Skip to main content
Log in

Does Gender Influence Core Deficits in ASD? An Investigation into Social-Communication and Play of Girls and Boys with ASD

  • Original Paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

Due to the predominance of boys diagnosed with autism spectrum disorders (ASD), girls are rarely studied independently. Research specifically focusing on play and social-communication in girls with ASD is extremely varied. We were interested in whether girls with ASD demonstrated equivalent social-communication and play skills in early childhood relative to boys, using two measures focused on the specific quantification of these variables. We also examined whether the associations between developmental variables and social-communication and play differed by gender. Forty girls with ASD were individually matched to 40 boys based on ASD severity. Our results suggest that girls and boys were more similar than different, however they also raise questions about the potential differential associations between development and requesting ability in girls and boys with ASD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

Abbreviations

ASD:

Autism spectrum disorder

ESCS:

Early Social Communication Scales

SPA:

Structured Play Assessment

JA:

Joint attention

BR:

Behavioral requesting

References

  • Andersson, G. W., Gillberg, C., & Miniscalco, C. (2013). Pre-school children with suspected autism spectrum disorders: Do girls and boys have the same profiles? Research in Developmental Disabilities, 34(1), 413–422. doi:10.1016/j.ridd.2012.08.025.

    Article  PubMed  Google Scholar 

  • Auyeung, B., Lombardo, M. V., & Baron-Cohen, S. (2013). Prenatal and postnatal hormone effects on the human brain and cognition. Pflügers Archiv-European Journal of Physiology, 465, 1–15.

    Article  Google Scholar 

  • Baron-Cohen, S. (1987). Autism and symbolic play. British Journal of Developmental Psychology, 5(2), 139–148.

    Article  Google Scholar 

  • Baron-Cohen, S. (2002). The extreme male brain theory of autism. Trends in Cognitive Sciences, 6(6), 248–254.

    Article  PubMed  Google Scholar 

  • Brugha, T. S., McManus, S., Bankart, J., Scott, F., Purdon, S., Smith, J., et al. (2011). Epidemiology of autism spectrum disorders in adults in the community in England. Archives of General Psychiatry, 68(5), 459–465. doi:10.1001/archgenpsychiatry.2011.38.

    Article  PubMed  Google Scholar 

  • Caldera, Y. M., Huston, A. C., & O’Brien, M. (1989). Social interactions and play patterns of parents and toddlers with feminine, masculine, and neutral toys. Child Development, 60, 70–76.

  • Carter, A. S., Black, D. O., Tewani, S., Connolly, C. E., Kadlec, M. B., & Tager-Flusberg, H. (2007). Sex differences in toddlers with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37(1), 86–97. doi:10.1007/s10803-006-0331-7.

    Article  PubMed  Google Scholar 

  • Chakrabarti, S., & Fombonne, E. (2005). Pervasive developmental disorders in preschool children. Annual Progress in Child Psychiatry and Child development, 2002, 273.

    Google Scholar 

  • Charman, T. (2003). Why is joint attention a pivotal skill in autism? Philosophical Transactions of the Royal Society of London. Series B, Biological sciences, 358(1430), 315–324. doi:10.1098/rstb.2002.1199.

    Article  PubMed Central  PubMed  Google Scholar 

  • Charman, T., Baron-Cohen, S., Swettenham, J., Baird, G., Cox, A., & Drew, A. (2000). Testing joint attention, imitation, and play as infancy precursors to language and theory of mind. Cognitive Development, 15(4), 481–498. doi:10.1016/S0885-2014(01)00037-5.

    Article  Google Scholar 

  • Cherney, I. D., Vance, K. L., Golver, G. K., Ruane, A., & Ryalls, O. B. (2003). The effects of stereotyped toys and gender on play assessment in children aged 18–47 months. Educational Psychology, 23(1), 95–106.

    Article  Google Scholar 

  • Clifford, S. M., & Dissanayake, C. (2008). The early development of joint attention in infants with autistic disorder using home video observations and parental interview. Journal of Autism and Developmental Disorders, 38(5), 791–805.

