A Pilot Study – Better Performance of Autism Spectrum Disorder Girls Compared to Boys in a Theory of Mind Test

Background:

Autism spectrum disorders (ASD) occur in more males than females, with a ratio of 4to 1.

Recent literature    raised the possibility that the female presentation of ASD differs  from the male  presentation.                                                                                                                       ,

More specifically  ,clinical observations suggest that females with ASD superficially demonstrate better social and emotional skills than males with ASD, which may camouflage other diagnostic features. This may explain the under-diagnosis of females with ASD.                                                             

Objectives:

The aim of the  present  study was to examine  the female presentation of ASD by examining the Theory Of Mind Skills of children with ASD.

Methods:

We hypothesized that girls  with ASD would display better theory of mind  skills than boys  with ASD on a theory of mind  test . 48  6- to 18-year-olds (ASD girls , n = 12; typically developing (TD) girls, n = 12; ASD boys, n = 12; TD boys, n = 12) were administered  the social attribution task ( SAT).

Results:  

The current study tested six measures of ToM (Theory of Mind) using the SAT. A one-way ANOVA was conducted to determine the differences between the two groups. This test revealed a significant main effect of sex (=3.24, p<.05, =.53).

Variance analysis of each index of ToM revealed a significant effect of sex for the Person Index variance (=12.19, p<.001). Comparison of the mean scores on the Person Index showed that girls scored significantly higher than boys (Table 1).

Since the standard deviations were larger than the mean scores, a Mann-Whitney test was conducted. This analysis also revealed a significant difference between girls and boys for the Person Index measure (p< 0.001; Table 1). The difference in Person Index measure remained significant following Bonferroni correction for multiple comparisons.

 

 

Table 1

Measures	Girls with ASD		Boys with ASD			Mann Whitney
	SD	Mean	SD	Mean
Salience	0.23	0.44	0.16	0.43	0.01	65.00
Pertinence	0.12	0.18	0.15	0.14	0.39	54.00
ToM Cognitive	0.12	0.17	0.10	0.09	3.51	46.00
ToM Affective	0.06	0.07	0.07	0.07	0.03	67.50
Animation	1.44	3.08	1.56	2.92	0.07	67.00
Person	1.77	3.67	0.89	1.67	12.19**	24.50**
**p<.001, remains significant following Bonferroni correction for multiple comparisons

 These findings are preliminary; further  results of the typically developing groups   will be presented in the conference.

 

 

 

Conclusions:  

This study investigated the female phenotype of ASD by assessing gender differences in a  Theory of Mind task.

It was predicted that girls  with ASD would score higher than boys with ASD on the SAT task.

This study found that ASD girls perform better on the Person index of the SAT task, a test measuring ToM. The Person index specifically captures the child's capability to confer personal traits to the geometric shapes presented in the task.

The findings support the observations that differences exist  between ASD boys and girls .

Further research is needed   to examine the causes for this phenomenon in order to develop gender-appropriate diagnostic tools  and interventions for ASD girls.