How Different Are Girls and Boys Above and Below the Diagnostic Threshold for Autism Spectrum Disorders?
Open accessAbstract
Objective This study aimed to explore sex differences in autistic traits in relation to diagnosis, to elucidate factors that might differentially impact whether girls versus boys meet diagnostic criteria for autism or a related autism spectrum disorder (ASD).Method Data from a large population-based sample of children were examined. Girls and boys (aged 10-12 years) meeting diagnostic criteria for an ASD were compared with those failing to meet diagnostic criteria despite very high scores on a trait measure of ASD, the Childhood Autism Spectrum Test (CAST). Information about behavioral difficulties as reported by teachers, and early estimates of intellectual functioning, were compared.Results Girls, but not boys, meeting diagnostic criteria for ASD showed significantly more additional problems (low intellectual level, behavioral difficulties) than peers with similarly high CAST scores who did not meet diagnostic criteria.Conclusions These data suggest that, in the absence of additional intellectual or behavioral problems, girls are less likely than boys to meet diagnostic criteria for ASD at equivalently high levels of autistic-like traits. This might reflect gender bias in diagnosis or genuinely better adaptation/compensation in girls.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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?
Among females and males with similar ASD traits, females with more behavior problems or intellectual disability, or both, are more likely to be recognized and diagnosed.
“Among females and males with similar ASD traits, females with more behavior problems or ID, or both, are more likely to be recognized and diagnosed [34, 35].”
From DSM-5 criteria for autism spectrum disorder maximizes diagnostic sensitivity and specificity in preschool children (2019) · cites this paper as [34]
The Discussion (page not supplied) reports that lower cognitive ability and/or additional behavior problems distinguished diagnosed from undiagnosed girls with similarly high ASD traits, but not boys. It suggests that girls may be missed in diagnosis, while also offering better adaptation as an alternative explanation; it does not establish that the additional problems make girls more likely to be recognized. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn a population-based sample, girls, but not boys, meeting diagnostic criteria for ASD showed significantly lower levels of verbal cognitive ability than peers with similarly high CAST scores who did not meet criteria for ASD.
“Dworzynski et al. (2012) found that in a population-based sample, girls, but not boys, meeting diagnostic criteria for ASD showed significantly lower levels of verbal cognitive ability than peers with similarly high CAST (Childhood Autism Spectrum Test) scores who did not meet criteria for ASD.”
From Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review (2021) · cites this paper as Dworzynski et al. 2012
The Dichotomous Measures section reports that diagnosed girls were significantly more likely than high-CAST girls to have low early cognitive abilities, including verbal ability. But it also reports a significant difference for verbal ability in boys: diagnosed boys had 2.7 times the odds of falling more than 1.5 standard deviations below the mean compared with high-CAST boys. The claim’s “but not boys” qualification is therefore unsupported. (LLM, conf=0.91)
Experimental — accuracy not yet measuredVerbally able girls may be waiting longer for a diagnosis, supporting the suggestion that additional language or other difficulties are often necessary for girls to receive an ASD diagnosis in contrast to boys.
“These results indicate that verbally able girls may be waiting longer for a diagnosis, thereby supporting Dworzynski et al.’s (2012) suggestion that additional language (or other) difficulties are often necessary for girls to receive an ASD diagnosis in contrast to boys.”
From Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review (2021) · cites this paper as Dworzynski et al. 2012
The Discussion suggests that girls with high ASD traits may need additional problems to cross the diagnostic threshold, and the Clinical Guidance identifies lower intellectual level or behavioral problems. The paper does not specifically establish additional language difficulties or that such difficulties are often necessary. The statement about waiting longer is the citing authors’ interpretation of their own results, not a finding attributed to this source. (LLM, conf=0.86)
Experimental — accuracy not yet measuredGirls with ASD may be missed in the diagnostic process and require additional verbal ability or behaviour problems to be noticed and to reach the diagnostic threshold, unlike boys.
“our results suggest that girls might be being missed within the diagnostic process, and that they require additional problems in verbal ability or behaviour, in order to be noticed and to push them over the diagnostic threshold, a finding which did not occur for boys (Duvekot et al. 2017; Dworzynski et al. 2012; Salomone et al. 2016).”
From Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review (2021) · cites this paper as Dworzynski et al. 2012
The Discussion says girls with high ASD traits may be missed and may need additional cognitive or behavioral problems to cross the diagnostic threshold, a pattern it characterizes as absent in boys. The Dichotomous Measures results qualify the claim about verbal ability: diagnosed boys, too, had significantly higher odds of low verbal cognitive ability than their nondiagnosed high-trait peers. The behavioral-problems result was significant for girls but not boys. (LLM, conf=0.86)
Experimental — accuracy not yet measuredFour papers described gender comparisons in behavioural problems and presented conflicting findings.
“Four papers described comparisons between genders and presented conflicting findings (Duvekot et al. 2017; Dworzynski et al. 2012; Giarelli et al. 2010; Petrou et al. 2018).”
From Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review (2021) · cites this paper as Dworzynski et al. 2012
Girls meeting diagnostic criteria had lower intellectual abilities than those who did not meet criteria in the low IQ analysis.
“This was also true for low IQ, with girls meeting diagnostic criteria having lower intellectual abilities than those who did not meet the criteria.”
From Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review (2021) · cites this paper as Dworzynski et al. 2012
ASD girls were more likely to have behavioural difficulties such as hyperactivity compared to high-trait girls not meeting diagnostic criteria, while boys showed no such difference.
“Within genders, it was found that ASD girls were more likely to have behavioural difficulties (e.g. hyperactivity), compared to high-trait girls not meeting diagnostic criteria, while boys showed no such difference (Dworzynski et al. 2012).”
From Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review (2021) · cites this paper as Dworzynski et al. 2012
In a clinic-based sample, having additional behavioural problems increased the likelihood of obtaining an ASD diagnosis in females, whereas this effect was not present for males.
“However, Duvekot et al. (2017) found that in a clinic-based sample, having additional behavioural problems increased the likelihood of obtaining an ASD diagnosis in females, whereas this effect was not present for males; this reflects the findings from a high-trait sample (Dworzynski et al. 2012).”
From Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review (2021) · cites this paper as Dworzynski et al. 2012
RRB quantity at 2 years of age is inversely related to language skills at 9 years.
“results from a longitudinal study suggested that RRB quantity at 2 years of age is inversely related to language skills at 9 years [37].”
From DSM-5 and autism spectrum disorders (ASDs): an opportunity for identifying ASD subtypes (2013) · cites this paper as [37]
The Intellectual Ability Estimates section says the analyses used verbal-ability measures from ages 2, 3, and 4, rather than later assessments. The passages on autistic traits do not relate RRB quantity at age 2 to language skills at age 9; searches for that longitudinal relationship found no passage in our copy. Page numbers were not available. (LLM, conf=0.76)
Experimental — accuracy not yet measuredThe current evidence base appears to support the idea that camouflaging is more associated with autistic females and girls or women and may partly explain their higher rates of missed or late diagnosis.
“the current evidence base appears to support suggestions that camouflaging is more associated with the experiences of autistic females and girls/ women, and may partially explain increased rates of missed or late diagnosis found amongst them”
From Camouflaging in autism: A systematic review (2021) · cites this paper as Dworzynski et al., 2012
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Statistical Power Analysis for the Behavioral Sciences
Muller, K. E., & Cohen, J. (1989) · Technometrics · doi:10.2307/1270020 · Cited by 99,588 · see citing works
The Strengths and Difficulties Questionnaire: A research note
Goodman, R. (1997) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1997.tb01545.x · Cited by 14,908 · see citing works
Goodman, R., Meltzer, H., & Bailey, V. (1998) · European Child & Adolescent Psychiatry · doi:10.1007/s007870050057 · Cited by 2,238 · see citing works
Epidemiology of Pervasive Developmental Disorders
Fombonne, E. (2009) · Pediatric Research · doi:10.1203/pdr.0b013e31819e7203 · Cited by 1,971 · see citing works
Goodman, R., Ford, T., Richards, H., Gatward, R., & Meltzer, H. (2000) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2000.tb02345.x · Cited by 1,755 · see citing works
Why are autism spectrum conditions more prevalent in males?
Baron-Cohen, S., Lombardo, M. V., Auyeung, B., Ashwin, E., Chakrabarti, B., & Knickmeyer, R. (2011) · PLoS Biology · doi:10.1371/journal.pbio.1001081 · Cited by 754 · see citing works
Mandy, W., Chilvers, R., Chowdhury, U., Salter, G., Seigal, A., & Skuse, D. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-011-1356-0 · Cited by 715 · see citing works
A behavioral comparison of male and female adults with high functioning autism spectrum conditions
Lai, M.-C., Lombardo, M. V., Pasco, G., Ruigrok, A. N. V., Wheelwright, S. J., Sadek, S. A., Chakrabarti, B., MRC AIMS Consortium, & Baron-Cohen, S. (2011) · PLoS ONE · doi:10.1371/journal.pone.0020835 · Cited by 650 · see citing works
Genetic Heterogeneity Between the Three Components of the Autism Spectrum: A Twin Study
RONALD, A., HAPPÉ, F., BOLTON, P., BUTCHER, L. M., PRICE, T. S., WHEELWRIGHT, S., BARON-COHEN, S., & PLOMIN, R. (2006) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000215325.13058.9d · Cited by 508 · see citing works
Self-citationSibling Recurrence and the Genetic Epidemiology of Autism
Constantino, J. N., Zhang, Y., Frazier, T., Abbacchi, A. M., & Law, P. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.09101470 · Cited by 481 · see citing works
Trouton, A., Spinath, F. M., & Plomin, R. (2002) · Twin Research · doi:10.1375/136905202320906255 · Cited by 410 · see citing works
Scott, F. J., Baron-Cohen, S., Bolton, P., & Brayne, C. (2002) · Autism · doi:10.1177/1362361302006001003 · Cited by 393 · see citing works
Self-citationOliver, B. R., & Plomin, R. (2007) · Twin Research and Human Genetics · doi:10.1375/twin.10.1.96 · Cited by 350 · see citing works
Robinson, E. B. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.119 · Cited by 322 · see citing works
Lord, C., Schopler, E., & Revicki, D. (1982) · Journal of Autism and Developmental Disorders · doi:10.1007/bf01538320 · Cited by 303 · see citing works
Review of gender differences in core symptomatology in autism spectrum disorders
Rivet, T. T., & Matson, J. L. (2011) · Research in Autism Spectrum Disorders · doi:10.1016/j.rasd.2010.12.003 · Cited by 258 · see citing works
Ronald, A., Happé, F., & Plomin, R. (2005) · Developmental Science · doi:10.1111/j.1467-7687.2005.00433.x · Cited by 250 · see citing works
Self-citationGenetic influence on language delay in two-year-old children
Dale, P. S., Simonoff, E. A., Bishop, D., Eley, T. C., Oliver, B. R., Price, T. S., Purcell, S., Stevenson, J., & Plomin, R. J. (1998) · Nature Neuroscience · doi:10.1038/1142 · Cited by 244 · see citing works
Social and demographic factors that influence the diagnosis of autistic spectrum disorders
Russell, G., Steer, C., & Golding, J. (2011) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-010-0294-z · Cited by 239 · see citing works
Phenotypic and Genetic Overlap Between Autistic Traits at the Extremes of the General Population
Ronald, A., Happe, F. G. E., Price, T. S., Baron‐Cohen, S., & Plomin, R. J. (2006) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000230165.54117.41 · Cited by 232 · see citing works
Self-citationThe CAST (Childhood Asperger Syndrome Test)
Williams, J. G., Gullon-Scott, F., Stott, C., Allison, C. L., Bolton, P., Baron‐Cohen, S., & Brayne, C. (2004) · Autism · doi:10.1177/1362361305049029 · Cited by 209 · see citing works
