CoChat
Sign Up
Cited by 133Autism Spectrum Disorder ResearchChild Nutrition and Feeding IssuesGenetics and Neurodevelopmental Disorders

Clinical characteristics and problems diagnosing autism spectrum disorder in girls

Young, H., Oreve, M.-J., Speranza, M.·2018·Archives de Pédiatrie
DOI 10.1016/j.arcped.2018.06.008
Open this paper in CoChat — free account

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.

Integrity signals

Registry

Crossref · 10.1016/j.arcped.2018.06.008

Cites

14 of 14 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • 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

Cites

Flagged first, then by citations

Research works printed but not linked: 25

  1. Ingudomnukul, 2007, Elevated rates of testosterone-related disorders in women with autism spectrum conditions, Horm Behav, 51, 597, 10.1016/j.yhbeh.2007.02.001 · DOI
  2. Tsai, 1983, The development of sex differences in infantile autism, Br J Psychiatry, 142, 373, 10.1192/bjp.142.4.373 · DOI · Paper page
  3. Kopp, 1992, Girls with social deficits and learning problems: autism, atypical Asperger syndrome or a variant of these conditions, Eur Child Adolesc Psychiatry, 1, 89, 10.1007/BF02091791 · DOI · Paper page
  4. Kreiser, 2014, ASD in Females: are we overstating the gender difference in diagnosis?, Clin Child Fam Psychol Rev, 17, 67, 10.1007/s10567-013-0148-9 · DOI · Paper page
  5. Lai, 2015, Sex/gender differences and autism: setting the scene for future research, J Am Acad Child Adolesc Psychiatry, 54, 11, 10.1016/j.jaac.2014.10.003 · DOI · Paper page
  6. Kim, 2011, Prevalence of autism spectrum disorders in a total population sample, Am J Psychiatry, 168, 904, 10.1176/appi.ajp.2011.10101532 · DOI · Paper page
  7. Thompson, 2003, Sex matters in autism and other developmental disabilities, J Learn Disabil, 7, 345, 10.1177/1469004703074003 · DOI
  8. Sedgewick, 2016, Gender differences in the social motivation and friendship experiences of autistic and non-autistic adolescents, J Autism Dev Disord, 46, 1297, 10.1007/s10803-015-2669-1 · DOI
  9. Hiller, 2014, Sex differences in autism spectrum disorder based on DSM-5 criteria: evidence from clinician and teacher reporting, J Abnorm Child Psychol, 42, 1381, 10.1007/s10802-014-9881-x · DOI
  10. Frazier, 2017, Equivalence of symptom dimensions in females and males with autism, Autism, 21, 749, 10.1177/1362361316660066 · DOI · Paper page
  11. Hiller, 2016, Sex differences in pre-diagnosis concerns for children later diagnosed with autism spectrum disorder, Autism, 20, 75, 10.1177/1362361314568899 · DOI · Paper page
  12. Shattuck, 2009, The timing of identification among children with an autism spectrum disorder: findings from a population-based surveillance study, J Am Acad Child Adolesc Psychiatry, 48, 474, 10.1097/CHI.0b013e31819b3848 · DOI · Paper page
  13. Rynkiewicz, 2016, An investigation of the “female camouflage effect” in autism using a computerized ADOS-2 and a test of sex/gender differences, Mol Autism, 7, 10, 10.1186/s13229-016-0073-0 · DOI · Paper page
  14. Mandy, 2012, Sex differences in autism spectrum disorder: evidence from a large sample of children and adolescents, J Autism Dev Disord, 42, 1304, 10.1007/s10803-011-1356-0 · DOI · Paper page
  15. Gould, 2011, Missed diagnosis or misdiagnosis? Girls and women on the autism spectrum, Good Autism Pract, 12, 34
  16. Lord, 1994, Autism diagnostic interview-revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders, J Autism Dev Disord, 24, 659, 10.1007/BF02172145 · DOI · Paper page
  17. Beggiato, 2017, Gender differences in autism spectrum disorders: divergence among specific core symptoms, Autism Res, 10, 680, 10.1002/aur.1715 · DOI · Paper page
  18. Mussey, 2017, Are males and females with autism spectrum disorder more similar than we thought?, Autism, 21, 733, 10.1177/1362361316682621 · DOI
  19. Pilowsky, 1998, The autism diagnostic interview-revised and the childhood autism rating scale: differences between diagnostic systems and comparison between genders, J Autism Dev Disord, 28, 143, 10.1023/A:1026092632466 · DOI
  20. Mandic-Maravic, 2015, Sex differences in autism spectrum disorders: does sex moderate the pathway from clinical symptoms to adaptive behavior?, Sci Rep, 5, 10418, 10.1038/srep10418 · DOI
  21. Jamison, 2017, The clinician perspective on sex differences in autism spectrum disorders, Autism, 21, 772, 10.1177/1362361316681481 · DOI
  22. McLennan, 1993, Sex differences in higher functioning people with autism, J Autism Dev Disord, 23, 217, 10.1007/BF01046216 · DOI
  23. Pisula, 2017, Behavioral and emotional problems in high-functioning girls and boys with autism spectrum disorders: parents’ reports and adolescents’ self-reports, Autism, 21, 738, 10.1177/1362361316675119 · DOI
  24. Frazier, 2014, Behavioral and cognitive characteristics of females and males with autism in the Simons simplex collection, J Am Acad Child Adolesc Psychiatry, 53, 329, 10.1016/j.jaac.2013.12.004 · DOI · Paper page
  25. Halladay, 2015, Sex and gender differences in autism spectrum disorder: summarizing evidence gaps and identifying emerging areas of priority, Mol Autism, 6, 36, 10.1186/s13229-015-0019-y · DOI

Cited by

Sorted by citations

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.
ORCID
Venue
Archives de Pédiatrie
Publisher
Elsevier BV
Published
2018-08
Volume
25
Issue
6
Pages
399-403
ISSN
0929-693X (ISSN-L)
DOI
10.1016/j.arcped.2018.06.008
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
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
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

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review