Sex differences in parent‐reported executive functioning and adaptive behavior in children and young adults with autism spectrum disorder

White, E., Wallace, G. L., Bascom, J., Armour, A. C., Register‐Brown, K., Popal, H., Ratto, A. B., Martin, A., & Kenworthy, L. (2017). Sex differences in parent‐reported executive functioning and adaptive behavior in children and young adults with autism spectrum disorder. Autism Research, 10(10), 1653-1662. https://doi.org/10.1002/aur.1811

Publication date: 1 Jun 2017 Added to AutiHub: 4 Jul 2026 Type: Article Article language: English

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Publication authors
9
Publication authors identified as autistic
1 / 9 (11.1%)

Abstract

This study is the largest to date examining executive function and adaptive skills in females with autism spectrum disorder (ASD). Its primary aim was to utilize parent ratings of real-world executive functioning and adaptive behavior to better understand whether females with ASD differ from males with ASD in these areas of everyday functioning. We compared 79 females with ASD to 158 males with ASD (ages 7-18) who were statistically matched on age, IQ, and level of ADHD or ASD traits. All participants were assessed using the Behavior Rating Inventory of Executive Function (BRIEF) and a subset (56 females and 130 males) also received the Vineland Adaptive Behavior Scales (VABS). Females were rated by parents as having greater problems with executive function on the BRIEF. Parents also rated females as exhibiting more difficulties than males on the Daily Living Skills domain of the VABS. There was a correlation between increased global EF difficulty and decreased adaptive ability in both males and females. Our results indicate relative weaknesses for females compared to males diagnosed with ASD on executive function and daily living skills. These differences occur in the absence of sex differences in our sample in age, IQ, clinician ratings of core ASD symptomatology, parent ratings of ADHD symptoms, and parent-reported social and communication adaptive skills on the VABS. These findings indicate specific liabilities in real world EF and daily living skills for females with ASD and have important implications for targeting their treatments. Autism Res 2017, 10: 1653-1662. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

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Cited references
54
Total cited references integrated for this publication.
Cited references with an identified autistic author
0 / 54 (0.0%)
Cited author occurrences identified as autistic
0 / 257 (0.0%)
Among occurrences linked to AutiHub author records: 0 / 67 (0.0%). Distinct cited authors identified as autistic: 0 / 219 (0.0%).
Cited author occurrences linked to AutiHub author records
67 / 257 (26.1%)
Distinct linked cited authors: 36 / 219 (16.4%)
Linked cited-author occurrences not identified as autistic
67 / 67 (100.0%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 67 / 257 (26.1%). Distinct linked cited authors not identified as autistic: 36 / 36 (100.0%).
  1. George J. DuPaul , Thomas J. Power , Arthur D. Anastopoulos , Robert Reid (1998). Adhd Rating Scale-IV: Checklists, Norms, and Clinical Interpretation .
    Type: Book OpenAlex: https://openalex.org/W629283852
    Crossref OpenAlex
  2. Thomas M. Achenbach , Catherine T. Howell , Herbert C. Quay , C. Keith Conners , John E. Bates (1991). National Survey of Problems and Competencies among Four- to Sixteen-Year-Olds: Parents' Reports for Normative and Clinical Samples . Monographs of the Society for Research in Child Development, 56(3), i. Oxford University Press (OUP).
    Type: Article DOI: 10.2307/1166156 OpenAlex: https://openalex.org/W4296981185
    Crossref OpenAlex OpenCitations
  3. Lauren Kenworthy , Benjamin E. Yerys , Laura G. Anthony , Gregory L. Wallace (2008). Understanding Executive Control in Autism Spectrum Disorders in the Lab and in the Real World . Neuropsychology Review, 18(4), 320-338. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  4. Janine M. Lemon , Belinda Gargaro , Peter G. Enticott , Nicole Rinehart (2011). Brief Report: Executive Functioning in Autism Spectrum Disorders: A Gender Comparison of Response Inhibition . Journal of Autism and Developmental Disorders, 41(3), 352-356. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  5. González Moreno, Andrés Santiago (2013). Diagnostic and Statistical Manual of Mental Disorders . American Psychiatric Association.
    Crossref OpenAlex OpenCitations
  6. Rachel A. Lawson , Alison A. Papadakis , Christopher I. Higginson , Jeffrey E. Barnett , Meagan C. Wills , John F. Strang et al. (2015). Everyday executive function impairments predict comorbid psychopathology in autism spectrum and attention deficit hyperactivity disorders. Neuropsychology, 29(3), 445-453. American Psychological Association (APA).
