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Sex-Specific Metrics for Success: Gaps in Social Word Use Are Bigger for Autistic Girls than Boys

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Title: Sex-Specific Metrics for Success: Gaps in Social Word Use Are Bigger for Autistic Girls than Boys
Language: English
Authors: Meredith Cola (ORCID 0000-0001-6737-6828), Sarah Schillinger (ORCID 0009-0002-9842-7418), Margaret Lyons, Amanda Lee (ORCID 0009-0004-3973-6338), Calliana Faulk, Maxine Covello, Nasya Howard, Hannah Franke, Alexandria Mulqueen, Lizzy Fulop, Azia Knox, Sunghye Cho, Mark Y. Liberman, Juhi Pandey, Ashlee Yates Flanagan (ORCID 0000-0002-8428-2820), Joseph Donaher, Robert T. Schultz, Julia Parish-Morris (ORCID 0000-0001-9633-2904)
Source: Autism: The International Journal of Research and Practice. 2026 30(6):1608-1614.
Availability: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
Peer Reviewed: Y
Page Count: 7
Publication Date: 2026
Sponsoring Agency: National Institute on Deafness and Other Communication Disorders (NIDCD) (DHHS/NIH)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (DHHS/NIH)
Contract Number: R01DC018289
T32DC017703
Document Type: Journal Articles
Reports - Research
Descriptors: Autism Spectrum Disorders, Sex, Gender Differences, Language Usage, Social Behavior, Diagnostic Tests, Observation
Assessment and Survey Identifiers: Autism Diagnostic Observation Schedule
DOI: 10.1177/13623613261417535
ISSN: 1362-3613
1461-7005
Abstract: Autistic girls are often diagnosed late, missed, or misdiagnosed, which can negatively impact quality of life and mental health. Although research shows the social profiles of autistic girls differ from boys in systematic ways that might explain gaps in diagnosis, little is known about how autistic girls' social language compares to their same-sex non-autistic peers. This study investigated social words--words that make reference to other people--produced by 138 age- and IQ-matched autistic and non-autistic youth (ages 6-15) during one Autism Diagnostic Observation Schedule, Second Edition task. Girls used significantly more social words than boys across both diagnostic groups. There was a larger gap in social word production between autistic girls and non-autistic girls than autistic boys and non-autistic boys, with non-autistic girls using the most social words. Non-autistic girls' social language behavior--including their social word production--sets an especially high bar for autistic girls, who often report trying to blend in with other girls. Growing evidence of the distinct social language profiles of autistic and non-autistic girls versus boys should guide researchers and clinicians to assess autism in ways that are sensitive to sex-associated differences and develop interventions that consider the norms of youth's target social circles.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1506443
Database: ERIC
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  Value: <anid>AN0193858184;f9d01jun.26;2026May21.02:15;v2.2.500</anid> <title id="AN0193858184-1">Sex-specific metrics for success: Gaps in social word use are bigger for autistic girls than boys </title> <p>Autistic girls are often diagnosed late, missed, or misdiagnosed, which can negatively impact quality of life and mental health. Although research shows the social profiles of autistic girls differ from boys in systematic ways that might explain gaps in diagnosis, little is known about how autistic girls' social language compares to their same-sex non-autistic peers. This study investigated social words—words that make reference to other people—produced by 138 age- and IQ-matched autistic and non-autistic youth (ages 6–15) during one Autism Diagnostic Observation Schedule, Second Edition task. Girls used significantly more social words than boys across both diagnostic groups. There was a larger gap in social word production between autistic girls and non-autistic girls than autistic boys and non-autistic boys, with non-autistic girls using the most social words. Non-autistic girls' social language behavior—including their social word production—sets an especially high bar for autistic girls, who often report trying to blend in with other girls. Growing evidence of the distinct social language profiles of autistic and non-autistic girls versus boys should guide researchers and clinicians to assess autism in ways that are sensitive to sex-associated differences and develop interventions that consider the norms of youth's target social circles. Autism is often diagnosed later in girls and women as compared to boys and men. More research is needed to understand how autism presents differently in girls. This study investigates how autistic and non-autistic youth aged 6 to 15 years use social words (e.g. "friend," "mom," "help," "talk") during an interview about friends, relationships, and marriage as part of an autism diagnostic assessment. Overall, girls used more social words compared to boys and talked more about friends. Specifically, non-autistic girls used the most social words in comparison with other groups. Highly social language produced by non-autistic girls may make it especially hard for autistic girls to blend in with other girls and could lead them to engage in more camouflaging behaviors to hide their autistic characteristics. With such different average social language behavior from girls and boys, researchers should consider adapting autism assessments and interventions to support the unique needs of autistic girls.