Sex-typical Play: Masculinization/Defeminization in Girls with an Autism Spectrum Condition

Abstract

We tested the hypothesis that prenatal masculinization of the brain by androgens increases risk of developing an autism spectrum condition (ASC). Sex-typical play was measured in n = 66 children diagnosed with an ASC and n = 55 typically developing age-matched controls. Consistent with the hypothesis, girls with autism did not show the female-typical play preferences, though this was only seen on non-pretence items. Boys with autism showed a preference for male play on non-pretence items, in keeping with their sex. Girls with autism engaged in more pretend play than boys with autism, suggesting that pretence is relatively more protected in females with autism. We conclude that play preference studies in ASC provide partial support for the fetal androgen theory.

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Acknowledgments

RK was supported by a British Government Overseas Research Studentship (ORS) and the Cambridge Overseas Trust. We are grateful to the Nancy Lurie Marks Family Foundation for supporting this work. SW and SBC were also supported by the Medical Research Council (MRC) UK. We are grateful to Ian Goodyer, Joe Herbert, John Manning, and Carrie Allison for their discussion of this work. This work was submitted as partial fulfillment of the degree of PhD, University of Cambridge by RK

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Correspondence to Rebecca C. Knickmeyer.

Appendix: The children’s play questionnaire

Appendix: The children’s play questionnaire

Child’s name –––––––––––––Your name–––––––––––––

Date of birth –––––––––––––Today’s date –––––––––––––

In this section you will find a list of games or activities that children may play. Read through the list and indicate how interested your child would be in each game by ticking the right box. 1 means not at all interested, 3 is somewhat interested, and 5 is very interested

  1 not at all interested 2 3 somewhat interested 4 5 very interested
Playing with Barbie-type dolls*      
Pretending to be a soldier**      
Looking at picture books      
Role-playing domestic activities (eg cooking, cleaning, bathing)*      
Pretending to be a superhero**      
Playing with toy guns or other weapons**      
Playing with stuffed animals      
Playing dress up (fashion/jewelry)*      
Playing with toy cars and trucks**      
Riding on tricycles/bicycles      
Role-playing family relationships (eg parenting/marriage)*      
Pretending to be an astronaut (space-man) or explorer**      
Skipping rope or skipping*      
Playing with toy tools**      
Swimming      
Playing with electric trains**      
Playing school (pretending to be a teacher)*      
Playing on swings      
Playing Cowboys and Indians or similar**      
Playing on see-saws      
Dancing*      
Playing with toy airplanes**      
Play fighting/wrestling**      
Playing with hair (e.g., brushing someone else’s hair)*      
Watching cartoons      
Playing tea-parties*      
Playing board-games (e.g.,Ludo, Snakes and Ladders)      
Playing with baby dolls*      
  1. * Female-typical games
  2. ** Male-typical games

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Knickmeyer, R.C., Wheelwright, S. & Baron-Cohen, S.B. Sex-typical Play: Masculinization/Defeminization in Girls with an Autism Spectrum Condition. J Autism Dev Disord 38, 1028–1035 (2008). https://doi.org/10.1007/s10803-007-0475-0

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Keywords

  • Autism
  • Sex differences
  • Play
  • Fetal testosterone