Note on language: Although there are individual preferences, polls of the autism community regularly demonstrate that autistic persons prefer identity-first language over person-first language (i.e., “autistic person” instead of “person with autism”). This article uses the wording that the community prefers.
Boys’ Autism Prevalence
Autism, also known as autism spectrum disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is a neurological abnormality that affects behavior, social skills, and functioning.
Although earlier studies revealed that males were more likely than other genders to have autism, more recent studies suggest that the current diagnostic criteria emphasize how guys typically exhibit. 1 Boys are therefore more prone to have autistic-like behaviors and characteristics.
What to Know About Childhood Autism
Autism diagnosis in boys
Autism is frequently diagnosed by psychologists and psychiatrists through psychological tests. Additionally, developmental professionals can test young children for autism. An interview with the client (or, in the case of young children, the parent or caregiver) to get history and background information may be part of an autism evaluation. To determine whether an individual’s appearance and symptoms fulfill the diagnostic criteria for autism, the evaluator may also give structured interviews, behavioral rating scales, and direct evaluations.
If a person is masking (camouflaging or disguising) their autistic symptoms, it may be difficult to spot them. Boys exhibit less disguising behaviors than other genders, which may facilitate diagnosis. 2
The fact that many of the tests used to diagnose autism have better test-retest reliability for males than for girls and other genders helps explain why autistic boys are diagnosed earlier than other genders. The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) is a particular autism diagnostic tool that is sometimes called the “gold standard” but is best effective when assessing cisgender boys.
Autism Diagnostic Standards
Communication and social interaction deficiencies or issues that can appear in a variety of circumstances, such as:
- Lack to launch or respond to social encounters, as well as atypical social approach and failure of typical back-and-forth dialog. Reduced sharing of interests, emotions, or affect.
- Difficulty understanding nonverbal cues or communicating them in a way that others can understand.
- Lowered interest in relationships due to difficulty in comprehending, creating, and maintaining relationships.
- Restrictive or repetitious actions, words, hobbies, or interests, such as:
- Repetitive speech or movement (sometimes called “stimming”).
- Strong requirement for dependable routines, structures, or behavior.
(Occasionally called “special interests”) Specific, passionate interests.
- Abnormal reactions to sensory input, such as excessive or insufficient sensitivity to lights, noises, odors, etc.
Early developmental stages are required for the start of symptoms, albeit they may not become completely apparent until later in life when demands outweigh one’s capacity to conceal symptoms.
- Clinical impairment must be caused by symptoms across several domains.
- No alternative diagnosis should be able to describe a set of symptoms better.
Depending on the individual’s level, an autism diagnosis will often specify whether the person needs “assistance,” “substantial support,” or “very considerable support.” This is a measure of how much assistance a person requires to operate and prosper.
How the DSM Explains
The diagnostic criteria for autism were somewhat amended in the most recent DSM, the DSM-5-TR (text revision). Individuals merely had to satisfy two of the three social-communication requirements in the DSM-5. However, according to the 5-TR, a person must satisfy all three social-communication requirements to be classified as having autism. 3
How to Diagnose Autism
How Boys’ Presentation Differs
There is no gender distinction in the autism diagnosis standards. However, a lot of the research used to generate these criteria is focused on the typical presentation of autistic cisgender guys. Boys are more frequently diagnosed with autism and tend to receive the diagnosis earlier than girls or other genders. 4
Neurological disparities in the motor, linguistic, and visual-spatial systems were discovered in a 2022 research of autistic boys and girls, providing evidence that different diagnosis criteria for autism depending on gender may be warranted. 5 These brain variations lend credence to the notion that autism manifests itself differently in males and girls.
The current diagnostic criterion is likely to be present in boys since research has previously concentrated on how symptoms occur in boys.
Why Does Autism Occur?
Researchers are unable to correctly predict who will or will not get autism since they do not completely understand what causes autism. However, given that autistic individuals are born with this characteristic, it is quite likely that autism has a significant hereditary component. Here are some more elements that might cause autism:
Studies on twins have indicated that, if one twin has autism, the other twin has between a 64% and 91% risk of also having autism. Siblings of autistic children have a 20% chance of also having autism. 7 Recent studies have revealed that of all DSM diagnoses, autism has one of the greatest hereditary components. 8
Some genetic conditions, such as Down syndrome, muscular dystrophy, and fragile X syndrome, are more prevalent among autistic persons than in non-autistic populations.
9 This may mean that the genetic combinations that produce autism also include the genes that cause these illnesses.
Another factor that has been connected to a higher likelihood that someone may be autistic is the parent’s age. Autistic children are more likely to be born to older parents. This association might have a similar origin as parental age, which is well known to raise the chance of numerous genetic problems. 10
Researchers can state with certainty that autism is not brought on by environmental factors like parental decisions or vaccinations, even though we are still learning about the precise genetic components that contribute to whether someone will be autistic.
Risk factors and causes of autism spectrum disorder (ASD)
The Treatment for Autism
Treatment for autism differs from that for conditions like depression, anxiety, people with a psychotic condition disorders, personality disorders, etc. since it is a neurodivergence rather than a mental illness. However, persons with autism can experience mental health problems, are more likely to be given certain diagnoses than those without autism, and are also more likely to experience trauma and abuse.
To treat whatever mental health issues they may have, autistic persons may benefit from psychotherapy treatments. Finding effective coping mechanisms and promoting self-acceptance are two things that neurodiverse-affirming therapy may benefit with. This can also aid in spotting, disguising habits, which can be exhausting and unpleasant.
For autism, particularly in youngsters, many healthcare professionals advise applied behavioral analysis (ABA). But many autistic persons claim that using ABA was distressing for them. 11 This can happen if an ABA therapist teaches masking behavior rather than addressing the autistic person’s underlying needs to make the person look less autistic.
Boys are more inclined to externalize their emotional reactions than other genders, and they do not participate in as much masking activity as other genders.
2 Behavior outbursts and sensory meltdowns are two ways this might show themselves. Autistic boys can process and express these emotions more healthily if assistance is provided in selecting safe, effective strategies that will suit their communication and sensory demands.
Speech therapy services can support autistic persons who have trouble communicating express their needs in a way that others can comprehend. Occupational therapy may help them with sensory problems that bother them or interfere with their everyday lives.