</p> <p>Keywords: autism; communication and language; sex differences; social communication; social phenotype</p> <hd id="AN0193858184-2">Introduction</hd> <p>Girls are less likely to be diagnosed with autism than boys ([<reflink idref="bib25" id="ref1">25</reflink>]), even when they have comparable autistic characteristics ([<reflink idref="bib8" id="ref2">8</reflink>]). Girls are also diagnosed disproportionately later in life ([<reflink idref="bib9" id="ref3">9</reflink>]; [<reflink idref="bib23" id="ref4">23</reflink>]). Diagnostic disparities may be attributable to sex differences in the behavioral presentation of autism across development ([<reflink idref="bib19" id="ref5">19</reflink>]) and may contribute to later emotional and social difficulties ([<reflink idref="bib17" id="ref6">17</reflink>]).</p> <p>Childhood social interactions have many universal elements, but certain domains—including social language (i.e. language used for social purposes)—differ by sex during middle childhood. For example, non-autistic girls generally spend more time engaged in conversation, self-disclose more, and have more extended dyadic interactions than non-autistic boys ([<reflink idref="bib21" id="ref7">21</reflink>]). These sex differences in social language behavior in non-autistic populations mean autistic girls who are trying to fit into neurotypical norms have a unique set of goalposts that may be harder to scale.</p> <p>Some evidence suggests that verbally fluent autistic girls produce a unique pattern of social language and communication behaviors that reflect population-level sex differences. For example, research shows autistic girls employ language styles and produce content that—consciously or not—could help them to "blend in" with non-autistic peers. These subtle differences include distinct patterns of filled pauses ([<reflink idref="bib20" id="ref8">20</reflink>]), prosodic elements ([<reflink idref="bib6" id="ref9">6</reflink>]), cognitively rich content words like "think" and "know" ([<reflink idref="bib3" id="ref10">3</reflink>]), and plural pronouns ([<reflink idref="bib26" id="ref11">26</reflink>]). A person's overall tendency to talk about social topics has been considered a marker of social phenotype in autism ([<reflink idref="bib12" id="ref12">12</reflink>]) and has recently been shown to differentiate autistic girls and boys ([<reflink idref="bib7" id="ref13">7</reflink>]).</p> <p>A study by [<reflink idref="bib7" id="ref14">7</reflink>] found that autistic girls (<emph>N</emph> = 25; M = 10.66 years) used more social words than autistic boys (<emph>N</emph> = 76; M = 10.15 years) during the conversation and reporting sections of the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2; [<reflink idref="bib16" id="ref15">16</reflink>]). However, the small exploratory sample of non-autistic children (<emph>N</emph> = 34) in that study rendered it unclear whether the findings reflected autism-specific differences or a broader trend that also distinguishes non-autistic boys and girls.</p> <p>To address this knowledge gap, we investigated social word use in a matched sample of autistic and non-autistic girls and boys during the Friends, Relationships, and Marriage section of the ADOS-2. This task elicits discussion of a variety of social relationships and has been used in prior research ([<reflink idref="bib7" id="ref16">7</reflink>]; [<reflink idref="bib13" id="ref17">13</reflink>]; [<reflink idref="bib14" id="ref18">14</reflink>]; [<reflink idref="bib18" id="ref19">18</reflink>]). Social words were defined as words that make reference to other people (e.g. "classmates," "them"). The primary question—whether increased social word use in girls is a broader <emph>population-level difference</emph> that emerges in autistic children too, or whether these differences are <emph>specific to autism</emph>—has implications for understanding behavior in autistic children's potential target peer groups, and could inform the development of sex-sensitive social supports.