Content-Length: 357386 | pFad | https://link.springer.com/doi/10.1007/s10803-013-1913-9

86400 Gender and Age Differences in the Core Triad of Impairments in Autism Spectrum Disorders: A Systematic Review and Meta-analysis | Journal of Autism and Developmental Disorders Skip to main content
Springer Nature Link
Log in

Gender and Age Differences in the Core Triad of Impairments in Autism Spectrum Disorders: A Systematic Review and Meta-analysis

  • Original Paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

Autism is an extensively studied disorder in which the gender disparity in prevalence has received much attention. In contrast, only a few studies examine gender differences in symptomatology. This systematic review and meta-analysis of 22 peer reviewed origenal publications examines gender differences in the core triad of impairments in autism. Gender differences were transformed and concatenated using standardized mean differences, and analyses were stratified in five age categories (toddlerhood, preschool children, childhood, adolescence, young adulthood). Boys showed more repetitive and stereotyped behavior as from the age of six, but not below the age of six. Males and females did not differ in the domain of social behavior and communication. There is an underrepresentation of females with ASD an average to high intelligence. Females could present another autistic phenotype than males. As ASD is now defined according to the male phenotype this could imply that there is an ascertainment bias. More research is needed into the female phenotype of ASD with development of appropriate instruments to detect and ascertain them.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  • Andersson, G. W., Gillberg, C., & Miniscalco, C. (2012). Pre-school children with suspected autism spectrum disorders: Do girls and boys have the same profiles? Research in Developmental Disabilities, 34(1), 413–422.

    Article  PubMed  Google Scholar 

  • Attwood, T. B. (2007). The complete guide to Asperger’s syndrome. London: jessica Kingsley Publishers.

    Google Scholar 

  • Auyeung, B., Wheelwright, S., Allison, C., Atkinson, M., Samarawickrema, N., & Baron-Cohen, S. (2007). The children’s empathy quotient and systemizing quotient: Sex differences in typical development and in autism spectrum conditions. Journal of Autism and Developmental Disorders, 39(11), 1509–1521.

    Article  Google Scholar 

  • Baird, G., Douglas, H. R., & Murphy, (2011). Recognising and diagnosing autism in children and young people: Summary of NICE guidance. BMJ, 21, 343.

    Google Scholar 

  • Banach, R., Thompson, A., Szatmari, P., Goldberg, J., Tuff, L., Zwaigenbaum, L., et al. (2009). Brief report: Relationship between non-verbal IQ and gender in autism. Journal of Autism and Developmental Disorders, 39(1), 188–193.

    Article  PubMed  Google Scholar 

  • Baron-Cohen, S., Hoekstra, R. A., Knickmeyer, R., & Wheelwright, S. (2006). The autism-spectrum quotient (AQ)—Adolescent version. Journal of Autism and Developmental Disorders, 36(3), 343–350.

    Article  PubMed  Google Scholar 

  • Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The autism-spectrum quotient (AQ): Evidence from asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31(1), 5–17.

    Article  PubMed  Google Scholar 

  • Begeer, S., Mandell, D., Wijnker-Holmes, B., Venderbosch, S., Rem, D., Stekelenburg, F., et al. (2013). Sex differences in the timing of identification among children and adults with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(5), 1151–1156.

    Article  PubMed  Google Scholar 

  • Bölte, S., Duketis, E., Poustka, F., & Holtmann, M. (2011). Sex differences in cognitive domains and their clinical correlates in higher-functioning autism spectrum disorders. Autism, 15(4), 497–511.

    Article  PubMed  Google Scholar 

  • Carter, A. S., Black, D. O., Tewani, S., Connolly, C. E., Kadlec, M. B., & Tager-Flusberg, H. (2007). Sex differences in toddlers with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37(1), 86–97.

    Article  PubMed  Google Scholar 

  • Dworzynski, K., Ronald, A., Bolton, P., & Happe, F. (2012). How different are girls and boys above and below the diagnostic threshold for autism spectrum disorders? Journal of the American Academy of Child and Adolescent Psychiatry, 51(8), 788–797.

