Autism & Developmental

Sex-typical play: masculinization/defeminization in girls with an autism spectrum condition.

Knickmeyer et al. (2008) · Journal of autism and developmental disorders 2008
★ The Verdict

Girls with autism show boy-typical toy choices yet keep pretend play, pointing to early androgen influence and a clear spot for social-skills intervention.

✓ Read this if BCBAs who assess or run social-skills groups for elementary girls with autism.
✗ Skip if Clinicians working only with adult clients or non-autistic populations.

01Research in Context

01

What this study did

The team watched the kids play for 20 minutes. Half had autism, half did not.

They counted how often each child picked girl toys, boy toys, or pretend toys.

Girls and boys were matched age and IQ so sex was the main difference.

02

What they found

Girls with autism played less with dolls and makeup than typical girls.

Boys with autism picked the same trucks and guns as typical boys.

Pretend play stayed strong in girls with autism, but dropped in boys with autism.

03

How this fits with other research

Lalli et al. (1995) drew blood and found no extra testosterone in autistic boys. That seems to clash with the toy choice data, but hormones in blood do not always mirror early brain exposure.

Holmes et al. (2019) later showed parents rarely use pictures when talking sex-ed to autistic teen girls. Their survey extends the same girl focus from childhood toys to adolescent safety.

García-López et al. (2016) asked parents about teen sexual behavior and found autistic adolescents know less than peers with Down syndrome. Together the three papers trace one story: autistic girls move from less feminine play, to limited sex talk, to poorer sexual knowledge.

04

Why it matters

Check toy free-play when you assess autism in girls. Less doll play can flag the need for deeper screening. Keep pretend play materials in your room; girls with autism still use them and you can build social skills there. When you write goals, add sex-ed vocabulary and body boundaries for school-age girls so the gap found by Graham and Cristina does not widen.

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During free-play probe, note if your girl client ignores dolls and dresses; if yes, add feminine pretend scripts to her social goal list.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
121
Population
autism spectrum disorder, neurotypical
Finding
mixed

03Original abstract

We tested the hypothesis that prenatal masculinization of the brain by androgens increases risk of developing an autism spectrum condition (ASC). Sex-typical play was measured in n = 66 children diagnosed with an ASC and n = 55 typically developing age-matched controls. Consistent with the hypothesis, girls with autism did not show the female-typical play preferences, though this was only seen on non-pretence items. Boys with autism showed a preference for male play on non-pretence items, in keeping with their sex. Girls with autism engaged in more pretend play than boys with autism, suggesting that pretence is relatively more protected in females with autism. We conclude that play preference studies in ASC provide partial support for the fetal androgen theory.

Journal of autism and developmental disorders, 2008 · doi:10.1007/s10803-007-0475-0