Is There a Bias Towards Males in the Diagnosis of Autism? A Systematic Review and Meta-Analysis

AbstractAutism is more frequently diagnosed in males, with evidence suggesting that females are more likely to be misdiagnosed or underdiagnosed. Possibly, the male/female ratio imbalance relates to phenotypic andcamouflaging differences between genders. Here, we performed a comprehensive approach to phenotypic andcamouflaging research in autism addressed in two studies. First (Study 1 – Phenotypic Differences in Autism), we conducted a systematic review and meta-analysis of gender differences in autism phenotype. The electronic datasets Pubmed, Scopus, Web of Science, and PsychInfo were searched. We included 67 articles that compared females and males in autism core symptoms, a nd in cognitive, socioemotional, and behavioural phenotypes. Autistic males exhibited more severe symptoms and social interaction difficulties on standard clinical measures than females, who, in turn, exhibited more cognitive and behavioural difficulties. Considering the hypothesis ofcamouflaging possibly underlying these differences, we then conducted a meta-analysis of gender differences in camouflaging (Study 2 –Camouflaging Differences in Autism). The same datasets as the first study were searched. Ten studies were included. Females used more compensation and masking camouflage strategies than males. The results support the argument of a bias in clinical procedures towards males and the importance of considering a ‘female autism phenotype’—potentially involvingcamouflaging—in the diagn...
Source: Neuropsychology Review - Category: Neuroscience Source Type: research