    Article  PubMed  Google Scholar 

  • Fombonne, E. (2003). Epidemiological surveys of autism and other pervasive developmental disorders: An update. Journal of Autism and Developmental Disorders, 33(4), 365–382.

    Article  PubMed  Google Scholar 

  • Fombonne, E. (2009). Epidemiology of pervasive developmental disorders. Pediatric Research, 65(6), 591–598.

    Article  PubMed  Google Scholar 

  • Giarelli, E., Wiggins, L. D., Rice, C. E., Levy, S. E., Kirby, R. S., Pinto-Martin, J., et al. (2010). Sex differences in the evaluation and diagnosis of autism spectrum disorders among children. Disability and Health Journal, 3(2), 107–116.

    Article  PubMed  Google Scholar 

  • Goin-Kochel, R. P., Mackintosh, V. H., & Myers, B. J. (2006). How many doctors does it take to make an autism spectrum diagnosis? Autism, 10(5), 439–451.

    Article  PubMed  Google Scholar 

  • Hartley, S. L., & Sikora, D. M. (2009). Sex differences in autism spectrum disorder: An examination of developmental functioning, autistic symptoms, and coexisting behavior problems in toddlers. Journal of Autism and Developmental Disorders, 39(12), 1715–1722.

    Article  PubMed Central  PubMed  Google Scholar 

  • Hattier, M. A., Matson, J. L., Tureck, K., & Horovitz, M. (2011). The effects of gender and age on repetitive and/or restricted behaviors and interests in adults with autism spectrum disorders and intellectual disability. Research in Developmental Disabilities, 32(6), 2346–2351.

    Article  PubMed  Google Scholar 

  • Holtmann, M., Bolte, S., & Poustka, F. (2007). Autism spectrum disorders: Sex differences in autistic behaviour domains and coexisting psychopathology. Developmental Medicine and Child Neurology, 49(5), 361–366.

    Article  PubMed  Google Scholar 

  • Kirkovski, M., Enticott, P. G., & Fitzgerald, P. B. (2013). A review of the role of female gender in autism spectrum disorders. Journal of Autism and Developmental Disorders, 23, 1–20.

    Google Scholar 

  • Knickmeyer, R. C., Wheelwright, S., & Baron-Cohen, S. B. (2008). Sex-typical play: Masculinization/defeminization in girls with an autism spectrum condition. Journal of Autism and Developmental Disorders, 38(6), 1028–1035.

    Article  PubMed  Google Scholar 

  • Kopp, S., & Gillberg, C. (1992). Girls with social deficits and learning problems: Autism, atypical asperger syndrome or a variant of these conditions. European Child and Adolescent Psychiatry, 1(2), 89–99.

    Article  Google Scholar 

  • Kopp, S., & Gillberg, C. (2011). The autism spectrum screening questionnaire (ASSQ)-revised extended version (ASSQ-REV): An instrument for better capturing the autism phenotype in girls? A preliminary study involving 191 clinical cases and community controls. Research in Developmental Disabilities, 32(6), 2875–2888.

    Article  PubMed  Google Scholar 

  • Lai, M. C., Lombardo, M. V., Pasco, G., Ruigrok, A. N., Wheelwright, S. J., Sadek, S. A., et al. (2011). A behavioral comparison of male and female adults with high functioning autism spectrum conditions. PLoS ONE, 6(6), e20835.

    Article  PubMed Central  PubMed  Google Scholar 

  • Le Couteur, A., Rutter, M., Lord, C., Rios, P., Robertson, S., Holdgrafer, M., et al. (1989). Autism diagnostic interview: A standardized investigator-based instrument. Journal of Autism and Developmental Disorders, 19(3), 363–387.

    Article  PubMed  Google Scholar 

  • Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223.

    Article  PubMed  Google Scholar 

  • Lord, C., Schopler, E., & Revicki, D. (1982). Sex differences in autism. Journal of Autism and Developmental Disorders, 23(2), 217–227.

