Autism in girls: Pelphrey calls for targeted research

Scientists and clinicians have worked hard to understand autism in recent years, says neuroscientist Kevin Pelphrey. But most of their hard-won knowledge turns out to be limited in scope, leaving much unknown about autism in one population: girls.

Autism is one area of child development where differentiating between biological sexes is pivotal, Pelphrey explained as he spoke during CASW’s New Horizons in Science briefings on Oct. 15 at George Washington University in Washington, D.C. The briefings were part of ScienceWriters2018, the annual conference of U.S. science writers.

Pelphrey explained that autism is a complex neurobehavioral condition that impairs social interaction and communication skills and can manifest differently in boys and girls. A nationally renowned neuroscientist, professor of neurology at University of Virginia School of Medicine, and father of a young daughter with autism, Pelphrey experiences the impacts of this research on many levels, and he displayed a parent’s passion in his discussion on Monday.

Difficulty in recognizing movements that denote familiar human activity and social gestures is a hallmark of autism. Because the visual system’s ability to process these movements is developed as early as infancy, impaired function of the “social brain”—the parts of the brain involved in social functioning—in an infant can be predictive of autism. Yet new findings show that an impaired social brain is almost anti-predictive of autism in girls.

Pelphrey explained that the behaviors we attribute to autism have different biological origins in boys and girls. While boys with autism often show problems with social and physical perception, girls often show symptoms of attention deficit, anxiety and depression, and they are highly prone to develop eating disorders. Social brain function often proves more resilient in girls than in boys, so that a girl with an autism spectrum disorder can appear hyperactive at times. Taking this evidence into account, Pelphrey argues that new research must continue to be done to determine the best ways to treat all children in ways appropriate to their sex.

The discrepancies in previous research likely stem from fact that the frequency of an autism diagnosis is far lower for girls than boys. Currently, science suggests that there are five boys diagnosed for every girl diagnosed. This imbalance means that in many general studies of autism, most if not all participants are male, providing scant evidence of how autism may be different in girls.

Among Pelphrey’s suggestions are that magnetic resonance imaging (MRI) scans be made more accessible, and that universal screenings for developmental differences be made common practice for infants. Using MRI to target regions of the brain would allow physicians to better identify and diagnose signs of autism early, so that treatment can begin while the brain still has the most plasticity and before autism has emerged in its most syndromic form.

While Pelphrey mentioned that he has experienced pushback on the universal scanning idea and other aspects of his work, he stressed that his research aims at better treatment of the individuals who experience this syndrome in all its beauty and pain. With more careful research on autism in girls, he asserts, physicians, teachers, and therapists alike will become better equipped to treat these children with the care and respect they deserve.