A Systematic Review and Meta-Analysis of Sex/Gender Differences in Social Interaction and Communication in Autistic and Non-Autistic Children and Adolescents

Wood-Downie, Henry and Wong, Bonnie and Kovshoff, Hanna and Cortese, Samuele and Hadwin, Julie A. (2020) A Systematic Review and Meta-Analysis of Sex/Gender Differences in Social Interaction and Communication in Autistic and Non-Autistic Children and Adolescents. Journal of Child Psychology and Psychiatry. ISSN 1469-7610 (Accepted for Publication)

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Abstract

Background: Evidence increasingly suggests that ASD manifests differently in females than males. Previous reviews investigating sex/gender differences in social interaction and social communication have focused at the level of broad constructs (e.g., comparing algorithm scores from pre-existing diagnostic instruments) and have typically reported no significant differences between males and females. However, a number of individual studies have found sex/gender differences in narrow construct domains.
Methods: We conducted a systematic review and random effects model meta-analyses (in January 2019 and updated January 2020) that investigated sex/gender differences in narrow construct measures of social communication and interaction in autistic and non-autistic children and adolescents, and adults. Study quality was appraised using the Appraisal Tool for Cross-Sectional Studies (AXIS, Downes et al., 2016).
Results: Across 16 studies (including 2730 participants), the analysis found that female (versus male) individuals with ASD had significantly better social interaction and social communication skills (SMD = 0.39, p < .001), which was reflective of a similar sex/gender profile in non-autistic individuals (SMD = 0.35, p < .001). Non-autistic males had significantly better social interaction and communication than males with ASD (SMD = 0.77, p < .001). Non-autistic females also had significantly better social interaction and communication than females with ASD (SMD = 0.72, p = <. 001). Non-autistic males had better social interaction and communication than females with ASD, though this difference was not significant (SMD = 0.30, p = .07).
Conclusions: This systematic review and meta-analysis highlighted important sex/gender differences in social interaction and communication for individuals with ASD, likely not captured by pre-existing diagnostic instruments, which potentially contribute to the under recognition of autism in females, and may need to be reflected in the diagnostic process.

Item Type: Article
Additional Information and Comments: This article when published will be available at: https://acamh.onlinelibrary.wiley.com/loi/14697610
Keywords: Autism spectrum disorders; Sex differences; Gender difference; DSM; Meta-analysis
Faculty / Department: Faculty of Education > Early Childhood
Depositing User: Julie Hadwin
Date Deposited: 21 Sep 2020 13:36
Last Modified: 21 Sep 2020 13:36
URI: https://hira.hope.ac.uk/id/eprint/3147

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