Visual attention to faces in children with autism spectrum disorder: are there sex differences?

This publication is included in the Autistic Autism Scholarship Project. one author of this publication is identified as autistic in the project.

About the autistic author marker

Harrop, C., Jones, D., Zheng, S., Nowell, S. W., Schultz, R., & Parish-Morris, J. (2019). Visual attention to faces in children with autism spectrum disorder: are there sex differences? Molecular Autism, 10(1), Article 28. https://doi.org/10.1186/s13229-019-0276-2

Publication date: 28 Jun 2019 Added to AutiHub: 23 Oct 2026 Type: Article Article language: English

This publication is integrated into AutiHub through:

Authors

Publication authors
6
Publication authors identified as autistic
1 / 6 (16.7%)

Abstract

BACKGROUND: The male bias in autism spectrum disorder (ASD) diagnoses is well documented. As a result, less is known about the female ASD phenotype. Recent research suggests that conclusions drawn from predominantly male samples may not accurately capture female behavior. In this study, we explore potential sex differences in attention to social stimuli, which is generally reported to be diminished in ASD. Population-based sex differences in attention to faces have been reported, such that typically developing (TD) females attend more to social stimuli (including faces) from infancy through adulthood than TD males. It is yet unknown whether population-based sex differences in the face domain are preserved in ASD. METHODS: A dynamic, naturalistic infrared eye-tracking paradigm measured attention to social stimuli (faces) in 74 school-aged males and females with ASD (male N = 23; female N = 19) and without ASD (male N = 16; female N = 16). Two kinds of video stimuli were presented that varied in social content: rich social scenes (dyadic play between two children) and lean social scenes (parallel play by two children). RESULTS: Results revealed a significant 3-way interaction between sex, diagnosis, and condition after controlling for chronological and mental age. ASD females attended more to faces than ASD males in the socially lean condition. This effect was not found in the typically developing (TD) group. ASD males attended less to faces regardless of social context; however, ASD females only attended significantly less to faces compared to TD females in the socially rich condition. TD males and ASD females did not differ in their attention to faces in either condition. CONCLUSIONS: This study has implications for how the field understands core social deficits in children with ASD, which should ideally be benchmarked against same-sex peers (male and female). Social attention in ASD females fell on a continuum-greater than their ASD male peers, but not as great as TD females. Overall, their social attention mirrored that of TD males. Improved understanding of the female social phenotype in ASD will enhance early screening and diagnostic efforts and will guide the development of sex-sensitive experimental paradigms and social interventions.

Bibliography cited by this reference

Cited references are imported from external metadata sources when they are available. The list may be partial.

Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 27 Oct 2026 01:01.

