This week, Drs. Casey Burrows from @UMN and Shuting Zheng from @UTexas discuss a new paper looking at sex differences in autism features from 20-40 months of age. A new analysis done with data from the Baby Siblings Research Consortium concludes that, early in life, girls with autism show differences in some autism features (like joint attention) compared to boys. There are many reasons for this, including that boys and girls are just different, period. However, it adds to mounting data which may help explain why more males are diagnosed compared to females. More research needs to examine how girls and females present, what symptoms are harder to observe in females andy why, and most importantly, sheds insight how girls and females with autism need to be specifically supported. More here:

https://www.epicresearch.org/articles/diagnosis-of-autism-occurring-earlier-in-children-though-still-late-for-many-initial-diagnosis-in-adulthood-increasing-in-women

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2837366

Today’s #ASFpodcast explains the potential and the unknowns behind folate, known as leucovorin when prescribe, for treating autism. CBSNews reported on a “miraculous” study using leucovorin that will need further research before it lives up to the type. However, it is an example of how different biological markers may direct what treatments work best in what people, and possibly an example of precision medicine in ASD. Second, more of the mystery of the male/female diagnosis difference in ASD. How do genetics affect liability in males and females? It’s been well established females have more of a certain type of genetic variation, but females are less likely to be diagnosis. New results show that the liability for autism is the same in males and females (both are just as likely to receive a diagnosis based on their genetics), however these two sexes may have a different threshold for an autism diagnosis. Females may need more of these mutations to receive an autism diagnosis. Read more below:

https://link.springer.com/article/10.1007/s00431-024-05762-6

https://pubmed.ncbi.nlm.nih.gov/27752075

https://pubmed.ncbi.nlm.nih.gov/39954678

This week, special podcast correspondent #MiaKotikovski summarizes new research on the increasing prevalence of autism, with a focus on females. While the number of diagnosed females is increasing faster than the number for males, females assigned at birth still are less likely to receive a diagnosis than males. Additional evidence points to females having more genetic mutations and lower cognitive ability, so the questions remain: Are there females with autism who are just not getting diagnosed despite having all the autism features? Why not? Does autism in females “look” the same as autism in males? What sets them apart? These articles are all featured in the year-end highlight of research, so this is the time to get a deep explanation of the latest in sex differences in #autism.

https://pubmed.ncbi.nlm.nih.gov/34563942

https://pubmed.ncbi.nlm.nih.gov/39334436

https://pubmed.ncbi.nlm.nih.gov/33966484

A recent publication in the Lancet was dedicated to clinical recommendations to support autistic females at birth. Because more males than females are diagnosed with autism, their needs are often misunderstood, misinterpreted, or just ignored. Researchers, clinicians, scientists, parents and self-advocates from around the world joined together to identify those needs and propose solutions that can be implemented in everyday care. To read the article in it’s entirety, click here: https://authors.elsevier.com/c/1i5LV8Mut2Mzvb

With just a few weeks to go until June, this week’s podcast is a short summary of the prevalence of transsexuality in the autism community and how many people are autistic in the trans community. More importantly, there are guidelines about the identification and care for those who have these co-occurring conditions. The references mentioned are below:

https://pubmed.ncbi.nlm.nih.gov/36996732/

https://pubmed.ncbi.nlm.nih.gov/36721890/

https://pubmed.ncbi.nlm.nih.gov/36358354/

https://www.tandfonline.com/doi/full/10.1080/15374416.2016.1228462

https://4w.pub/autism-puberty-gender-dysphoria-view-from-an-autistic-desisted-woman/amp/

The CDC released data from the Autism and Developmental Disabilities Monitoring Network (ADDM) on Thursday. In the past 2 years, the prevalence of autism has increased about 20%. Why? Are there more new cases or is diagnostic practices improving? For 20 years there has been fewer Black and Hispanic kids diagnosed. Is that still the case? Listen to this week’s #ASFpodcast to hear some early thoughts, the CDC will join us for an interview on April 20th:

https://www.cdc.gov/mmwr/volumes/72/ss/ss7202a1.htm

https://www.cdc.gov/ncbddd/autism/data.html

This year’s Day of Learning was a huge success, with topics ranging from biological sex differences to mobile technologies all the way to the importance and documented value of leisure activities in people on the spectrum. the speakers included a discussion of the IACC, sex differences, the value of prevalence data, mobile technologies, leisure activities, and a recognition of two advocates who made or make a difference in families: Samantha Els and Suzanne Wright. Listen to this week’s podcast for a quickie, but don’t let it prevent you from watching the longer videos, a link to which can be found below

www.babynavigator.com

www.autismnavigator.com

It’s estimated that anywhere from 10%-30% of females on the spectrum also suffer from an eating disorder, and that autistic traits are high (even without a diagnosis of ASD) in those with eating disorders. There is clearly crossover in the underlying biology somehow, but while that is being determined – help for those with ASD and eating disorders is not waiting. There are many obstacles for autistic women to receive help for their eating disorders, and this podcast outlines the overlap between ASD and ED, and describes what could help women on the spectrum who experience eating disorders.

https://pubmed.ncbi.nlm.nih.gov/33653157/

https://pubmed.ncbi.nlm.nih.gov/34193255/

https://pubmed.ncbi.nlm.nih.gov/34264484/

https://pubmed.ncbi.nlm.nih.gov/33588579/

Girls and boys with autism generally show the same symptoms of ASD overall, but what about different aspects of features? What would happen if you studied girls and boys separately and examined detailed assessments of things like motor skills, repetitive behavior, communication or social interaction? These are where subtle signs of differences between genders is showing up. Girls show a higher age of diagnosis, but that depends on cognitive ability. Also, girls with ASD seem to have superior social interaction skills, which reflects normal gender differences. These differences are magnified over time. A new study also looks at Vitamin D levels during pregnancy and outcome in boys vs. girls…..the results are still unclear but interesting.

https://pubmed.ncbi.nlm.nih.gov/33137209/

https://pubmed.ncbi.nlm.nih.gov/33135392/

https://pubmed.ncbi.nlm.nih.gov/33136459/

A fresh take on an existing topic: why there are more boys diagnosed with ASD than girls. Even from a few months old, girls are different than boys, and they show subtle differences in toddlerhood. But at the time of diagnosis, they score the same on standardized instruments of ASD used to categorize someone as having ASD or not. This means it isn’t about the measures. It could be cultural factors, it could be a protective effect, but there needs to be a better understanding of these differences across the lifespan to help everyone with ASD, especially females.

https://www.cell.com/current-biology/retrieve/pii/S096098222030419X?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS096098222030419X%3Fshowall%3Dtrue

https://doi.org/10.1007/s10803-020-04526-z

https://doi.org/10.1111/jcpp.13242