Abstract
BackgroundFour times as many males are diagnosed with high functioning autism compared to females. A growing body of research that focused on females with autism spectrum disorder (ASD) questions the assumption of gender invariance in ASD. Clinical observations suggest that females with ASD superficially demonstrate better social and emotional skills than males with ASD, which may camouflage other diagnostic features. This may explain the under-diagnosis of females with ASD.MethodsWe hypothesised that females with ASD would display better social skills than males with ASD on a test of friendship and social function. One hundred and one 10- to 16-year-olds (ASD females, n = 25; typically developing (TD) females, n = 25; ASD males, n = 25; TD males, n = 26) were interviewed (using the friendship questionnaire (FQ)) with high scores indicating the child has close, empathetic and supportive relationships. One parent of each child completed the FQ to assess whether there are differences in perception of friendships between parents and children.ResultsIt was found that, independent of diagnosis, females demonstrated higher scores on the FQ than males. Further, regardless of gender, children with ASD demonstrated lower scores than TD children. Moreover, the effect of ASD was independent of gender. Interestingly, females with ASD and TD males displayed similar scores on the FQ.ConclusionsThis finding is supported by clinical reports that females with ASD have more developed social skills than males with ASD. Further research is now required to examine the underlying causes for this phenomenon in order to develop gender-appropriate diagnostic criteria and interventions for ASD.
Highlights
Four times as many males are diagnosed with high functioning autism compared to females
As it has been well established that people with autism spectrum disorder (ASD) experience social deficits, it was anticipated that typically developing (TD) participants would score higher than ASD participants, regardless of gender
Children with ASD demonstrated lower levels on the friendship questionnaire (FQ) when compared to their TD counterparts
Summary
Four times as many males are diagnosed with high functioning autism compared to females. Clinical observations suggest that females with ASD superficially demonstrate better social and emotional skills than males with ASD, which may camouflage other diagnostic features. This may explain the under-diagnosis of females with ASD. Research into the female phenotype has been limited and findings have generally been inconsistent [1,2,3] Within this limited literature, it has been suggested that, in order for females to be diagnosed with ASD, they will generally be more impaired than males and frequently have an accompanying intellectual disability [1,3,4]. Whether these differences in gender are supported in the ASD population is yet to be examined
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