Self-citationSex differences in repetitive stereotyped behaviors in autism: Implications for genetic liability
Szatmari, P., Liu, X., Goldberg, J., Zwaigenbaum, L., Paterson, A. D., Woodbury‐Smith, M., Georgiades, S., Duku, E., & Thompson, A. (2012) · American Journal of Medical Genetics Part B: Neuropsychiatric Genetics · doi:10.1002/ajmg.b.31238 · Cited by 187 · see citing works
Ronald, A., Viding, E. M., Happe, F. G. E., & Plomin, R. J. (2006) · Social Neuroscience · doi:10.1080/17470910601068088 · Cited by 101 · see citing works
Self-citationRelationship Between Symptom Domains in Autism Spectrum Disorders: A Population Based Twin Study
Dworzynski, K., Happé, F., Bolton, P., & Ronald, A. (2009) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-009-0736-1 · Cited by 79 · see citing works
Self-citationGender Differences in Core Symptomatology in Autism Spectrum Disorders across the Lifespan
Taylor, T., & Matson, J. L. (2011) · Journal of Developmental and Physical Disabilities · doi:10.1007/s10882-011-9235-3 · Cited by 53 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis
Loomes, R., Hull, L., & Mandy, W. P. L. (2017) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2017.03.013 · Cited by 2,804 · see citing works
Lai, M.-C., Lombardo, M. V., & Baron-Cohen, S. (2014) · The Lancet · doi:10.1016/s0140-6736(13)61539-1 · Cited by 2,371 · see citing works
“Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions
Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M.-C., & Mandy, W. (2017) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3166-5 · Cited by 1,365 · see citing works
Sex differences in autism spectrum disorders
Werling, D. M., & Geschwind, D. H. (2013) · Current Opinion in Neurology · doi:10.1097/wco.0b013e32835ee548 · Cited by 1,245 · see citing works
Sex/Gender Differences and Autism: Setting the Scene for Future Research
Lai, M.-C., Lombardo, M. V., Auyeung, B., Chakrabarti, B., & Baron-Cohen, S. (2015) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2014.10.003 · Cited by 1,120 · see citing works
“Given similar levels of autistic features, males are more easily diagnosed with autism than females,(60) who require more concurrent behavioral/cognitive problems to receive a clinical diagnosis of autism.(61) These may be related”
BackgroundBargiela, S., Steward, R., & Mandy, W. (2016) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-016-2872-8 · Cited by 1,087 · see citing works
“…that include strengths as well as difficulties. require more severe autistic symptoms (Russell et al. 2010) and greater cognitive and behavioural problems (Dworzynski et al. 2012) to meet ASC criteria, and teachers underreport autistic traits in their female pupils (Posserud et al. 2006).”
BackgroundInfluentialThe Changing Epidemiology of Autism Spectrum Disorders
Lyall, K., Croen, L., Daniels, J., Fallin, M. D., Ladd-Acosta, C., Lee, B. K., Park, B. Y., Snyder, N. W., Schendel, D., Volk, H., et al. (2017) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-031816-044318 · Cited by 1,011 · see citing works
“Although this pronounced sex disparity is found in all populations studied and has been historically consistent, differences in symptom presentation in females and potential attendant diagnostic biases (54), even though unlikely to fully explain observed differences, are worthy of additional investigation.”
An Overview of Autism Spectrum Disorder, Heterogeneity and Treatment Options
Masi, A., DeMayo, M. M., Glozier, N., & Guastella, A. J. (2017) · Neuroscience Bulletin · doi:10.1007/s12264-017-0100-y · Cited by 987 · see citing works
Quantifying and exploring camouflaging in men and women with autism
Lai, M.-C., Lombardo, M. V., Ruigrok, A. N., Chakrabarti, B., Auyeung, B., Szatmari, P., Happé, F., Baron-Cohen, S., & MRC AIMS Consortium (2017) · Autism · doi:10.1177/1362361316671012 · Cited by 705 · see citing works
“, 2016), unless there are concurrent behavioural or cognitive challenges (Dworzynski et al., 2012).”
Disentangling the heterogeneity of autism spectrum disorder through genetic findings
Jeste, S. S., & Geschwind, D. H. (2014) · Nature Reviews Neurology · doi:10.1038/nrneurol.2013.278 · Cited by 644 · see citing works
“55 Additionally, females with ASD tend to show greater cog nitive impairment, with the male:female ratio being close to 1:1 in severely intellectually disabled populations.”
Jacquemont, S., Coe, B. P., Hersch, M., Duyzend, M. H., Krumm, N., Bergmann, S., Beckmann, J. S., Rosenfeld, J. A., & Eichler, E. E. (2014) · The American Journal of Human Genetics · doi:10.1016/j.ajhg.2014.02.001 · Cited by 605 · see citing works
The Female Autism Phenotype and Camouflaging: a Narrative Review
Hull, L., Petrides, K. V., & Mandy, W. (2020) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-020-00197-9 · Cited by 614 · see citing works
Dean, M., Harwood, R., & Kasari, C. (2017) · Autism · doi:10.1177/1362361316671845 · Cited by 566 · see citing works
“Concomitantly, girls are described as being better able than boys to “camouflage” their symptoms of ASD and to use compensatory behaviors that mitigate their social challenges (Dworzynski et al., 2012; Gould and Ashton-Smith, 2011; Tierney et al., 2016).”
BackgroundInfluentialSalari, N., Rasoulpoor, S., Rasoulpoor, S., Shohaimi, S., Jafarpour, S., Abdoli, N., Khaledi-Paveh, B., & Mohammadi, M. (2022) · Italian Journal of Pediatrics · doi:10.1186/s13052-022-01310-w · Cited by 571 · see citing works
“These social and communication capabilities, which are related to a feature of the female phenotype, can help women adapt to social situations, masking some of the main symptoms of ASD and leading to either misdiagnosis or late diagnosis of ASD in girls [118, 119].”
