Sex/Gender Differences and Autism: Setting the Scene for Future Research

By Meng-Chuan Lai, Michael V. Lombardo, Bonnie Auyeung, Bhismadev Chakrabarti, Simon Baron-Cohen. Journal of the American Academy of Child and Adolescent Psychiatry, 2015

1,045 citations recorded by the source corpus.

Objective The relationship between sex/gender differences and autism has attracted a variety of research ranging from clinical and neurobiological to etiological, stimulated by the male bias in autism prevalence. Findings are complex and do not always relate to each other in a straightforward manner. Distinct but interlinked questions on the relationship between sex/gender differences and autism remain underaddressed. To better understand the implications from existing research and to help design future studies, we propose a 4-level conceptual framework to clarify the embedded themes. Method We searched PubMed for publications before September 2014 using search terms “‘sex OR gender OR females’ AND autism.” A total of 1,906 articles were screened for relevance, along with publications identified via additional literature reviews, resulting in 329 articles that were reviewed. Results Level 1, “Nosological and diagnostic challenges,” concerns the question, “How should autism be defined and diagnosed in males and females?” Level 2, “Sex/gender-independent and sex/gender-dependent characteristics,” addresses the question, “What are the similarities and differences between males and females with autism?” Level 3, “General models of etiology: liability and threshold,” asks the question, “How is the liability for developing autism linked to sex/gender?” Level 4, “Specific etiological–developmental mechanisms,” focuses on the question, “What etiological–developmental mechanisms of autism are implicated by sex/gender and/or sexual/gender differentiation?” Conclusions Using this conceptual framework, findings can be more clearly summarized, and the implications of the links between findings from different levels can become clearer. Based on this 4-level framework, we suggest future research directions, methodology, and specific topics in sex/gender differences and autism.

Subfields: Cognitive Neuroscience, Developmental and Educational Psychology, Psychiatry and Mental health

View Paper: https://www.semanticscholar.org/paper/ac1aab3e6b4ca8f4179d41eabe086d183f9c2b7e

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Citations in the corpus

The Experiences of Late-diagnosed Women with Autism Spectrum Conditions: An Investigation of the Female Autism Phenotype (2016, background): “First, most studies have investigated participants with ASC ascertained from autism clinics [e.g., see reviews by Lai et al. (2015) and Van Wjingaarden-Cremers et al. (2014)].”
An investigation of the ‘female camouflage effect’ in autism using a computerized ADOS-2 and a test of sex/gender differences (2016, background): “The tests in autism may be biased toward identifying autism predominantly in males [31].”
Autistic girls and school exclusion: Perspectives of students and their parents (2017, background): “, 2011), developmental differences across the genders (Lai et al., 2015) and a male assessment bias (Russell, Steer, & Golding, 2011).”
Big data approaches to decomposing heterogeneity across the autism spectrum (2018, background): “cularly intervention and biological studies [73–75], which may lead to male-biased inferences about autism [76].”
Quantifying and exploring camouflaging in men and women with autism (2016, background): “Thus, the male-preponderance may reflect aetiological sex/gender differences, but may also be a product of under- or misrecognition of autism in females, potentially associated with gender stereotypes and the historically male-based behavioural characterization of autism, with insufficient acknowled”