    Crossref OpenAlex OpenCitations
  7. Éric Fombonne (1999). The epidemiology of autism: a review . Psychological Medicine, 29(4), 769-786. Cambridge University Press (CUP).
    Crossref OpenAlex OpenCitations
  8. (n.d.). Baggs M. (2007 April 5). The naked mechanisms of echolalia. https://ballastexistenz.wordpress.com/2007/04/05/the-naked-mechanisms-of-echolalia/
    Type: Other
    Crossref
  9. Catherine Lord , Michael Rutter , Ann Le Couteur (1994). Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders . Journal of Autism and Developmental Disorders, 24(5), 659-685. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  10. Cara E. Pugliese , Laura G. Anthony , John F. Strang , Katerina Dudley , Gregory L. Wallace , Lauren Kenworthy (2015). Increasing Adaptive Behavior Skill Deficits From Childhood to Adolescence in Autism Spectrum Disorder: Role of Executive Function . Journal of Autism and Developmental Disorders, 45(6), 1579-1587. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  11. Simon Baron-Cohen , Rebecca C. Knickmeyer , Matthew K. Belmonte (2005). Sex Differences in the Brain: Implications for Explaining Autism . Science, 310(5749), 819-823. American Association for the Advancement of Science (AAAS).
    Crossref OpenAlex OpenCitations
  12. Lauren Kenworthy , David O. Black , Bryan Harrison , Anne della Rosa , Gregory L. Wallace (2009). Are Executive Control Functions Related to Autism Symptoms in High-Functioning Children? Child Neuropsychology, 15(5), 425-440. Informa UK Limited.
    Crossref OpenAlex OpenCitations
  13. Sander Begeer , David S. Mandell , Bernadette Wijnker-Holmes , Stance Venderbosch , Dorien Rem , Fred Stekelenburg et al. (2013). Sex Differences in the Timing of Identification Among Children and Adults with Autism Spectrum Disorders . Journal of Autism and Developmental Disorders, 43(5), 1151-1156. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  14. Meng-Chuan Lai , Michael Lombardo , Amber Ruigrok , Bhismadev Chakrabarti , Sally J. Wheelwright , Bonnie Auyeung et al. (2012). Cognition in Males and Females with Autism: Similarities and Differences . PLoS ONE, 7(10), e47198. Public Library of Science (PLoS).
    Crossref OpenAlex OpenCitations
  15. Lauren Bishop-Fitzpatrick , Jinkuk Hong , Leann E. Smith , Renee A. Makuch , Jan S. Greenberg , Marsha R. Mailick (2016). Characterizing Objective Quality of Life and Normative Outcomes in Adults with Autism Spectrum Disorder: An Exploratory Latent Class Analysis . Journal of Autism and Developmental Disorders, 46(8), 2707-2719. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  16. Kara Hume , Rachel Loftin , Johanna Lantz (2009). Increasing Independence in Autism Spectrum Disorders: A Review of Three Focused Interventions . Journal of Autism and Developmental Disorders, 39(9), 1329-1338. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  17. Katharine Johnson , Melinda Caskey , Katherine Rand , Richard Tucker , Betty Vohr (2014). Gender Differences in Adult-Infant Communication in the First Months of Life . Pediatrics, 134(6), e1603-e1610. American Academy of Pediatrics (AAP).
    Crossref OpenAlex OpenCitations
  18. Sven Bölte , Eftichia Duketis , Fritz Poustka , Martin Holtmann (2011). Sex differences in cognitive domains and their clinical correlates in higher-functioning autism spectrum disorders . Autism, 15(4), 497-511. SAGE Publications.
    Crossref OpenAlex OpenCitations
  19. Marshalyn Yeargin-Allsopp , Catherine Rice , Tanya Karapurkar , Nancy Doernberg , Coleen Boyle , Catherine Murphy (2003). Prevalence of Autism in a US Metropolitan Area . JAMA, 289(1), 49. American Medical Association (AMA).
    Crossref OpenAlex OpenCitations
  20. Ann Le Couteur , Michael Rutter , Catherine Lord , Patricia Rios , Sarah Robertson , Mary Holdgrafer et al. (1989). Autism diagnostic interview: A standardized investigator-based instrument . Journal of Autism and Developmental Disorders, 19(3), 363-387. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  21. Marc H. Bornstein , Zeno Giusti , Diane B. Leach , Paola Venuti (2005). Maternal reports of adaptive behaviours in young children: urban-rural and gender comparisons in Italy and United States . Infant and Child Development, 14(4), 403-424. Wiley.
