Gender differences in the timing of identification among children with autism

Background and Objectives: There is a paucity of research studies, especially from the low- and middle-income countries, on gender-specific clinical profiles of autism and whether this lack of information is a barrier for early diagnosis among females. The present paper examined the gender differences in the timing of identification of autism among children. Methods: The case records diagnosed children with autism spectrum disorder with no documented intellectual disability (IQ <70) were retrospectively analyzed. The demographic and clinical characteristics such as the presence of repetitive behaviors, deficits/delays in language, social-emotional reciprocity impairments, history of developmental regression, presence of hyperactivity, and self-injurious behaviors were extracted from the case files. Gender differences in the timing of identification, clinical characteristics, and sociodemographic variables were examined by utilizing the t-test. Results: A total of 309 case records (Mean = 5.04 years, standard deviation = 2.50) were retrieved. Girls, as compared to boys, were significantly less likely to show restricted and repetitive behaviors (χ2 = 3.92, P = 0.048) and showed greater socio-emotional reciprocity despite a similar level of autism severity (χ2 = 4.48, P = 0.034). No sex differences were found in hyperactivity, self-injurious behavior, history of developmental regression, and severity of autism (all P > 0.05). There was a significant difference in the timing of the identification of autism by gender and females were found to be identified at significantly older ages relative to males (t = 2.13, P = 0.034). Conclusions: There is an imperative need to develop more gender-sensitive diagnostic tools incorporating the sex-specific differences in clinical presentation to improve the assessment of autism in girls.