The Autistic Child – Is there a Gender Difference?

We all may know a child affected by Autism.  According to the National Autism Association, 1 in 68 children fall somewhere on the Autism spectrum.  That rate has grown steadily over the last 20 years, and we now know more about what in the past has been a mystifying diagnosis:

• An autism diagnosis is four times more likely in boys than girls
• 40% of children with autism do not speak.
• Its prevalence is not affected by race, region, or socio-economic status

The NAA defines Autism as a bio-neurological developmental disability that usually appears before the age of 3, and impacts development of the brain in the areas of social interaction, communication skills, and cognitive function. (NAA, 2015)  Children with autism typically have problems with verbal and non-verbal communication, social interactions, and activities.  There is no cure for autism, but symptoms can be improved with early intervention and treatment.  And while it doesn’t affect the child’s life expectancy, it does come with an exhaustive list of comorbid health conditions:

• Comorbid conditions often associated with autism include – Fragile X, allergies, asthma, epilepsy, bowel disease, gastrointestinal disorders, recurrent viral infections, PANDAS, anxiety disorder, bipolar disorder, ADHD, Tourette Syndrome, OCD, sensory integration dysfunction, sleep disorders, immune and autoimmune disorders. (NAA, 2015)

While researchers have just begun to untangle the mystery of Autism, a new study from Stanford University School of Medicine may provide new insights into how Autism affects male and female brains.  Researchers used two large, public US databases to review records of about 800 children at high functioning levels on the autism spectrum.  They found that girls with autism display less repetitive and restricted behavior than boys – and that differences in the brain between the genders could explain the differences. (Science Daily, 2015)

Repetitive and restricted behavior in a child include narrow or focused interest, an inflexibility with routines and repetitive motions – usually the most widely recognized of autistic symptoms.

The study, published in Molecular Autism and reported in Science Daily, tracked the autistic symptoms of 128 girls and 614 boys in the National Database for Autism Research.  Ranging in age from 7 to 13, the children had IQ scores above 70 and were evaluated with standardized testing for autistic behavior.   The findings shows girls and boys had similar scores for social behavior and communication, but girls had more normal scores for repetitive behaviors.

Scientists in the study also reviewed data from the Autism Brain Imaging Data Exchange; including MRI brain scans of 25 boys and 25 girls with autism, compared to 19 typically developing boys and girls each matched for age and IQ.   The researchers repeated the finding that girls and boys scored the same on social behavior and communication skills, but the girls had less-severe repetitive behaviors.

Researchers believe this is the strongest evidence to date to prove gender differences in core features of autism, and is important because autism research has typically been driven from a male viewpoint – causing girls to be underdiagnosed or not given the correct treatment.   These advances in understanding how autism manifests differently in boys and girls can help target and improve treatments and outcomes in the future.