Are males and females with autism spectrum disorder more similar than we thought?
Boys and girls with autism look almost identical on IQ, age at diagnosis, and symptom scores.
01Research in Context
What this study did
Bassett-Gunter et al. (2017) looked at 679 kids and teens with autism. Half were boys, half were girls.
They checked IQ, age at diagnosis, and autism severity using the CARS. They wanted to see if boys and girls looked different.
What they found
Boys and girls scored almost the same on every measure. The gap was tiny and not useful in real life.
Girls were only one point lower on the CARS total score. That change does not move a child to a different support level.
How this fits with other research
Ivy et al. (2017) ran the same test on 2,643 youth and got the same null result. Both papers say our tools work the same for boys and girls.
Hodge et al. (2025) seems to disagree. In a clinic, girls were rated as having milder symptoms and were checked six months later. The difference is the setting: L et al. studied a research group, while Antoinette watched real-world referrals where milder cases can slip through the cracks.
Fusar-Poli et al. (2017) review backs up L et al. Core traits show the same sex pattern in autistic and non-autistic kids. Only side features, like restricted interests, may differ.
Why it matters
Stop expecting girls to be "more autistic" or "less autistic" than boys. If a girl meets criteria, she meets criteria. Use the same cut scores, same tools, and same urgency. Watch for late-identified girls who were missed because their symptoms were called "mild."
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02At a glance
03Original abstract
Differences in behavioral and cognitive profiles have been suggested to potentially impact the presentation of social and communication symptoms in females with autism spectrum disorder. This study examined gender differences in age of diagnosis, cognitive profiles, social communication symptomatology, and autism spectrum disorder symptom severity in a community-based sample of 566 males and 113 females with autism spectrum disorder ranging in age from 1 year, 9 months to 56 years, 4 months. Results suggest either very small or no gender differences in age at diagnosis, intelligence quotient, cognitive profiles, or autism spectrum disorder symptom severity. This is a departure from clinical lore that females with autism spectrum disorder are more likely to have lower intelligence quotient and more severe impairments. There is a slight difference in symptom severity with females having higher average total Childhood Autism Rating Scale scores, but this difference is likely of minimal clinical significance. In contrast, on the Autism Diagnostic Observation Schedule-Generic, females were found to receive lower scores than males particularly on modules 2 and 3. Across males and females, individuals with stronger verbal problem-solving skills were found to receive lower Autism Diagnostic Observation Schedule-Generic module 3 scores. Given the language demands of this module, additional attention may be warranted when evaluating older children and adolescents for autism spectrum disorder.
Autism : the international journal of research and practice, 2017 · doi:10.1177/1362361316682621