Far fewer girls are diagnosed with autism spectrum disorders (ASD) than boys; male children are four to five times more likely to be diagnosed than female children. Are boys more likely to have autism, or is there something else that causes this discrepancy? Researchers from University College London explored the connection between gender and emotion recognition in children identified as having autistic traits. They found that girls performed better in emotional recognition in situations that resembled everyday life, leading them to conclude that girls develop the ability to mask symptoms, which may be a cause of the difference in diagnostic prevalence between the sexes.

Data was gathered from the “Children of the 90s” Avon Longitudinal Study of Parents and Children, which surveyed a cohort of over 3,600 children. Two tests that asked participants to identify emotions were administered: the Diagnostic Analysis of Non-Verbal Accuracy and the Emotional Triangles Task. In the first task, the participants were shown pictures of children’s faces displaying emotions—happiness, sadness, anger, etc. The second involved short animations of triangles moving in ways that suggest emotions. The children were also evaluated for autistic-like traits using a questionnaire about social communication completed by their parents. Using this data, the researchers compared the performance of children with autistic traits to those without and also compared the results of boys and girls with autistic traits.

On the whole, children who had been identified as having autistic traits were more likely to misinterpret sad and scared faces and to incorrectly label a variety of facial expressions as happiness. However, when the researchers separated the data by sex, they found that girls were less prone to make mistakes in identifying facial expressions. Boys and girls both did poorly in evaluating emotion in the Emotional Triangles Task.

The findings suggest that girls may be better at masking their autistic traits than boys in every day situations. Since girls were better able to identify the emotions on another child’s face (a typical activity), but not the emotional movement of an animated triangle (an unconventional activity), they may be better at recognizing emotional cues in their environments, which might cause some clinicians, teachers, or parents to assume that they are essentially neurotypical. This may explain the disparity between ASD diagnoses in boys and girls and may indicate that many girls are not receiving appropriate interventions.

“The lack of association between social communication difficulties and facial emotion recognition in girls suggests girls might learn to compensate for facial emotion recognition difficulties,” stated Dr. Radha Kothari, lead study author.

This research is published in the journal Child and Adolescent Psychiatry.

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