Gender Similarities: Impact of Autism Symptoms on Everyday Functioning

Background: There continues to be a need for more research to clarify whether symptomatology presents differently in males and females with autism spectrum disorder (ASD). Prior research has yielded mixed results with regard to whether boys and girls score differently on diagnostic measures of ASD. A few studies have found that girls demonstrate relatively better social reciprocity than boys, whereas others have found no gender differences in this area. Furthermore, previous studies of gender differences have been conducted with diagnostic instruments that measure frequency of ASD symptomatology. It is also important to examine gender differences on instruments that measure the impact of ASD symptoms on everyday functioning, especially given that some prior work suggest girls may camouflage symptoms.

Objectives: The study’s purpose was to determine whether gender differences exist in social communication symptoms on the Autism Impact Measure (AIM), a parent-report scale that measures ASD symptom frequency and impact.

Methods: The sample of 470 children ages 2 to 12 consisted of 386 males and 84 females diagnosed with ASD. Mean age was 6.8 years and mean overall IQ score was 85. Female and male groups did not differ significantly on mean age or IQ. AIM measures of frequency and impact were considered as a combined score and as separate scores for the Social Reciprocity and Peer Interactions subscales. Measurement invariance (MI) tests were used to examine whether each AIM subscale functioned differently by gender. Once the measurement model was established, latent means of Social Reciprocity and Peer Interactions were compared across gender when controlling for age and overall intelligence.

Results: The MI tests revealed partial invariance for the Social Reciprocity subscale and full invariance for the Peer Interactions subscale. When controlling for age and IQ there were no significant differences between boys and girls on the AIM Social Reciprocity or Peer Interactions domains. This was true when frequency and impact were combined or considered separately for each domain. IQ was a significant predictor of parent report of social reciprocity and peer interactions, as parents of children with higher IQ reported them to have fewer ASD symptoms and less symptom impact.

Conclusions: Findings highlighted that IQ is more predictive than gender with regard to social reciprocity and peer interactions in ASD. This large sample of boys and girls with ASD did not differ significantly in social reciprocity or peer interactions. Parent-reported similarities in symptom frequency add to the small body of evidence that boys and girls with ASD are more similar than different in core social symptoms of ASD, at least in children who have received diagnoses. Furthermore, findings suggest that social reciprocity and peer interaction problems are just as impactful for girls as for boys, despite possible symptom camouflaging by girls. These results also demonstrate that the AIM, a relatively new measure, is sensitive to social communication symptoms in both boys and girls with ASD. Future research will include an analysis of age as a possible mediator for gender differences in ASD symptoms.