BackgroundExamining and interpreting the female protective effect against autistic behavior
Robinson, E. B., Lichtenstein, P., Anckarsäter, H., Happé, F., & Ronald, A. (2013) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1211070110 · Cited by 531 · see citing works
“Although this difference is in and of itself difficult to interpret given that diagnosed females are often, on average, more severely affected than diagnosed males (1, 21, 22), an excess burden of de novo events among female probands could nonetheless influence sibling recurrence estimates (albeit in the opposite dire…”
BackgroundSelf-citationVan Wijngaarden-Cremers, P. J. M., van Eeten, E., Groen, W. B., Van Deurzen, P. A., Oosterling, I. J., & Van der Gaag, R. J. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-013-1913-9 · Cited by 547 · see citing works
Camouflaging in autism: A systematic review
Cook, J., Hull, L., Crane, L., & Mandy, W. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.102080 · Cited by 554 · see citing works
Livingston, L. A., & Happé, F. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2017.06.005 · Cited by 414 · see citing works
DSM-5 and autism spectrum disorders (ASDs): an opportunity for identifying ASD subtypes
Grzadzinski, R., Huerta, M., & Lord, C. (2013) · Molecular Autism · doi:10.1186/2040-2392-4-12 · Cited by 378 · see citing works
“females [43-46], in individuals with known genetic abnormalities [47,48] and in individuals with dysmorphic”
BackgroundSex differences in autism spectrum disorder: a review
Ferri, S. L., Abel, T., & Brodkin, E. S. (2018) · Current Psychiatry Reports · doi:10.1007/s11920-018-0874-2 · Cited by 392 · see citing works
A Review of the Role of Female Gender in Autism Spectrum Disorders
Kirkovski, M., Enticott, P. G., & Fitzgerald, P. B. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-013-1811-1 · Cited by 397 · see citing works
“The authors interpret this finding as reflective of either (a) some unknown coping mechanism protecting girls from reaching the threshold for clinical diagnosis, or (b) as being reflective of a strong male bias in the clinical understanding of ASD resulting in females with ASD being un- or misdiagnosed (Dworzynski et…”
BackgroundResultInfluentialASD in Females: Are We Overstating the Gender Difference in Diagnosis?
Kreiser, N. L., & White, S. W. (2014) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-013-0148-9 · Cited by 367 · see citing works
Hiller, R. M., Young, R. L., & Weber, N. (2014) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-014-9881-x · Cited by 364 · see citing works
“It has also been proposed that ASD may be particularly difficult to identify in girls due to impairments not presenting consistently across settings (Attwood et al. 2006; Dworzynski et al. 2012; Mandy, et al. 2012).”
BackgroundResultInfluentialBarriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review
Lockwood Estrin, G., Milner, V., Spain, D., Happé, F., & Colvert, E. (2021) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-020-00225-8 · Cited by 357 · see citing works
Leedham, A. T., Thompson, A. R., Smith, R. S., & Freeth, M. (2019) · Autism · doi:10.1177/1362361319853442 · Cited by 364 · see citing works
What about the girls? Sex-based differences in autistic traits and adaptive skills
Ratto, A. B., Kenworthy, L., Yerys, B. E., Bascom, J., Wieckowski, A. T., White, S. W., Wallace, G. L., Pugliese, C., Schultz, R. T., Ollendick, T. H., et al. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3413-9 · Cited by 342 · see citing works
“Some prior studies have also found that even when presenting with comparable levels of socio-communicative impairment females are less likely than males to be diagnosed with ASD and are more likely to be able to “camouflage” their social impairments on performance-based measures (Dworzynski et al. 2012; Lai et al. 201…”
BackgroundSubgrouping the Autism Spectrum: Reflections on DSM-5
Lai, M.-C., Lombardo, M. V., Chakrabarti, B., & Baron-Cohen, S. (2013) · PLoS Biology · doi:10.1371/journal.pbio.1001544 · Cited by 330 · see citing works
“This issue is especially relevant for understanding the male bias in prevalence and potential u n d e r r e c o g n i t i o n o f f e m a l e s [37,44,47].”
Gender differences in self-reported camouflaging in autistic and non-autistic adults
Hull, L., Lai, M.-C., Baron-Cohen, S., Allison, C., Smith, P., Petrides, K., & Mandy, W. (2020) · Autism · doi:10.1177/1362361319864804 · Cited by 337 · see citing works
Cassidy, S., Gould, K., Townsend, E., Pelton, M., Robertson, A., & Rodgers, J. (2019) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-019-04323-3 · Cited by 320 · see citing works
Looking behind the mask: Social coping strategies of girls on the autistic spectrum
Tierney, S., Burns, J., & Kilbey, E. (2016) · Research in Autism Spectrum Disorders · doi:10.1016/j.rasd.2015.11.013 · Cited by 316 · see citing works
Gender differences in emotionality and sociability in children with autism spectrum disorders
Head, A. M., McGillivray, J. A., & Stokes, M. A. (2014) · Molecular Autism · doi:10.1186/2040-2392-5-19 · Cited by 315 · see citing works
“; licensee BioMed Central L Commons Attribution License (http://creativec reproduction in any medium, provided the or [5], whereas for those who are also profoundly intellectually disabled the ratio is closer to two males for each female [6].”
BackgroundMethodResultInfluentialConstantino, J. N., & Charman, T. (2016) · The Lancet Neurology · doi:10.1016/s1474-4422(15)00151-9 · Cited by 294 · see citing works
Sedgewick, F., Hill, V., Yates, R., Pickering, L., & Pellicano, E. (2015) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-015-2669-1 · Cited by 304 · see citing works
“…Kreiser and White 2014; Kopp and Gillberg 2011; Lai et al. 2015)—with many girls potentially beingmisdiagnosed ormissing out on a diagnosis until later (Begeer et al. 2012; Giarelli et al. 2010) or even altogether (Dworzynski et al. 2012; see also Gould and Ashton-Smith 2011; Mandy et al. 2011).”
