This result was also confirmed in a recent Italian study ( Siracusano et al., 2021). (2022), a similar clinical profile in adaptive functioning emerged between boys and girls with ASD in a population of 876 children (aged 2 to 16 years) by using Wechsler Scales to assess the IQ and the Vineland Adaptive Behavior Scales to evaluate the adaptive behavior. In contrast, in a recent study conducted by Dellapiazza et al. (2018), who had considered a population of 228 children, including 114 girls, assessed by using Wechsler Scales for the IQ and the Vineland Adaptive Behavior Scales to evaluate the adaptive behavior. A similar result was found in the study by Ratto et al. The authors found that reductions in intelligence quotient (IQ) mediated greater social impairment and reduced adaptive behavior in girls with ASD. (2014) found lower adaptive functioning in female participants with ASD than in male participants, including 304 female participants and 2,114 male participants with ASD from the Simons Simplex Collection, assessed by using multiple instruments for the IQ and the Vineland Adaptive Behavior Scales to evaluate the adaptive behavior. Similarly, regarding adaptive functioning, there is conflicting evidence. Other studies have also investigated sex differences in cognitive and adaptive functioning, but the results are mixed ( Carter et al., 2007 Lemon et al., 2011 Mandy et al., 2012 Frazier et al., 2014). Additionally, girls with higher cognitive functioning may exhibit milder symptoms of ASD compared to boys, leading to potential under-recognition and underdiagnosis ( Goldman, 2013 Lai et al., 2017a). Indeed, when examining sex differences in cognitive functioning, it has been observed that the percentage of girls with ASD without intellectual disability is lower compared to boys ( Fombonne, 1999, 2009 Nicholas et al., 2008 Frazier et al., 2014 Howe et al., 2015 Mussey et al., 2017) with a male-to-female ratio of 7:1 for high-functioning ASD and 2:1 for individuals with intellectual disability ( Fombonne, 2003 Napolitano et al., 2022). Previous research has shown a sex ratio of 4:1 across the spectrum, which increases to 8:1 when considering patients with average intelligence ( Fombonne, 2003 American Psychiatric Association, 2013 Blumberg et al., 2013 Christensen et al., 2016). These findings confirm the results of a systematic review and meta-analysis conducted in the United Kingdom ( Loomes et al., 2017), as well as recent American data, which estimated a 3.8-fold higher prevalence among boys than girls and a prevalence estimate of ASD per 1,000 children aged 8 years was 27.6 ( Maenner et al., 2023). An Italian study conducted on a large sample of children with ASD highlighted a prevalence of 1% with a male-to-female ratio close to 3:1 ( Narzisi et al., 2020). ASD is diagnosed more often in boys than in girls. Older girls showed fewer restricted and repetitive behaviors.ĭiscussion: Exploring phenotypic differences in children and adolescents with ASD fosters an understanding of subtle diagnostic facets that may go unrecognized, allowing for increasingly individualized and tailored interventions.Īutism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by core social impairment, communication difficulties, and the presence of restricted and repetitive interests ( American Psychiatric Association, 2013). With increasing age, boys with ASD showed greater impairment in social communication skills than girls and increased psychopathological comorbidities. The severity of symptoms of ASD was greater in boys than in girls, as were scores on psychopathological measures. Results: Present results showed that girls with ASD had lower IQs than boys but similar adaptive functioning. The study sought to include all children and adolescents diagnosed with Autism or ASD. The age of the participants ranged from 1.35 to 19.05 years (mean age 9.98 ± 3.64). Methods: The study included a total of 2,146 children and adolescents diagnosed with ASD, comprising 1785 boys (mean age 7.12 ± 3.69 years) and 361 girls (mean age 6.25 ± 3.30 years). The present study aims to assess possible sex differences in cognitive and adaptive functioning, symptomatology of ASD, and psychopathological comorbidities in a large sample of children and adolescents with ASD. Recent studies have hypothesized the presence of different phenotypes in male and female participants with ASD. Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by a higher prevalence in male than in female participants. 2Department of Life Sciences and Public Health, Catholic University, Rome, Italy.1Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy.
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