoogle Scholar
  23. Posserud, M., Lundervold, A. J., & Gillberg, C. (2006). Autistic features in a total population of 7–9-year-old children assessed by the ASSQ (Autism Spectrum Screening Questionnaire). Journal of Child Psychology and Psychiatry, 47(2), 167–175.PubMedCrossRefGoogle Scholar
  24. Schopler, E., Reichler, R., & Renner, B. R. (1986). The Childhood Autism Rating Scales (CARS) for diagnostic screening and classification of autism. New York: Irvington.Google Scholar
  25. Sparrow, S. S., Balla, D. A., & Cicchetti, D. V. (1984). Vineland Adaptive Behavior Scales. Circle Pines, MN: American Guidance Service, Inc.Google Scholar
  26. Spelke, E. S. (2005). Sex differences in intrinsic aptitude for mathematics and science? A critical review. American Psychologist, 60(9), 950–958.PubMedCrossRefGoogle Scholar
  27. Stone, J. L., Merriman, B., Cantor, R. M., Yonan, A. L., Gilliam, T. C., Geschwind, D. H. et al. (2004). Evidence for sex-specific risk alleles in autism spectrum disorder. American Journal of Human Genetics, 75, 1117–1123.PubMedCrossRefGoogle Scholar
  28. Szatmari, P., MacLean, J. E., Jones, M. B., Bryson, S. E., Zwaigenbaum, L., Bartolucci, G., Mahoney, W. J., & Tuff, L. (2000). The familial aggregation of the lesser variant in biological and nonbiological relatives of PDD probands: A family history study. Journal of Child Psychology and Psychiatry, 41(5), 579–586.PubMedCrossRefGoogle Scholar
  29. Tsai, L. Y., & Beisler, J. M. (1983). The development of sex differences in infantile autism. British Journal of Psychiatry, 142, 373–378.PubMedCrossRefGoogle Scholar
  30. Tsai, L., Stewart, M. A., & August, G. (1981). Implication of sex differences in the familial transmission of infantile autism. Journal of Autism and Developmental Disorders, 11(2) 165–173.PubMedCrossRefGoogle Scholar
  31. Volkmar, F. R., & Klin, A. (2005). Issues in the classification of autism and related conditions. In F. R. Volkmar, R. Paul, A. Klin, & D. Cohen (Eds.), Handbook of autism and pervasive developmental disorders, Vol. 1: Diagnosis, development, neurobiology, and behavior (3rd Ed., pp. 5–41). Hoboken, NJ: John Wiley & Sons, Inc.Google Scholar
  32. Volkmar, F. R., Szatmari, P., & Sparrow, S. S. (1993). Sex differences in pervasive developmental disorders. Journal of Autism and Developmental Disorders, 23(4), 579–591.PubMedCrossRefGoogle Scholar
  33. Wing, L. (1981). Sex ratios in early childhood autism and related conditions. Psychiatric Research, 5, 129–137.CrossRefGoogle Scholar
  34. World Health Organization. (1990). International classification of diseases (10th rev.); Criteria for research. Geneva, Switzerland: Author.Google Scholar
  35. Yeargin-Allsopp, M., Rice, C., Karapurkar, T., Doernberg, N., Boyle, C., & Murphy, C. (2003). Prevalence of autism in a US metropolitan area. Journal of the American Medical Association, 289(1), 49–55.PubMedCrossRefGoogle Scholar
  36. Zahn-Waxler, C., Robinson, J. L., & Emde, R. N. (1992). The development of empathy in twins. Developmental Psychology, 28, 1038–1047.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • Alice S. Carter
    • 1
    • 2
    Email author
  • David O. Black
    • 2
  • Sonia Tewani
    • 2
  • Christine E. Connolly
    • 2
  • Mary Beth Kadlec
    • 2
  • Helen Tager-Flusberg
    • 2
  1. 1.Department of PsychologyUniversity of Massachusetts, BostonBostonUSA
  2. 2.Department of Anatomy and NeurobiologyBoston University School of MedicineBostonUSA

Personalised recommendations