BackgroundFrazier, T. W., Ratliff, K. R., Gruber, C., Zhang, Y., Law, P. A., & Constantino, J. N. (2013) · Autism · doi:10.1177/1362361313500382 · Cited by 269 · see citing works
“For example, poorer ER in ASD-affected females may prove to be a critical underlying factor in the observation that girls who garner an ASD diagnosis tend to exhibit more severe phenotypes than their male counterparts (Carter et al., 2007; Dworzynski et al., 2012; Lord et al., 1982), and the observation of increasingl…”
BackgroundA qualitative exploration of the female experience of autism spectrum disorder (ASD)
Milner, V., McIntosh, H., Colvert, E., & Happé, F. (2019) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-019-03906-4 · Cited by 262 · see citing works
Sex and gender in neurodevelopmental conditions
Bölte, S., Neufeld, J., Marschik, P. B., Williams, Z. J., Gallagher, L., & Lai, M.-C. (2023) · Nature Reviews Neurology · doi:10.1038/s41582-023-00774-6 · Cited by 249 · see citing works
Hull, L., Mandy, W., & Petrides, K. (2017) · Autism · doi:10.1177/1362361316669087 · Cited by 254 · see citing works
“Females with similar levels of ASC symptoms are less likely to be diagnosed with ASC than males (Dworzynski et al., 2012), and it is suggested that females are more likely to be misdiagnosed with other conditions, especially internalising and eating disorders (Kopp and Gillberg, 1992; Mandy and…”
BackgroundInfluentialAutism: the micro-movement perspective
Torres, E. B., Brincker, M., Isenhower, R. W., Yanovich, P., Stigler, K. A., Nürnberger, J. I., Metaxas, D., & José, J. V. (2013) · Frontiers in Integrative Neuroscience · doi:10.3389/fnint.2013.00032 · Cited by 256 · see citing works
“John I. Nurnberger 7, Dimitris N. Metaxas 8 and Jorge V. José9 1 Psychology Department, Rutgers Center for Cognitive Science, Center for Computational Biomedicine Imaging and Modeling (Computer Science), Movement Disorders, Neurology, Rutgers University School of Medicine, Rutgers University, New Brunswick, NJ, USA 2…”
BackgroundSex and gender impacts on the behavioural presentation and recognition of autism
Lai, M.-C., & Szatmari, P. (2020) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000575 · Cited by 237 · see citing works
Factors influencing the probability of a diagnosis of autism spectrum disorder in girls versus boys
Duvekot, J., van der Ende, J., Verhulst, F. C., Slappendel, G., van Daalen, E., Maras, A., & Greaves-Lord, K. (2017) · Autism · doi:10.1177/1362361316672178 · Cited by 236 · see citing works
“This could ref lect a diagnostic bias, resulting in girls with ASD being more likely to be overlooked in the absence of additional problems (Dworzynski et al., 2012).”
BackgroundResultInfluentialHeterogeneity within Autism Spectrum Disorders: What have We Learned from Neuroimaging Studies?
Lenroot, R., & Yeung, P. K. (2013) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2013.00733 · Cited by 230 · see citing works
“Although in general females who have been identified with ASD have tended to be characterized as clinically more severely affected than males (Dworzynski et al., 2012), suggested by some as due to ascertainment biases, this study as well as the others described above did not find gender differences…”
ResultSex/Gender Differences in Camouflaging in Children and Adolescents with Autism
Wood‐Downie, H., Wong, B., Kovshoff, H., Mandy, W., Hull, L., & Hadwin, J. A. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04615-z · Cited by 236 · see citing works
The role of sex-differential biology in risk for autism spectrum disorder
Werling, D. M. (2016) · Biology of Sex Differences · doi:10.1186/s13293-016-0112-8 · Cited by 208 · see citing works
“A study of children with high levels of autistic traits who either met, or fell just short of, the diagnostic criteria for ASD found patterns consistent with this hypothesis: diagnosed girls were more likely than diagnosed boys to score significantly below average on a test of verbal and nonverbal cognitive ability an…”
ResultCognition in males and females with autism: similarities and differences
Lai, M.-C., Lombardo, M. V., Ruigrok, A. N. V., Chakrabarti, B., Wheelwright, S. J., Auyeung, B., Allison, C., MRC AIMS Consortium, & Baron-Cohen, S. (2012) · PLoS ONE · doi:10.1371/journal.pone.0047198 · Cited by 217 · see citing works
“In other words, we may be under-diagnosing females due to their ‘non-male-typical’ profile, or their ability to better camouflage/compensate for their difficulties [2–9].”
The experiences and needs of female adults with high-functioning autism spectrum disorder
Baldwin, S., & Costley, D. (2016) · Autism · doi:10.1177/1362361315590805 · Cited by 248 · see citing works
“In one revealing study, Dworzynski et al. (2012) showed that girls who scored highly on a screening test for autistic-like traits were less likely than equivalent scoring boys to meet clinical diagnostic criteria for ASD, especially in the absence of accompanying intellectual or behavioural…”
BackgroundThe EU-AIMS Longitudinal European Autism Project (LEAP): clinical characterisation
Charman, T., Loth, E., Tillmann, J., Crawley, D., Wooldridge, C., Goyard, D., Ahmad, J., Auyeung, B., Ambrosino, S., Banaschewski, T., et al. (2017) · Molecular Autism · doi:10.1186/s13229-017-0145-9 · Cited by 183 · see citing works
“In addition, there is evidence from population studies that girls with similar levels of symptoms to boys are less likely to be diagnosed by community services [19], unless there are more substantial behavioural or cognitive difficulties [20].”
Rutherford, M., McKenzie, K., Johnson, T., Catchpole, C., O’Hare, A., McClure, I., Forsyth, K., McCartney, D., & Murray, A. (2016) · Autism · doi:10.1177/1362361315617879 · Cited by 197 · see citing works
“…more severe symptomatology to receive a diagnosis of ASD may explain the apparent paradox that in clinically diagnosed samples, females may show more severe ASD traits and comorbid psychopathology than males even though the latter have a greater vulnerability to ASD (e.g. Dworzynski et al., 2012).”
BackgroundInfluentialZhang, Y., Li, N., Li, C., Zhang, Z., Teng, H., Wang, Y., Zhao, T., Shi, L., Zhang, K., Xia, K., et al. (2020) · Translational Psychiatry · doi:10.1038/s41398-020-0699-8 · Cited by 177 · see citing works
Sedgewick, F., Hill, V., & Pellicano, E. (2018) · Autism · doi:10.1177/1362361318794930 · Cited by 191 · see citing works
“…differences in the social relationships of autistic males and females might be one reason why girls tend to be clinically identified later than their male counterparts (Begeer et al., 2013; Giarelli et al., 2010) or why they might miss out on a diagnosis altogether (Dworzynski et al., 2012).”
