Pre-school children with suspected autism spectrum disorders: do girls and boys have the same profiles?
When toddlers are matched for ability, girls and boys with suspected autism look alike on tests—but girls may still be missed without sharper questions.
01Research in Context
What this study did
Andersson et al. (2013) compared 20 girls and 20 boys who were waiting for an autism check-up.
All kids were one to four years old and lived in Sweden.
The team matched each girl to a boy with the same developmental score, then looked at autism symptoms, language, and play.
What they found
When boys and girls had the same developmental level, their autism profiles looked the same.
No area—social skills, repetitive play, or language—showed a clear girl vs. boy split.
The authors warn that current screeners may still miss girls even when symptoms are present.
How this fits with other research
Kocher et al. (2015) and Crawford et al. (2015) also found no big sex gaps in matched toddlers, giving the target paper a thumbs-up.
Ros-Demarize et al. (2020) seems to disagree: they saw girls with stronger social-communication deficits. The difference is method—Rosmary used parent reports while Westman used direct testing, so both can be true at the same time.
Rodriguez-Seijas et al. (2020) adds a twist: after IQ-matching, girls showed milder social-affect symptoms. This refines, rather than erases, the null finding by showing that subtle strengths can hide in group averages.
Why it matters
For you at the clinic table, the takeaway is to stay alert even when the numbers look equal. Match every girl to a boy with the same developmental score before you decide she is "too mild" for autism. If parent concerns feel soft, probe deeper for restricted interests and sensory quirks—girls may mask them with quiet play. Update your intake forms to ask about doll play, sleep issues, and subtle social avoidance so you do not let camouflaged girls slip out of services.
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02At a glance
03Original abstract
The male to female ratio is raised in autism spectrum disorders (ASD). Previous studies have suggested that girls with ASD have more problems with communication than boys, but boys show more repetitive behaviours than girls. In this study, 20 girls, 1.8-3.9 years of age were matched for chronological and developmental age with 20 boys with suspected ASD. All the children were recruited after population screening and referral by Child Health Care Services to a specialised neuropsychiatry clinic, where they underwent comprehensive neuropsychiatric assessments. Comparisons were made with regard to diagnosis, developmental profiles and global disability. No significant gender differences were found. There were strong correlations between results obtained in different developmental areas. The results suggest that either (1) previous studies finding clear gender differences may have overrated discrepancies between girls and boys in ASD, or that (2) there may be girls, who will not be identified in the early years with our current screening instruments. More research with a much larger population representative study samples is required.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2012.08.025