Journal of Autism and Developmental Disorders

, Volume 49, Issue 4, pp 1693–1699 | Cite as

Brief Report: Sex Differences in ASD Diagnosis—A Brief Report on Restricted Interests and Repetitive Behaviors

  • T. C. McFaydenEmail author
  • J. Albright
  • A. E. Muskett
  • A. Scarpa
Brief Report


Previous research found repetitive and restricted behaviors (RRBs) were less predictive of Autism Spectrum Disorder (ASD) in females, indicating the diagnostic construct may not adequately describe RRB presentations in females. This mixed-methods study investigated the female presentation of RRBs, namely restricted interests, in a clinic sample of 125 participants (n = 40 female; ages 2–83 years; 75 ASD). RRB severity did not differ between sexes, t = 1.69, p = 0.094, though male participants scored higher on the Restricted Behavior subscale. Qualitatively, females demonstrated a narrower range of restricted interests and expressed them in a socially oriented manner compared to males. The results suggest unique quantitative and qualitative sex differences in RRB profiles that could shed light on the female ASD phenotype.


Autism spectrum disorder Restricted interests Sex differences Female Repetitive behaviors Assessment 



We would like to acknowledge the following sources for their support: the Virginia Tech Center for Autism Research, which is funded by the Institute for Society, Culture and Environment, the Fralin Life Science Institute, the College of Science, and the Psychology Department of Virginia Tech.

Author Contributions

The research idea, introduction, method, data analysis, and results were contributions of T.C. McFayden. The qualitative data coding, discussion, data analysis validity, and overall edits were contributions of A.E. Muskett and J. Albright. Edits and the database source were contributions of A. Scarpa.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.


  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th edn.). Arlington: American Psychiatric Publishing.CrossRefGoogle Scholar
  2. Attwood, T., Grandin, T., Bolick, T., Faherty, C., Iland, K., Myers, J. M., & Wroble, M. (2006). Asperger’s and girls. Texas: Future Horizons.Google Scholar
  3. Bodfish, J. W., Symons, F. W., & Lewis, M. H. (1999). The Repetitive Behavior Scale. Western Carolina Center Research Reports.Google Scholar
  4. Bruni, T. P. (2014). Test review: Social responsiveness scale-second edition (SRS-2). Journal of Psychoeducational Assessment, 32, 365–369. Scholar
  5. Centers for Disease Control and Prevention (CDC). (2012). Prevalence of Autism Spectrum Disorders- Autism and developmental disabilities monitoring network, 14 sites, United States, 2008”. MMWR 2012; 61: 1–22.Google Scholar
  6. Constantino, J. N., & Gruber, C. P. (2012). Social Responsiveness Scale-Second Edition (SRS-2). Torrance: Western Psychological Services.Google Scholar
  7. Duvekot, J., van der Ende, J., Verhulst, F., Slappendel, G., van Daalen, E., Maras, A., & Greaves-Lord, K. (2016). Factors influencing the probability of a diagnosis of autism spectrum disorder in girls versus boys. Autism, 1, 1–13. Scholar
  8. Esbensen, A. J., Seltzer, M. M., Lam, K. S. L., & Bodfish, J. W. (2009). Age-related differences in restricted repetitive behaviors in autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 57–66.CrossRefGoogle Scholar
  9. Frazier, T. W., Georgiades, S., Bishop, S. L., & Hardan, A. Y. (2014). Behavioral and cognitive characteristics of females and males with Autism in the Simons Simplex collection. Journal of American Academy of Child and Adolescent Psychiatry, 53, 329–340. Scholar
  10. Gotham, K., Risi, S., Picles, A., & Lord, C. (2007). The Autism Diagnostic Observation Schedule: Revised algorithms for improved diagnostic validity. Journal of Autism and Developmental Disorders, 37, 613–627. Scholar
  11. Harkness, S., Zylicz, P. O., Super, C. M., Wells-Nystrom, B., Bermudez, M. R., Bonichini, S., & Moscardino, U. (2011). Children’s activities and their meanings for parents: A mixed-methods study in six western cultures. Journal of Family Psychology, 25, 799–813. Scholar
  12. Hartley, S. L., & Sikora, D. M. (2009). Sex differences in Autism Spectrum Disorder: An examination of developmental functioning, autistic symptoms, and coexisting behavior problems in toddlers. Journal of Autism and Developmental Disorders, 39, 1715–1722.CrossRefGoogle Scholar
  13. Hiller, R. M., Young, R. L., & Weber, N. (2014). Sex differences in Autism Spectrum Disorder based on DSM-5 criteria: Evidence from clinical and teacher reporting. Journal of Abnormal Child Psychology, 42, 1381–1393. Scholar
  14. IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.Google Scholar
  15. Lai, M. C., Lombardo, M. V., Auyeung, B., et al. (2015). Sex/sex differences and autism: Setting the scene for future research. Journal of the American Academy of Child and Adolescent Psychaitry, 54, 11–24.CrossRefGoogle Scholar
  16. Lam, K. S. L., & Aman, M. G. (2007). The Repetitive Behavior Scale-Revised: Independent validation in individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37, 855–866.CrossRefGoogle Scholar
  17. Lord, C., Rutter, M., DiLavore, P. C., Risi, S., Gotham, K., & Bishop, S. (2012). Autism Diagnostic Observation Schedule (2) Edition. Torrance: Western Psychological Services.Google Scholar
  18. 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.CrossRefGoogle Scholar
  19. Westeinde, A. V., Cauvet, E., Toro, R., Kuja-Halkola, R., Neufeld, J., Mevel, K., & Bolte, S. (2018). Sex differences in brain structure: An autism twin study on restricted and repetitive behaviors. BioRxiv, 1–32.

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Virginia Polytechnic Institute and State UniversityBlacksburgUSA

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