    Article  PubMed  Google Scholar 

  • Constantino, J. N., Davis, S. A., Todd, R. D., Schindler, M. K., Gross, M. M., Brophy, S. L., et al. (2003). Validation of a brief quantitative measure of autistic traits: comparison of the social responsiveness scale with the autism diagnostic interview-revised. Journal of Autism and Developmental Disorders, 33(4), 427–433.

    Article  PubMed  Google Scholar 

  • DiPietro, J. A. (1981). Rough and tumble play: A function of gender. Developmental Psychology, 17(1), 50.

    Article  Google Scholar 

  • Drew, A., Baird, G., Baron-Cohen, S., Cox, A., Slonims, V., Wheelwright, S., et al. (2002). A pilot randomised control trial of a parent training intervention for pre-school children with autism. Preliminary findings and methodological challenges. European Child and Adolescent Psychiatry, 11(6), 266–272. doi:10.1007/s00787-002-0299-6.

    Article  PubMed  Google Scholar 

  • Dworzynski, K., Ronald, A., Bolton, P., & Happe, F. (2012). How different are girls and boys above and below the diagnostic threshold for autism spectrum disorders? Journal of the American Academy of Child and Adolescent Psychiatry, 51(8), 788–797. doi:10.1016/j.jaac.2012.05.018.

    Article  PubMed  Google Scholar 

  • Eisenberg, N., Wolchik, S. A., Hernandez, R., & Pasternack, J. F. (1985). Parental socialization of young children’s play: A short-term longitudinal study. Child Development, 56, 1506–1513.

  • Fombonne, E. (1999). The epidemiology of autism: A review. Psychological Medicine, 29(4), 769–786.

    Article  PubMed  Google Scholar 

  • Fombonne, E. (2003a). Epidemiological surveys of autism and other pervasive developmental disorders: An update. Journal of Autism and Developmental Disorders, 33(4), 365–382.

    Article  PubMed  Google Scholar 

  • Fombonne, E. (2003b). The prevalence of autism. JAMA, 289(1), 87–89.

    Article  PubMed  Google Scholar 

  • Fombonne, E. (2009). Epidemiology of pervasive developmental disorders. Pediatric Research, 65(6), 591–598.

    Article  PubMed  Google Scholar 

  • Freeman, S., & Kasari, C. (2013). Parent-child interactions in autism: Characteristics of play. Autism, 17(2), 147–161. doi:10.1177/1362361312469269.

    Article  PubMed  Google Scholar 

  • Gillberg, C., Cederlund, M., Lamberg, K., & Zeijlon, L. (2006). Brief report: “the autism epidemic”. The registered prevalence of autism in a Swedish urban area. Journal of Autism and Developmental Disorders, 36(3), 429–435. doi:10.1007/s10803-006-0081-6.

    Article  PubMed  Google Scholar 

  • Hartley, S. L., & Sikora, D. M. (2009). Sex differences in autism spectrum disorder: An examination of developmental functioning, autistic symptoms, and coexisting behavior problems in toddlers. Journal of Autism and Developmental Disorders, 39(12), 1715–1722. doi:10.1007/s10803-009-0810-8.

    Article  PubMed Central  PubMed  Google Scholar 

  • Holtmann, M., Bolte, S., & Poustka, F. (2007). Autism spectrum disorders: Sex differences in autistic behaviour domains and coexisting psychopathology. Developmental Medicine and Child Neurology, 49(5), 361–366. doi:10.1111/j.1469-8749.2007.00361.x.

    Article  PubMed  Google Scholar 

  • Jarrold, C., Boucher, J., & Smith, P. K. (1996). Generativity deficits in pretend play in autism. British journal of developmental psychology, 14(3), 275–300.

    Article  Google Scholar 

  • Jones, Amanda, & Glenn, Sheila M. (1991). Gender differences in pretend play in a primary school group. Early Child Development and Care, 77(1), 127–135.

    Article  Google Scholar 

  • Kaale, A., Smith, L., & Sponheim, E. (2012). A randomized controlled trial of preschool-based joint attention intervention for children with autism. Journal of Child Psychology and Psychiatry, 53(1), 97–105. doi:10.1111/j.1469-7610.2011.02450.x.

    Article  PubMed  Google Scholar 

  • Kasari, C., Freeman, S., & Paparella, T. (2006). Joint attention and symbolic play in young children with autism: A randomized controlled intervention study. Journal of Child Psychology and Psychiatry, 47(6), 611–620. doi:10.1111/j.1469-7610.2005.01567.x.

