High functioning autism in child and adolescent females

Passing from a prevalence of 1:1000 (DSM-IV-TR) to 1:100 (DSM-5) in the last 13 years, Autism Spectrum Disorder (ASD) has earned a central role in scientific research and clinical practice. Even if we assume that Male:Female... [ view full abstract ]

Passing from a prevalence of 1:1000 (DSM-IV-TR) to 1:100 (DSM-5) in the last 13 years, Autism Spectrum Disorder (ASD) has earned a central role in scientific research and clinical practice. Even if we assume that Male:Female ratio remains 4:1 (neglecting the most recent large-scale population-based epidemiological studies that report an increasing trend toward 2-3:1), females would become 10 times more prevalent. Why does scientific literature about females continue to be so poor? It seems that scientific community is less able to recognize and describe females, especially in subjects without intellectual disability.
25 females (4-17 years) with high functioning autism (HFA) are reported and compared to 25 males (4-17 years) with HFA. All the cases, in both groups, have a diagnosis of ASD, according to DSM-5. Exclusionary criteria is IQ<70. Description and analysis of clinical profile, cognitive function and comorbidities are provided.
The study reveals qualitative differences in female clinical profile compared to males in terms of “more hidden” social impairment, higher emotional dysregulation, different typologies of restricted interests, more internalized comorbidities.
It seems that the peculiarity of female phenotype, the use of diagnostic criteria developed on “male model” and instruments standardized on male cohorts justify the under-diagnosis of female. Further research are required, possibly leading to the development of more sex/gender-specific diagnostic instruments.

I have no conflict of interest to declare [ view full abstract ]

I have no conflict of interest to declare