Autism spectrum disorder: An examination of sex differences in neuropsychological and self-report measures of executive and non-executive cognitive function.
Thinking differences between males and females stay the same in autism—no special female autism profile appears.
01Research in Context
What this study did
Shawler et al. (2021) gave memory, planning, and flexibility tests to autistic and neurotypical people.
They compared males and females in both groups to see if autism changes how sex affects thinking.
What they found
Females scored higher than males on several tests, but the gap looked the same in both groups.
There was no special "autistic female" thinking style—just the usual sex differences everyone shows.
How this fits with other research
Bölte et al. (2011) also saw females outperform males on executive tasks, yet they lacked neurotypical controls, so they couldn’t tell if the gap was autism-specific. A et al. answer that question: it isn’t.
Two toddler studies—Fleury et al. (2018) and Kocher et al. (2015)—found no sex differences at all. The clash disappears when you notice age: very young kids show no gap, but later the usual male-female differences emerge, even in autism.
Deng et al. (2021) add brain data showing girls with autism have more “male-typical” asymmetry, supporting the Female Protective Effect. A et al. fit here by showing those brain differences do not create a unique cognitive profile.
Why it matters
Stop expecting autistic girls to think like autistic boys with a twist. Use the same sex-based norms you already use for neurotypical clients when you interpret EF tests. If a girl’s scores look “average for boys,” she may still need support—compare her to other girls, not the male mean.
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02At a glance
03Original abstract
Research comparing females and males with a diagnosis of autism suggests that there are sex differences in some characteristics such as behaviour regulation. One area not studied in detail is whether females and males with autism perform differently in tests of cognitive ability. The results of previous research are quite mixed. One explanation may be that some research comparing females and males with autism did not include a neurotypical control group for comparison. As a result, it is not clear whether the sex differences in cognitive ability observed in people with autism are similar to differences between neurotypical males and females. To better understand whether there are unique differences between males and females with autism, it is important to also compare them with neurotypical males and females. In our research, we included a neurotypical group and compared males and females with and without a diagnosis of autism. We found that the sex differences in autism are similar to what we observe in males and females without autism. Our study showed that compared with males, females (with and without autism) do better in assessments of processing speed, cognitive flexibility, verbal learning and memory and semantic fluency. Our results suggest that although females show different cognitive performance to males, these sex differences were not specific to the group with a diagnosis of autism.
Autism : the international journal of research and practice, 2021 · doi:10.1177/13623613211014991