Characteristics of restricted interests in girls with ASD compared to boys: a systematic review of the literature

Eur Child Adolesc Psychiatry. 2024 Apr;33(4):987-1004. doi: 10.1007/s00787-022-01998-5. Epub 2022 May 30.

Abstract

The existence of a female phenotype profile in autistic spectrum disorder is one of the current hypotheses to explain the diagnostic discrepancy between men and women. In this context, an international literature review was carried out to evidence and describe the characteristics of restricted interests found in girls with autistic spectrum disorder. A documentary search was conducted on PubMed and a systematic literature review was carried out based on the PRISMA methodology. We selected studies with a population of boys and girls diagnosed as autistic according to the DSM-IV or the DSM-5, in which quantitative and descriptive comparisons of restricted interests, according to gender were carried out. Nineteen studies were found to be relevant. Fifteen enabled a refining of the characteristics of restricted interests among females: fewer restricted interests were identified in comparison with boys, and the autistic girls' interests seem to be closer to those of neurotypical girls than to those of autistic boys, which thus led to more complex screening. Age and Intelligence quotient seem to be two factors that trigger variations in restricted interests differently according to gender. Representations among professionals also have an impact on diagnoses among girls. For future research, one of the perspectives could be a comparison between girls with autism and neurotypical girls to limit gender bias. The present results contribute to potentially extending knowledge of a female phenotypical profile in autism and show the need to improve the general population's awareness, to improve health professionals' training and possibly to revise the diagnostic tools.

Keywords: Autistic spectrum disorder; Circumscribed interests; Diagnosis; Girl; Restricted interests; Women.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Autism Spectrum Disorder* / diagnosis
  • Autism Spectrum Disorder* / epidemiology
  • Autistic Disorder*
  • Child
  • Child Development Disorders, Pervasive*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Humans
  • Male
  • Sexism