How do Girls with Low Functioning Autism Compare to Boys with Autism and Typically Developing Girls with regard to Behavior, Cognition, and Psychopathology?

Abstract

Background: The female autism spectrum disorder (ASD) phenotype is currently underresearched. Girls with ASD may differ from boys with ASD, yet few studies have tested this hypothesis, particularly among low functioning individuals. This study compared girls and boys with predominantly low functioning ASD and typically developing girls during middle and late childhood across autism symptoms, cognition, sensory overresponsivity, and co-occurring psychopathology. Methods: Three mental-age-matched groups were compared: girls with ASD (N = 27), boys with ASD (N = 27), and typically developing girls (N = 17). Their ages ranged from 7 to 19 years old. The majority of individuals in the ASD sample had an intelligence quotient of less than 70. Participants were assessed on standard social cognition and attention to detail tasks. Parents completed behavior questionnaires. Results: Mean levels of autism symptoms were not significantly different for boys and girls with ASD, and they were significantly higher than those of typically developing girls. There were some weak trends for boys with ASD to show more compulsive behavior, inattention/hyperactivity and taste sensory overresponsivity than girls with ASD, but differences were not significant after controlling for multiple comparisons. The Block Design task, assessing attention to detail, showed a significant sex difference, with boys with ASD outperforming both girls with ASD and typically developing girls. Conclusions: Predominantly low functioning girls with ASD differed from typically developing girls but did not differ from boys with ASD with regard to their levels of autism symptoms, sensory overresponsivity, or co-occurring psychopathology. These data feed into debates about whether ASD assessment tools require sex-specific criteria and to what degree treatment should be tailored to the sex of the individual.

Sex Differences in Salience Network Connectivity and its Relationship to Sensory Over‐Responsivity in Youth with Autism Spectrum Disorder

“…At the behavioral level, we found that males and females with ASD did not show sex differences in SOR symptom severity, which is consistent with a number of other studies [Mandy et al 2012;Bitsika et al, 2018;Nguyen & Ronald, 2014]. Although one study [Kumazaki et al, 2015] reported greater sensory issues in females compared to males with ASD, these participants were younger than in the current study, suggesting a need to examine sex differences in sensory processing across development.…”

Developmental neurogenetics and multimodal neuroimaging of sex differences in autism

“…Another study examining predominately low functioning ASD girls and boys found no sex differences in autistic symptoms (i.e. restricted behavior, sensory over-responsivity, social cognition, and psychopathology), but did find sex differences in attention to detail (Nguyen and Ronald 2014). Several other studies have indicated that sex differences in perception, eye-hand integration, and communication disappear when IQ is controlled (Lord, Schopler et al 1982, Banach, Thompson et al 2009).…”

“…A few studies have concluded that no sex differences exist on some specific domains of ASD (Pilowsky, Yirmiya et al 1998, Rivet and Matson 2011, Worley and Matson 2011, Nguyen and Ronald 2014, Reinhardt, Wetherby et al 2015). For instance, one study discovered that no sex differences exist in psychopathology of high functioning ASD children, although the ASD group exhibited higher psychiatric symptoms than the control (Worley and Matson 2011).…”