Objective: The literature on sex related-clinical differences for children with autism spectrum disorder ASD is highly contradictory, whereas this topic has major clinical implications. We aimed to investigate sex-related clinical differences in children with ASD without intellectual disability ID.
Materials and methods: We compared boys and 65 girls with ASD without ID, aged from 2 to 12 years, recruited from a multiregional cohort on their clinical profiles based on the scores for the Vineland-II, the SRS-2, the ADOS calibrated severity score, sensory processing, aberrant behaviors, and comorbidity rates.
Results: Our results confirm a high sex ratio of 4. Many similarities were found in the clinical profiles. However, we found that girls had higher SRS-2 total scores. In addition, there was a negative correlation between the SRS-2 total score and the intellectual quotient level IQ for girls only. A comparison between the girls and boys showed them to have similar clinical profiles, except for the SRS- 2 total scores, which were higher among girls, suggesting more severe social impairment perceived by parents.
Our findings that the cognitive level is related to ASD severity in girls should be taken into account during the diagnostic procedure in the clinical interpretation of gold-standard measures of ASD, and additional clinical observations are necessary.
Clinical trial registration: [ ClinicalTrials. Autism spectrum disorder ASD is an early and chronic neurodevelopmental disorder for which the estimated prevalence has dramatically increased over the last five decades, with rates that remain higher among males 1. In the past ASD was thought to be a rare condition, affecting about one in 2, individuals while the Centers for Disease Control and Prevention CDC in United States estimated in the prevalence at 1 in 44 children 2 , 3. Indeed, although the overall sex ratio in ASD is estimated to be approximately , it is in cases of associated intellectual disability ID and in the absence of ID 3 , 5 β 7.
