Intersecting effects of sex/gender and autism on structural language: A scoping review.
Compare autistic girls to typical girls, not just to boys, or you will miss real language gaps that need therapy.
01Research in Context
What this study did
Oates et al. (2023) mapped every paper that compared structural language skills between autistic girls and boys. They also pulled studies that compared autistic girls to non-autistic girls. The team screened hundreds of articles to see how sex and autism interact when kids build sentences, grammar, and vocabulary.
What they found
The review shows a clear pattern. Autistic girls usually score better than autistic boys on tests of sentence structure and grammar. Yet the same girls still lag behind non-autistic girls of the same age. In short, their “good” language is only good when you compare them to boys, not to typical girls.
How this fits with other research
Udhnani et al. (2025) asked parents to rate language skills in kids with autism and Down syndrome. Parents saw no sex difference in the autism group, even though Morgan’s review found one. The clash is simple: parent report versus formal tests. Parents may miss small grammar gaps that lab tasks catch.
Kauschke et al. (2016) and Conlon et al. (2019) ran the original lab work that Morgan later pooled. Both teams showed autistic girls using richer story language than autistic boys, but still below typical girls. Morgan’s review simply adds more studies and shouts the warning louder.
Diemer et al. (2022) widen the lens. They argue that race and gender together shape who gets diagnosed. Morgan’s language data fit that view: if we only compare autistic girls to boys, we may think the girl is “fine” and miss the real gap against typical peers.
Why it matters
Next time you assess an autistic girl, do not stop at the standard score. Ask, “How does she sound next to her typical girlfriends?” If she falls short, write language goals even if her score beats the boys. Gender-normed tables are already in most test manuals—flip to them before you exit the report.
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02At a glance
03Original abstract
Research about autism is mostly about boys and men, even though many autistic people are girls, women, and transgender/nonbinary. We wanted to learn more about how gender interacts with language skills in autistic people, so we reviewed existing research articles on this topic. We also wanted to know how this previous research talked about gender. Included articles had to measure language skills for autistic people of different genders. They also had to be published between 2000 and 2021. Twenty-four articles met these requirements. We found that autistic girls showed better language skills than autistic boys but worse skills than nonautistic girls. This may be one reason that autistic girls are underdiagnosed compared to autistic boys. If we compare autistic girls to nonautistic girls instead, we can see more language differences and possible areas to target in interventions. This study supports the need to create diagnostic and support measures for autism that take gender into account. Also, only one article mentioned autistic people who are transgender or nonbinary. Researchers who want to learn more about gender and autism need to understand gender diversity and recognize that many autistic people are transgender or nonbinary.
Autism : the international journal of research and practice, 2023 · doi:10.1177/13623613221151095