Table of ContentsView AllTable of ContentsAutism Prevalence in BoysDiagnosis of Autism in BoysHow Presentation Differs in BoysWhat Causes Autism?How Is Autism Treated?
Table of ContentsView All
View All
Table of Contents
Autism Prevalence in Boys
Diagnosis of Autism in Boys
How Presentation Differs in Boys
What Causes Autism?
How Is Autism Treated?
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Language note: Although individual preferences exist, surveys of the autistic community consistently show that autistic people preferidentity-first languagerather than person-first language (i.e., “autistic person” rather than “person with autism”). This article reflects that community language preference.
Autism, known in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) as autism spectrum disorder, is a neurodevelopmental difference that impacts functioning, social skills, and behavior.
Previous research has suggested that autism is more prevalent in boys than other genders, but more recent research suggests that the existing diagnostic criteria highlight how boys tend to present.As such, boys are more likely to exhibit behaviors and mannerisms that are recognized as autistic.
What to Know About Autism in Kids
Psychologists and psychiatrists often usepsychological assessmentsto diagnose autism. Developmental specialists can also assess for autism in young children. Autism assessments may include a diagnostic interview during which the client (or in young children, the parent or caregiver) provides history and background information. The evaluator may also administer structured interviews, behavioral ratingscales, and direct assessments to determine whether ran individual’s presentation and symptoms meet the diagnostic criteria for autism.
It can be challenging to identify autistic traits if an individual is masking (camouflaging or hiding) their autistic traits. Boys engage in less masking behavior than other genders, which can make the diagnostic process easier.
Boys also engage in less masking behavior because society is more accepting of autistic traits in masculine-presenting people and more generally is accepting of men not fitting in or being able to do certain things. Women and other feminine-presenting folks are held to a higher standard in general, including the number of autistic traits they are allowed to show without masking.
Many existing measures to test for autism have higher validity for boys than for girls and other genders, contributing to autistic boys being identified at an earlier age compared to other genders. Specifically, the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) is often referred to as the “gold standard” of autism assessment but is most accurate in evaluating cisgender boys.
Diagnostic Criteria for Autism
Deficits or problems related tocommunicationand social interactions, manifesting in multiple contexts and including:
Restrictive or repetitive behaviors, language, interests, or activities, including:
Note that this criteria is limited, pathologizing, and does not accurately describe the autistic experience for many folks.
Typically, an autism diagnosis includes information about whether an individual requires “support,” “substantial support,” or “very substantial support” based on the individual’slevel. This refers to how much support the individual needs in order to function and thrive.
What the DSM SaysThe newest edition of theDSM, the DSM-5-TR (text revision), modified the diagnostic criteria for autism slightly. In the DSM-5, individuals only needed to meet two out of the three social-communication criteria. However, in the 5-TR, all three social-communication criteria must be met for an individual to meet the criteria for autism.
What the DSM Says
The newest edition of theDSM, the DSM-5-TR (text revision), modified the diagnostic criteria for autism slightly. In the DSM-5, individuals only needed to meet two out of the three social-communication criteria. However, in the 5-TR, all three social-communication criteria must be met for an individual to meet the criteria for autism.
How Autism Is Diagnosed
A 2022 study of autistic boys and girls found neurological differences related to motor, language, and visual-spatial systems, suggesting that distinct diagnostic criteria for autism based on gender may be appropriate.These brain differences support the idea that autism does in fact look different in boys than in girls.
Becauseresearchhas historically focused on symptom presentation in boys, the current diagnostic criteria is likely to manifest in boys.
Researchers do not fully understand what causesautismand cannot accurately predict who will or will not be autistic. However, because autistic people are born this way, it is highly likely that autism has a stronggeneticcomponent. Here are some other factors that may contribute to autism:
Since autism is aneurodivergenceand not a mental illness, treatment looks different than it would for an issue like depression, anxiety, psychotic disorders, personality disorders, et cetera. However, autistic people can develop mental health issues and are at higher risk for many diagnoses than non-autistic people, and they are at higher risk for trauma and abuse than non-autistic people.
Autistic people may benefit from psychotherapy services to treat any mental health diagnoses they have.Neurodiverse-affirming therapycan help with self-acceptance and identifying coping skills that work for them. This can additionally help in identifying masking behaviors, which can be stressful and lead to burnout.
Many providers will recommend applied behavioral analysis (ABA) for autism, especially in children. However, many autistic people report that their experience with ABA was traumatic.This can occur when an ABA therapist teaches masking behavior with the goal of making the individual appear less autistic rather than meeting the autistic person’s underlying needs.
Boys do not engage in as much masking behavior as other genders, and they are more likely to externalize their emotional responses.This can manifest as sensory meltdowns and behavioral outbursts. Supporting autistic boys in identifying effective, safe skills to meet their communication and sensory needs can help them process and express these feelings in a healthier way.
Autistic people who struggle with communication can benefit from speech therapy services to help them express their needs in a way that those around them can understand. They may also benefit fromoccupational therapyto address sensory issues that cause distress or interfere with daily life.
Getting Support for Autism
11 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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