    Article  PubMed  Google Scholar 

  • Kasari, C., Gulsrud, A., Freeman, S., Paparella, T., & Hellemann, G. (2012). Longitudinal follow-up of children with autism receiving targeted interventions on joint attention and play. Journal of the American Academy of Child and Adolescent Psychiatry, 51(5), 487–495. doi:10.1016/j.jaac.2012.02.019.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kasari, C., Gulsrud, A. C., Wong, C., Kwon, S., & Locke, J. (2010). Randomized controlled caregiver mediated joint engagement intervention for toddlers with autism. Journal of Autism and Developmental Disorders, 40(9), 1045–1056. doi:10.1007/s10803-010-0955-5.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kasari, C., Paparella, T., Freeman, S., & Jahromi, L. B. (2008). Language outcome in autism: Randomized comparison of joint attention and play interventions. Journal of Consulting and Clinical Psychology, 76(1), 125–137. doi:10.1037/0022-006X.76.1.125.

    Article  PubMed  Google Scholar 

  • Kim, Y. S., Leventhal, B. L., Koh, Y. J., Fombonne, E., Laska, E., Lim, E. C., et al. (2011). Prevalence of autism spectrum disorders in a total population sample. American Journal of Psychiatry, 168(9), 904–912. doi:10.1176/appi.ajp.2011.10101532.

    Article  PubMed  Google Scholar 

  • Kirkovski, M., Enticott, P. G., & Fitzgerald, P. B. (2013). A review of the role of female gender in autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(11), 2584–2603. doi:10.1007/s10803-013-1811-1.

    Article  PubMed  Google Scholar 

  • Knickmeyer, R. C., Wheelwright, S., & Baron-Cohen, S. B. (2008). Sex-typical play: Masculinization/defeminization in girls with an autism spectrum condition. Journal of Autism and Developmental Disorders, 38(6), 1028–1035. doi:10.1007/s10803-007-0475-0.

    Article  PubMed  Google Scholar 

  • Kopp, Svenny, & Gillberg, Christopher. (1992). Girls with social deficits and learning problems: Autism, atypical Asperger syndrome or a variant of these conditions. European Child and Adolescent Psychiatry, 1(2), 89–99.

    Article  Google Scholar 

  • Landa, R. J., Holman, K. C., O’Neill, A. H., & Stuart, E. A. (2011). Intervention targeting development of socially synchronous engagement in toddlers with autism spectrum disorder: A randomized controlled trial. Journal of Child Psychology and Psychiatry, 52(1), 13–21. doi:10.1111/j.1469-7610.2010.02288.x.

    Article  PubMed Central  PubMed  Google Scholar 

  • Langlois, J. H., & Downs, A. C. (1980). Mothers, fathers, and peers as socialization agents of sex-typed play behaviors in young children. Child Development, 1237–1247.

  • Lawton, K., & Kasari, C. (2012). Teacher-implemented joint attention intervention: Pilot randomized controlled study for preschoolers with autism. Journal of Consulting and Clinical Psychology, 80(4), 687–693. doi:10.1037/a0028506.

    Article  PubMed  Google Scholar 

  • Lifter, K. (2000). Linking assessment to intervention for children with developmental disabilities or at-risk for developmental delay: The developmental play assessment (DPA) instrument. In K. Gitlin-Weiner, A. Sandgrund, & C. E. Schaefer (Eds.), Play diagnosis and assessment (2nd ed., pp. 228–261). New York: Wiley.

    Google Scholar 

  • Liss, M. B. (1981). Patterns of toy play: An analysis of sex differences. Sex Roles, 7(11), 1143–1150.

    Article  Google Scholar 

  • Lord, C., Rutter, M. L., DiLavore, P. S., Risi, S., Gotham, K., & Bishop, S. L. (2012). Autism diagnostic observation schedule–second edition (ADOS-2): WPS.

  • Lord, C., Schopler, E., & Revicki, D. (1982). Sex differences in autism. Journal of Autism and Developmental Disorders, 12(4), 317–330.

