Sex/gender differences in autistic traits, intelligence and executive functions of school-aged autistic children without intellectual disability

TL;DR

This study finds that girls with autism show different traits and executive function challenges compared to boys, which could improve diagnosis and support.

Contribution

The study identifies sex/gender differences in autistic traits and executive functions among children without intellectual disability.

Findings

Girls showed fewer restricted and repetitive behaviors compared to boys.

Girls exhibited more severe deficits in emotion regulation and cognitive regulation.

Executive function challenges in girls may aid in early diagnosis and support.

Abstract

ASD has been more often diagnosed and researched in men than women, shaping diagnostic criteria which may not adequately capture the female presentation. Examining differences between girls and boys with ASD could enhance diagnostic accuracy and help reduce gender-related biases in research and clinical practice. The aim of this research was to analyze potential differences in autistic traits, intelligence, and executive functions of school-aged girls and boys diagnosed with ASD without intellectual disability.

The research sample consisted of 79 children with ASD, 20 girls and 59 boys, aged between 6 and 12 years. Autistic traits were measured by Autism Diagnostic Observation Schedule – Second Version and Autism Diagnostic Interview-Revised, intelligence by the Woodcock-Johnson International Editions II, and executive functions by Wisconsin Card Sorting Test and Behavior Rating Inventory of Executive Function 2.

Girls scored lower in the amount of restricted, repetitive and stereotyped behaviors, but showed more severe deficits in Emotion Regulation, Cognitive Regulation and clinical scales Shift and Initiate, as measured by BRIEF-2.

Our results indicate girls with ASD exhibit certain differences from boys with ASD, which may be diagnostically relevant and helpful for their early detection and access to necessary resources and support. Nevertheless, extensive further research on the sex/gender differences and female ASD presentation is still needed.

ASD has been more often diagnosed and researched in men than women, potentially resulting in biased diagnostic criteria and female underdiagnosis.

There is still a considerable lack of research on the distinct traits and presentation of autism in females.

Girls in our research scored lower in the amount of restricted, repetitive and stereotyped behaviors, but showed more severe executive function deficits as measured by BRIEF-2.

Our results indicate that girls with ASD exhibit certain differences from boys with ASD, which may be diagnostically relevant and helpful for their early detection.