Assessment & Research

Sex-Related Cognitive Profile in Autism Spectrum Disorders Diagnosed Late in Life: Implications for the Female Autistic Phenotype.

Lehnhardt et al. (2016) · Journal of autism and developmental disorders 2016
★ The Verdict

Late-found ASD women outrun men on speed and planning—use these strengths, don’t let them hide support needs.

✓ Read this if BCBAs who assess or coach adults with suspected late-diagnosed ASD.
✗ Skip if Clinicians who only work with early-diagnosed children under 10.

01Research in Context

01

What this study did

Lehnhardt et al. (2016) looked at the adults who learned they had autism after age 30.

The team gave each person a full battery of thinking tests.

They split scores by sex to see if men and women showed different strengths.

02

What they found

Women scored higher on processing speed and everyday planning skills.

Men scored higher on word knowledge.

These patterns were large enough to show up on standard scores.

03

How this fits with other research

Koyama et al. (2009) saw the same girl advantage in speed with children on the WISC-III.

Tonizzi et al. (2022) meta-analysis says, on average, people with ASD have weak executive function.

The new data do not clash with the meta.

The meta mixed boys and girls together, so the female strength got buried in the average.

Gandhi et al. (2022) also show broad EF problems in early grades, again pooling sexes.

When you pull women out, the EF edge appears.

04

Why it matters

If you assess an adult woman who may have missed diagnosis, do not let strong planning or quick work mask social struggles.

Use her faster processing speed to build visual schedules or self-monitoring apps.

At the same time, check if word-heavy tests under-rate her IQ; give non-verbal options.

Spotting the pattern early can guide job placement and reduce late-life stress.

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Add a timed visual sorting task to your intake battery; note if women crush it, then probe social skills either way.

02At a glance

Intervention
not applicable
Design
case series
Sample size
107
Population
autism spectrum disorder
Finding
not reported

03Original abstract

Females with high-functioning ASD are known to camouflage their autistic symptoms better than their male counterparts, making them prone to being under-ascertained and delayed in diagnostic assessment. Thus far the underlying cognitive processes that enable such successful socio-communicative adaptation are not well understood. The current results show sex-related differences in the cognitive profile of ASD individuals, which were diagnosed late in life exclusively. Higher verbal abilities were found in males (n = 69) as opposed to higher processing speed and better executive functions in females with ASD (n = 38). Since both sexes remained unidentified during childhood and adolescence, these results are suggestive for sex-distinctive cognitive strategies as an alternative to typically-developed reciprocal social behavior and social mimicry in high functioning ASD.

Journal of autism and developmental disorders, 2016 · doi:10.1007/s10803-015-2558-7