Autism spectrum disorder: An examination of sex differences in neuropsychological and self-report measures of executive and non-executive cognitive function

Abstract

Sex differences in autism may in part be understood by an atypical sex profile of executive function and non-executive function. In this study, we compared females and males with autism against non-autistic individuals on neuropsychological and self-report measures to examine whether any sex differences in executive function and non-executive function might be unique to autism. Our study showed a significant overall female advantage for measures of psychomotor speed, cognitive flexibility, verbal learning and memory and semantic fluency. There was no significant interaction effect between diagnosis and sex. No sex differences were observed on the self-report measure of executive function. Our results suggest that while females show different cognitive performance to males, these sex differences were not specific to the autistic cohort. Lay abstract Research comparing females and males with a diagnosis of autism suggests that there are sex differences in some characteristics such as behaviour regulation. One area not studied in detail is whether females and males with autism perform differently in tests of cognitive ability. The results of previous research are quite mixed. One explanation may be that some research comparing females and males with autism did not include a neurotypical control group for comparison. As a result, it is not clear whether the sex differences in cognitive ability observed in people with autism are similar to differences between neurotypical males and females. To better understand whether there are unique differences between males and females with autism, it is important to also compare them with neurotypical males and females. In our research, we included a neurotypical group and compared males and females with and without a diagnosis of autism. We found that the sex differences in autism are similar to what we observe in males and females without autism. Our study showed that compared with males, females (with and without autism) do better in assessments of processing speed, cognitive flexibility, verbal learning and memory and semantic fluency. Our results suggest that although females show different cognitive performance to males, these sex differences were not specific to the group with a diagnosis of autism.

Intersecting effects of sex/gender and autism on structural language: A scoping review

“…With respect to our research question regarding how studies define, incorporate, or approach sex and/or gender, 18 of the 24 articles approached the concept from a position rooted in the biological and binary idea of sex. Five of the 18 articles used consistent language to demonstrate whether they were discussing sex or gender: Asberg et al (2010) and Lin and Chiang (2014) consistently used “gender,” “boy,” and “girl,” and Demetriou et al (2021), Lai et al (2011), and Ludwig (2013) consistently used “sex,” “male,” and “female,” with contextually appropriate usage of “boy” and “girl” when discussing other research about gender. The remaining 13 articles used inconsistent language (i.e.…”

“…In language samples from autistic adolescents, analyzed by Oates (2019), girls produced significantly more first-person singular pronouns and negative emotion words, while boys produced significantly more modifiers. The overall female advantage in semantic ability seen in the school-age years continues into adulthood: Within a semantic fluency task, women produced significantly more associated words than men, regardless of autism status (Demetriou et al, 2021).…”

“…However, a more complex picture emerges in articles comparing both sexes/genders and neurotypes. For example, regardless of autism status, girls' emotional word usage and verbal fluency were stronger than those of autistic and nonautistic boys' (Demetriou et al, 2021;Goddard et al, 2014;Sturrock, Yau, Freed, & Adams, 2020). That is, these skills were roughly equivalent across neurotypes within samesex/gender groups, with girls collectively outperforming boys.…”

“…Two of these 10 articles reported that boys showed significantly more autistic traits than girls (Craig et al, 2020;Harrop et al, 2020), featuring participants with mean ages of 4 and 12.5 years, respectively. One reported higher levels of autistic traits in girls than in boys (Carter et al, 2007) and the remaining seven reported no significant sex/gender differences in autistic trait scores (Asberg et al, 2010;Boorse et al, 2019;Conlon et al, 2019;Demetriou et al, 2021;Immormino, 2016;Sturrock, Marsden, Adams, & Freed, 2020). Thirteen articles simply stated that participants were clinically diagnosed with autism or an autism spectrum disorder, and one relied on participants' reports of their autism status.…”

Network Meta-Analysis of Physical Activity Interventions On Cognitive Functions In Children With Autism Spectrum Disorder: A Protocol of Randomized Controlled Trials

“…Cognitive function has been categorized into executive function (EF) and non-executive function(non-EF). EF presents an individual's adapting skills and ability to conduct goal-oriented meaningful actions [19].…”