Department of Clinical, Educational and Health Psychology, University College London, London, UK.
Centre for Addiction and Mental Health and The Hospital for Sick Children, Department of Psychiatry, University of Toronto, Toronto, Canada.
Autism Res. 2020 Aug;13(8):1358-1372. doi: 10.1002/aur.2316. Epub 2020 Jun 3.
Autism has long been considered a predominantly male condition. It is increasingly understood, however, that autistic females are under-recognized. This may reflect gender stereotyping, whereby symptoms are missed in females, because it is assumed that autism is mainly a male condition. Also, some autistic girls and women may go unrecognized because there is a "female autism phenotype" (i.e., a female-typical autism presentation), which does not fit current, male-centric views of autism. Potential biases shown by educators, in their role as gatekeepers for an autism assessment, may represent a barrier to the recognition of autism in females. We used vignettes describing autistic children to test: (a) whether gender stereotyping occurs, whereby educators rate males as more likely to be autistic, compared to females with identical symptoms; (b) whether recognition is affected by sex/gender influences on autistic presentation, whereby children showing the male autism phenotype are rated as more likely to be autistic than those with the female phenotype. Ratings by primary school educators showed a significant main effect of both gender and presentation (male phenotype vs. female phenotype) on estimations of the child in the vignette being autistic: respondents showed a bias against girls and the female autism phenotype. There was also an interaction: female gender had an effect on ratings of the female phenotype, but not on the male phenotype vignette. These findings suggest that primary school educators are less sensitive to autism in girls, through under-recognition of the female autism phenotype and a higher sensitivity to autism in males. LAY SUMMARY: Educators have an important role in identifying children who need an autism assessment, so gaps in their knowledge about how autism presents in girls could contribute to the under-diagnosis of autistic girls. By asking educators to identify autism when presented with fictional descriptions of children, this study found that educators were less able to recognize what autism "looks like" in girls. Also, when given identical descriptions of autistic boys and girls, educators were more likely to identify autism in boys. These results suggest that primary school educators might need extra help to improve the recognition of girls on the autism spectrum. Autism Res 2020, 13: 1358-1372. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.
自闭症长期以来一直被认为是一种主要发生在男性身上的病症。然而，人们越来越认识到，自闭症女性患者被识别的比例较低。这可能反映了性别刻板印象，即由于人们认为自闭症主要发生在男性身上，因此女性的症状会被忽视。此外，一些自闭症女孩和女性可能未被识别，因为存在“女性自闭症表型”（即女性特有的自闭症表现），这与当前以男性为中心的自闭症观点不符。教育工作者作为自闭症评估的把关人，在其角色中可能表现出潜在的偏见，这可能成为识别女性自闭症的障碍。我们使用描述自闭症儿童的情景描述来测试：（a）是否存在性别刻板印象，即教育工作者认为与具有相同症状的女性相比，男性更有可能患有自闭症；（b）是否识别受到自闭症表现的性别/性别影响，即表现出男性自闭症表型的儿童比表现出女性表型的儿童更有可能被认为患有自闭症。小学教育工作者的评分显示，性别和表现（男性表型与女性表型）对情景描述中儿童患有自闭症的估计存在显著的主效应：受访者对女孩和女性自闭症表型表现出偏见。还有一个相互作用：女性性别对女性表型的评分有影响，但对男性表型的情景描述没有影响。这些发现表明，小学教育工作者对女孩自闭症的敏感性较低，原因是他们对女性自闭症表型的识别不足，对男性自闭症的敏感性较高。
教育工作者在识别需要进行自闭症评估的儿童方面发挥着重要作用，因此他们在自闭症女孩表现方面的知识差距可能导致女孩自闭症的诊断不足。通过要求教育工作者在呈现虚构的儿童描述时识别自闭症，本研究发现教育工作者在识别女孩自闭症方面的能力较弱。此外，当教育工作者得到自闭症男孩和女孩的描述相同时，他们更有可能识别出男孩的自闭症。这些结果表明，小学教育工作者可能需要额外的帮助来提高对自闭症谱系女孩的识别能力。自闭症研究 2020 年，13：1358-1372。© 2020 国际自闭症研究协会，威利期刊，公司。