</p> <hd id="AN0193858184-3">Methods</hd> <p></p> <hd id="AN0193858184-4">Participants</hd> <p>One hundred thirty-eight verbally fluent autistic and non-autistic youth (ages 6–15) participated in research at the Children's Hospital of Philadelphia. Participant sex was characterized using parent/caregiver-reported assigned sex at birth. Youth participated in a series of studies that included autism diagnostic assessments and IQ testing (S1). Participants with complete data (ADOS-2 recordings and IQ testing) were selected from the larger pool. Participants were excluded if they had a full-scale IQ or verbal IQ ⩽ 70. Diagnostic groups were matched on average age and IQ (Table 1). Autistic girls and boys were group-matched on parent- and clinician-rated autistic traits.</p> <p>Table 1. Demographic and clinical characteristics of participants (means, standard deviations, and ranges).</p> <p>Graph</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /></colgroup><thead><tr><th /><th align="left" colspan="2">Autistic (<italic>N</italic> = 82)</th><th align="left" colspan="2">Non-autistic (<italic>N</italic> = 56)</th><th align="left" colspan="3">Effects</th></tr></thead><tbody><tr><td>Sex ratio</td><td colspan="2">26f, 56m (68% Male)</td><td colspan="2">24f, 32m (57% Male)</td><td colspan="3"><italic>p</italic> = 0.25</td></tr><tr><td>Race</td><td colspan="2">Asian or Pacific Islander: 4.88% (<italic>n</italic> = 4) Black or African American: 3.66% (<italic>n</italic> = 3) Multiracial: 6.10% (<italic>n</italic> = 5) White: 85.36 % (<italic>n</italic> = 70)</td><td colspan="2">Asian or Pacific Islander: 1.79% (<italic>n</italic> = 1) Black or African American: 33.93% (<italic>n</italic> = 19) Multiracial: 10.71% (<italic>n</italic> = 6) White: 53.57% (<italic>n</italic> = 30)</td><td colspan="3">–</td></tr><tr><td>Maternal Education</td><td colspan="2">High school or less: 2.44% (<italic>n</italic> = 2) Bachelor's or less: 48.78% (<italic>n</italic> = 40) Graduate degree: 36.59% (<italic>n</italic> = 30) Not reported: 12.20% (<italic>n</italic> = 10)</td><td colspan="2">High school or less: 7.14% (<italic>n</italic> = 4) Bachelor's or less: 48.21% (<italic>n</italic> = 27) Graduate degree: 33.93% (<italic>n</italic> = 19) Not reported: 10.72% (<italic>n</italic> = 6)</td><td colspan="3">–</td></tr><tr><th /><th align="left">Female</th><th align="left">Male</th><th align="left">Female</th><th align="left">Male</th><th align="left">Sex</th><th align="left">Dx</th><th align="left">Sex in AUT</th></tr><tr><td>Age (years)</td><td>10.69 (1.57)8.7–14.0</td><td>10.26 (2.31)6.1–15.2</td><td>10.35 (2.47)6.4–15.2</td><td>10.23 (2.30)6.9–15.1</td><td><italic>p</italic> = 0.47<italic>d</italic> = −0.13</td><td><italic>p</italic> = 0.77<italic>d</italic> = −0.05</td><td><italic>p</italic> = 0.38<italic>d</italic> = −0.21</td></tr><tr><td>Full-Scale IQ</td><td>105.81 (11.84)78–131</td><td>106.96 (14.12)81–148</td><td>106.71 (15.16)82–134</td><td>109.78 (10.53)86–133</td><td><italic>p</italic> = 0.45<italic>d</italic> = 0.13</td><td><italic>p</italic> = 0.41<italic>d</italic> = 0.85</td><td><italic>p</italic> = 0.72<italic>d</italic> = 0.09</td></tr><tr><td>Verbal IQ</td><td>106.31 (12.71)79–134</td><td>108.14 (14.21)79–150</td><td>108.63 (16.44)80–148</td><td>108.81 (12.71)86–131</td><td><italic>p</italic> = 0.69<italic>d</italic> = 0.07</td><td><italic>p</italic> = 0.63<italic>d</italic> = 0.08</td><td><italic>p</italic> = 0.58<italic>d</italic> = 0.13</td></tr><tr><td>Non-verbal IQ</td><td>105.92 (13.58)73–133</td><td>106.55 (14.28)86–143</td><td>103.17 (14.99)79–132</td><td>108.16 (9.93)89–128</td><td><italic>p</italic> = 0.28<italic>d</italic> = 0.19</td><td><italic>p</italic> = 0.88<italic>d</italic> = −0.03</td><td><italic>p</italic> = 0.85<italic>d</italic> = 0.05</td></tr><tr><td>ADOS-2 Total</td><td>10.77 (4.99)3–23</td><td>10.98 (4.28)4–21</td><td>1.33 (1.60)0–7</td><td>1.75 (1.55)0–5</td><td>–</td><td>–</td><td><italic>p</italic> = 0.84<italic>d</italic> = 0.05</td></tr><tr><td> ADOS-2 SA</td><td>8.19 (4.14)3–17</td><td>8.41 (3.62)3–16</td><td>1.21 (1.25)0–5</td><td>1.50 (1.39)0–4</td><td>–</td><td>–</td><td><italic>p</italic> = 0.81<italic>d</italic> = 0.06</td></tr><tr><td> ADOS-2 RRB</td><td>2.58 (1.86)0–7</td><td>2.57 (1.68)0–7</td><td>0.13 (0.45)0–2</td><td>0.25 (0.51)0–2</td><td>–</td><td>–</td><td><italic>p</italic> = 0.99<italic>d</italic> = 0.003</td></tr><tr><td>SCQ Total Score</td><td>19.88 (5.85)8–31</td><td>19.16 (7.41)5–38</td><td>2.33 (2.74)0–10</td><td>2.33 (1.81)0–7</td><td>–</td><td>–</td><td><italic>p</italic> = 0.66<italic>d</italic> = −0.10</td></tr></tbody></table> </ephtml> </p> <p>1 CSS: ADOS-2 calibrated severity score; SA CSS: social affect calibrated severity score; RRB CSS: repetitive behaviors/restricted interests calibrated severity score. Chi-square tests with Yates' continuity correction tested for diagnostic group differences in sex ratio and maternal educational attainment. <emph>p</emph>-values and Cohen's <emph>d</emph> values for main effects of sex and diagnosis are shown, as well as <emph>p</emph> and Cohen's <emph>d</emph> values of sex differences in the autism group only. One male non-autistic participant was missing SCQ data.