Intellectual disabilities moderate sex/gender differences in autism spectrum disorder: a systematic review and meta-analysis.
J Intellect Disabil Res
; 67(1): 1-34, 2023 01.
Article
in En
| MEDLINE
| ID: mdl-36444668
BACKGROUND: Girls/women with autism spectrum disorder (ASD) are suggested to exhibit different symptom profiles than boys/men with ASD. Accumulating evidence suggests that intellectual disability (ID) may affect sex/gender differences in ASD. However, a systematic review and meta-analysis on this topic is missing. METHODS: Two databases (MEDLINE and PsycINFO) were used to search for studies reporting sex/gender differences (girls/women versus boys/men) in social communication and interaction, restrictive and repetitive behaviour and interests (RRBIs), sensory processing, and linguistic and motor abilities in ASD. The final sample consisted of 79 studies. The meta-analysis was performed with Review Manager using a random-effects model. Participants with ASD without and with ID were analysed as separate subgroups, and the effects in these two subgroups were also compared with each other. RESULTS: Girls/women with ASD without ID displayed fewer RRBIs, more sensory symptoms and less problems in linguistic abilities than their boys/men counterparts. In contrast, girls/women with ASD with ID displayed more social difficulties and RRBIs, poorer linguistic abilities and more motor problems than boys/men with ASD with ID. Comparisons of groups of participants with ASD without ID versus participants with ASD with ID confirmed differences in sex/gender effects on social difficulties, sensory processing, linguistic abilities and motor abilities. CONCLUSIONS: Our results clearly suggest that the female phenotype of ASD is moderated by ID. Among individuals with ASD with ID, girls/women seem to be more severely affected than boys/men, whereas among individuals with ASD without ID, girls/women with ASD may have less symptoms than boys/men. Such phenotypic differences could be a potential cause of underrecognition of girls/women with ASD, and it is also possible that observed phenotypic differences may reflect underdiagnosing of girls/women with ASD.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Autism Spectrum Disorder
/
Intellectual Disability
Type of study:
Systematic_reviews
Aspects:
Determinantes_sociais_saude
Limits:
Female
/
Humans
Language:
En
Journal:
J Intellect Disabil Res
Journal subject:
TRANSTORNOS MENTAIS
Year:
2023
Document type:
Article
Affiliation country:
Finland
Country of publication:
United kingdom