Skip to main content
Log in

Sex Differences in Autism Spectrum Disorder: An Examination of Developmental Functioning, Autistic Symptoms, and Coexisting Behavior Problems in Toddlers

  • original paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

Little is known about the female presentation of autism spectrum disorder (ASD) during early childhood. We investigated sex differences in developmental profiles using the Mullen Scales of Early Learning, autistic symptoms on the ADOS-G, and coexisting behavior problems on the CBCL in 157 boys and 42 girls with ASD aged 1.5–3.9 years. Overall, boys and girls evidenced a markedly similar pattern of developmental profiles, autism symptoms, and coexisting behavior problems, although subtle differences exist. Boys and girls evidenced a similar pattern of developmental strengths and weaknesses. Girls with ASD evidenced greater communication deficits than boys and boys evidenced more restricted, repetitive, and stereotyped behavior than girls. Girls exhibited more sleep problems and anxious or depressed affect than boys.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Achenbach, T., & Rescorla, L. (2000). Child behavior checklist. Burlington VT: ASEBA.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (fourth edition, text revision). Washington, DC: Author.

    Book  Google Scholar 

  • Baron-Cohen, S., & Hammer, J. (1997). Is autism an extreme form of the ‘male brain’? Advances in Infancy Research, 11, 193–217.

    Google Scholar 

  • Baron-Cohen, S., Hoekstra, R., Kickmeyer, R., & Wheelwright, S. (2006). The autism quotient (AQ)—Adolescent version. Journal of Autism and Developmental Disorders, 36, 343–350.

    Article  PubMed  Google Scholar 

  • Baron-Cohen, S., Wheelwright, S., Skinner, M., Martin, J., & Clubley, E. (2001). The autism-spectrum quotient (AQ): Evidence from Asperger syndrome/high functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31, 5–17.

    Article  PubMed  Google Scholar 

  • Bartak, L., & Rutter, M. (1976). Differences between mentally retarded and normally intelligent autistic children. Journal of Autism and Childhood Schizophrenia, 6, 109–120.

    Article  PubMed  Google Scholar 

  • Carter, A. S., Black, D. O., Tewani, S., Connolly, C. E., Kadlec, M. B., & Tager-Flusberg, H. (2007). Sex differences in toddlers with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37, 86–97.

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2007). Prevalence of autism spectrum disorder—Autism and developmental disability monitoring network, 14 sites, United States, 2002. In Surveillance Summary (pp. 12–27). 9, Feb, 2007. Morbidity and Mortality Weekly Report, 56.

  • Gadow, K. D., & DeVincent, C. J. (2005). Clinical significance of tics and attention-deficit/hyperactivity disorder (ADHD) in children with pervasive developmental disorder. Journal of Child Neurology, 20, 481–488.

    PubMed  Google Scholar 

  • Gadow, K. D., DeVincent, C. J., & Pomeroy, J. (2005). Comparison of DSM-IV symptoms in elementary school-aged children with PDD versus clinic and community samples. Autism, 9, 392–415.

    Article  PubMed  Google Scholar 

  • Gadow, K. D., DeVincent, C. J., Pomeroy, J., & Azizian, A. (2004). Psychiatric symptoms in preschool children with PDD and Clinic and Comparison samples. Journal of Autism and Developmental Disorders, 34, 379–393.

    Article  PubMed  Google Scholar 

  • Hastings, R. P., Kovshoff, H., Ward, N. J., Espinosa, F., Brown, T., & Remington, B. (2005). Systems analysis of stress and positive perceptions in mothers and fathers of pre-school children with autism. Journal of Autism and Developmental Disorders, 35, 635–644.

    Article  PubMed  Google Scholar 

  • Herring, S., Gray, L., Taffe, J., Tonge, G., Sweeney, D., & Einfield, S. (2006). Behaviour and emotional problems in toddlers with pervasive developmental disorders and developmental delay: Association with parental mental health and family functioning. Journal of Intellectual Disability Research, 50, 874–888.

    Article  PubMed  Google Scholar 

  • Holtmann, M., Bolte, S., & Poustka, F. (2007). Autism spectrum disorders: Sex differences in autistic behavior in autistic behavior domains and coexisting psychopathology. Developmental Medicine and Child Neurology, 49, 361–366.

    Article  PubMed  Google Scholar 

  • Hus, V., Pickles, A., Cook, E. H., Risi, S., & Lord, C. (2007). Using the autism diagnostic interview-revised to increase phenotypic homogeneity in genetic studies of autism. Biological Psychiatry, 61, 438–444.

    Article  PubMed  Google Scholar 

  • Ingudomnukul, E., Baron-Cohen, S., Wheelwright, S., & Kickmeyer, R. (2007). Elevated rates of testosterone-related disorders in women with autism spectrum conditions. Hormones and Behavior, 51, 597–604.

    Article  PubMed  Google Scholar 

  • 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 and Allied Disciplines, 43, 807–821.

    Article  Google Scholar 

  • Kopp, S., & Gillberg, C. (1992). Girls with social deficits and learning problems: Autism, atypical Asperger syndrome or a variant of these conditions. European Child and Adolescent Psychiatry, 1, 89–99.

    Article  Google Scholar 

  • Le Couteur, A., Rutter, M., Lord, C., & Rios, P. (1989). Autism diagnostic interview: A standardized investigator-based instrument. Journal of Autism and Developmental Disorders, 19, 363–387.

    Article  PubMed  Google Scholar 

  • Lecavalier, L., Leone, S., & Wiltz, J. (2006). The impact of behaviour problems on caregiver stress in young people with autism spectrum disorders. Journal of Intellectual Disability Research, 50, 172–183.

