McFayden Tyler C, Putnam Orla, Grzadzinski Rebecca, Harrop Clare
Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, USA.
Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, USA.
Curr Dev Disord Rep. 2023 Mar;10(1):80-91. doi: 10.1007/s40474-023-00270-y. Epub 2023 Jan 27.
Females and males are disproportionately diagnosed with autism, a sex difference that has historically represented this neurodevelopmental condition. The current review examines lifespan developmental trajectories of autism based on sex to elucidate behavioral phenotypic differences that may contribute to differential rates of diagnosis.
We review sex differences in diagnostic criteria: social communication and restricted interests/repetitive behaviors (RRBs). Results suggest RRBs are more indicative of a diagnosis in males, whereas social differences are more indicative of a diagnosis in females. Factors contributing to a later diagnosis in females include social strengths (camouflaging) and diagnostic overshadowing.
Sex differences in diagnostic criteria may contribute to differential rates of identification in males and females. Sex differences are most pronounced when assessing naturalistic social communication instead of reliance on standardized measure. Numerous future directions are identified including increasing samples of sub-threshold autistic females and evaluating longitudinal sex differences.
女性和男性被诊断为自闭症的比例失调，这种性别差异一直以来都代表着这种神经发育状况。本综述基于性别研究自闭症的终生发展轨迹，以阐明可能导致诊断率差异的行为表型差异。
我们综述了诊断标准中的性别差异：社交沟通和狭隘兴趣/重复行为（RRBs）。结果表明，RRBs在男性诊断中更具指示性，而社交差异在女性诊断中更具指示性。导致女性诊断较晚的因素包括社交优势（伪装）和诊断遮蔽。
诊断标准中的性别差异可能导致男性和女性的识别率不同。在评估自然主义社交沟通而非依赖标准化测量时，性别差异最为明显。确定了许多未来的研究方向，包括增加亚阈值自闭症女性的样本量以及评估纵向性别差异。