</p> <hd id="AN0193858184-5">Measures</hd> <p>Participants completed the ADOS-2 Module 3 ([<reflink idref="bib16" id="ref20">16</reflink>]), a clinician-administered assessment of autism characteristics. Parents/caregivers completed the Social Communication Questionnaire (SCQ; [<reflink idref="bib24" id="ref21">24</reflink>]). Autism diagnoses were made by doctoral-level clinicians using the clinical best estimate approach ([<reflink idref="bib15" id="ref22">15</reflink>]) which prioritizes <emph>Diagnostic and Statistical Manual of Mental Disorders</emph> (5th ed., <emph>DSM</emph>-5) criteria.</p> <hd id="AN0193858184-6">Language sample</hd> <p>Language data were drawn from the ADOS-2 Module 3 Friends, Relationships, and Marriage section and orthographically transcribed by annotators. LIWC-22 software ([<reflink idref="bib4" id="ref23">4</reflink>]) was used to calculate the overall number of words, and the number of social, friend, and family words produced by participants (S2).</p> <hd id="AN0193858184-7">Statistical approach</hd> <p>Data were analyzed using generalized linear regression models (GLM) in R ("lme4" package) with sex, diagnosis, age, and IQ as covariates. Estimated effects, standard errors (SE), <emph>z</emph>-values, and <emph>p</emph>-values are provided. Dependent variables were positive, interval, and non-normally distributed (Shapiro–Wilk test <emph>p</emph>s < 0.001); these data were modeled using a Poisson distribution with a log link. Significance values for planned pairwise comparisons of estimated marginal means were corrected using the Tukey method. GLM modeled relationships between social language and clinical phenotype. For each dependent variable (i.e. social, friend, and family words), we removed outliers ±2 SDs from the mean in each subgroup. To determine whether social word production was associated with clinician-rated phenotype in autism, ADOS-2 Social Affect scores were modeled as a function of social word production.</p> <hd id="AN0193858184-8">Dependent variables</hd> <p>Following the transcription and statistical analysis procedures outlined in [<reflink idref="bib7" id="ref24">7</reflink>], preliminary analyses examined total word count controlling for sex, diagnosis, age, and IQ. Results revealed a significant interactive effect of sex and diagnosis on overall word count (<emph>p</emph> = 0.009), with the non-autistic group producing significantly more words than the autistic group (Table 2). In addition, non-autistic girls produced significantly more total words than autistic girls (estimate: −0.08, SE: 0.01, <emph>z</emph> = −5.71, <emph>p</emph> < 0.001), autistic boys (estimate: −0.27, SE: 0.01, <emph>z</emph> = −23.54, <emph>p</emph> < 0.001), and non-autistic boys (estimate: 0.24, SE: 0.01, <emph>z</emph> = 18.83, <emph>p</emph> < 0.001). Thus, to understand social word use in the context of each individual's overall volubility, subsequent analyses were conducted on the number of social words standardized per 1000 words. To assess the dimensional relationship between language features and autism characteristics, autism characteristics were measured using ADOS-2 domain scores.</p> <p>Table 2. Characteristics of participant speech by sex and diagnosis (means, standard deviations, and ranges).</p> <p>Graph</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /></colgroup><thead><tr><th /><th align="left" colspan="2">Autistic</th><th align="left" colspan="2">Non-autistic</th><th /></tr><tr><th /><th align="left">Female</th><th align="left">Male</th><th align="left">Female</th><th align="left">Male</th><th align="left">Sex*Dx effect</th></tr></thead><tbody><tr><td>Total Words</td><td>452.72 (265.22)99–1172</td><td>368.13 (222.08)21–977</td><td>484.21 (217.40)122–1058</td><td>382.00 (216.57)100–1138</td><td><italic>p</italic> = 0.01est: −0.05</td></tr><tr><td>Social Words (per 1000)</td><td>165.96 (41.46)76–238</td><td>144.40 (30.83)53–206</td><td>176.54 (25.43)136–222</td><td>144.97 (30.36)88–236</td><td><italic>p</italic> = 0.03est: −0.06</td></tr><tr><td>Friend Words (per 1000)</td><td>8.72 (7.60)0–30</td><td>7.44 (7.55)0–33</td><td>10.71 (6.76)0–23</td><td>8.44 (6.30)0–24</td><td>–</td></tr><tr><td>Family Words (per 1000)</td><td>9.75 (7.43)0–28</td><td>8.91 (10.17)0–53</td><td>8.38 (7.62)0–30</td><td>9.44 (9.14)0–28</td><td>–</td></tr></tbody></table> </ephtml> </p> <p>2 Effect sizes for GLM are reported as unstandardized effects. The final GLM model (glm(variable ~ age.z + IQ.z + dx*sex, data = lang.par, family = "Poisson")) accounts for age (centered), IQ (centered), and examines the interactive effect of sex and diagnosis as the primary predictor variable.