    Type: Article DOI: 10.1002/icd.414 OpenAlex: https://openalex.org/W2157811992
    Crossref OpenAlex OpenCitations
  22. Gerard A. Gioia , Peter K. Isquith , Lauren Kenworthy , Richard M. Barton (2002). Profiles of Everyday Executive Function in Acquired and Developmental Disorders . Child Neuropsychology, 8(2), 121-137. Swets & Zeitlinger Publishers.
    OpenAlex OpenCitations
  23. Traolach Brugha , Nicola Spiers , John Bankart , Sally‐Ann Cooper , Sally McManus , Fiona J. Scott et al. (2016). Epidemiology of autism in adults across age groups and ability levels . British Journal of Psychiatry, 209(6), 498-503. Royal College of Psychiatrists.
    Crossref OpenAlex OpenCitations
  24. Elise Robinson , Paul Lichtenstein , Henrik Anckarsäter , Francesca Happé , Angelica Ronald (2013). Examining and interpreting the female protective effect against autistic behavior . Proceedings of the National Academy of Sciences, 110(13), 5258-5262. National Academy of Sciences.
    Crossref OpenAlex OpenCitations
  25. Benjamin E. Yerys , Lauren Kenworthy , Kathryn F. Jankowski , John F. Strang , Gregory L. Wallace (2013). Separate components of emotional go/no-go performance relate to autism versus attention symptoms in children with autism. Neuropsychology, 27(5), 537-545. American Psychological Association (APA).
    Type: Article DOI: 10.1037/a0033615 OpenAlex: https://openalex.org/W2005782489
    Crossref OpenAlex OpenCitations
  26. 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
  27. Catherine Lord , Eric Schopler (1985). Brief report: Differences in sex ratios in autism as a function of measured intelligence . Journal of Autism and Developmental Disorders, 15(2), 185-193. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  28. Ovsanna T. Leyfer , Susan E. Folstein , Susan Bacalman , Naomi Davis , Elena Dinh , Jubel Morgan et al. (2006). Comorbid Psychiatric Disorders in Children with Autism: Interview Development and Rates of Disorders . Journal of Autism and Developmental Disorders, 36(7), 849-861. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  29. Blythe A. Corbett , Laura J. Constantine , Robert L. Hendren , David Rocke , Sally Ozonoff (2009). Examining executive functioning in children with autism spectrum disorder, attention deficit hyperactivity disorder and typical development . Psychiatry Research, 166(2-3), 210-222. Elsevier BV.
    Crossref OpenAlex OpenCitations
  30. Hyo Jung Lee , Hye Ran Park (2007). An Integrated Literature Review on the Adaptive Behavior of Individuals With Asperger Syndrome . Remedial and Special Education, 28(3), 132-139. SAGE Publications.
    Crossref OpenAlex OpenCitations
  31. Amir Hossein Memari , Vahid Ziaee , Monir Shayestehfar , Parisa Ghanouni , Mohammad Ali Mansournia , Pouria Moshayedi (2013). Cognitive flexibility impairments in children with autism spectrum disorders: Links to age, gender and child outcomes . Research in Developmental Disabilities, 34(10), 3218-3225. Elsevier BV.
    Crossref OpenAlex OpenCitations
  32. Dan Levy , Michael Ronemus , Boris Yamrom , Yoon-ha Lee , Anthony Leotta , Jude Kendall et al. (2011). Rare De Novo and Transmitted Copy-Number Variation in Autistic Spectrum Disorders . Neuron, 70(5), 886-897. Elsevier BV.
    Crossref OpenAlex OpenCitations
  33. Katharina Dworzynski , Angelica Ronald , Patrick Bolton , Francesca Happé (2012). How Different Are Girls and Boys Above and Below the Diagnostic Threshold for Autism Spectrum Disorders? Journal of the American Academy of Child & Adolescent Psychiatry, 51(8), 788-797. Elsevier BV.
    Crossref OpenAlex OpenCitations
  34. John F. Strang , Lauren Kenworthy , Aleksandra Dominska , Jennifer Sokoloff , Laura E. Kenealy , Madison Berl et al. (2014). Increased Gender Variance in Autism Spectrum Disorders and Attention Deficit Hyperactivity Disorder . Archives of Sexual Behavior, 43(8), 1525-1533. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  35. Stephen M. Kanne , Andrew J. Gerber , Linda M. Quirmbach , Sara S. Sparrow , Domenic V. Cicchetti , Celine A. Saulnier (2011). The Role of Adaptive Behavior in Autism Spectrum Disorders: Implications for Functional Outcome . Journal of Autism and Developmental Disorders, 41(8), 1007-1018. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  36. Thomas Frazier , Stelios Georgiades , Somer Bishop , Antonio Y. Hardan (2014). Behavioral and Cognitive Characteristics of Females and Males With Autism in the Simons Simplex Collection . Journal of the American Academy of Child & Adolescent Psychiatry, 53(3), 329-340.e3. Elsevier BV.
