Rates of autism in girls and boys more equal than previously thought, research finds
Rates of autism among girls and boys may be more equal than previously thought, according to a large Swedish study which found differences in timing of diagnosis.
The study of health records from 2.7 million individuals tracked from birth to up to 37 years of age found a show a clear female catch-up effect during adolescence in autism diagnoses.
Writing in the BMJ, the researchers said a high male-to-female diagnosis ratio of around four to one had been suggested to be related to better social and communication skills among girls which makes autism more difficult to spot.
But no research had looked at this trend over the life-course, they noted.
The analysis, which looked at a national register of people born between 1985 and 2022 of which autism was diagnosed in 78,522 (2.8%) of individuals at an average age of 14.3 years.
They found that diagnosis rates increased with each five-year age interval throughout childhood, peaking at 645.5 per 100,000 person years for male individuals at age 10-14 years and 602.6 for female individuals at age 15-19 years.
It meant that while boys were more likely to be diagnosed in childhood, by the age of 20 years the ratio between males and females was almost the same.
The analysis did not consider other conditions associated with autism, such as ADHD nor did it look at shared genetic and environmental conditions like parental mental health.
They concluded: ‘These findings indicate that the male to female ratio for autism has decreased over time and with increasing age at diagnosis.
‘This male to female ratio may therefore be substantially lower than previously thought, to the extent that, in Sweden, it may no longer be distinguishable by adulthood.’
But they added the findings highlight the need to investigate why female individuals receive diagnoses later than male individuals.
Dr Monique Botha, associate professor in social and developmental psychology, at Durham University, said autism is not a male condition, ‘yet girls struggle to get a diagnosis in a timely or robust manner’.
‘Importantly, these diagnostic disparities are not unique to Sweden. We see parallel patterns in the UK and given the UK’s more fragmented diagnostic pathways and constrained infrastructure, there is good reason to think these inequities may be even more pronounced here.’
Dr Laura Hull, research fellow at the University of Bristol Medical School, said the findings support the idea that historically autism has been under-diagnosed in girls and women.
It is important to note there may have been other factors, such as co-occurring mental health conditions, influencing diagnosis timing which were not measured, she added.
‘Accounting for the whole picture of individuals being assessed is important considering the high rates of conditions such as anxiety, depression, and eating disorders in this group.
‘Diagnostic rates are still changing and it remains to be seen whether the male-to-female ratio will continue decreasing, will stabilise, or even will increase again as we continue to “catch up” with diagnosis of girls and women who were missed earlier in life.’
Visit Pulse Reference for details on 140 symptoms, including easily searchable symptoms and categories, offering you a free platform to check symptoms and receive potential diagnoses during consultations.
Related Articles
READERS' COMMENTS [2]
Please note, only GPs are permitted to add comments to articles
The more I hear about ADHD/Autism, the more I think that people with the features noted are actually the ‘normal’ ones, and the ones without (supposedly normal in mainstream views) are probably a much smaller group of sociopathic psychopaths !
Autistic traits are becoming so muh more widely recognised in the community that they are rapidly exceeding the 50% mark which should indicate the commoner, and hence ‘normal’
condition.
Surely the ‘Average’ normal person prefers a degree of scurity and regularity of schedule, familiar surroundings, familiar social interactions, favourite foods, colours, preferences in music and environmental sounds, etc. We value the security of knowing meals are coming on schedule, work and income are coming when due, seasons and sunny weather, but not too hot. I am sure, from observing many patients and other people, including myself, and even several kinds of domestic animals and semi-wild birds and chickens, that prolonged eye contact is not only uncomfortable for people with autism. Being uncomfortable with prolonged close direct eye contact is NORMAL in humans, chickens, cats and dogs, and especially at certain ages in children. Being uncomfortable demonstrating personal skills (or personal body growth and development) is likewise normal in children at some ages, especially teens, whilst the opposite may be the case at other ages (eg toddlers), and in between it varies with person and time.
Some have asked why autism diagnosis is increasing so rapidly. One answer is better awareness and diagnosis. But this leads us towards making the diagnosis in close to 3/4 of people, or more, a level where statistics indicates this is ‘normal’.
A different answer would be that perhaps older-style education and childrearing was more appreciative of differences in child development and learning of coping strategies, that, to be honest, it is not only autistic children who need to learn such coping skills, but all of us.
We were all shy and socially uncomfortable at some times, new schools, university, etc, and we need to accep this is normal, but needs support, not necessarily go to the extent of possibly labelling 98 % of population autistic because they were overly shy or obsessive at one point in their past. We should instead tailor and target support to coping skills at developmental stages whenever they occur in early years. And maybe look sat nutrition and environment, rather than drugs, and pick out those who have no autistic traits and are unaware of them, as being th eminority who might actually be, statistically, abnormal, for having never shown inhibition, introsepction, shyness, embarrassment, etc.
Reward illness with money and special privileges; act puzzled when diagnostic rates rise ever higher.