</p> <hd id="AN0193858184-9">Results</hd> <p></p> <hd id="AN0193858184-10">Social words</hd> <p>A GLM controlling for age and IQ revealed a significant interactive effect of sex and diagnosis on participant social word production (estimate: −0.06, SE: 0.02, <emph>z</emph> = −2.18, <emph>p</emph> = 0.03). Tukey-corrected pairwise comparisons revealed the effect was driven by non-autistic girls producing more social words than any other subgroup (Figure 1, Table 2). Non-autistic girls produced significantly more social words than autistic girls (estimate: −0.06, SE: 0.02, <emph>z</emph> = −3.12, <emph>p</emph> = 0.001), autistic boys (estimate: −0.20, SE: 0.02, <emph>z</emph> = −10.44, <emph>p</emph> < 0.001), and non-autistic boys (estimate: 0.13, SE: 0.02, <emph>z</emph> = 9.06, <emph>p</emph> < 0.001). Autistic girls produced significantly more social words than autistic boys (estimate: 0.13, SE: 0.02, <emph>z</emph> = 6.81, <emph>p</emph> < 0.001) and non-autistic boys (estimate: 0.13, SE: 0.02, <emph>z</emph> = 5.82, <emph>p</emph> < 0.001). Autistic boys and non-autistic boys produced similar amounts of social words (estimate: −0.01, SE: 0.02, <emph>z</emph> = −0.30, <emph>p</emph> = 0.99).</p> <p>Graph: Figure 1. Social word use by sex and diagnosis presented as mean values. Error bars represent standard error of the mean. *** p ⩽ 0.001.</p> <hd id="AN0193858184-11">Friend words</hd> <p>To assess the types of social words participants produced, we investigated use of friend and family words in each diagnostic group separately, in alignment with procedures outlined in the work by [<reflink idref="bib7" id="ref25">7</reflink>]. In the autistic group, a GLM controlling for age and IQ revealed a significant effect of sex on friend word production (estimate: −0.18, SE: 0.08, <emph>z</emph> = −2.13, <emph>p</emph> = 0.03), with autistic girls producing significantly more friend words than autistic boys. In the non-autistic group, a GLM revealed significant effect of sex on participant friend word production (estimate: −0.23, SE: 0.08, <emph>z</emph> = −2.59, <emph>p</emph> < 0.001), with girls producing more friend words than boys.</p> <hd id="AN0193858184-12">Family words</hd> <p>GLMs controlling for age and IQ revealed no significant effect of sex on participant family word production in the autistic (estimate: −0.09, SE: 0.08, <emph>z</emph> = −1.15, <emph>p</emph> = 0.25) and non-autistic group (estimate: 0.13, SE: 0.09, <emph>z</emph> = 1.37, <emph>p</emph> = 0.17).</p> <hd id="AN0193858184-13">Correlations with clinician-rated phenotype</hd> <p>After controlling for age, IQ, and sex, social word production significantly predicted ADOS-2 SA total scores in the autistic group (estimate: −0.004, SE: 0.001, <emph>z</emph> = −3.67, <emph>p</emph> < 0.001), indicating that participants who used fewer social words during this task were rated as having greater autism characteristics on this measure. When examined in each sex separately, this effect held in autistic girls (estimate: −0.005, SE: 0.002, <emph>z</emph> = −2.47, <emph>p</emph> = 0.01) and autistic boys (estimate: −0.004, SE: 0.002, <emph>z</emph> = −2.45, <emph>p</emph> = 0.01). In the non-autistic group, social word production did not significantly predict ADOS-2 SA scores (estimate: 0.005, SE: 0.004, <emph>z</emph> = 1.11, <emph>p</emph> = 0.27).</p> <hd id="AN0193858184-14">Discussion</hd> <p>This study investigated sex differences in social phenotype, as measured by natural language samples, during one task of a diagnostic assessment in autistic and non-autistic youth. We addressed a critical question: Are sex differences in the social language of autistic children <emph>unique to autism</emph> ([<reflink idref="bib7" id="ref26">7</reflink>]) or do they reflect <emph>population-level sex differences</emph> that occur in boys and girls regardless of diagnosis? Building on prior research, we found that girls produced more social words than boys, reflecting a population-level sex difference in language use that emerges in both non-autistic and autistic children. Girls also talked more about friends than boys, and social words predicted clinician-rated social phenotype. This study is therefore an important extension of prior research on sex-based variation in social language in autism ([<reflink idref="bib7" id="ref27">7</reflink>]) because it demonstrates that sex differences in autistic girls' and boys' social language reflect population-level differences that also appear in autism.