    Crossref OpenAlex OpenCitations
  37. Gadow K.D. (2005). Child and Adolescent Symptom Inventory‐4R (CASI‐4R) . Child and Adolescent Symptom Inventory‐4R (CASI‐4R).
    Type: Other
    Crossref
  38. Svenny Kopp , Christopher Gillberg (1992). Girls with social deficits and learning problems: Autism, atypical Asperger syndrome or a variant of these conditions . European Child & Adolescent Psychiatry, 1(2), 89-99. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  39. T M Achenbach , C T Howell , H C Quay , C K Conners (1991). National survey of problems and competencies among four- to sixteen-year-olds: parents' reports for normative and clinical samples. PubMed, 56(3), 1-131.
    Type: Article OpenAlex: https://openalex.org/W2020162735
    OpenAlex
  40. G. A. Gioia , P. K. lsquith , S. C. Guy , Lauren Kenworthy (2022). Behavior Rating Inventory of Executive Function . PsycTESTS Dataset. American Psychological Association (APA).
    Crossref OpenAlex
  41. Catherine Lord , Eric Schopler , Dennis Revicki (1982). Sex differences in autism . Journal of Autism and Developmental Disorders, 12(4), 317-330. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  42. Gould J. (2011). Missed diagnosis or misdiagnosis? Girls and women on the autism spectrum . Good Autism Practice (GAP), 12, 34.
    Type: Other
    Crossref
  43. Yamini J. Howe , Julia A. O’Rourke , Yvette Yatchmink , Emma W. Viscidi , Richard N. Jones , Eric M. Morrow (2015). Female Autism Phenotypes Investigated at Different Levels of Language and Developmental Abilities . Journal of Autism and Developmental Disorders, 45(11), 3537-3549. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  44. Gregory L. Wallace , Lauren Kenworthy , Cara E. Pugliese , Haroon Popal , Emily White , Emily Brodsky et al. (2016). Real-World Executive Functions in Adults with Autism Spectrum Disorder: Profiles of Impairment and Associations with Adaptive Functioning and Co-morbid Anxiety and Depression . Journal of Autism and Developmental Disorders, 46(3), 1071-1083. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  45. Karen Kuhlthau , Felice Orlich , Trevor A. Hall , Darryn Sikora , Erica A. Kovacs , Jennifer Delahaye et al. (2010). Health-Related Quality of Life in Children with Autism Spectrum Disorders: Results from the Autism Treatment Network . Journal of Autism and Developmental Disorders, 40(6), 721-729. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  46. Tessa Taylor Rivet , Johnny L. Matson (2011). Review of gender differences in core symptomatology in autism spectrum disorders . Research in Autism Spectrum Disorders, 5(3), 957-976. Elsevier BV.
    Crossref OpenAlex OpenCitations
  47. Meng-Chuan Lai , Michael Lombardo , Bonnie Auyeung , Bhismadev Chakrabarti , Simon Baron-Cohen (2015). Sex/Gender Differences and Autism: Setting the Scene for Future Research . Journal of the American Academy of Child & Adolescent Psychiatry, 54(1), 11-24. Elsevier BV.
    Crossref OpenAlex OpenCitations
  48. Donna M. Werling , Daniel H. Geschwind (2013). Sex differences in autism spectrum disorders . Current Opinion in Neurology, 26(2), 146-153. Ovid Technologies (Wolters Kluwer Health).
    Crossref OpenAlex OpenCitations
  49. 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
  50. Catherine Lord (2012). ADOS‐2: Autism diagnostic observation schedule, second edition . ADOS‐2: Autism diagnostic observation schedule, second edition.
    Type: Other
    Crossref
  51. (n.d.). Mead. (2016 July 14). You call me expressive and miss the struggle it takes. https://kpagination.wordpress.com/2016/07/13/you-call-me-expressive-and-miss-the-struggle-it-takes/
    Type: Other
    Crossref
  52. (n.d.). Rosa S. D. R. (2016 April). Thinking person's guide to autism: How can we all do better by our autistic girls? http://www.thinkingautismguide.com/2016/04/how-can-we-all-do-better-by-our.html
    Type: Other
    Crossref
  53. Sparrow S.S. (1984). Vineland adaptive behavior scales: Survey form manual . Vineland adaptive behavior scales: Survey form manual.
    Type: Other
    Crossref
  54. Sparrow S.S. (2005). Vineland adaptive behavior scales–2nd Edition manual . Vineland adaptive behavior scales–2nd Edition manual.
    Type: Other
    Crossref