Is autism more common among boys?

Autism It is a developmental disorder in which the central nervous system develops in a different way than usual, which leads to difficulties in communication and social skills, and sometimes also repetitive behaviors and narrowing of interests. The prevalence of autism in the United States and Western Europe is estimated at 1-3.3 percent of the population. It is common to think that the phenomenon more common in boysby a significant margin. According to existing estimates, compared to every girl diagnosed with autism, there are between 2.7 and 4.1 diagnosed boys.

dictation Originally published on the Davidson Institute for Science Education website

There are several hypotheses that try to explain this gap between the sexes. According to one of them, human females have biological properties that endow them protection certain from the development of autism, therefore only when their genetic predisposition to autism is particularly strong do clear symptoms appear and the disorder is diagnosed. According to another hypothesis, males have a greater variety of versions of genes (alleles) associated with autism, and therefore more of them pass the threshold necessary for diagnosis.

A third hypothesis suggests the possibility that there are average differences between the sexes in the ability to understand the emotions of others and to analyze and identify patterns and rules in systems. Thus, individuals with autism exhibit an extreme version of normal characteristics that are more commonly associated with males. However, this hypothesis Controversial. Another option is girls and boys disguised Autistic characteristics in their behavior through imitating the social behavior of their peers. In addition, it is possible that mental conditions that are more common in girls, such as anxiety or depression, blur the characteristics of autism during the diagnosis, so the diagnosticians tend to miss the existence of the phenomenon in them.

It is also possible that there is gender bias In autism research and the diagnostic criteria. There are those who claim that many of the studies dealing with autism, and the clinical criteria developed to diagnose the disorder, were mainly based on patterns observed in males, and are therefore less sensitive to its different expression patterns that are more common in females. Recently, the claim that there is no real difference in the prevalence of autism in girls and boys, and that for whatever reasons there are differences between the sexes only in the diagnosis of the phenomenon, has been examined. Indeed, in recent years we have seen a continuous trend of a decrease in the ratio between the sexes in diagnosing autism.

Beyond these differences, over the years there has been a significant increase in the diagnosis of autism in the entire population. in Israel For example, the prevalence of diagnosis increased from 4.5 per thousand people (a little less than half a percent) among those born in 2000, to more than two percent (22.2 per thousand) among those born in 2018. This increase creates the feeling that there are more autistic people today than there were in the past, and fuels the baseless claims of people who claim that autism arises from external causes such as vaccinations, certain medications or watching screens. In practice, it seems that the increase in the rate of autistics diagnosed in the population probably stems from an improvement in our ability to identify the phenomenon, and from the expansion of the criteria for diagnosing the phenomenon over the years, and not necessarily a real increase in its prevalence. For example, in 2014, new diagnostic criteria were adopted that included conditions such as Asperger’s syndrome under the autistic continuum, so that more people are now included under the general definition “autism”.

Extensive research that was recently published sought to examine how the relationship between the sexes has changed over the years. The study included detailed medical data on all children born and recorded in the Swedish Medical Birth Registry between 1985 and 2020. In total, the data of 2,756,779 people were examined, of which 78,522 (2.8 percent) were diagnosed with autism during the follow-up period. The findings showed that over the years there was a sharp and continuous increase in the number of diagnoses, in all age groups, and it reached its peak in adolescence. Until the age of 10, the ratio between the sexes was high and stood at about three diagnosed boys for every girl. After that the ratio began to shrink almost to 1:1 in late adolescence. A model they presented predicted that in the near future there may be almost complete equality in matriculation.

The researchers describe these findings as a phenomenon of delayed completion in girls, meaning a gradual narrowing of the gap between the sexes over time. Here the question arises why girls with autism are diagnosed at an older age than boys. According to them, the study points to the need to investigate the differences in the way autism manifests itself in boys and girls, and the consequences of these differences on the diagnosis. That is, it is important to find out if certain diagnostic methods are more sensitive to a certain sex or gender, and if it is necessary to develop targeted diagnostic methods for girls.

In addition, it is important to remember that the study was based on data from Sweden, a fairly homogeneous country in its population, and with an advanced public health system. Therefore it is difficult to generalize his findings to other regions of the world whose characteristics are different. It is possible that in other countries, with other cultural norms and less accessible to diagnosis, a different picture will be obtained.

Alongside such epidemiological studies, which examine trends that develop in a large population, has also been expanding in recent years the discussion the theoretical and social surrounding the meaning of the diagnosis. For several decades, there has been increasing recognition of neurological variation exists on a wide spectrum in the population. there is who who claim Because the difficulties associated with autism do not arise only from the characteristics of the person himself, but also from the mutual relations between him and the environment.

Such discussions raise the question of how to avoid therapeutic concepts whose entire purpose is to normalize the behavior of autistic people, without taking into account the real needs of the people and their predicaments. This position reflects complexity: recognition that neurological variation is part of human diversity, along with the understanding that difficulties may require support and adjustments.

So it is possible that the changes that have occurred over the years in the criteria for diagnosing autism may testify to the role that society plays in defining behavioral norms. It is also possible that the differences in diagnosis between the sexes reflect not only biological differences but also changes in the way society recognizes behavioral variation throughout life, interprets it and reacts to it. Future studies will be required to examine not only the biological and behavioral side of autism, but also to understand how norms, expectations and living environments affect the way people experience the difficulty and the very fact of receiving the diagnosis.