A Sensory Approach to Design: Inclusive Principles.
Check autistic girls for sound and balance distress—it shows up worse than in boys and can tip the diagnostic scale.
01Research in Context
What this study did
Gaines et al. (2025) asked 244 French-speaking kids to complete the Sensory Processing Measure. Half had autism, half were neurotypical. The team compared boys and girls on every sensory item.
What they found
Autistic girls scored much higher than autistic boys on hearing and balance items. The gap was large enough to matter in daily life. Neurotypical kids showed almost no sex difference.
How this fits with other research
Duvekot et al. (2017) saw no sex gap in sensory scores when they tracked who got diagnosed. That sounds opposite, but they used a short screener, not the full SPM. Bitsika et al. (2019) showed that ADOS-2 severity changes which SRS-2 items split boys and girls. Their point: severity and tool choice can hide or create sex gaps, just like here. Irwin et al. (2022) found autistic kids use fewer facial cues when hearing speech. Kristi’s hearing-severity scores give a real-world reason: girls’ ears may be even more stressed.
Why it matters
When you assess an autistic girl, add deep hearing and motion questions. Strong scores can push you toward diagnosis when social items are subtle. They also guide you to ear-defender breaks, seating away from buzzers, or vestibular input before work tasks.
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02At a glance
03Original abstract
Despite the high prevalence of sensory processing difficulties in children with autism spectrum disorder (ASD), little research has focused on the sex differences in sensory processing. Furthermore, there is a lack of knowledge on the female-specific symptoms of ASD, contributing to later referral, diagnosis and intervention. In this study, we examined the sex differences in sensory processing symptoms in large cohorts of ASD children (N = 168; 26 females, 142 males) and typically developing (TD) children (N = 439; 209 females, 230 males). For this, we translated the sensory processing measure (SPM) and SPM - Preschool (SPM-P) Home Forms to French. The SPM/SPM-P are parent/caregiver questionnaires that assess typical behavioral responses to sensory stimuli. Overall, our results showed that the magnitude of the differences in sensory processing between males and females is larger in ASD children relative to TD children, with females showing more severe symptoms in Hearing, as well as Balance and Motion subscales. Additionally, linear discriminant analysis showed that the SPM/SPM-P are good at discriminating TD children from ASD, children with higher accuracy rates for females than for males. These findings are discussed in light of the heterogeneity of sensory processing difficulties present in ASD. Overall, our results suggest that there seem to be female-specific profiles in sensory processing difficulties in ASD. Implications of findings concerning sex differences in sensory processing and their potential for improving identification and diagnosis of ASD females are discussed. LAY SUMMARY: The present study examined sex differences in behavioral responses to sensory stimuli in children with autism spectrum disorder (ASD), and typically developing (TD) children. While there is a small trend for TD males to show more sensory processing atypicalities, female ASD children show significantly more atypical responses compared to their male counterparts. This has important implications for characterizing female autism profiles, and ultimately improving the chance for earlier detection, diagnosis and treatment.
Journal of autism and developmental disorders, 2025 · doi:10.1016/j.rasd.2020.101517