The Early Childhood Signs of Autism in Females: a Systematic Review

Abstract

Compared to males, females are at a much greater likelihood of receiving a later diagnosis of autism, which impacts their opportunity to receive early support. To assist with early identification, this systematic literature review aimed to ascertain whether females differ from males in the early childhood signs of autism. The small number of heterogeneous studies made it difficult to draw conclusions, although it appears that females and males under 6 years of age are more similar than different in terms of their expression of autistic behaviours. Given the discrepant sex/gender ratio in autism, these findings highlight the importance of exploring whether there are different and/or specific, not yet identified, early signs of autism in females and males.

Finding the Proportion of Females with Autistic Spectrum Disorder Who Develop Anorexia Nervosa, the True Prevalence of Female ASD and Its Clinical Significance.

“…Recognition bias prior to diagnosis was assumed to be minimal because the carers knew what to look for due to their prior experience with ASD probands and therefore they would present for assessment of possible ASD. The diagnostic method was clinical (DSM-5), paying particular attention to the nuances of early female presentation [30,31,32] and 49% had prior testing, normally ADOS 2 and/or ADI-R, by allied health professionals (table 7). Gendered differences in early presentation have been hard to tease out [27] probably because early diagnosed girls have behaved like the boys.…”