Cited references
70
With a DOI
63
Without a DOI, from raw bibliography text
7
2 / 70 (2.9%) cited references include at least one author identified as autistic.
References with data to complete
1 / 70 (1.4%)
References with detected author names
69 / 70 (98.6%)
Without detected author names
1
Without a structured title
1
Without a stable identifier
7
References with raw author names still to review
1
References with external metadata lookup issues
1
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
298
From DOI or external metadata
298
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
1
116 / 298 (38.9%) names are linked to an author already present in AutiHub. 182 / 298 (61.1%) names are not yet linked.
Names linked to a person identified as autistic
2 / 298 (0.7%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 2 / 116 (1.7%). Distinct people identified as autistic: 1 / 239 (0.4%).
  1. Coralie Chevallier , Julia Parish-Morris , Alana J. McVey , Keiran M. Rump , Noah Sasson , John Herrington et al. (2015). Measuring social attention and motivation in autism spectrum disorder using eye‐tracking: Stimulus type matters . Autism Research, 8(5), 620-628. Wiley.
    Type: Article DOI: 10.1002/aur.1479 OpenAlex: https://openalex.org/W1773684352
    Crossref OpenAlex OpenCitations
  2. Meia Chita-Tegmark (2016). Social attention in ASD: A review and meta-analysis of eye-tracking studies . Research in Developmental Disabilities, 48, 79-93. Elsevier BV.
    Crossref OpenAlex OpenCitations
  3. Leslie L. Speer , Anne E. Cook , William M. McMahon , Elaine Clark (2007). Face processing in children with autism . Autism, 11(3), 265-277. SAGE Publications.
    Crossref OpenAlex OpenCitations
  4. Michelle Dean , Connie Kasari , Wendy Shih , Fred Frankel , Rondalyn Whitney , Rebecca Landa et al. (2014). The peer relationships of girls with ASD at school: comparison to boys and girls with and without ASD . Journal of Child Psychology and Psychiatry, 55(11), 1218-1225. Wiley.
    Crossref OpenAlex OpenCitations
  5. Katarzyna Chawarska , Suzanne Macari , Frederick Shic (2013). Decreased Spontaneous Attention to Social Scenes in 6-Month-Old Infants Later Diagnosed with Autism Spectrum Disorders . Biological Psychiatry, 74(3), 195-203. Elsevier BV.
    Crossref OpenAlex OpenCitations
  6. Paola Escudero , Rachel A. Robbins , Scott P. Johnson (2013). Sex-related preferences for real and doll faces versus real and toy objects in young infants and adults . Journal of Experimental Child Psychology, 116(2), 367-379. Elsevier BV.
    Crossref OpenAlex OpenCitations
  7. Warren Jones , Katelin Carr , Ami Klin (2008). Absence of Preferential Looking to the Eyes of Approaching Adults Predicts Level of Social Disability in 2-Year-Old Toddlers With Autism Spectrum Disorder . Archives of General Psychiatry, 65(8), 946. American Medical Association (AMA).
    Crossref OpenAlex OpenCitations
  8. Jessica Hunter , Oliver Rivero‐Arias , Angel Angelov , Edward Kim , Iain Fotheringham , Jose Leal (2014). Epidemiology of fragile X syndrome: A systematic review and meta‐analysis . American Journal of Medical Genetics Part A, 164(7), 1648-1658. Wiley.
    Crossref OpenAlex OpenCitations
  9. Ami Klin , Warren Jones , Robert Schultz , Fred Volkmar , Donald Cohen (2002). Visual Fixation Patterns During Viewing of Naturalistic Social Situations as Predictors of Social Competence in Individuals With Autism . Archives of General Psychiatry, 59(9), 809. American Medical Association (AMA).
    Crossref OpenAlex OpenCitations
  10. Laura Hull , K.V. Petrides , C. Allison , P. Smith , S. Baron-Cohen , Meng-Chuan Lai et al. (2017). “Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions . Journal of Autism and Developmental Disorders, 47(8), 2519-2534. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  11. Deborah M. Riby , Peter J. B. Hancock (2009). Do Faces Capture the Attention of Individuals with Williams Syndrome or Autism? Evidence from Tracking Eye Movements . Journal of Autism and Developmental Disorders, 39(3), 421-431. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  12. Sue Fletcher-Watson , Susan Leekam , V. Benson , M.C. Frank , J.M. Findlay (2009). Eye-movements reveal attention to social information in autism spectrum disorder . Neuropsychologia, 47(1), 248-257. Elsevier BV.
    Crossref OpenAlex OpenCitations
  13. Felicity Sedgewick , Vivian Hill , Rhiannon Yates , Leanne Pickering , Elizabeth Pellicano (2016). Gender Differences in the Social Motivation and Friendship Experiences of Autistic and Non-autistic Adolescents . Journal of Autism and Developmental Disorders, 46(4), 1297-1306. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  14. Noah Sasson , Lauren M. Turner‐Brown , Tia N. Holtzclaw , Kristen S.L. Lam , James Bodfish (2008). Children with autism demonstrate circumscribed attention during passive viewing of complex social and nonsocial picture arrays . Autism Research, 1(1), 31-42. Wiley.