    Article  PubMed  Google Scholar 

  • Mandy, W., Chilvers, R., Chowdhury, U., Salter, G., Seigal, A., & Skuse, D. (2012). Sex differences in autism spectrum disorder: Evidence from a large sample of children and adolescents. Journal of Autism and Developmental Disorders, 42(7), 1304–1313. doi:10.1007/s10803-011-1356-0.

    Article  PubMed  Google Scholar 

  • Markus, J., Mundy, P., Morales, M., Delgado, C. E. F., & Yale, M. (2000). Individual differences in infant skills as predictors of child-caregiver joint attention and language. Social Development, 9(3), 302–315. doi:10.1111/1467-9507.00127.

    Article  Google Scholar 

  • McLennan, J. D., Lord, C., & Schopler, E. (1993). Sex differences in higher functioning people with autism. Journal of Autism and Developmental Disorders, 23(2), 217–227.

    Article  PubMed  Google Scholar 

  • Mullen, E. M. (1995). Mullen scales of early learning. Circle Pines, MN: American Guidance Service Inc.

    Google Scholar 

  • Mundy, P., Block, J., Delgado, C., Pomares, Y., Van Hecke, A. V., & Parlade, M. V. (2007). Individual differences and the development of joint attention in infancy. Child Development, 78(3), 938–954. doi:10.1111/j.1467-8624.2007.01042.x.

    Article  PubMed Central  PubMed  Google Scholar 

  • Mundy, P., Delgado, C., Block, J., Venezia, M., Hogan, A., & Seibert, J. (2003). A manual for the Abridged Early Social Communication Scales (ESCS). Coral Cables: University of Miami.

    Google Scholar 

  • Mundy, P., Sigman, M., & Kasari, C. (1990). A longitudinal study of joint attention and language development in autistic children. Journal of Autism and Developmental Disorders, 20(1), 115–128.

    Article  PubMed  Google Scholar 

  • Mundy, P., Sigman, M., & Kasari, C. (1994). Joint attention, developmental level, and symptom presentation in autism. Development and Psychopathology, 6(03), 389–401. doi:10.1017/S0954579400006003.

    Article  Google Scholar 

  • Mundy, P., Sigman, M., Ungerer, J., & Sherman, T. (1986). Defining the social deficits of autism: the contribution of non-verbal communication measures. Journal of Child Psychology and Psychiatry, 27(5), 657–669.

    Article  PubMed  Google Scholar 

  • Naber, F., Bakermans-Kranenburg, M. J., van Ijzendoorn, M. H., Dietz, C., van Daalen, E., Swinkels, S. H., et al. (2008). Joint attention development in toddlers with autism. European Child and Adolescent Psychiatry, 17(3), 143–152. doi:10.1007/s00787-007-0648-6.

    Article  PubMed  Google Scholar 

  • Olafsen, K. S., Ronning, J. A., Kaaresen, P. I., Ulvund, S. E., Handegard, B. H., & Dahl, L. B. (2006). Joint attention in term and preterm infants at 12 months corrected age: The significance of gender and intervention based on a randomized controlled trial. Infant Behavior and Development, 29(4), 554–563. doi:10.1016/j.infbeh.2006.07.004.

    Article  PubMed  Google Scholar 

  • Oosterling, I., Visser, J., Swinkels, S., Rommelse, N., Donders, R., Woudenberg, T., et al. (2010). Randomized controlled trial of the focus parent training for toddlers with autism: 1-year outcome. Journal of Autism and Developmental Disorders, 40(12), 1447–1458. doi:10.1007/s10803-010-1004-0.

    Article  PubMed Central  PubMed  Google Scholar 

  • Pilowsky, T., Yirmiya, N., Shulman, C., & Dover, R. (1998). The Autism Diagnostic Interview-Revised and the Childhood Autism Rating Scale: differences between diagnostic systems and comparison between genders. Journal of Autism and Developmental Disorders, 28(2), 143–151.

    Article  PubMed  Google Scholar 

  • Posserud, M. B., Lundervold, A. J., & Gillberg, C. (2009). Validation of the autism spectrum screening questionnaire in a total population sample. Journal of Autism and Developmental Disorders, 39(1), 126–134. doi:10.1007/s10803-008-0609-z.

