Executive functioning in men and women with an autism spectrum disorder.
Women with autism can show quiet executive-function gaps—check working memory and flexibility against female norms, not male ones.
01Research in Context
What this study did
Kiep et al. (2017) compared executive-function skills in adults with and without autism. They looked at men and women separately to see if sex changes the autism picture.
Each person completed paper-and-pencil and computer tests of working memory, planning, and mental flexibility. The team then asked, 'Do women with autism score lower than typical women, and is that gap different from the male gap?'
What they found
Women with autism showed small but clear weaknesses in working memory and flexibility when stacked against typical women. Men with autism also scored lower than typical men, but the male gap was no larger than the female gap.
In short, autism brings executive-function challenges for both sexes; there is no unique 'female autism profile' on these tests.
How this fits with other research
Bölte et al. (2011) first reported that girls with autism outscore boys on executive-function tasks. Michelle's adult data keep the sex comparison alive but add typical adults as a yardstick.
Shawler et al. (2021) later repeated the design and found that sex differences look the same in autistic and typical groups. This 2021 paper sharpens Michelle's message: any sex gap is general, not autism-specific.
Spriggs et al. (2016) moved the question to adults over 65 and still saw only modest objective deficits, showing that small mixed effects hold across the lifespan.
Why it matters
If you assess an adult woman for autism, do not trust male norms to flag problems. Add targeted working-memory and flexibility probes, and compare her to other women. The same rule applies to goal plans and job supports: subtle executive slips can hide behind average scores that look 'good enough' when judged against men.
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02At a glance
03Original abstract
Executive functioning (EF) is thought to be linked to autism spectrum disorders (ASD) specific symptoms. The majority of research has focused on children and adolescents with ASD and, therefore, little is known about EF in adults. Furthermore, little is known about gender differences. Ninety-nine men and forty women with ASD were compared with and 35 neurotypical men 25 neurotypical women. Participants were matched on age, total intelligence, and verbal ability. The following instruments were used to measure executive functioning: digit span and letter and number sequencing of the WAIS-III, Tower of Hanoi, WCST, and Verbal fluency. Multiple analysis of variance was conducted to determine group differences. Women with ASD performed worse on the working memory tasks of the WAIS-III than neurotypical women. Furthermore, women with ASD had more perseverations on the WCST than neurotypical women. The gender comparison in the ASD group showed differences in performance on mental flexibility (WCST), working memory (WAIS-III), generativity and self-monitoring (Verbal fluency). However, these differences were unequivocal and no gender specific cognitive profile could be pinpointed. Individual strengths and frailties should be highlighted in clinical practice, as impairments in EF can be under influence of the overall cognitive abilities of the individual. Furthermore, gender differences were found. This could explain differences in representation of ASD symptoms in both groups. These differences show how important thorough diagnostics are. Autism Res 2017, 10: 940-948. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.
Autism research : official journal of the International Society for Autism Research, 2017 · doi:10.1002/aur.1721