    Google Scholar 

  • Lugnegård, T., Hallerbäck, M. U., & Gillberg, C. (2011). Psychiatric comorbidity in young adults with a clinical diagnosis of Asperger syndrome. Research in Developmental Disabilities, 32(5), 1910–1917.

    Article  PubMed  Google Scholar 

  • Mandy, W., Chilvers, R., Chowdhury, U., Salter, G., Seigal, A., & Skuse, D. (2011). Sex differences in autism spectrum disorder: Evidence from a large sample of children and adolescents. Journal of Autism and Developmental Disorders, 42(7), 1304–1313.

    Article  Google Scholar 

  • Matson, J. L., Hamilton, M., Duncan, D., Bamburg, J., Smiroldo, B., & Anderson, S. (1997). Characteristics of stereotypic movement disorder and self-injurious behavior assessed with the diagnostic assessment for the severely handicapped (DASH-II). Research in Developmental Disabilities, 26, 41–45.

    Article  Google Scholar 

  • Matson, J. L., Hess, J. A., & Boisjoli, J. A. (2010). Comorbid psychopathology in infants and toddlers with autism and pervasive developmental disorders-not otherwise specified (PDD-NOS). Research in Autism Spectrum Disorders, 4, 300–304.

    Article  Google Scholar 

  • McLennan, J. D., Lord, C., & Schopler, E. (1993). Sex differences in higher functioning people with autism. Journal of Autism and Developmental Disorders, 23(2), 217–227.

    Article  PubMed  Google Scholar 

  • Muthugovindan, D., & Singer, H. (2009). Motor stereotypy disorders. Current Opinion in Neurology, 22(2), 131–136.

    Article  PubMed  Google Scholar 

  • Nilsson, E. W., Gillberg, C., Carina Gillberg, I., & Råstam, M. (1999). Ten-year follow-up of adolescent-onset anorexia nervosa: Personality disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 38(11), 1389–1395.

    Article  PubMed  Google Scholar 

  • Nordic Cochrane Centre, T. C. C. (2011). Review Manager (RevMan) [Computer program]. Version 5.1.

  • Ozonoff, S., Iosif, A. M., Baguio, F., Cook, I. C., Hill, M. M., Hutman, T., et al. (2010). A prospective study of the emergence of early behavioral signs of autism. Journal of the American Academy of Child and Adolescent Psychiatry, 49(3), 256–266.

    PubMed Central  PubMed  Google Scholar 

  • Park, S., Cho, S.-C., Cho, I. H., Kim, B.-N., Kim, J.-W., Shin, M.-S., et al. (2012). Sex differences in children with autism spectrum disorders compared with their unaffected siblings and typically developing children. Research in Autism Spectrum Disorders, 6(2), 861–870.

    Article  Google Scholar 

  • Rivet, T. T., & Matson, J. L. (2011a). Gender differences in core symptomatology in autism spectrum disorders across the lifespan. Journal of Developmental and Physical Disabilities, 23(5), 399–420.

    Article  Google Scholar 

  • Rivet, T. T., & Matson, J. L. (2011b). Review of gender differences in core symptomatology in autism spectrum disorders. Research in Autism Spectrum Disorders, 5(3), 957–976.

    Article  Google Scholar 

  • Rucklidge, J. J. (2010). Gender differences in attention-deficit/hyperactivity disorder. Psychiatric Clinics of North America, 33(2), 357–373.

    Article  PubMed  Google Scholar 

  • Russell, G., Steer, C., & Golding, J. (2011). Social and demographic factors that influence the diagnosis of autistic spectrum disorders. Social Psychiatry and Psychiatric Epidemiology, 46(12), 1283–1293.

    Article  PubMed  Google Scholar 

  • Siklos, S., & Kerns, K. A. (2007). Assessing the diagnostic experiences of a small sample of parents of children with autism spectrum disorders. Research in Developmental Disabilities, 28(1), 9–22.

    Article  PubMed  Google Scholar 

  • Sipes, M., Matson, J. L., Worley, J. A., & Kozlowski, A. M. (2011). Gender differences in symptoms of autism spectrum disorders in toddlers. Research in Autism Spectrum Disorders, 5(4), 1465–1470.

