Autism in Males vs Females

Autism in Males vs Females

Autism in Males vs Females

There are some major differences when it comes to autism in males vs females. Unlike mental health problems, Autism falls under the category of neurodevelopmental disorders and covers a large population of the world. According to the statistics of the Center for Disease Control & Prevention (CDC) – the national public health agency of the US – around 75 million people around the world (1% of the world population) have autism spectrum disorder. This is a huge number to count but there are certain variations among the types of the disease itself in this population.

Autism is a pervasive developmental disorder. The common symptoms of autism spectrum disorders include difficulties in communication skills, social skills, and restrictive and repetitive behaviors. But research suggests the differences in autism spectrum disorders of the two genders, i.e. there is a difference in autistic traits of male ASD and female ASD subjects while the systematic review of ASD diagnosis is performed.

What is the ratio of males to females with autism?

Research suggests that there is a difference in male to female ratio when male ASD and female ASD CASES are compared. There is a difference in the ratio of autism in males vs females. According to the National Institute of Health, autism spectrum disorder (ASD) in females is found at a considerably lower rate than in male. The male to female ratio of ASD is 4:1.

The diagnostic criteria of autism in males vs females

The ASD diagnostic criteria in males and females are not different. There is no diagnostic gender bias while studying male ASD and female ASD subjects. But there is evidence in recent research that suggests that autism spectrum conditions look different in males and females.

The criteria used for the diagnosis of autism in males vs females is the same. For an individual to have autism, he/she must fulfill the following two criteria:

  • The individual must have autistic symptoms from early childhood.
  • Must have the common autistic symptoms like social communication difficulties, restrictive & repetitive behaviors, behavioral disturbances, avoidance in eye contact, poor body posture and facial expressions, etc.

The major difference is that the criteria for diagnosis are the same, but the rate of diagnosis in males to females is different. The reasons behind these differences are described later in this article.

The new definition of ASD diagnosis:

The fifth edition of the Diagnostic & Statistical Manual of Mental Disorders combines four independent diagnoses – autistic disorder, Asperger’s syndrome, childhood disintegrative disorder, and pervasive developmental disorder- into the single definition of autism spectrum disorder.

How does autism differ in males and females?

1) Differences in motor skills and communication skills:

According to a study related to autism in males vs females, during the developmental changes of children within the range of 17 to 37 months having ASD, girls had more motor skill deficiencies whereas boys had more communication skills deficits.

2) Degree of Impairment:

According to Dr. Asma Sadiq, MD, by a systematic review of the male to female ratio of autism, it is found that females are prone to a higher degree of impairment on the autism spectrum pertaining to the female autism phenotype.  The reason behind these sex differences in autistic spectrum disorders is unknown.

3) Genetic Mutations:

According to the female protective effect hypothesis, there are sex differences when it comes to the developmental disorders of autism. This hypothesis says that to develop autism, more genetic mutations are required for females than males. According to the female protective model, females present a higher genetic mutation burden than males.

4) Environmental and Genetic Risk Factors:

Pertaining to the sex differences in autism, Harvard researchers published findings, suggesting that, on average, the developmental disorders of autism require more genetic and environmental risk factors for males than males. This results in more biological sex affects in males as a result of genetic risk factors than females.

5) Speech Delay:

Between the male and female children having ASD diagnosis, there are more chances of speech delay in males than the females.

6) Survival Chances in Infants:

According to Asma Sadiq, MD, when infants with autism spectrum disorders get sick in the neonatal ICU, the female infants have more chances of survival than their male counterparts.

7) Comparison of IQ:

Research suggests that intelligent females with ASD are often underrepresented in the autistic spectrum as compared to males. The reason behind that is the coping ability of females with the environment. Even females ASD with higher intelligence are not naturally social, they can find ways to adjust to the environment and society and learn social skills by imitating.

8) Restrictive and Repetitive Behaviors:

When it comes to sex differences in autism, females show more restrictive and repetitive behaviors. But, these behaviors are less noticeable in the subject to an outside observer, which results in lesser clinical diagnosis of ASD in females.

Why is it harder to diagnose females with autism?

Unlike males, it is a harder task to get females diagnosed with an autism spectrum disorder. Is there a diagnostic gender bias when it comes to ASD diagnosis males and females?

