Sex Differences in an Autism Spectrum Disorder Diagnosis: Are Restricted Repetitive Behaviors and Interests the Key?

Restricted and repetitive behaviors and interests (RRBI) have garnered attention for their presenting sex differences in Autism Spectrum Disorder (ASD). Specifically, previous works have claimed that RRBI are less predictive of an ASD diagnosis for females relative to males. Previous reports have demonstrated mixed findings: females present with greater RRBI (e.g., compulsive behaviors), females present with fewer RRBI (e.g., restricted interests), and females are not distinguishable from males based on overall RRBI profiles. The following review details behavioral and neurophysiological RRBI findings to argue that female presentations are qualitatively and quantitatively unique and should be taken into consideration for diagnostic measures. Future directions will be suggested in under-explored areas including functional imaging, sensory profiles, and typically developing control groups.