</p> <hd id="AN0193858184-15">Societal expectations</hd> <p>Why do girls—autistic or not—talk more about social topics than boys? One possibility is that social demands and standards differ by sex, and this impacts what girls and boys say and do. In Western cultures, the social contexts of girls and boys differ from an early age across a variety of domains. For example, children demonstrate an awareness of sex/gender-based expectations about behavior by age 12 months, when they show a preference for gender-typical toys ([<reflink idref="bib2" id="ref28">2</reflink>]). In terms of emotional sex/gender-based expectations, research suggests that girls are expected to display more positive and internalizing emotions, while it is more acceptable for boys to display externalizing emotions ([<reflink idref="bib5" id="ref29">5</reflink>]). Girls' friendships are characterized by social conversation and self-disclosure, while boys' more often revolve around activities like organized sports ([<reflink idref="bib21" id="ref30">21</reflink>]; [<reflink idref="bib22" id="ref31">22</reflink>]). Thus, girls and boys develop in different contexts, and the metric for achieving "social success" varies by sex/gender (i.e. for girls, emotional sharing and self-disclosure may be more contextually important than for boys).</p> <p>The implications for autism are clear Due to higher demands for social and emotional competence in girls, autistic girls and women may feel pressured to try and achieve gender-specific expectations about social language behavior by hiding their autistic traits or compensating socially (e.g. camouflaging, masking; [<reflink idref="bib1" id="ref32">1</reflink>]; [<reflink idref="bib10" id="ref33">10</reflink>]; [<reflink idref="bib11" id="ref34">11</reflink>]), more so than autistic boys and men. With such different average social language behavior from girls and boys, researchers should consider adapting autism assessments and interventions to support the unique needs of autistic girls and women. Specifically, when making determinations about what is "normal," it may be beneficial for researchers/clinicians to compare autistic girls' social language to the social language produced by same-sex non-autistic peers, rather than to the language of autistic boys.</p> <p>Several limitations of the current research should be considered when interpreting our results. First, we utilized a frequency-based lexical analysis, which does not provide information regarding the appropriateness or context of the social words. Second, we assessed language in one conversational context (i.e. a clinical interview about friends, relationships, and marriage). Thus, it is unknown whether our findings would replicate in other, more naturalistic contexts (e.g. conversations with a peer). Third, it is possible that participants' social word production was impacted by their level of comfort discussing these topics with an unfamiliar adult, which could relate to their experiences with gendered socialization (e.g. girls may be conditioned to talk more readily about social topics than boys). Fourth, we did not collect information about participants' gender identity, which limited our ability to examine nuances related to gender expression and social communication. Fifth, our sample was largely White, educated, and did not include individuals with ID, which may limit generalizability of our results.</p> <hd id="AN0193858184-16">Conclusion</hd> <p>From birth, girls and boys are exposed to sex-differentiated societal pressures and influences that shape behavior. In this study, we demonstrated that observed sex differences in one area of behavior—social language—transcend diagnostic status. We found that girls used more social words than boys, and non-autistic girls used the most social words of all. Heightened sociality in non-autistic girls establishes especially high expectations for autistic girls attempting to blend in with their non-autistic peers. For autistic girls, observed sex differences in the "average" social language behaviors of non-autistic peer groups should illuminate new paths to accurate autism assessment, and inform personalized supports to help autistic girls.</p> <hd id="AN0193858184-17">Supplemental Material</hd> <p>Graph: Supplemental material, sj-docx-1-aut-10.1177_13623613261417535 for Sex-specific metrics for success: Gaps in social word use are bigger for autistic girls than boys by Meredith Cola, Sarah Schillinger, Margaret Lyons, Amanda Lee, Calliana Faulk, Maxine Covello, Nasya Howard, Hannah Franke, Alexandria Mulqueen, Lizzy Fulop, Azia Knox, Sunghye Cho, Mark Y Liberman, Juhi Pandey, Ashlee Yates Flanagan, Joseph Donaher, Robert T Schultz and Julia Parish-Morris in Autism</p> <p>The authors thank the individuals and families who participated in this research, as well as students, interns, volunteers, postdocs, clinicians, and administrative staff at the Center for Autism Research.</p> <ref id="AN0193858184-18"> <title> References </title> <blist> <bibl id="bib1" idref="ref32" type="bt">1</bibl> <bibtext> Bernardin C. 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We recognize that sex and gender are not interchangeable nor binary, and that many autistic individuals hold diverse gender identities. Therefore, we acknowledge the inherent limitations of the approach used in this study.