    Type: Article DOI: 10.1002/aur.4 OpenAlex: https://openalex.org/W2010392115
    Crossref OpenAlex OpenCitations
  15. Jennifer M. Moriuchi , Ami Klin , Warren Jones (2017). Mechanisms of Diminished Attention to Eyes in Autism . American Journal of Psychiatry, 174(1), 26-35. American Psychiatric Association Publishing.
    Crossref OpenAlex OpenCitations
  16. Cynthia S. Keysor , Michèle M.M. Mazzocco (2002). A developmental approach to understanding Fragile X syndrome in females . Microscopy Research and Technique, 57(3), 179-186. Wiley.
    Crossref OpenAlex OpenCitations
  17. Hugh Lytton , David M. Romney (1991). Parents' differential socialization of boys and girls: A meta-analysis. Psychological Bulletin, 109(2), 267-296. American Psychological Association (APA).
    Crossref OpenAlex OpenCitations
  18. Kevin A. Pelphrey , Noah Sasson , J. Steven Reznick , Gregory Paul , Barbara D. Goldman , Joseph Piven (2002). Visual Scanning of Faces in Autism . Journal of Autism and Developmental Disorders, 32(4), 249-261. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  19. Patricia J. M. Van Wijngaarden-Cremers , Evelien van Eeten , Wouter B. Groen , Patricia A. Van Deurzen , Iris J. Oosterling , Rutger Jan Van der Gaag (2014). 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, 44(3), 627-635. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  20. Svetlana Lutchmaya , S. Baron-Cohen , Peter Raggatt (2002). Foetal testosterone and eye contact in 12-month-old human infants . Infant Behavior and Development, 25(3), 327-335. Elsevier BV.
    Crossref OpenAlex OpenCitations
  21. Noah Sasson , Emily W. Touchstone (2014). Visual Attention to Competing Social and Object Images by Preschool Children with Autism Spectrum Disorder . Journal of Autism and Developmental Disorders, 44(3), 584-592. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  22. Deborah M. Riby , Gwyneth Doherty‐Sneddon , Lisa Whittle (2012). Face‐to‐face interference in typical and atypical development . Developmental Science, 15(2), 281-291. Wiley.
    Crossref OpenAlex OpenCitations
  23. Faraz Farzin , Susan M. Rivera , David Hessl (2009). Brief Report: Visual Processing of Faces in Individuals with Fragile X Syndrome: An Eye Tracking Study . Journal of Autism and Developmental Disorders, 39(6), 946-952. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  24. Maccoby EE (1998). The two sexes: growing up apart, coming together . Choice Reviews Online, 36(03), 36-1880-36-1880. American Library Association.
    OpenAlex
  25. Ami Tint , Jonathan Weiss (2018). A qualitative study of the service experiences of women with autism spectrum disorder . Autism, 22(8), 928-937. SAGE Publications.
    Crossref OpenAlex OpenCitations
  26. Tania A. Mann , Peter Walker (2003). Autism and a deficit in broadening the spread of visual attention . Journal of Child Psychology and Psychiatry, 44(2), 274-284. Wiley.
    Crossref OpenAlex OpenCitations
  27. Yair Bar-Haim , Cory Shulman , Dominique Lamy , Arnon Reuveni (2006). Attention to Eyes and Mouth in High-Functioning Children with Autism . Journal of Autism and Developmental Disorders, 36(1), 131-137. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  28. Kathryn E. Unruh , Noah Sasson , Robin L. Shafer , Allison Whitten , Stephanie J. Miller , Lauren Turner-Brown et al. (2016). Social Orienting and Attention Is Influenced by the Presence of Competing Nonsocial Information in Adolescents with Autism . Frontiers in Neuroscience, 10, 586. Frontiers Media SA.
    Crossref OpenAlex OpenCitations
  29. Jennifer Connellan , S. Baron-Cohen , Sally Wheelwright , Anna Batki , Jag Ahluwalia (2000). Sex differences in human neonatal social perception . Infant Behavior and Development, 23(1), 113-118. Elsevier BV.
    Crossref OpenAlex OpenCitations
  30. Katarzyna Chawarska , Suzanne Macari , Frederick Shic (2012). Context modulates attention to social scenes in toddlers with autism . Journal of Child Psychology and Psychiatry, 53(8), 903-913. Wiley.
    Crossref OpenAlex OpenCitations
  31. Christine Wu Nordahl , Ana-Maria Iosif , Gregory S Young , Lee Michael Perry , Robert Dougherty , Aaron Lee et al. (2015). Sex differences in the corpus callosum in preschool-aged children with autism spectrum disorder . Molecular Autism, 6(1), 26. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  32. Catherine Lord , Susan Risi , Linda Lambrecht , Edwin H. Cook , Bennett L. Leventhal , Pamela C. DiLavore et al. (2000). The Autism Diagnostic Observation Schedule—Generic: A Standard Measure of Social and Communication Deficits Associated with the Spectrum of Autism . Journal of Autism and Developmental Disorders, 30(3), 205-223. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  33. Andrew P. Bayliss , Giuseppe di Pellegrino , Steven P. Tipper (2005). Sex differences in eye gaze and symbolic cueing of attention . The Quarterly Journal of Experimental Psychology Section A, 58(4), 631-650. SAGE Publications.
