Sex differences in the reciprocal behaviour of children with autism

Abstract

Differences in the social limitations of girls compared to boys on the autism spectrum are still poorly understood. Impaired social-emotional reciprocity is a core diagnostic criterion for an autism spectrum disorder. This study compares sex differences in reciprocal behaviour in children with autism spectrum disorder (32 girls, 114 boys) and in typically developing children (24 girls, 55 boys). While children with autism spectrum disorder showed clear limitations in reciprocal behaviour compared to typically developing children, sex differences were found only in the autism spectrum disorder group: girls with autism spectrum disorder had higher reciprocity scores than boys with autism spectrum disorder. However, compared to typically developing girls, girls with autism spectrum disorder showed subtle differences in reciprocal behaviour. The sex-specific response patterns in autism spectrum disorder can inform and improve the diagnostic assessment of autism in females.

Reciprocity in autistic and typically developing children and adolescents with and without mild intellectual disabilities

“…The experimenter prompts the child non‐verbally to contribute meaningful elements to the drawing. The experimenter and the child take turns in drawing, using their own coloured marker (see for more details Backer van Ommeren et al , , in press). For each turn of the child, four scales of reciprocal behaviour are rated: Turn‐taking (one point is awarded if the child copies the experimenter's turn‐taking behaviour), Reciprocal interaction (one point is awarded if the child adds meaningful elements to a shared drawing object), Reciprocal interaction in the other's initiative (one point is awarded if the child contributes to objects initiated by the experimenter) and Reciprocal flexibility (one point is awarded if the child accepts a specific interfering input of the experimenter in his or her own drawing object).…”

“…It is evident that in both ASD and ID individuals, impairments in social interactions are to be found (DSM‐5). Within this domain, recent studies have indicated that limitations in reciprocity can be measured reliably and are clearly linked to ASD in normally intelligent children (Backer van Ommeren et al ; Backer van Ommeren et al , in press). It is currently unknown whether these limitations may also be indicative for ASD in children with ID.…”

“…Such understanding could contribute to finding more specific cues for treatment or training for children with ASD and ID. In this study, we used a new, standardised test for measuring the quality of reciprocal behaviour, the Interactive Drawing Test (IDT; Backer van Ommeren et al , Backer van Ommeren et al , in press) to compare reciprocity in ASD and typical development (TD) individuals with mild ID (MID, denoted as ASD‐MID and TD‐MID, respectively).…”

“…by adding windows to the house). Previous studies showed that the ability to reciprocate and contribute to the experimenter‐initiated drawing was the most sensitive aspect of reciprocal behaviour to distinguish between normally intelligent participants with or without ASD (Backer van Ommeren et al ; Backer van Ommeren et al , in press). Administration of the IDT is largely non‐verbal, making the test particularly suitable for testing MID groups.…”

Towards sex- and gender-informed autism research

“…This notion is reenforced by several studies in this Special Issue that went beyond the use of standardised diagnostic tools, employing novel measures that tap key constructs. Backer van Ommeren et al (2017) use a sensitive and ecologically valid paradigm, the Interactive Drawing Test, to measure social reciprocity. In so doing, they were able to tease out strengths and difficulties of autistic girls that would have been invisible had they used cruder, ordinary diagnostic measures.…”