A researcher at Kennedy Krieger Interactive Autism Network tried to find out the answer to this question. As per the research, it was suggested that ASD symptoms are the same when it comes to autism in males vs females. But, it is harder to diagnose females with autism spectrum disorders because the females diagnosed with ASD are those who resemble boys in their activity in the community.

Female autism phenotype is not different from that of males. They experience the same set of common characteristics associated with the autism patient and it is not the gender bias that results in the lesser diagnosis of autism cases in females.

The reason behind fewer female cases of ASD diagnosis is that the females ASD cases come to the limelight less often than the males. Females exhibit the same underlying characteristics of autism spectrum disorders but these characteristics are considered acceptable for females and not males. This explains that there are no sex differences in autism when it comes to the common traits.

The person under autism spectrum disorder is considered to be having difficulties in social interaction, communication, and having restrictive and repetitive behaviors. These traits are considered acceptable for female ASD subjects. The autistic disturbances of affective contact also suggest that women are less likely to be diagnosed with ASD or can be misdiagnosed.

The female within the autistic spectrum appears to be a nervous child who is socially withdrawn, passive, uninvolved in society, dependent, and depressed. As these traits match the diagnostic threshold of an autistic person, they are not as noticeable in females as they are in males. The reason is that males are more active and involved in society than females.

How does autism look different in females?

There is a lot of research going on in autism spectrum disorders and the sex differences in autism. Results suggest that the female phenotype meets criteria of autism spectrum disorder (ASD) in the same way as the male samples.  The research in the area is moving forward and future research is expected to bring more results.

But, according to recent research, there are certain ways in which there is a sex difference in autism when it comes to the differences in autism spectrum disorders of males and females:

1) Areas of play:

When it comes to the ratio of autism in males vs females, males tend to have a very limited area of play, whereas autistic traits of females tend to give them a broader area of play.

2) Focus:

Females are more focused and they tend to be less affected by distractions when it comes to performing a specific task.

3) Response to non-verbal communication:

The sex differences in the autism spectrum in this area are inclined towards females. When it comes to nonverbal communications, females are more likely to respond than males, like gaze following or pointing

4) Social Communication:

There is sex difference, together with the age differences when it comes to the social communication skills of childhood autism and young adults with autism spectrum disorders. Social communication becomes a huge issue for boys at a very early age. Whereas girls with childhood autism meet criteria of social communication at an early age, their adolescent psychiatry is different, as they face problems in communication once they hit adolescence.

5) Objects vs Attention:

According to a study by the Kennedy Krieger Institute, boys and girls with autism spectrum disorders engage in disruptive behaviors differently. Boys will engage in such behaviors to gain objects, whereas girls do so to gain attention.

6) Depression and Anxiety:

According to research, girls with autism spectrum disorders are more likely to suffer from depression than their male counterparts.

7) Aggression:

Boys with autism spectrum disorders are more likely to get aggressive in some situations. Whereas, females are passive with a less likely chance of getting into aggression.

8) Social Competence:

Adolescent psychiatry suggests a trend in the social competence of females with autism. Girls within the autistic spectrum appear to be more socially competent when they are young children under their peers as girls like to mentor their fellows. But, adolescent psychiatry says that once these girls hit adolescence, they find other interests. As a result, the lack of mentorship causes a decline in their social competence.

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Some helpful resources:

  • Autism in Females Maya’s Story | Demystifying Medicine (Youtube Video)
  • What About the Girls? Sex-Based Differences in Autistic Traits and Adaptive Skills (Journal)
  • Autism in Females: How is it Different? | Kati Morton (Youtube Video)
  • Sex differences in autism spectrum disorders (Journal)
  • Hiding in Plain Sight: Girls With Autism Spectrum Disorder | Seattle Children’s (Youtube Video)
  • Comparison of Males and Females with ASD (Article)
  • Autism in Girls vs. Autism in Boys | Autism (Youtube Video)

Conclusion on Autism in Males vs Females

Concluding the article, regardless of autism in males vs females, it is a serious issue that must be considered and acted upon to get the proper treatment to excel in life and not let these disorders hinder your progress, regardless of the gender differences in autism spectrum.

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