</bibtext> </blist> <blist> <bibtext> Meredith Cola</bibtext> </blist> <blist> <bibtext>Graph</bibtext> </blist> <blist> <bibtext>https://orcid.org/0000-0001-6737-6828 Sarah Schillinger</bibtext> </blist> <blist> <bibtext>Graph</bibtext> </blist> <blist> <bibtext>https://orcid.org/0009-0002-9842-7418 Amanda Lee</bibtext> </blist> <blist> <bibtext>Graph</bibtext> </blist> <blist> <bibtext>https://orcid.org/0009-0004-3973-6338 Ashlee Yates Flanagan</bibtext> </blist> <blist> <bibtext>Graph</bibtext> </blist> <blist> <bibtext>https://orcid.org/0000-0002-8428-2820 Julia Parish-Morris</bibtext> </blist> <blist> <bibtext>Graph https://orcid.org/0000-0001-9633-2904</bibtext> </blist> <blist> <bibtext> The Institutional Review Board of Children's Hospital of Philadelphia provided approval and oversight for this study. All participants provided consent to participate in the study.</bibtext> </blist> <blist> <bibtext> Meredith Cola: Conceptualization; Data curation; Formal analysis; Investigation; Methodology; Project administration; Visualization; Writing—original draft; Writing—review & editing.Sarah Schillinger: Data curation; Formal analysis; Methodology; Project administration; Writing—original draft; Writing—review & editing.Margaret Lyons: Data curation; Methodology; Project administration; Writing—review & editing.Amanda Lee: Data curation; Methodology; Project administration; Writing—review & editing.Calliana Faulk: Data curation; Methodology; Project administration; Writing—review & editing.Maxine Covello: Data curation; Methodology; Project administration; Writing—review & editing.Nasya Howard: Data curation; Methodology; Project administration; Writing—review & editing.Hannah Franke: Data curation; Methodology; Project administration; Writing—review & editing.Alexandria Mulqueen: Data curation; Methodology; Project administration; Writing—review & editing.Lizzy Fulop: Data curation; Formal analysis; Methodology; Resources; Visualization; Writing—review & editing.Azia Knox: Data curation; Methodology; Project administration; Writing—review & editing.Sunghye Cho: Methodology; Software; Writing—review & editing.Mark Y Liberman: Methodology; Software; Writing—review & editing.Juhi Pandey: Data curation; Investigation; Methodology; Project administration; Writing—review & editing.Ashlee Yates Flanagan: Investigation; Writing—review & editing.Joseph Donaher: Investigation; Writing—review & editing.Robert T Schultz: Funding acquisition; Investigation; Resources; Writing—review & editing.Julia Parish-Morris: Conceptualization; Data curation; Formal analysis; Funding acquisition; Investigation; Methodology; Project administration; Resources; Software; Supervision; Validation; Visualization; Writing—original draft; Writing—review & editing.</bibtext> </blist> <blist> <bibtext> The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by R01DC018289 (PI: Parish-Morris), a CHOP Research Institute Director's Award to Dr Parish-Morris, the Allerton Foundation (PI: Schultz), and NICHD 5U54HD086984 (MPI: Robinson and Schultz) to Dr Schultz. Research reported in this publication was supported by the National Institute on Deafness and other Communication Disorders of the National Institutes of Health under award number T32DC017703. This award supported co-author Schillinger to conduct this research. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.</bibtext> </blist> <blist> <bibtext> The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.</bibtext> </blist> <blist> <bibtext> The datasets generated and/or analyzed during the current study are not publicly available. Requests to access the dataset should be directed to the final author.</bibtext> </blist> <blist> <bibtext> Supplemental material for this article is available online.</bibtext> </blist> </ref> <aug> <p>By Meredith Cola; Sarah Schillinger; Margaret Lyons; Amanda Lee; Calliana Faulk; Maxine Covello; Nasya Howard; Hannah Franke; Alexandria Mulqueen; Lizzy Fulop; Azia Knox; Sunghye Cho; Mark Y Liberman; Juhi Pandey; Ashlee Yates Flanagan; Joseph Donaher; Robert T Schultz and Julia Parish-Morris</p> <p>Reported by Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib25" firstref="ref1"></nolink> <nolink nlid="nl2" bibid="bib23" firstref="ref4"></nolink> <nolink nlid="nl3" bibid="bib19" firstref="ref5"></nolink> <nolink nlid="nl4" bibid="bib17" firstref="ref6"></nolink> <nolink nlid="nl5" bibid="bib21" firstref="ref7"></nolink> <nolink nlid="nl6" bibid="bib20" firstref="ref8"></nolink> <nolink nlid="nl7" bibid="bib26" firstref="ref11"></nolink> <nolink nlid="nl8" bibid="bib12" firstref="ref12"></nolink> <nolink nlid="nl9" bibid="bib16" firstref="ref15"></nolink> <nolink nlid="nl10" bibid="bib13" firstref="ref17"></nolink> <nolink nlid="nl11" bibid="bib14" firstref="ref18"></nolink> <nolink nlid="nl12" bibid="bib18" firstref="ref19"></nolink> <nolink nlid="nl13" bibid="bib24" firstref="ref21"></nolink> <nolink nlid="nl14" bibid="bib15" firstref="ref22"></nolink> <nolink nlid="nl15" bibid="bib22" firstref="ref31"></nolink> <nolink nlid="nl16" bibid="bib10" firstref="ref33"></nolink> <nolink nlid="nl17" bibid="bib11" firstref="ref34"></nolink>
