Sex differences in social attention in autism spectrum disorder.
Autistic girls maintain typical face-looking habits, so boy-based gaze norms will miss them.
01Research in Context
What this study did
Harrop et al. (2018) watched where kids looked while they viewed pictures of faces. They compared 38 autistic girls, 38 autistic boys, and 76 typical kids of the same ages.
An eye-tracking camera recorded every glance. The team asked: Do autistic girls look at faces the same way autistic boys do?
What they found
Autistic girls kept the same face-looking pattern as typical girls. Autistic boys looked at faces far less than typical boys.
In short: girls with autism looked like girls, not like autistic boys.
How this fits with other research
Pielech et al. (2016) saw the same split in brain scans. Autistic boys had weaker STS activity during social tasks; autistic girls matched typical girls.
Spanoudis et al. (2011) reported less face looking in autistic adults, but they lumped men and women together. Clare’s sex-split data now shows why that average hid the girl subgroup.
KAgiovlasitis et al. (2025) repeated the eye-tracking in Indian adults and again found less social gaze with higher autism traits. The sex effect seen in kids has not yet been tested there.
Why it matters
If you screen for autism using eye gaze, know that typical girl gaze norms apply to autistic girls. Using boy norms could miss girls who still look at faces. Add sex-specific cut-offs to your eye-tracking or observation tools and watch for girls who show social anxiety or depression, not just reduced face looking.
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02At a glance
03Original abstract
Although reduced social attention and increased nonsocial attention have been reported in individuals with autism spectrum disorder (ASD), the studies have relied on predominantly male samples and have been underpowered to examine sex differences. These processes may differ for females with ASD, who have been shown to be dissimilar to males in social motivation and nonsocial features, including circumscribed interests (CI). The goal of this study was to compare social and nonsocial visual attention between males and females with ASD on a validated eye-tracking paradigm. Eighty-five school-aged (6-10 years) males and females with and without ASD completed a paired preference task of face and object stimuli (half of which related to common CI). After covarying for chronological and mental age, the presence of concurrently presented CI images reduced prioritization and attention to faces for males more than females, replicating previous findings. ASD females maintained comparable attention patterns to typically developing females, suggesting that previous findings of reduced social attention and increased attention to CI-related objects in autism may be specific to males. These findings are also inconsistent with the "extreme male brain" theory of autism. The more normative orienting and attention to social stimuli for females with ASD may indicate distinct phenotypic characteristics relative to males and possibly serve as a protective effect. Autism Res 2018, 11: 1264-1275. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: As autism is more commonly diagnosed in males, less is known about females with autism. Two areas of interest include the interests held by individuals with autism and how socially motivated they are. We used eye tracking as a way to understand these two areas. Our data reveal that elementary school-aged females (6-10 years) with autism attended to faces comparatively to females without autism, suggesting that (1) they were more socially motivated than males with autism and (2) the images of common interests were less motivating to them.
Autism research : official journal of the International Society for Autism Research, 2018 · doi:10.1016/j.rasd.2016.11.006