    Article  PubMed  Google Scholar 

  • Reavis, S. B. (2003). Social orienting as a construct underlying joint attention and imitation skills deficits in preschool children with autism (Master of Arts). Chapel Hill: University of North Carolina at Chapel Hill.

    Google Scholar 

  • Rivet, T. T., & Matson, J. L. (2011). Review of gender differences in core symptomatology in autism spectrum disorders. Research in Autism Spectrum Disorders, 5(3), 957–976.

    Article  Google Scholar 

  • Ronald, A., Happe, F., Bolton, P., Butcher, L. M., Price, T. S., Wheelwright, S., et al. (2006). Genetic heterogeneity between the three components of the autism spectrum: A twin study. Journal of the American Academy of Child and Adolescent Psychiatry, 45(6), 691–699. doi:10.1097/01.chi.0000215325.13058.9d.

    Article  PubMed  Google Scholar 

  • Ronald, A., Happe, F., & Plomin, R. (2005). The genetic relationship between individual differences in social and nonsocial behaviours characteristic of autism. Developmental Science, 8(5), 444–458. doi:10.1111/j.1467-7687.2005.00433.x.

    Article  PubMed  Google Scholar 

  • Toth, K., Munson, J., Meltzoff, A. N., & Dawson, G. (2006). Early predictors of communication development in young children with autism spectrum disorder: Joint attention, imitation, and toy play. Journal of Autism and Developmental Disorders, 36(8), 993–1005. doi:10.1007/s10803-006-0137-7.

    Article  PubMed Central  PubMed  Google Scholar 

  • Tsai, L. Y., & Beisler, J. M. (1983). The development of sex differences in infantile autism. British Journal of Psychiatry, 142, 373–378.

    Article  PubMed  Google Scholar 

  • Ungerer, J. A., & Sigman, M. (1984). The relation of play and sensorimotor behavior to language in the second year. Child Development, 55, 1448–1455.

  • Van Wijngaarden-Cremers, P. J., van Eeten, E., Groen, W. B., Van Deurzen, P. A., Oosterling, I. J., & Van der Gaag, R. J. (2013). Gender and age differences in the core triad of impairments in autism spectrum disorders: A systematic review and meta-analysis. Journal of Autism and Developmental Disorders,. doi:10.1007/s10803-013-1913-9.

    Google Scholar 

  • Volkmar, F. R., Carter, A., Sparrow, S. S., & Cicchetti, D. V. (1993). Quantifying social development in autism. Journal of the American Academy of Child and Adolescent Psychiatry, 32(3), 627–632. doi:10.1097/00004583-199305000-00020.

    Article  PubMed  Google Scholar 

  • Werling, D. M., & Geschwind, D. H. (2013a). Sex differences in autism spectrum disorders. Current Opinion in Neurology, 26(2), 146–153. doi:10.1097/WCO.0b013e32835ee548.

    Article  PubMed Central  PubMed  Google Scholar 

  • Werling, D. M., & Geschwind, D. H. (2013b). Understanding sex bias in autism spectrum disorder. Proc Natl Acad Sci U S A, 110(13), 4868–4869. doi:10.1073/pnas.1301602110.

    Article  PubMed Central  PubMed  Google Scholar 

  • Wong, C., & Kasari, C. (2012). Play and joint attention of children with autism in the preschool special education classroom. Journal of Autism and Developmental Disorders, 42(10), 2152–2161. doi:10.1007/s10803-012-1467-2.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

This research was funded by Autism Speaks, Health Resources and Services Administration (Maternal and Child Health Bureau) and National Institute of Health (National Institute of Child Health and Human Development). We thank the families who kindly participated in this research. Thank you to Ted Hutman and Themba Carr for their discussion of the findings and Wendy Shih for her assistance with data analysis. We also thank the graduate students and research assistants who coded these data, in particular K.C. Berry and Jonathan Panganiban for their additional coding.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Clare Harrop.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Harrop, C., Shire, S., Gulsrud, A. et al. Does Gender Influence Core Deficits in ASD? An Investigation into Social-Communication and Play of Girls and Boys with ASD. J Autism Dev Disord 45, 766–777 (2015). https://doi.org/10.1007/s10803-014-2234-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-014-2234-3

Keywords

Navigation