    Article  PubMed  Google Scholar 

  • Lincoln, A. J., Allen, M. H., & Kilman, K. (1995). The assessment and interpretation of intellectual abilities in people with autism. In E. Schopler & G. B. Mesibov (Eds.), Learning and cognition in autism (pp. 89–117). New York, NY: Plenum Press.

    Google Scholar 

  • Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  • Mandell, D. S., Walrath, C. M., Manteuffel, B., Sgro, G., & Pinto-Martin, J. A. (2005). The prevalence and correlates of abuse among children with autism served in comprehensive community-based mental health settings. Child Abuse and Neglect, 29, 1359–1372.

    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 Disabilities, 23, 217–227.

    Article  Google Scholar 

  • Mullen, E. (1995). Mullen Scales of Early Learning (AGS ed.). Circle Pines, MN: American Guidance Systems.

    Google Scholar 

  • Pilowsky, T., Yirmiya, N., Sulman, C., & Dover, R. (1998). The autism diagnostic interview-revised and the childhood autism rating scale: Differences between diagnostic systems and comparison between gender. Journal of Autism and Developmental Disorders, 28, 143–151.

    Article  PubMed  Google Scholar 

  • Rutter, M., Le Couteur, A., & Lord, C. (2003). ADI-R: The autism diagnostic interview—Revised. Los Angelos, CA: Western Psychological Services.

    Google Scholar 

  • Schopler, E., Reichler, R. J., & Renner, B. R. (1988). The childhood autism rating scale. Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Schultz, R. T., Romanski, L. M., & Tsatsanis, K. D. (2000). Neurofunctional models of autistic disorder and Asperger syndrome: Clues from neuroimaging. In A. Klin, F. R. Volkmar, & S. S. Sparrow (Eds.), Asperger syndrome (pp. 172–209). New York, NY: Guilford Press.

    Google Scholar 

  • Skuse, D. H. (2000). Imprinting, the X-chromosome, and the male brain: Explaining sex differences in the liability to autism. Pediatric Research, 47, 9–16.

    Article  PubMed  Google Scholar 

  • Sparrow, S. S., Cicchetti, D. V., & Balla, D. A. (2005). Vineland adaptive behavior scales (2nd ed.). Circle Pines, MN: AGS Publishing.

  • Szatmarr, P., Jones, M. B., Holden, J., Bryson, S., Mahoney, W., Tuff, L., et al. (1996). High phenotypic correlations among siblings with autism and pervasive developmental disorders. American Journal of Medical Genetics, 67, 354–360.

    Article  Google Scholar 

  • Tsai, L. Y., & Beisler, J. M. (1983). The developmental of sex differences in infantile autism. British Journal of Psychiatry, 142, 373–378.

    Article  PubMed  Google Scholar 

  • Tsi, L., Stewart, M. A., & August, G. (1981). Implications of sex differences in the familial transmission of infantile autism. Journal of Autism and Developmental Disorders, 11, 165–173.

    Article  Google Scholar 

  • Voigt, R. G., Llorente, A. M., Jensen, C. L., Fraley, J. K., Barbaresi, W. J., & Heird, W. C. (2007). Comparison of the validity of direct pediatric developmental evaluation versus developmental screening by parent report. Clinical Pediatrics, 46(6), 523–529.

    Article  PubMed  Google Scholar 

  • Volkmar, F. R., Bregman, J., Cohen, D. J., & Cicchetti, D. V. (1988). DSM III and DSM III-R diagnoses of autism. American Journal of Psychiatry, 145, 1404–1408.

    PubMed  Google Scholar 

  • Volkmar, F. R., Szatmari, P., & Sparrow, S. S. (1993). Sex differences in pervasive developmental disorders. Journal of Autism and Developmental Disorders, 23, 579–591.

    Article  PubMed  Google Scholar 

  • Wakabayashi, A., Tojo, Y., Baron-Cohen, S., & Wheelwright, S. (2004). The autism quotient (AQ) Japanese version: Evidence from high functioning clinical group and normal adults. The Japanese Journal of Psychology, 75, 78–84.

    Google Scholar 

  • Wakabayashi, A., Uchiyama, T., Tojo, Y., Yoshida, Y., Kuroda, M., Baron-Cohen, S., et al. (2007). The autism spectrum quotient (AQ) Japanese children version: Comparison between high functioning children with autism spectrum disorder and normal controls. The Japanese Journal of Psychology, 77, 534–540.

    Google Scholar 

  • Wing, L. (1981). Sex ratios in early childhood autism and related conditions. Psychiatric Research, 5, 129–137.

    Article  Google Scholar 

  • Wing, L., & Gould, J. (1979). Severe impairments of social interaction and associated abnormalities in children: Epidemiology and classification. Journal of Autism and Developmental Disorders, 9, 11–29.

    Article  PubMed  Google Scholar 

  • Winsler, A., & Wallace, G. (2002). Behavior problems and social skills in preschool children: Parent-teacher agreement and relations with classroom observations. Early Education & Development, 13(1), 41–58.

    Article  Google Scholar 

  • Wolff, S., & McGuire, R. J. (1995). Schiziod personality in girls: A follow-up study—What are the links with Asperger’s syndrome? Journal of Child Psychology and Psychiatry, 56, 793–817.

    Article  Google Scholar 

Download references

Acknowledgment

This manuscript was prepared with support from the National Institute on Child Health and Human Development (P30 HD03352, T32 HD07489). We would like to extend our thanks to the families who participated in this study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sigan L. Hartley.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hartley, S.L., Sikora, D.M. Sex Differences in Autism Spectrum Disorder: An Examination of Developmental Functioning, Autistic Symptoms, and Coexisting Behavior Problems in Toddlers. J Autism Dev Disord 39, 1715–1722 (2009). https://doi.org/10.1007/s10803-009-0810-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-009-0810-8

Keywords

Navigation