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Open Access 01-12-2018 | Research

Self-reported sex differences in high-functioning adults with autism: a meta-analysis

Published in: Molecular Autism | Issue 1/2018

Abstract

Background

Sex differences in autistic symptomatology are believed to contribute to the mis- and missed diagnosis of many girls and women with an autism spectrum condition (ASC). Whilst recent years have seen the emergence of clinical and empirical reports delineating the profile of young autistic girls, recognition of sex differences in symptomatology in adulthood is far more limited.

Methods

We chose here to focus on symptomatology as reported using a screening instrument, the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R). In a meta-analysis, we pooled and analysed RAADS-R data from a number of experimental groups. Analysis of variance (ANOVA) searched for the presence of main effects of Sex and Diagnosis and for interactions between these factors in our sample of autistic and non-autistic adults.

Results

In social relatedness and circumscribed interests, main effects of Diagnosis revealed that as expected, autistic adults reported significantly greater lifetime prevalence of symptoms in these domains; an effect of Sex, in circumscribed interests, also suggested that males generally reported more prevalent symptoms than females. An interaction of Sex and Diagnosis in language symptomatology revealed that a normative sex difference in language difficulties was attenuated in autism. An interaction of Sex and Diagnosis in the sensorimotor domain revealed the opposite picture: a lack of sex differences between typically developing men and women and a greater prevalence of sensorimotor symptoms in autistic women than autistic men.

Conclusions

We discuss the literature on childhood sex differences in relation to those which emerged in our adult sample. Where childhood sex differences fail to persist in adulthood, several interpretations exist, and we discuss, for example, an inherent sampling bias that may mean that only autistic women most similar to the male presentation are diagnosed. The finding that sensorimotor symptomatology is more highly reported by autistic women is a finding requiring objective confirmation, given its potential importance in diagnosis.

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Unusually, four of the twenty items within this domain describe difficulties modulating vocal tone, pitch and volume which in other diagnostic instruments are related rather to differences in language and social communication [56, 81]. The apparent incongruence of these items within this domain is corroborated by the fact that the factor analysis conducted by the original authors [65] found these items loaded instead on factors related to social relatedness and social blindness. The sensorimotor domain, inadequately specific for autism, was subsequently removed from the RAADS-14 [71]

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Title: Self-reported sex differences in high-functioning adults with autism: a meta-analysis
Publication date: 01-12-2018
Published in: Molecular Autism / Issue 1/2018
Electronic ISSN: 2040-2392
DOI: https://doi.org/10.1186/s13229-018-0216-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Self-reported sex differences in high-functioning adults with autism: a meta-analysis

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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