BackgroundD’Mello, A. M., Frosch, I. R., Li, C. E., Cardinaux, A. L., & Gabrieli, J. D. E. (2022) · Autism Research · doi:10.1002/aur.2795 · Cited by 194 · see citing works
“Indeed, girls are less likely to meet diagnostic thresholds than boys, despite having equally high levels of autistic traits (Dworzynski et al., 2012; Kalb et al., 2022; Mo et al., 2021), and teachers report significantly fewer concerns about social skills in girls than boys (Hiller et al., 2014).”
BackgroundWhat Is Autistic Burnout? A Thematic Analysis of Posts on Two Online Platforms
Mantzalas, J., Richdale, A. L., Adikari, A., Lowe, J., & Dissanayake, C. (2021) · Autism in Adulthood · doi:10.1089/aut.2021.0021 · Cited by 195 · see citing works
Attenuation of Typical Sex Differences in 800 Adults with Autism vs. 3,900 Controls
Baron-Cohen, S., Cassidy, S., Auyeung, B., Allison, C., Achoukhi, M., Robertson, S., Pohl, A., & Lai, M.-C. (2014) · PLoS ONE · doi:10.1371/journal.pone.0102251 · Cited by 177 · see citing works
“A less male-typical presentation of autism in females, especially in high-functioning individuals, may be related to the existing diagnostic bias towards males [39–41].”
BackgroundCook, A., Ogden, J., & Winstone, N. (2018) · European Journal of Special Needs Education · doi:10.1080/08856257.2017.1312797 · Cited by 178 · see citing works
“…findings indicated that many girls would undertake masking behaviours, reflecting findings by Attwood (2006), Dean, Harwood, and Kasari (2016), Dworzynski et al. (2012) and Kopp and Gillberg (1992) who described a tendency of girls with autism to imitate others in social interactions or…”
BackgroundInfluentialChallenges Surrounding the Diagnosis of Autism in Children
Hus, Y., & Segal, O. (2021) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s282569 · Cited by 201 · see citing works
Brookman-Frazee, L., Stadnick, N., Chlebowski, C., Baker-Ericzén, M., & Ganger, W. (2018) · Autism · doi:10.1177/1362361317712650 · Cited by 174 · see citing works
“Research suggests that girls display unique behavioral and cognitive profiles that may lead to underdiagnoses of these conditions (Dworzynski et al., 2012; Rucklidge, 2010).”
BackgroundNarzisi, A., de la Paz, M. P., Barbieri, F., Chericoni, N., Ciuffolini, D., Pinzino, M., Romanò, R., Scattoni, M. L., Tancredi, R., Calderoni, S., et al. (2018) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796018000483 · Cited by 176 · see citing works
Schuck, R. K., Flores, R. E., & Fung, L. K. (2019) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-019-03998-y · Cited by 172 · see citing works
Ecker, C. (2016) · Autism · doi:10.1177/1362361315627136 · Cited by 165 · see citing works
“Moreover, it has also been suggested that females with ASD may have a greater ability to ‘camouflage’ difficulties, particularly in the social domain (Dworzynski et al., 2012).”
BackgroundWood‐Downie, H., Wong, B., Kovshoff, H., Cortese, S., & Hadwin, J. A. (2021) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13337 · Cited by 162 · see citing works
“Future studies should attempt to systematically address the relationship between sex/gender, social and communicative behavioural presentation, underlying social-cognitive ability and/or neurobiology (Livingston & Happ e, 2017), IQ and likelihood of receiving a diagnosis.”
BackgroundSex differences in pre-diagnosis concerns for children later diagnosed with autism spectrum disorder
Hiller, R. M., Young, R. L., & Weber, N. (2016) · Autism · doi:10.1177/1362361314568899 · Cited by 153 · see citing works
“Indeed, our finding that teachers were less concerned with girls than boys, coupled with evidence of boys with ASD showing more problematic behaviour at school (Dworzynski et al., 2012; Hiller et al., 2014; Mandy et al., 2012) suggests that home and school presentation are likely starkly different for girls with ASD.”
BackgroundResultLehnhardt, F.-G., Falter, C. M., Gawronski, A., Pfeiffer, K., Tepest, R., Franklin, J., & Vogeley, K. (2016) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-015-2558-7 · Cited by 153 · see citing works
“by observational learning of non-verbal behavior, ‘‘internal scripting’’ of attitudes in social interactions or better dealing with novel situations (Dworzynski et al. 2012; South et al. 2007), might contribute to the capability of assimilating into typical developing peer circles more easily.”
BackgroundEnglish, M. C. W., Gignac, G. E., Visser, T. A. W., Whitehouse, A., Enns, J. T., & Maybery, M. T. (2021) · Molecular Autism · doi:10.1186/s13229-021-00445-7 · Cited by 160 · see citing works
Brain Connectivity and Neuroimaging of Social Networks in Autism
Müller, R., & Fishman, I. (2018) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2018.09.008 · Cited by 143 · see citing works
Understanding autism in the light of sex/gender
Lai, M., Baron‐Cohen, S., & Buxbaum, J. D. (2015) · Molecular Autism · doi:10.1186/s13229-015-0021-4 · Cited by 153 · see citing works
Evaluating Posed and Evoked Facial Expressions of Emotion from Adults with Autism Spectrum Disorder
Faso, D. J., Sasson, N. J., & Pinkham, A. E. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-014-2194-7 · Cited by 147 · see citing works
“Although the small sample size precludes definitive conclusions about these gender effects, recent research in the field has reported marked gender differences in ASD on many dimensions, including diagnostic severity and aspects of social cognition (Dworzynski et al. 2012; Lai et al. 2012).”
BackgroundNeural self-representation in autistic women and association with ‘compensatory camouflaging’
Lai, M.-C., Lombardo, M. V., Chakrabarti, B., Ruigrok, A. N., Bullmore, E. T., Suckling, J., Auyeung, B., Happé, F., Szatmari, P., Baron-Cohen, S., et al. (2019) · Autism · doi:10.1177/1362361318807159 · Cited by 134 · see citing works
“First, autistic females tend to be under-recognized clinically, unless there are coexisting behavioural, emotional, or cognitive difficulties (Duvekot et al., 2017; Dworzynski et al., 2012).”
BackgroundSelf-citationMelancia, F., Schiavi, S., Servadio, M., Cartocci, V., Campolongo, P., Palmery, M., Pallottini, V., & Trezza, V. (2018) · British Journal of Pharmacology · doi:10.1111/bph.14435 · Cited by 145 · see citing works
The role of gender in the perception of autism symptom severity and future behavioral development
Geelhand, P., Bernard, P., Klein, O., van Tiel, B., & Kissine, M. (2019) · Molecular Autism · doi:10.1186/s13229-019-0266-4 · Cited by 141 · see citing works
Prevalence and Characteristics of Autism Spectrum Disorder Among Spanish School-Age Children
Morales‐Hidalgo, P., Castellví, J. R., Hernández‐Martínez, C., Voltas, N., & Canals, J. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3581-2 · Cited by 137 · see citing works
“They show a smaller complement of ASD diagnostic criteria than boys at equivalently high levels of autistic-like traits (Dworzynski et al. 2012).”
BackgroundMandy, W., & Tchanturia, K. (2015) · Molecular Autism · doi:10.1186/2040-2392-6-6 · Cited by 136 · see citing works
“When they are identified, this tends to be later than for males [54] and they require more severe symptomatology than males to be meet ASD diagnostic criteria [55].”
BackgroundDell’Osso, L., Gesi, C., Massimetti, E., Cremone, I. M., Barbuti, M., Maccariello, G., Moroni, I., Barlati, S., Castellini, G., Luciano, M., et al. (2016) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2016.11.001 · Cited by 135 · see citing works
“Previous literature insights indicate that male subjects with ASD exhibit poorer verbal abilities than female counterparts [73]; however, somehow in keeping with our results, another study revealed that girls with high autistic symptoms but without a diagnosis of ASD show greater communication difficulties than males,…”
ResultSex differences in social attention in autism spectrum disorder
Harrop, C., Jones, D. R., Zheng, S., Nowell, S. W., Boyd, B. A., & Sasson, N. J. (2018) · Autism Research · doi:10.1002/aur.1997 · Cited by 125 · see citing works
Allely, C. S. (2019) · Advances in Autism · doi:10.1108/aia-09-2018-0036 · Cited by 123 · see citing works
Tillmann, J., Ashwood, K., Absoud, M., Bölte, S., Bonnet-Brilhault, F., Buitelaar, J. K., Calderoni, S., Calvo, R., Canal-Bedia, R., Canitano, R., et al. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3510-4 · Cited by 121 · see citing works
“2013), unless they present with more substantial behavioural and/or cognitive difficulties (Dworzynski et al. 2012).”
BackgroundClinical 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 · Cited by 133 · see citing works
Rydzewska, E., Hughes-McCormack, L. A., Gillberg, C., Henderson, A., MacIntyre, C., Rintoul, J., & Cooper, S.-A. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-023945 · Cited by 122 · see citing works
“A view has been expressed that autism is currently underdiagnosed in more intellectually able females compared with males.(14) We found that 34% of women compared with only 27% of men with autism reported accompanying intellectual disabilities, so the female population with autism was intellectually less able than the…”
Kaat, A. J., Shui, A. M., Ghods, S. S., Farmer, C. A., Esler, A. N., Thurm, A., Georgiades, S., Kanne, S. M., Lord, C., Kim, Y. S., et al. (2021) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13242 · Cited by 116 · see citing works
The development of autistic social traits across childhood and adolescence in males and females
Mandy, W., Pellicano, L., St Pourcain, B., Skuse, D., & Heron, J. (2018) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12913 · Cited by 117 · see citing works
Autistic girls and school exclusion: Perspectives of students and their parents
Sproston, K., Sedgewick, F., & Crane, L. (2017) · Autism & Developmental Language Impairments · doi:10.1177/2396941517706172 · Cited by 114 · see citing works
“, 2016) and a lack of behavioural problems (Dworzynski et al., 2012; Hiller et al., 2014; Mandy et al., 2012).”
BackgroundCorbett, B. A., Schwartzman, J. M., Libsack, E. J., Muscatello, R. A., Lerner, M. D., Simmons, G. L., & White, S. W. (2020) · Autism Research · doi:10.1002/aur.2440 · Cited by 115 · see citing works
“In fact, under-identification of autism in females may be driven, in part, by use of camouflaging among females (Dworzynski et al., 2012; Kopp & Gillberg, 1992; Lai et al., 2015).”
BackgroundKauschke, C., van der Beek, B., & Kamp‐Becker, I. (2015) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-015-2620-5 · Cited by 112 · see citing works
“This practice may have implications for affected females, making it more likely for them to be misdiagnosed (Dworzynski et al. 2012; Kirkovski et al. 2013; Lai et al. 2014).”
BackgroundHippocampus and amygdala radiomic biomarkers for the study of autism spectrum disorder
Chaddad, A., Desrosiers, C., Hassan, L., & Tanougast, C. (2017) · BMC Neuroscience · doi:10.1186/s12868-017-0373-0 · Cited by 109 · see citing works
“The age bias in group B could be related to the fact that girls are less likely than boys to meet diagnostic criteria for ASD [47, 48].”
BackgroundRecognition of Girls on the Autism Spectrum by Primary School Educators: An Experimental Study
Whitlock, A., Fulton, K., Lai, M., Pellicano, E., & Mandy, W. (2020) · Autism Research · doi:10.1002/aur.2316 · Cited by 110 · see citing works
Opinion: Sex, gender and the diagnosis of autism—A biosocial view of the male preponderance
Goldman, S. (2013) · Research in Autism Spectrum Disorders · doi:10.1016/j.rasd.2013.02.006 · Cited by 108 · see citing works
Werling, D. M., & Geschwind, D. H. (2015) · Molecular Autism · doi:10.1186/s13229-015-0004-5 · Cited by 110 · see citing works
“With regard to the reports from other samples on sex ratios in high- and low-functioning individuals, it has been suggested that current diagnostic tools are calibrated to a male-typical phenotype and that females are under-diagnosed for ASD due to their nonprototypical presentation of ASD symptoms [54,55].”