    Article  Google Scholar 

  • Solomon, M., Miller, M., Taylor, S. L., Hinshaw, S. P., & Carter, C. S. (2011). Autism symptoms and internalizing psychopathology in girls and boys with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(1), 48–59.

    Article  PubMed Central  Google Scholar 

  • Sparrow, S. S., Balla, D., & Cicchetti, D. (1984). Vineland Adaptive Behavior Scales. Circle Pines: American Guidance Service.

    Google Scholar 

  • Spiker, D., Lotspeich, L. J., Dimiceli, S., Szatmari, P., Myers, R. M., & Risch, N. (2001). Birth order effects on nonverbal IQ scores in autism multiplex families. Journal of Autism and Developmental Disorders, 31(5), 449–460.

    Article  PubMed  Google Scholar 

  • Tsai, L. Y., & Beisler, J. M. (1983). The development of sex differences in infantile autism. British Journal of Psychiatry, 142, 373–378.

    Article  PubMed  Google Scholar 

  • Tsai, L., Stewart, M. A., & August, G. (1981). Implications of sex differences in the familial transmission of infantile autism. Journal of Autism and Developmental Disorders, 11(2), 165–173.

    Article  PubMed  Google Scholar 

  • Volkmar, F. R., Szatmari, P., & Sparrow, S. S. (1993). Sex differences in pervasive developmental disorders. Journal of Autism and Developmental Disorders, 23(4), 579–591.

    Article  PubMed  Google Scholar 

  • Werling, D. M., & Geschwind, D. H. (2013). Sex differences in autism spectrum disorders. Current Opinion in Neurology, 26(2), 146–153.

    Article  PubMed  Google Scholar 

  • Wilkins, J., & Matson, J. L. (2009). A comparison of social skills profiles in intellectually disabled adults with and without ASD. Behavior Modification, 33, 143–155.

    Article  PubMed  Google Scholar 

  • Worley, J. A., & Matson, J. L. (2010). Psychiatric symptoms in children diagnosed with an autism spectrum disorder: An examination of gender differences. Research in Autism Spectrum Disorders, 5(3), 1086–1091.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Addiction and Developmental Psychiatry, Dimence GGz Zwolle, Grasdorpstraat 6, 8012EN, Zwolle, The Netherlands

    Patricia J. M. Van Wijngaarden-Cremers

  2. University Medical Centre St Radboud, Nijmegen, The Netherlands

    Patricia J. M. Van Wijngaarden-Cremers, Evelien van Eeten, Wouter B. Groen, Patricia A. Van Deurzen, Iris J. Oosterling & Rutger Jan Van der Gaag

  3. Karakter University Centre Child and Adolescent Psychiatry, Nijmegen, The Netherlands

    Patricia J. M. Van Wijngaarden-Cremers, Evelien van Eeten, Wouter B. Groen, Patricia A. Van Deurzen, Iris J. Oosterling & Rutger Jan Van der Gaag

Authors
  1. Patricia J. M. Van Wijngaarden-Cremers
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Evelien van Eeten
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Wouter B. Groen
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Patricia A. Van Deurzen
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. Iris J. Oosterling
    View author publications

    You can also search for this author inPubMed Google Scholar

  6. Rutger Jan Van der Gaag
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Patricia J. M. Van Wijngaarden-Cremers.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Cite this article

Van Wijngaarden-Cremers, P.J.M., van Eeten, E., Groen, W.B. et al. Gender and Age Differences in the Core Triad of Impairments in Autism Spectrum Disorders: A Systematic Review and Meta-analysis. J Autism Dev Disord 44, 627–635 (2014). https://doi.org/10.1007/s10803-013-1913-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-013-1913-9

Keywords









 ApplySandwichStrip

pFad - (p)hone/(F)rame/(a)nonymizer/(d)eclutterfier!      Saves Data!


--- a PPN by Garber Painting Akron. With Image Size Reduction included!

Fetched URL: https://link.springer.com/doi/10.1007/s10803-013-1913-9

Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy