Abstract
The presentation of autism in females is poorly understood, which is thought to contribute to missed or later- age diagnosis, especially for those without intellectual disability. Dedicated research into social and behavioral differences has indicated a specific female phenotype of autism. However, less has been done to explore language and communication profiles, despite known sex/gender differences in typically developing populations. This article provides a synthesis of recent work from this small but emerging field. It focuses on a series of four preliminary and explorative studies conducted by the authors and embeds this within the wider literature. Findings suggest a specific profile of language and communication strengths and weaknesses for autistic females without intellectual disability (compared to autistic males and typically developing females). Furthermore, despite the relatively subtle presentation of difficulties (compared to autistic males), the impact on functionality, social inter-relations and emotional well-being, appears to be equitable and significant. The discussion highlights the need for further empirical research and proposes areas for investigation. Implications for clinical practice include the need for better recognition, testing and provision of interventions dedicated to the language and communication difficulties for autistic females. This has relevance for diagnostic, mental health and speech and language therapy services.
Highlights
Sex/gender1 differences in language and communication profiles for typically developing individuals are well documented in the literature
Others used diagnostic measures, which may incur a homogenizing effect by constraining participants and measuring difference using the same tools (Lai et al, 2015). This current article focuses on the smaller body of work investigating subtle sex/gender difference using specific measures of language and communication, in pragmatic and above sentence-level language
It will consider four clinically driven studies from the authors’ research group; using direct assessment (Sturrock et al, 2019b), observation and report measures (Sturrock et al, 2019a), child interviews (Sturrock et al, 2021) and parental interviews (Sturrock et al.,), and synthesizes these with recent findings from the wider literature. It proposes that autistic females most likely to be missed from diagnosis have a specific profile of language and communication skills, different from both autistic males and typically developing females, and that these differences make them prone to negative social, functional and emotional sequelae
Summary
Language and Communication Difficulties for Autistic Females Without Intellectual Disability. This article provides a synthesis of recent work from this small but emerging field It focuses on a series of four preliminary and explorative studies conducted by the authors and embeds this within the wider literature. Findings suggest a specific profile of language and communication strengths and weaknesses for autistic females without intellectual disability (compared to autistic males and typically developing females). Implications for clinical practice include the need for better recognition, testing and provision of interventions dedicated to the language and communication difficulties for autistic females. This has relevance for diagnostic, mental health and speech and language therapy services
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