BackgroundWhite, E. I., Wallace, G. L., Bascom, J., Armour, A. C., Register‐Brown, K., Popal, H. S., Ratto, A. B., Martin, A. D., & Kenworthy, L. E. (2017) · Autism Research · doi:10.1002/aur.1811 · Cited by 104 · see citing works
“Sexual dimorphism may well make up part of the explanation, as biological differences between males and females, in both the typically developing [BaronCohen, Knickmeyer, & Belmonte, 2005] and ASD populations [Robinson, Lichtenstein, Anckars€ater, Happ e, & Ronald, 2013] have been found.”
BackgroundJourney to diagnosis for women with autism
Zener, D. (2019) · Advances in Autism · doi:10.1108/aia-10-2018-0041 · Cited by 108 · see citing works
Halsall, J., Clarke, C., & Crane, L. (2021) · Autism · doi:10.1177/13623613211012819 · Cited by 101 · see citing works
“Over the last decade, research examining gender differences among autistic people has reported that the needs of autistic girls and women may be under-recognised due to differences in their presentation (Dean et al., 2017; Dworzynski et al., 2012; Hiller et al., 2014).”
BackgroundThe Effects of Psychological Trauma on Children with Autism Spectrum Disorders: a Research Review
Hoover, D. W. (2015) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-015-0052-y · Cited by 101 · see citing works
“It may be that females show relatively better developed social communication and emotional expression than males (Dworzynski et al. 2012).”
BackgroundLinguistic markers of autism in girls: evidence of a “blended phenotype” during storytelling
Boorse, J., Cola, M., Plate, S., Yankowitz, L., Pandey, J., Schultz, R., & Parish-Morris, J. (2019) · Molecular Autism · doi:10.1186/s13229-019-0268-2 · Cited by 77 · see citing works
“The present study contributes new evidence to recent efforts aimed at understanding why girls with ASD may meet clinical criteria for diagnosis, but still fail to be diagnosed with ASD and receive intervention [38, 68, 87].”
BackgroundPelton, M., Crawford, H., Robertson, A., Rodgers, J., Baron‐Cohen, S., & Cassidy, S. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04393-8 · Cited by 103 · see citing works
Retico, A., Giuliano, A., Tancredi, R., Cosenza, A., Apicella, F., Narzisi, A., Biagi, L., Tosetti, M., Muratori, F., & Calderoni, S. (2016) · Molecular Autism · doi:10.1186/s13229-015-0067-3 · Cited by 97 · see citing works
“First of all, a difficulty in identifying females with ASD is reported; these patients are diagnosed later in life than males, especially if coexistent intellectual or behavioural problems are present [15, 16].”
BackgroundComo, D. H., Duker, L. I. S., Polido, J. C., & Cermak, S. A. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18010135 · Cited by 98 · see citing works
Wiggins, L. D., Rice, C. E., Barger, B., Soke, G. N., Lee, L.-C., Moody, E., Edmondson-Pretzel, R., & Levy, S. E. (2019) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-019-01674-1 · Cited by 95 · see citing works
Enhanced Social Attention in Female Infant Siblings at Risk for Autism
Chawarska, K., Macari, S. L., Powell, K. K., DiNicola, L. M., & Shic, F. (2015) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2015.11.016 · Cited by 100 · see citing works
Atherton, G., Edisbury, E., Piovesan, A., & Cross, L. (2021) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05235-x · Cited by 97 · see citing works
Sex differences in brain plasticity: a new hypothesis for sex ratio bias in autism
Mottron, L., Duret, P., Mueller, S., Moore, R. D., d’Arc, B. F., Jacquemont, S., & Xiong, L. (2015) · Molecular Autism · doi:10.1186/s13229-015-0024-1 · Cited by 97 · see citing works
“This finding is most frequently reported in studies including adolescents [161] and adults of typical intelligence [162], suggesting that compensatory social communication strategies develop over time, especially in girls [163].”
ResultDuvekot, J., van der Ende, J., Verhulst, F. C., & Greaves‐Lord, K. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-014-2323-3 · Cited by 93 · see citing works
Heffler, K. F., Sienko, D. M., Subedi, K., McCann, K. A., & Bennett, D. S. (2020) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2020.0230 · Cited by 105 · see citing works
Gender Bias, Female Resilience, and the Sex Ratio in Autism
Constantino, J. N., & Charman, T. (2012) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2012.05.017 · Cited by 92 · see citing works
- Authors
- Dworzynski, K., Ronald, A., Bolton, P., & Happé, F.
- Affiliations
- Royal College of Physicians (GB)
- Birkbeck, University of London (GB)
- King's College London (GB)
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2012-08
- Volume
- 51
- Issue
- 8
- Pages
- 788-797
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W2019357894
- Cited by
- 633
- References
- 25
- Citations by year
- 2026: 28 · 2025: 39 · 2024: 39 · 2023: 55 · 2022: 62 · 2021: 65 · 2020: 66 · 2019: 49 · 2018: 48 · 2017: 52 · 2016: 35 · 2015: 43 · 2014: 19 · 2013: 26 · 2012: 5
- FWCI
- 15.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- BIROn (Birkbeck, University of London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Autism Speaks (AS1650)
- National Institute for Health and Care Research (NF-SI-0510-10268)
- 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, sex differences, autistic traits, diagnostic thresholds, gender bias in diagnosis, intellectual functioning, behavioral problems, girls, children
- MeSH terms
- Behavioral Symptoms, Child, Child Development, Child Development Disorders, Pervasive, Diagnostic Errors, Diseases in Twins, Female, United Kingdom, Humans, Male, Intellectual Disability, Psychiatric Status Rating Scales, Psychological Techniques, Risk Factors, Sex Factors, Diagnostic and Statistical Manual of Mental Disorders, Sexism
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
