National Clinical Guideline Centre, Royal College of Physicians, UK.
J Am Acad Child Adolesc Psychiatry. 2012 Aug;51(8):788-97. doi: 10.1016/j.jaac.2012.05.018. Epub 2012 Jun 26.
This study aimed to explore sex differences in autistic traits in relation to diagnosis, to elucidate factors that might differentially impact whether girls versus boys meet diagnostic criteria for autism or a related autism spectrum disorder (ASD).
Data from a large population-based sample of children were examined. Girls and boys (aged 10-12 years) meeting diagnostic criteria for an ASD were compared with those failing to meet diagnostic criteria despite very high scores on a trait measure of ASD, the Childhood Autism Spectrum Test (CAST). Information about behavioral difficulties as reported by teachers, and early estimates of intellectual functioning, were compared.
Girls, but not boys, meeting diagnostic criteria for ASD showed significantly more additional problems (low intellectual level, behavioral difficulties) than peers with similarly high CAST scores who did not meet diagnostic criteria.
These data suggest that, in the absence of additional intellectual or behavioral problems, girls are less likely than boys to meet diagnostic criteria for ASD at equivalently high levels of autistic-like traits. This might reflect gender bias in diagnosis or genuinely better adaptation/compensation in girls.
本研究旨在探讨自闭症特征与诊断之间的性别差异，阐明可能对女孩和男孩是否符合自闭症或相关自闭症谱系障碍（ASD）的诊断标准产生不同影响的因素。
研究人员对一个基于大样本儿童的数据集进行了分析。与那些尽管在自闭症特征测试（CAST）上得分非常高但仍不符合自闭症诊断标准的儿童相比，符合自闭症诊断标准的女孩和男孩（年龄在 10-12 岁之间）被进行了比较。研究比较了老师报告的行为困难信息以及早期智力功能的估计。
符合 ASD 诊断标准的女孩，而非男孩，与那些在 CAST 得分同样高但不符合诊断标准的同龄人相比，表现出明显更多的其他问题（智力水平低、行为困难）。
这些数据表明，在没有额外的智力或行为问题的情况下，女孩在具有相似高自闭症样特征的情况下，不太可能像男孩一样符合 ASD 的诊断标准。这可能反映了诊断中的性别偏见，或者女孩的适应/代偿能力确实更好。
