Sex differences in cognitive domains and their clinical correlates in higher-functioning autism spectrum disorders.
In higher-functioning autism, girls outperform boys on executive function and boys show stronger attention to detail, with weaker planning linked to more stereotypy.
01Research in Context
What this study did
Bölte et al. (2011) compared boys and girls with higher-functioning autism.
They looked at executive function, attention to detail, and repetitive behaviors.
The team wanted to see if thinking skills differ by sex in autism.
What they found
Girls scored better on planning and flexible thinking.
Boys noticed tiny details faster.
Boys with weaker planning showed more hand-flapping and rocking.
How this fits with other research
Shawler et al. (2021) ran a similar check and added neurotypical kids. They found the same girl-boy gaps in both groups. The gap is not autism-special; it mirrors typical sex trends.
Rodriguez-Seijas et al. (2020) moved the lens to preschoolers. Girls again looked milder, this time in social affect, and fine-motor skill predicted social trouble only in boys.
Deng et al. (2021) peered into brain scans. Girls with autism had more male-typical asymmetry, giving a neural hint for the female protective effect.
Why it matters
When you test a girl with autism, do not assume she will struggle with executive tasks the same way boys do. She may plan better yet still need support in other areas. Use sex-specific norms when you pick tools and set goals. If a boy flaps a lot, check his planning skills first; boosting them may cut the stereotypy.
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02At a glance
03Original abstract
Despite the skewed sex ratio, few studies have addressed possible cognitive sex differences in autism spectrum disorders (ASDs). This study compared visual attention to detail (ATTD) and selected executive functions (EF) in 35 males and 21 females with higher-functioning ASD and unaffected sibling controls. Females with ASD outperformed males on EF as assessed by the Trail Making Test B-A. Males with ASD showed superior performance for ATTD as measured by the Block Design Test (BD) when compared with females. EF difficulties in males were correlated with more stereotypic behaviours and interests on the Autism Diagnostic Interview-Revised or the Autism Diagnostic Observation Schedule. The results indicated clinically meaningful cognitive sex differences in ASD, particularly an association between EF and stereotypic behaviours and interests. ATTD as a potential basis for specific cognitive strengths (e.g. scientific/savant skills) might be more pronounced in males with ASD.
Autism : the international journal of research and practice, 2011 · doi:10.1177/1362361310391116