Affiliation:
1. Doctorate in Educational Psychology University of Southampton Southampton UK
2. Hampshire and Isle of Wight Educational Psychology Service (HIEP) Havant UK
3. Centre for Innovation in Mental Health – Developmental Lab, School of Psychology University of Southampton Southampton UK
4. Solent NHS Trust Southampton UK
5. New York University Child Study Center New York NY USA
6. Division of Psychiatry and Applied Psychology, School of Medicine University of Nottingham Nottingham UK
Abstract
BackgroundEvidence that autism often manifests differently between males and females is growing, particularly in terms of social interaction and communication, but it is unclear if there are sex differences in restricted and repetitive behaviours and interests (RRBIs) when rigorously focusing on the narrow construct level (i.e., stereotyped behaviour, restricted interests, insistence on sameness, and/or sensory experiences).MethodsWe conducted a systematic review and four random effects meta‐analyses investigating sex differences in narrow construct measures of RRBIs in autistic children, adolescents, and adults (Prospero registration ID: CRD42021254221). Study quality was appraised using the Newcastle‐Ottawa Quality Assessment Scale.ResultsForty‐six studies were narratively synthesised and 25 of these were included in four random effects meta‐analyses. Results found that autistic males had significantly higher levels of stereotyped behaviours (SMD = 0.21, 95% confidence interval (CI) [0.09, 0.33], p < .001) and restricted interests (SMD = 0.18, 95% CI [0.07, 0.29], p < .001) compared to autistic females. In contrast, there were no significant sex differences for sensory experiences (SMD = −0.09, 95% CI [−0.27, 0.09], p = .32) and insistence on sameness (SMD = 0.01, 95% CI [−0.03, 0.05], p = .68). The findings from the narrative synthesis were generally consistent with those from the meta‐analyses and also found qualitative sex differences in the way RRBIs manifest.ConclusionsOur findings show significant differences in narrowly defined RRBIs in males and females. Practitioners need to be aware of such differences, which could be contributing to the under‐recognition of autism in females and may not be captured by current diagnostic instruments.
Subject
Psychiatry and Mental health,Developmental and Educational Psychology,Pediatrics, Perinatology and Child Health
Cited by
3 articles.
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