Sex differences in sensory processing in children with autism spectrum disorder

Abstract

Despite the high prevalence of sensory processing difficulties in children with autism spectrum disorder (ASD), little research has focused on the sex differences in sensory processing. Furthermore, there is a lack of knowledge on the female-specific symptoms of ASD, contributing to later referral, diagnosis and intervention. In this study, we examined the sex differences in sensory processing symptoms in large cohorts of ASD children (N = 168; 26 females, 142 males) and typically developing (TD) children (N = 439; 209 females, 230 males). For this, we translated the sensory processing measure (SPM) and SPM - Preschool (SPM-P) Home Forms to French. The SPM/SPM-P are parent/caregiver questionnaires that assess typical behavioral responses to sensory stimuli. Overall, our results showed that the magnitude of the differences in sensory processing between males and females is larger in ASD children relative to TD children, with females showing more severe symptoms in Hearing, as well as Balance and Motion subscales. Additionally, linear discriminant analysis showed that the SPM/SPM-P are good at discriminating TD children from ASD, children with higher accuracy rates for females than for males. These findings are discussed in light of the heterogeneity of sensory processing difficulties present in ASD. Overall, our results suggest that there seem to be female-specific profiles in sensory processing difficulties in ASD. Implications of findings concerning sex differences in sensory processing and their potential for improving identification and diagnosis of ASD females are discussed. LAY SUMMARY: The present study examined sex differences in behavioral responses to sensory stimuli in children with autism spectrum disorder (ASD), and typically developing (TD) children. While there is a small trend for TD males to show more sensory processing atypicalities, female ASD children show significantly more atypical responses compared to their male counterparts. This has important implications for characterizing female autism profiles, and ultimately improving the chance for earlier detection, diagnosis and treatment.

Keywords: autism spectrum disorder (ASD); child development; sensory processing; sensory processing measure (SPM); sex differences.

FIGURE 1

Linear discrimination analysis global accuracy and specificity for females (red), males (blue) and the combined sample (gray). Sensitivity scores were not split by sex due to the low number of autism spectrum disorder females in the testing dataset. Error bars represent the SD. *p < 0.001, after correction for multiple comparisons

FIGURE 2

Dotplot displaying the number of individual observations (purple for autism spectrum disorder, green for typically developing) across the linear discriminant factor generated with the six sensory subscales. All dots correspond to the test subset (training subset is added in Figure S1). Individuals for which the linear discrimination analysis (LDA) wrongly estimated their membership to a group are displayed with a cross. LDA cutoff is displayed with a blue dotted line. TP, true positive; TN, true negative; FN, false negative; FP, false positive

FIGURE 3

Normalized mean Z‐score of the six SPM sensory subscales separately for males (blue) and females (red) in each group. Error bars represent the standard error of the mean. *p < 0.05; +p = 0.05, after correction for multiple comparisons. SPM, sensory processing measure