    Crossref OpenAlex OpenCitations
  34. Deborah L. Christensen , Jon Baio , Kim Van Naarden Braun , Deborah Bilder , Jane Charles , John N. Constantino et al. (2016). Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012 . MMWR. Surveillance Summaries, 65(3), 1-23. Centers for Disease Control MMWR Office.
    Crossref OpenAlex OpenCitations
  35. Rachel Loomes , Laura Hull , William Mandy (2017). What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis . Journal of the American Academy of Child & Adolescent Psychiatry, 56(6), 466-474. Elsevier BV.
    Crossref OpenAlex OpenCitations
  36. Cohen, Jacob 1923-1998 (1990). Statistical Power Analysis for the Behavioral Sciences . Computers, Environment and Urban Systems, 14(1), 71. Elsevier BV.
    Crossref OpenAlex
  37. Michelle Dean , Robin Harwood , Connie Kasari (2017). The art of camouflage: Gender differences in the social behaviors of girls and boys with autism spectrum disorder . Autism, 21(6), 678-689. SAGE Publications.
    Crossref OpenAlex OpenCitations
  38. Laura Hull , William Mandy , K.V. Petrides (2017). Behavioural and cognitive sex/gender differences in autism spectrum condition and typically developing males and females . Autism, 21(6), 706-727. SAGE Publications.
    Crossref OpenAlex OpenCitations
  39. Anna Cook , Jane Ogden , Naomi Winstone (2018). Friendship motivations, challenges and the role of masking for girls with autism in contrasting school settings . European Journal of Special Needs Education, 33(3), 1. Informa UK Limited.
    Crossref OpenAlex OpenCitations
  40. Meng-Chuan Lai , Michael Lombardo , Amber Ruigrok , Bhismadev Chakrabarti , Bonnie Auyeung , Peter Szatmari et al. (2017). Quantifying and exploring camouflaging in men and women with autism . Autism, 21(6), 690-702. SAGE Publications.
    Crossref OpenAlex OpenCitations
  41. Jennifer L. Rennels , Andrew J. Cummings (2013). Sex differences in facial scanning: Similarities and dissimilarities between infants and adults . International Journal of Behavioral Development, 37(2), 111-117. SAGE Publications.
    Crossref OpenAlex OpenCitations
  42. Rebecca Vine Foggo , Amanda A. Webster (2017). Understanding the social experiences of adolescent females on the autism spectrum . Research in Autism Spectrum Disorders, 35, 74-85. Elsevier BV.
    Crossref OpenAlex OpenCitations
  43. Thomas R. Insel (2014). The NIMH Research Domain Criteria (RDoC) Project: Precision Medicine for Psychiatry . American Journal of Psychiatry, 171(4), 395-397. American Psychiatric Association Publishing.
    Crossref OpenAlex OpenCitations
  44. Anna Servin , Gunilla Bohlin , Lisa Berlin (1999). Sex differences in 1‐, 3‐, and 5‐year‐olds' toy‐choice in a structured play‐session . Scandinavian Journal of Psychology, 40(1), 43-48. Wiley.
    Crossref OpenAlex OpenCitations
  45. Kristina M. Zosuls , Diane N. Ruble , Catherine S. Tamis-LeMonda , Patrick E. Shrout , Marc H. Bornstein , Faith K. Greulich (2009). The acquisition of gender labels in infancy: Implications for gender-typed play. Developmental Psychology, 45(3), 688-701. American Psychological Association (APA).
    Type: Article DOI: 10.1037/a0014053 OpenAlex: https://openalex.org/W2125976294
    Crossref OpenAlex OpenCitations
  46. Julia Parish-Morris , Ashley A. Pallathra , Emily F. Ferguson , Brenna Maddox , Alison Pomykacz , Leat S. Perez et al. (2019). Adaptation to different communicative contexts: an eye tracking study of autistic adults . Journal of Neurodevelopmental Disorders, 11(1), 5. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  47. Julia Parish-Morris , Mark Y. Liberman , Christopher Cieri , John Herrington , Benjamin Yerys , Leila Bateman et al. (2017). Linguistic camouflage in girls with autism spectrum disorder . Molecular Autism, 8(1), 48. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  48. Lisa A. Serbin , Diane Poulin-Dubois , Karen A. Colburne , Maya G. Sen , Julie A. Eichstedt (2001). Gender stereotyping in infancy: Visual preferences for and knowledge of gender-stereotyped toys in the second year . International Journal of Behavioral Development, 25(1), 7-15. SAGE Publications.
    Crossref OpenAlex OpenCitations
