Sex Differences in Autism Spectrum Disorder: Repetitive Behaviors and Adaptive Functioning.

Martina Siracusano,Monica Terribili,Luigi Mazzone,Leonardo Emberti Gialloreti,Valentina Postorino,Paolo Curatolo,Assia Riccioni

doi:10.3390/children8050325

Abstract

Sex differences in restricted and repetitive behaviors (RRBs) in individuals with Autism Spectrum Disorder (ASD) have been explored with mixed findings. We aimed to investigate sex differences in RRBs through a specific measure—i.e., the Repetitive Behavior Scale Revised (RBS-R)—in a sample of preschool-age and school-age children with ASD. Additionally, we evaluated if RRBs were differently related to adaptive functioning within the male and the female age groups. A sample of 210 ASD individuals (3–18 years; 145 males, 65 females) underwent an in-depth assessment including a cognitive, adaptive functioning evaluation (i.e., the Adaptive Behavior Assessment System, Second Edition (ABAS-II)) and RRBs assessment (i.e., RBS-R). No significant sex differences on the RBS-R total score or any RBS-R subscale emerged. Within the group of older participants, RRBs were negatively associated with all adaptive skill domains independently from sex and age. Our results suggest a lack of sex differences in RRBs in our sample. Additionally, our findings highlight the possible negative impact of RRBs on adaptive skills in older individuals with autism, emphasizing the need for autistic individuals of both sexes to undergo an early intervention targeting RRBs, in order to improve their adaptive skills.

Highlights

Autism Spectrum Disorder (ASD) is an early-onset and lifelong neurodevelopmental condition characterized by social communication and social skill deficits, restricted interests, and repetitive behaviors (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)) [1]
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This study examined sex differences in repetitive behaviors in a group of individuals with ASD

Summary

Introduction

Autism Spectrum Disorder (ASD) is an early-onset and lifelong neurodevelopmental condition characterized by social communication and social skill deficits, restricted interests, and repetitive behaviors (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)) [1]. The majority of studies have described lower cognitive and language skills [3,4,5,6,7], greater impairment in social communication skills [5,6,7,8,9], fewer restricted and repetitive behaviors (RRBs) [4,7,9,10,11], lower adaptive skills [5,6], and greater problem behaviors [6,7] in females with ASD. Other studies have reported that autistic females show less verbal and nonverbal communicative difficulties [12], no differences in adaptive skills [13,14,15,16], greater interest in social relationships and friendships, better imagination skills, and fewer, or at least less, atypical RRBs compared to males [12,17,18,19]. It is worth noting that these sex differences in symptoms presentation may represent one of the reasons why autism can be misdiagnosed or underdiagnosed in females [20]

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