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      A Behavioral Comparison of Male and Female Adults with High Functioning Autism Spectrum Conditions

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          Autism spectrum conditions (ASC) affect more males than females in the general population. However, within ASC it is unclear if there are phenotypic sex differences. Testing for similarities and differences between the sexes is important not only for clinical assessment but also has implications for theories of typical sex differences and of autism. Using cognitive and behavioral measures, we investigated similarities and differences between the sexes in age- and IQ-matched adults with ASC (high-functioning autism or Asperger syndrome). Of the 83 (45 males and 38 females) participants, 62 (33 males and 29 females) met Autism Diagnostic Interview-Revised (ADI-R) cut-off criteria for autism in childhood and were included in all subsequent analyses. The severity of childhood core autism symptoms did not differ between the sexes. Males and females also did not differ in self-reported empathy, systemizing, anxiety, depression, and obsessive-compulsive traits/symptoms or mentalizing performance. However, adult females with ASC showed more lifetime sensory symptoms ( p = 0.036), fewer current socio-communication difficulties ( p = 0.001), and more self-reported autistic traits ( p = 0.012) than males. In addition, females with ASC who also had developmental language delay had lower current performance IQ than those without developmental language delay ( p<0.001), a pattern not seen in males. The absence of typical sex differences in empathizing-systemizing profiles within the autism spectrum confirms a prediction from the extreme male brain theory. Behavioral sex differences within ASC may also reflect different developmental mechanisms between males and females with ASC. We discuss the importance of the superficially better socio-communication ability in adult females with ASC in terms of why females with ASC may more often go under-recognized, and receive their diagnosis later, than males.

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                Author and article information

                Role: Editor
                PLoS One
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                13 June 2011
                : 6
                : 6
                [1 ]Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, United Kingdom
                [2 ]School of Psychology and Clinical Language Sciences, Centre for Integrative Neuroscience and Neurodynamics, University of Reading, Reading, United Kingdom
                The University of Queensland, Australia
                Author notes

                Conceived and designed the experiments: M-CL SB-C. Performed the experiments: M-CL MVL GP ANVR SJW SAS BC. Analyzed the data: M-CL. Contributed reagents/materials/analysis tools: SJW SB-C MAC. Wrote the paper: M-CL MVL GP ANVR SJW SAS BC SB-C.

                ¶ Membership of the Medical Research Council Autism Imaging Multicentre Study Consortium is provided in the Acknowledgments.

                Lai et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                Pages: 10
                Research Article
                Diagnostic Medicine
                Mental Health
                Adolescent Psychiatry
                Child Psychiatry
                Neuropsychiatric Disorders
                Clinical Psychology
                Cognitive Psychology
                Public Health
                Behavioral and Social Aspects of Health
                Women's Health
                Social and Behavioral Sciences
                Cognitive Psychology
                Human Intelligence
                Clinical Psychology
                Developmental Psychology



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