  49. Agnieszka Rynkiewicz , Björn Schuller , Erik Marchi , Stefano Piana , Antonio Camurri , Amandine Lassalle et al. (2016). An investigation of the ‘female camouflage effect’ in autism using a computerized ADOS-2 and a test of sex/gender differences . Molecular Autism, 7(1), 10. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  50. Rachael Bedford , Emily Jones , Mark H. Johnson , Andrew Pickles , Tony Charman , Teodora Gliga (2016). Sex differences in the association between infant markers and later autistic traits . Molecular Autism, 7(1), 21. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  51. Johan Lundin Kleberg , Pär Nyström , Sven Bölte , Terje Falck-Ytter (2019). Sex Differences in Social Attention in Infants at Risk for Autism . Journal of Autism and Developmental Disorders, 49(4), 1342-1351. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  52. Katarzyna Chawarska , Suzanne Macari , Kelly Powell , Lauren DiNicola , Frederick Shic (2016). Enhanced Social Attention in Female Infant Siblings at Risk for Autism . Journal of the American Academy of Child & Adolescent Psychiatry, 55(3), 188-195.e1. Elsevier BV.
    Crossref OpenAlex OpenCitations
  53. Maxie Gluckman , Scott P. Johnson (2013). Attentional capture by social stimuli in young infants . Frontiers in Psychology, 4, 527. Frontiers Media SA.
    Crossref OpenAlex OpenCitations
  54. The EASE Team , Emilia Thorup , Pär Nyström , Gustaf Gredebäck , Sven Bölte , Terje Falck-Ytter (2016). Altered gaze following during live interaction in infants at risk for autism: an eye tracking study . Molecular Autism, 7(1), 12. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  55. Scott S. Hall , Michael C. Frank , Guido T. Pusiol , Faraz Farzin , Amy A. Lightbody , Allan L. Reiss (2015). Quantifying naturalistic social gaze in fragile X syndrome using a novel eye tracking paradigm . American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 168(7), 564-572. Wiley.
    Crossref OpenAlex OpenCitations
  56. (n.d.). Maccoby EE. The two sexes: growing up apart, coming together: Belknap Press of Harvard University Press; 1998.
    Type: Other
    Crossref
  57. M Rutter (2003). ADI-R. Autism diagnostic interview revised . ADI-R. Autism diagnostic interview revised.
    Type: Other
    Crossref
  58. M Rutter (2003). The Social Communication Questionnaire . The Social Communication Questionnaire.
    Type: Other
    Crossref
  59. CD Elliot (2007). Differential Ability Scales–second edition (DAS-II) . Differential Ability Scales–second edition (DAS-II).
    Type: Other
    Crossref
  60. A Olsen (2012). The Tobii I-VT fixation filter . The Tobii I-VT fixation filter.
    Type: Other
    Crossref
  61. R Core Team (2012). R: a language and environment for statistical computing . R: a language and environment for statistical computing.
    Type: Other
    Crossref
  62. R Core Team (2026). R: A Language and Environment for Statistical Computing . R Foundation for Statistical Computing.
    OpenAlex
  63. FM Hartig (2019). Package “DHARMa” Title Residual Diagnostics for Hierarchical (Multi-Level / Mixed) Regression Models . Package “DHARMa” Title Residual Diagnostics for Hierarchical (Multi-Level / Mixed) Regression Models.
    Type: Other
    Crossref
  64. Petya Radoeva , Olivia Welker , Elizabeth Aylward , John Darrell Van Horn , Kevin A. Pelphrey , Sara Jane Webb (2017). 335. Gender Differences in the Uncinate Fasciculus in Children and Adolescents with ASD as Compared to Typically Developing Youth . Biological Psychiatry, 81(10), S137-S138. Elsevier BV.
    Crossref OpenAlex OpenCitations
  65. Clare Harrop , Desiree Jones *Autistic author. Learn more… , Shuting Zheng , Sallie W. Nowell , Brian Boyd , Noah Sasson (2018). Circumscribed Interests and Attention in Autism: The Role of Biological Sex . Journal of Autism and Developmental Disorders, 48(10), 3449-3459. Springer Science and Business Media LLC.
    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex OpenCitations
  66. Rebecca Elias , Susan W White (2020). Measuring Social Motivation in Autism Spectrum Disorder: Development of the Social Motivation Interview . Journal of Autism and Developmental Disorders, 50(3), 798-811. Springer Science and Business Media LLC.
    OpenAlex
  67. Meredith Cola , Samantha Plate , Lisa Yankowitz , Victoria Petrulla , Leila Bateman , Casey J. Zampella et al. (2020). Sex differences in the first impressions made by girls and boys with autism . Molecular Autism, 11(1), 1. Springer Science and Business Media LLC.
    OpenAlex
  68. Anne Snow (2013). Social Communication Questionnaire . In Encyclopedia of Autism Spectrum Disorders (pp. 2893-2895). Springer New York.
    OpenAlex
  69. Keith Muller , Jacob Cohen (1989). Statistical Power Analysis for the Behavioral Sciences . Technometrics, 31(4), 499-500. Informa UK Limited.
    Type: Article DOI: 10.2307/1270020 OpenAlex: https://openalex.org/W4300870773
    OpenAlex