Abstract
Background: Sex differences in the prevalence of neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are well documented, but studies examining sex differences in social and communication function remain limited and inconclusive. Objectives: The objective of this study is to conduct a meta-analysis of sex differences in social-communication function in children with ASD or ADHD and typically developing controls. Methods: Using PRISMA, a search was performed on Medline and PSYCHINFO on English-language journals (2000–2017) examining sex differences in social and communication function in ASD and ADHD compared to controls. Inclusion criteria: 1) peer reviewed journal articles, 2) diagnosis of ASD or ADHD and controls, 3) age 6–18 years, 4) measures of social–communication function, and 5) means, standard deviations, and sample sizes reported in order to calculate standardized mean differences (SMD). Results: Eleven original/empirical studies met inclusion criteria for ASD and six for ADHD. No significant sex differences were found between ASD and controls in social (SMD = −0.43; p = 0.5; CI: −1.58–0.72), or communication function (SMD = 0.86; p = 0.5 CI; −1.57–−3.30) and between ADHD and controls in social function (SMD = −0.68: p = 0.7, CI: −4.17–2.81). No studies evaluated sex differences in communication in ADHD. Significant heterogeneity was noted in all analyses. Type of measure may have partially accounted for some variability between studies. Conclusions: The meta-analysis did not detect sex differences in social and communication function in children with ASD and ADHD; however, significant heterogeneity was noted. Future larger studies, controlling for measure and with adequate numbers of female participants are required to further understand sex differences in these domains.
Highlights
RationaleAutism spectrum disorder (ASD) and attention-deficit/ hyperactivity disorder (ADHD) are neurodevelopmental disorders, affecting multiple aspects of behavior and cognition [1]
Our findings would partially support the extreme male brain theory, as we found no differences between autism spectrum disorder (ASD) males and females, we did not find sex differences in social function and communication in controls
Study results cannot at this point inform these theories as we found no consistent sex differences
Summary
Autism spectrum disorder (ASD) and attention-deficit/ hyperactivity disorder (ADHD) are neurodevelopmental disorders, affecting multiple aspects of behavior and cognition [1]. Sex differences in prevalence are well documented, but how such sex differences interact/impact core symptom domain phenotypes remains unclear. ADHD is characterized by difficulties in attention, hyperactivity, and impulsivity, and has a prevalence of 5–7% in children [4]. Comorbidity among these disorders has been reported to be high. Sex differences in the prevalence of neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are well documented, but studies examining sex differences in social and communication function remain limited and inconclusive
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