The findings are limited, however, because the researchers included only girls already diagnosed with autism, says Kristin Sohl, associate professor of pediatrics at the University of Missouri in Columbia. Tests such as the ADOS miss many girls with the condition, she says, and the new work does not account for this population.
The bigger question, Sohl says, is why diagnostic tests may not spot girls with autism in the first place.
“What is it about those girls that is allowing them to not score [as autistic] on this excellent test?” she says. “It tells me there are probably some adaptations that need to be made to the scoring or how we interpret those scores in the context of gender.”
Bishop acknowledges this possibility but says the team would have seen bigger differences between boys and girls if the tests were inherently biased.
“If we were missing [girls] because they were systematically scoring lower than the boys, we would expect to see larger effects here,” she says.