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  Data: Sex-Specific Metrics for Success: Gaps in Social Word Use Are Bigger for Autistic Girls than Boys
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  Data: National Institute on Deafness and Other Communication Disorders (NIDCD) (DHHS/NIH)<br />Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (DHHS/NIH)
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  Label: Abstract
  Group: Ab
  Data: Autistic girls are often diagnosed late, missed, or misdiagnosed, which can negatively impact quality of life and mental health. Although research shows the social profiles of autistic girls differ from boys in systematic ways that might explain gaps in diagnosis, little is known about how autistic girls' social language compares to their same-sex non-autistic peers. This study investigated social words--words that make reference to other people--produced by 138 age- and IQ-matched autistic and non-autistic youth (ages 6-15) during one Autism Diagnostic Observation Schedule, Second Edition task. Girls used significantly more social words than boys across both diagnostic groups. There was a larger gap in social word production between autistic girls and non-autistic girls than autistic boys and non-autistic boys, with non-autistic girls using the most social words. Non-autistic girls' social language behavior--including their social word production--sets an especially high bar for autistic girls, who often report trying to blend in with other girls. Growing evidence of the distinct social language profiles of autistic and non-autistic girls versus boys should guide researchers and clinicians to assess autism in ways that are sensitive to sex-associated differences and develop interventions that consider the norms of youth's target social circles.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2026
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1506443
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1506443
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1177/13623613261417535
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 7
        StartPage: 1608
    Subjects:
      – SubjectFull: Autism Spectrum Disorders
        Type: general
      – SubjectFull: Sex
        Type: general
      – SubjectFull: Gender Differences
        Type: general
      – SubjectFull: Language Usage
        Type: general
      – SubjectFull: Social Behavior
        Type: general
      – SubjectFull: Diagnostic Tests
        Type: general
      – SubjectFull: Observation
        Type: general
      – SubjectFull: Autism Diagnostic Observation Schedule
        Type: general
    Titles:
      – TitleFull: Sex-Specific Metrics for Success: Gaps in Social Word Use Are Bigger for Autistic Girls than Boys
        Type: main
  BibRelationships:
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      – PersonEntity:
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            NameFull: Meredith Cola
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            NameFull: Sarah Schillinger
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            NameFull: Margaret Lyons
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            NameFull: Amanda Lee
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            NameFull: Lizzy Fulop
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            NameFull: Azia Knox
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            NameFull: Sunghye Cho
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            NameFull: Mark Y. Liberman
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            NameFull: Juhi Pandey
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            NameFull: Ashlee Yates Flanagan
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            NameFull: Joseph Donaher
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            NameFull: Robert T. Schultz
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            NameFull: Julia Parish-Morris
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          Dates:
            – D: 01
              M: 06
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-print
              Value: 1362-3613
            – Type: issn-electronic
              Value: 1461-7005
          Numbering:
            – Type: volume
              Value: 30
            – Type: issue
              Value: 6
          Titles:
            – TitleFull: Autism: The International Journal of Research and Practice
              Type: main
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