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Sex Differences in Autism Spectrum Disorder based on DSM-5 Criteria: Evidence from Clinician and Teacher Reporting

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Abstract

In the absence of intellectual impairment autism spectrum disorder (ASD) is diagnosed both less and later in females. This study used clinician and teacher report to explore sex differences in the behavioural presentation of 69 girls and 69 boys all diagnosed with high-functioning ASD. Evidence from DSM-IV-TR and DSM-5 are presented. Sex differences in teacher concerns were also explored. While no sex differences were found in the broad social criteria presented in the DSM-IV-TR or DSM-5, numerous differences were evident in how boys and girls came to meet each criterion. For example, girls were more likely to show an ability to integrate non-verbal and verbal behaviours, maintain a reciprocal conversation, and be able to initiate, but not maintain friendships. Moreover, girls presented with both less and different restricted interests. Teachers also reported substantially fewer concerns for girls than boys, including for externalising behaviours and social skills. Results suggest girls with ASD may present with a surface-level ‘look’ different from the ‘classic’ presentation of ASD, and present as less impaired when in a school setting. Consequently, results provide insight in to why the disorder may be more difficult to detect in cognitively-able girls.

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References

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, revised (4th ed.). Washington: Author.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: Author.

    Google Scholar 

  • Andersson, G. W., Gillberg, C., & Miniscalco, C. (2013). Pre-school children with suspected autism spectrum disorders: Do girls and boys have the same profiles? Research in Developmental Disabilities, 34, 413–422. doi:10.1016/j.ridd.2012.08.025.

    Article  PubMed  Google Scholar 

  • Attwood, T., Grandin, T., Bolick, T., Faherty, C., Iland, L., Myers, J. M., & Wroble, M. (2006). Asperger’s and girls. Texas: Future Horizons.

    Google Scholar 

  • Baron-Cohen, S. (2002). The extreme male brain theory of autism. Trends in Cognitive Science, 6, 248–254. doi:10.1016/S1364–6613(02)01904–6.

    Article  Google Scholar 

  • Bayley, N. (2006). Bayley scales of infant and toddler development® 3rd edition (Bayley-III®). San Antonio: The Psychological Corporation.

    Google Scholar 

  • Begeer, S., Mandell, D., Wijnker-Holmes, B., Venderbosch, S., Rem, D., Stekelenburg, F., & Koot, H. M. (2012). Sex differences in the timing of identification among children and adults with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43, 1–6. doi:10.1007/s10803–012–1656-z.

    Google Scholar 

  • Dworzynski, K., Ronald, A., Bolton, P., & Happé, F. (2012). How different are girls and boys above and below the diagnostic threshold for autism spectrum disorders? Journal of the American Academy of Child & Adolescent Psychiatry, 51, 788–797. doi:10.1016/j.jaac.2012.05.018.

    Article  Google Scholar 

  • Escudero, P., Robbins, R. A., & Johnson, S. P. (2013). Sex-related preferences for real and doll faces versus real and toy objects in young infants and adults. Journal of Experimental Child Psychology, 116, 367–379. doi:10.1016/j.jecp.2013.07.001.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fombonne, E. (2009). Epidemiology of pervasive developmental disorders. Pediatric Research, 65, 591–598. doi:10.1203/PDR.0b013e31819e7203.

    Article  PubMed  Google Scholar 

  • 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(12), 1715–1722.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lai, M. C., Lombardo, M. V., Pasco, G., Ruigrok, A. N., Wheelwright, S. J., Sadek, S. A., & Baron-Cohen, S. (2011). A behavioral comparison of male and female adults with high functioning autism spectrum conditions. PloS One, 6, 1–10. doi:10.1371/journal.pone.0020835.

    Google Scholar 

  • Lord, C., Schopler, E., & Revicki, D. (1982). Sex differences in autism. Journal of Autism and Developmental Disorders, 12, 317–330. doi:10.1007/BF01538320.

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M., Goode, S., Heemsbergen, J., Jordan, H., & Mawhood, L. (1989). Autism diagnostic observation schedule: a standardized observation of communicative and social behavior. Journal of Autism and Developmental Disorders, 19, 185–212.

    Article  PubMed  Google Scholar 

  • 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. doi:10.1007/BF02172145.

    Article  PubMed  Google Scholar 

  • Mandy, W., Chilvers, R., Chowdhury, U., Salter, G., Seigal, A., & Skuse, D. (2012). Sex differences in autism spectrum disorder: Evidence from a large sample of children and adolescents. Journal of Autism and Developmental Disorders, 42, 1304–1313. doi:10.1007/s10803–011–1356–0.

    Article  PubMed  Google Scholar 

  • McLennan, J. D., Lord, C., & Schopler, E. (1993). Sex differences in higher functioning people with autism. Journal of Autism and Developmental Disorders, 23, 217–227. doi:10.1007/BF01046216.

    Article  PubMed  Google Scholar 

  • Rivet, T. T., & Matson, J. L. (2011). Review of gender differences in core symptomatology in autism spectrum disorders. Research in Autism Spectrum Disorders, 5, 957–976. doi:10.1016/j.rasd.2010.12.003.

    Article  Google Scholar 

  • Schopler, E., Reichler, R. J., & Renner, B. R. (1986). The childhood autism rating scale (CARS). Irvington: For diagnostic screening and classification of autism.

    Google Scholar 

  • Siklos, S., & Kerns, K. A. (2007). Assessing the diagnostic experiences of a small sample of parents of children with autism spectrum disorders. Research in Developmental Disabilities, 28, 9–22. doi:10.1016/j.ridd.2005.09.003.

    Article  PubMed  Google Scholar 

  • Szatmari, P., Liu, X. Q., Goldberg, J., Zwaigenbaum, L., Paterson, A. D., Woodbury‐Smith, M., & Thompson, A. (2012). Sex differences in repetitive stereotyped behaviors in autism: implications for genetic liability. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics, 159, 5–12. doi:10.1002/ajmg.b.31238.

    Article  Google Scholar 

  • Wechsler, D. (2002). Wechsler preschool and primary scale of intelligenceTM third edition (WPPSITM-III): Sydney. NSW: Pearson.

    Google Scholar 

  • Wechsler, D. (2003). Wechsler intelligence scale for children–fourth edition (WISC-IV). San Antonio: The Psychological Corporation.

    Google Scholar 

  • Werling, D. M., & Geschwind, D. H. (2013). Sex differences in autism spectrum disorders. Current Opinion in Neurology, 26, 146–153.

    Article  PubMed  PubMed Central  Google Scholar 

  • Young, R. L. (2007). Autism detection in early childhood (ADEC) manual: ACER Press.

Download references

Acknowledgments

The authors wish to sincerely thank Tomoko Nishizawa for her assistance with inter-rater reliability, as well as all of the parents and children who volunteered their information for this research.

Author Notes

This research was supported by the Apex Trust for Autism PhD Research Grant. This research was conducted while the first author was at Flinders University, Australia. Over the course of the review process the first author relocated to the University of Bath, United Kingdom.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Correspondence to Rachel M. Hiller.

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Hiller, R.M., Young, R.L. & Weber, N. Sex Differences in Autism Spectrum Disorder based on DSM-5 Criteria: Evidence from Clinician and Teacher Reporting. J Abnorm Child Psychol 42, 1381–1393 (2014). https://doi.org/10.1007/s10802-014-9881-x

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