Autism Spectrum Disorders: The Difference Between Boys and Girls

Children and adolescents with autism spectrum disorders (ASD) are a growing patient population with 1 in 68 children being diagnosed with ASD. It is observed at a higher rate among boys, with 1 in 42 boys being identified as having ASD. This is a ratio of 1 female for every 4 males diagnosed with autism. As more is known about autism, there is a growing awareness that these gender and sex differences may be more complex than we originally thought.

What is Autism?

Diagnosed in early childhood, Autism Spectrum Disorders have lifelong implications for a child’s long term adjustment including their ability to succeed in school, relationships, and in jobs as adults. With effective treatment, children and adolescents with ASD can make remarkable gains and achievements, often living in ways that are indistinguishable from those who don’t have autism or are differently, but remarkably, fulfilling.

About one-third of children with ASD remain nonverbal and are diagnosed with an intellectual disability. Additionally, medical and mental health problems can complicate a child’s adjustment. Seizures, GI problems, sleep problems, ADHD, and anxiety are examples of concerns often observed among children with ASD which make living with this disorder even more challenging.

Why do more boys than girls have autism?

Boys are at greater risk for the varied genetic causes of autism and other neurodevelopmental conditions than girls are. Research over the last several years has shown that smaller genetic errors, or mutations, and fewer of these errors, are associated with ASD among boys – while more pronounced and severe genetic mutations are observed when girls are diagnosed with autism. There are also more studies showing children are more likely to inherit genetic mutations associated with autism from their mothers and the reasons for this are not yet fully understood.

Do referral and diagnostic practices affect the rate of autism among boys and girls?

The distinguishable patterns displayed by children with autism may favor the more severe and problematic symptoms observed among boys. Thus, boys get referred for diagnostic and treatment services earlier in development than do girls, and are more often diagnosed. The thought is that some girls are diagnosed later in middle childhood, adolescence, or even young adulthood while some girls may be missed and will never be appropriately supported.

Is ‘girl autism’ different than ‘boy autism’?

As the gender and sex differences among children with ASD get more closely examined, many experts are beginning to observe that girls may be better at imitating socially appropriate behaviors and have fewer behavior problems than boys. The thinking is that this creates a masking of autism symptoms for girls that help them get by without being referred for services. It is important that we attend to milder presentations of autism spectrum-related symptoms among younger girls and provide the help and support girls need to be successful in school, in relationships and in life.

For more information on Nationwide Children’s Hospital’s Center for Autism Spectrum Disorders, click here.

Eric Butter, PhD
Eric M. Butter, PhD, serves as Chief of the Division of Psychology in the Department of Pediatrics at The Ohio State University College of Medicine, Chief of the Section of Psychology at Nationwide Children’s and Director of Nationwide Children’s Hospital’s Child Development Center. Dr. Butter is a founding faculty member of Nationwide Children’s Child Development Center: an interdisciplinary program offering multiple medical subspecialties including psychology; social work; marriage and family therapy; speech and language therapy; and genetics counseling.He obtained a Doctor of Philosophy in Clinical Psychology with a specialization in Child Clinical and Community Psychology. His graduate school studies included a broad child clinical background with training in coping and adjustment, prevention, and childhood aggression. In 1999, Dr. Butter completed a pre-doctoral internship in Pediatric Psychology and a post-doctoral fellowship in Pediatric Psychology and Developmental Disabilities in Columbus before moving into clinical research activities in neurodevelopmental disabilities and autism in collaboration with The Ohio State University Nisonger Center. His research has focused on the bio-medical correlates and potential etiologies of autism spectrum disorders and ADHD as well as psychological and medical treatment of these disorders. He is currently the PI for several medical network grants and federally funded research studies focusing on pediatrics.

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