Clinical characteristics and problems diagnosing autism spectrum disorder in girls
Abstract
Background Autism is a neurodevelopmental disorder with various clinical presentations. It has been historically considered a male disorder. An increasing number of authors stress the existence of sex/gender bias in prevalence and the need to define sex/gender differences in the clinical presentation. Review Recently, an increasing number of authors have studied the impact of sex/gender on autism's clinical presentation. The sex ratio of four boys to one girl commonly reported in literature is questioned. Sociocultural and familial influences can impact female clinical presentation as well as the way the difficulties of girls with autism are perceived. Issues of autism diagnostic instruments such as sex/gender bias are also studied since they have an impact on the access to diagnosis for girls. Clinical variability is a part of autism spectrum disorder, but some traits appear to be more specific of the female phenotype: existence of a "camouflage" phenomenon and less unusual play or restricted interests. Discussion Better understanding and diagnosis of females with autism is required to ensure the access to the support and treatment they need. Professionals must apprehend the sex/gender clinical differences to prevent the frequent misdiagnosis or missed diagnosis of females with autism. Conclusion Pursuing research on sex/gender differences seems necessary to ensure appropriate support and diagnosis of undiagnosed females.
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Distinguishing male and female ASD phenotypes is complicated by methodological bias from predominantly male samples and clinical tools designed to fit the male ASD phenotype.
“This is partly due to methodological bias, resulting from the inclusion of predominantly male samples, as well as the use of clinical tools designed to fit the male ASD phenotype.”
From Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review (2021) · cites this paper as Young et al. 2018
Clinical tools may not be sensitive to the differing distribution of autistic traits between males and females.
“Such tools may not be sensitive to the differing distribution of autistic traits between males and females (Young et al. 2018).”
From Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review (2021) · cites this paper as Young et al. 2018
A previous systematic review outlined specific social communication areas seen more commonly in females than males with ASD, including desire to interact, better conscience of social interaction, passivity perceived as shyness, tendency to mimic people, and development of compensatory strategies.
“a systematic review (Young et al. 2018) has previously outlined specific areas of social communication that are seen more commonly in females than males with ASD. These include ‘desire to interact with others’, ‘better conscience of necessity of social interaction’, ‘passivity perceived as shyness’, ‘tendency to mimic people’, and ‘development of compensatory strategies’ (i.e. camouflaging)”
From Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review (2021) · cites this paper as Young et al. 2018
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Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review
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“In addition to potential sex(1) differences in clinical presentation (Lai et al. 2014; May et al. 2014; Young et al. 2018), it is increasingly recognised that autistic people can hide their ASD symptoms or use compensatory behaviours to mitigate social challenges (Gould and Ashton-Smith 2011; Hull et al.”
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Brown, C. M., Attwood, T., Garnett, M., & Stokes, M. A. (2020) · Autism in Adulthood · doi:10.1089/aut.2019.0054 · Cited by 39 · see citing works
- Authors
- Young, H., Oreve, M.-J., & Speranza, M.
- Affiliations
- Université Paris-Sud (FR)
- Université de Versailles Saint-Quentin-en-Yvelines (FR)
- Corresponding author
- Young, H.
- Venue
- Archives de Pédiatrie
- Publisher
- Elsevier BV
- Published
- 2018-08
- Volume
- 25
- Issue
- 6
- Pages
- 399-403
- ISSN
- 0929-693X (ISSN-L)
- OpenAlex
- W2888232445
- Cited by
- 133
- References
- 14
- Citations by year
- 2026: 16 · 2025: 13 · 2024: 26 · 2023: 20 · 2022: 22 · 2021: 21 · 2020: 8 · 2019: 7
- FWCI
- 1.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives de Pédiatrie (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
- Keywords
- autism spectrum disorder, girls, sex and gender differences, sex ratio, camouflage, misdiagnosis, clinical features, restricted and repetitive behaviors, sociocultural factors
- MeSH terms
- Autism Spectrum Disorder, Female, Humans, Male, Phenotype, Sex Factors, Prevalence
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