Sex Differences in an Autism Spectrum Disorder Diagnosis: Are Restricted Repetitive Behaviors and Interests the Key?

McFayden, Tyler C.; Antezana, Ligia; Albright, Jordan; Muskett, Ashley; Scarpa, Angela

doi:10.1007/s40489-019-00183-w

Cited by 23 publications

(19 citation statements)

References 57 publications

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“…Given the growing body of evidence suggesting that a female phenotype of autism might be different from the male phenotype, the high ratio of females in this study might have affected the kinds of experiences shared. Gender differences in the general structure of RRBIs are inconsistent across studies ( Barrett et al, 2018 ; McFayden et al, 2019 ), but some suggest that hoarding and SIBs are more prevalent in autistic girls, distinguishing them from autistic boys, who display heightened stereotyped behaviors and restricted interests ( Antezana et al, 2019 ). The relatively high representation of females in this study may have contributed in highlighting behaviors that were overlooked in previous studies.…”

Section: Discussionmentioning

confidence: 99%

Autistic adults’ subjective experiences of hoarding and self-injurious behaviors

Goldfarb

Zafrani

Hedley

et al. 2021

Autism

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Restrictive and Repetitive Behaviors and Interests represent a core feature of autism since the earliest conceptualization of the condition. Related behaviors, such as hoarding and self-injurious behaviors, are under-researched in adulthood, resulting in limited knowledge about their various manifestation through the life span. This study expands our understanding of hoarding and self-injurious behaviors through subjective experiences shared by autistic adults. Ten adults with an autism diagnosis (aged 18–55 years, five females) participated in semi-structured, in-depth interviews. Thematic analysis identified a cluster of behaviors related to hoarding and self-injurious behaviors. Further analysis sub-categorized each theme according to the underlying purpose of the behavior. Hoarding behaviors were motivated by (1) a need for emotional aids, (2) disposing difficulties, and (3) collecting items related to special interests. Reasons for engaging in self-injurious behaviors were (1) an urge for sensory stimulation and (2) emotional regulation purposes. Discussion focuses on the underlying motives of the participants for engaging in these behaviors, in respect to current research knowledge. Relations to the general construct of Restrictive and Repetitive Behaviors and Interests are discussed along with implications for research and practice. Lay abstract Hoarding and self-injurious behaviors are relatively common in autism, but knowledge about their expressions in adulthood is scarce. Through interviews collecting subjective experiences of autistic adults, these behaviors were explored, and categorized to their underlying purposes. Findings portray the occurrence of these behaviors in the lives of autistic adults, their self-regulatory purposes, and their relationship to other behaviors in the domain of Restrictive and Repetitive Behaviors and Interests.

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Section: Discussionmentioning

confidence: 99%

Autistic adults’ subjective experiences of hoarding and self-injurious behaviors

Goldfarb

Zafrani

Hedley

et al. 2021

Autism

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“…These differences are in contrast to Harrop and colleagues (Harrop et al, 2015), who found that girls and boys under the age of 5 were more similar with respect to this core deficit, while they found a trend toward gender-differential growth trajectories. However, different studies highlight that compared to autistic males, females tend to show reduced restricted, repetitive, and stereotyped behaviors and interests, but more self-injurious and compulsive behaviors and sensory challenge (McFayden et al, 2020;Moseley, Hitchiner, & Kirkby, 2018). A lack of difference across social-communicationinteraction, cognitive, and adaptive functioning was found in minimally verbal individuals (Howe et al, 2015) and in toddlers/preschoolers diagnosed early in life (Matheis et al, 2019;Duvall et al, 2020).…”

Section: Differences In Adi-r Scores Across Unusual Sensory Interest ...mentioning

confidence: 99%

Behavioral gender differences across Pre-School Children with Autism Spectrum Disorders: a cross-sectional study

Tofani

Scarcella

Giovannone

et al. 2022

J Autism Dev Disord

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There is increasing literature showing that the presentation of Autism Spectrum Disorder (ASD) could be different according to the sex of the patient. Through the analysis of the Autism Diagnostic Interview Revised interview results of a study group consisting of 56 preschool children diagnosed with ASD potential differences in the presentation of ASD were searched. Variables investigated were verbal abilities, the presence/absence of unusual sensory interests, as well as of echolalia. The results showed significant differences between gender in restricted and repetitive behavior (p < 0.01), in particular for those children who have no unusual sensory interest (p < 0.05) and with minimal verbal ability (p < 0.05). The findings contribute providing evidences on phenotypical differences in preschool children with a diagnosis of Autism Spectrum Disorder.

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“…One theory is that there are female-specific protective factors that allow girls to tolerate more of an etiological load before reaching clinical thresholds for ASD [Robinson, Lichtenstein, Anckarsäter, Happé, & Ronald, 2013]. Another theory is that cognitive and behavioral differences seen in males and females with ASD may result in under-diagnosis of females [Frazier, Georgiades, Bishop, & Hardan, 2014;McFayden, Antezana, Albright, Muskett, & Scarpa, 2019]. A third theory suggests that females are underdiagnosed because of their ability to mask their symptoms.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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Individuals with autism spectrum disorder (ASD) are significantly more likely to experience sensory over‐responsivity (SOR) compared to neurotypical controls. SOR in autism has been shown to be related to atypical functional connectivity in the salience network (SN), a brain network thought to help direct attention to the most relevant stimuli in one's environment. However, all studies to date which have examined the neurobiological basis of sensory processing in ASD have used primarily male samples so little is known about sex differences in the neural processing of sensory information. This study examined the relationship between SOR and resting‐state functional connectivity in the SN for 37 males and 16 females with autism, ages 8–17 years. While there were no sex differences in parent‐rated SOR symptoms, there were significant sex differences in how SOR related to SN connectivity. Relative to females with ASD, males with ASD showed a stronger association between SOR and increased connectivity between the salience and primary sensory networks, suggesting increased allocation to sensory information. Conversely, for females with ASD, SOR was more strongly related to increased connectivity between the SN and prefrontal cortex. Results suggest that the underlying mechanisms of SOR in ASD are sex specific, providing insight into the differences seen in the diagnosis rate and symptom profiles of males and females with ASD. Lay Summary Sensory over‐responsivity (SOR) is common in autism. Most research on the neural basis of SOR has focused on males, so little is known about SOR or its neurobiology in females with autism spectrum disorder. Here despite no sex differences in SOR symptoms, we found sex differences in how SOR related to intrinsic connectivity in a salience detection network. Results show sex differences in the neural mechanisms underlying SOR and inform sex differences seen in diagnosis rates and symptom profiles in autism. Autism Res 2020, 13: 1489–1500. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.

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Sex Differences in an Autism Spectrum Disorder Diagnosis: Are Restricted Repetitive Behaviors and Interests the Key?

Cited by 23 publications

References 57 publications

Autistic adults’ subjective experiences of hoarding and self-injurious behaviors

Autistic adults’ subjective experiences of hoarding and self-injurious behaviors

Behavioral gender differences across Pre-School Children with Autism Spectrum Disorders: a cross-sectional study

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

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