Evaluation of the ADHD Rating Scale in Youth with Autism.
Girls with ASD can show weaker everyday executive and adaptive skills than boys despite equal core autism traits.
01Research in Context
What this study did
The team used the ADHD Rating Scale to look for sex differences in youth with autism.
Parents filled out the scale for matched girls and boys with ASD. Core autism severity was the same for both groups.
What they found
Parents rated girls with ASD as having weaker executive function and daily living skills than boys.
Even though core autism traits were matched, girls looked more impaired on everyday tasks like planning and self-care.
How this fits with other research
Amore et al. (2011) saw the same girl-specific problem earlier, using a stop-task in the lab. Only girls with ASD were slower to stop, while boys with ASD looked like typical peers.
Harrop et al. (2018) seems to disagree. They found girls with ASD kept typical face-looking preferences, while boys looked less at faces. The clash fades when you see one study measured real-life skills and the other measured eye gaze.
Costa et al. (2017) extends the idea to adult women, showing reduced facial attention that links to autism severity. Together these papers chart sex-specific social-cognitive profiles across age.
Why it matters
If you assess a girl with ASD, do not assume her core symptom score tells the whole story. She may need extra support for executive function and daily living even when her autism traits look mild. Add parent questions about planning, organizing, and self-care to your intake forms. When you see a girl struggling with these areas, you have data to justify targeted goals or referrals.
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02At a glance
03Original abstract
This study is the largest to date examining executive function and adaptive skills in females with autism spectrum disorder (ASD). Its primary aim was to utilize parent ratings of real-world executive functioning and adaptive behavior to better understand whether females with ASD differ from males with ASD in these areas of everyday functioning. We compared 79 females with ASD to 158 males with ASD (ages 7-18) who were statistically matched on age, IQ, and level of ADHD or ASD traits. All participants were assessed using the Behavior Rating Inventory of Executive Function (BRIEF) and a subset (56 females and 130 males) also received the Vineland Adaptive Behavior Scales (VABS). Females were rated by parents as having greater problems with executive function on the BRIEF. Parents also rated females as exhibiting more difficulties than males on the Daily Living Skills domain of the VABS. There was a correlation between increased global EF difficulty and decreased adaptive ability in both males and females. Our results indicate relative weaknesses for females compared to males diagnosed with ASD on executive function and daily living skills. These differences occur in the absence of sex differences in our sample in age, IQ, clinician ratings of core ASD symptomatology, parent ratings of ADHD symptoms, and parent-reported social and communication adaptive skills on the VABS. These findings indicate specific liabilities in real world EF and daily living skills for females with ASD and have important implications for targeting their treatments. Autism Res 2017, 10: 1653-1662. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
Journal of autism and developmental disorders, 2017 · doi:10.1037/a0033615