Exploring the female autism phenotype of repetitive behaviours and restricted interests (RBRIs) : a systematic PRISMA review

Allely, CS

Abstract

Purpose: There is a need for increased understanding, awareness and recognition of the autism
female phenotype in terms of Repetitive Behaviours and Restricted Interests (RBRIs).

Design/methodology/approach: A systematic PRISMA review was conducted. The main aim of the
present systematic review is to identify studies which have investigated RBRIs in females with ASD or
the differences in RBRIs between males and females with ASD.

Findings: Nineteen relevant articles were identified. Five studies found no significant evidence to
support the notion of sex differences in RRBIs in ASD. One study did not report any differences in
RRBIs between males and females with ASD. Twelve studies found evidence that males with ASD had
significantly more RRBIs compared to females with ASD. Lastly, one study found that girls with ASD
have features of RRBIs which are exhibited more compared to boys with ASD.

Practical implications: The RBRIs exhibited in autistic females are not sufficiently captured by most
currently diagnostic instruments. Clinicians are less likely to identify the RBRIs in females as they
tend not to be the typical repetitive behaviours commonly associated with ASD. It has been
recommended that clinicians consider ‘females as a whole’ in terms of their clinical presentation and
look for any indication of RBRIs, even repetitive interests which appear clinically innocuous.

Research limitations/implications: There is a real lack of in-depth knowledge and understanding of
the female phenotype of ASD and such lack of knowledge has a detrimental impact on the
identification of autistic females and a lack of identification can have negative consequence. This is
important to address in future research as it is well-established that the earlier the diagnosis the
better the outcomes due to the timely access to appropriate interventions.

Originality/value: There is relatively little research investigating RBRIs in autistic women and girls.
There is a real need to highlight the importance of understanding and recognising how RBRIs can
differ between males and females with ASD.

Keywords: RBRIs; Repetitive behaviours and restricted interests; Autism spectrum disorder; autism;
females; women; woman; girls; diagnosis; gender

Citation

Allely, C. (2019). Exploring the female autism phenotype of repetitive behaviours and restricted interests (RBRIs) : a systematic PRISMA review. Advances in Autism, 5(3), 171-186. https://doi.org/10.1108/AIA-09-2018-0030

• Journal Article Type: Article
• Acceptance Date: Mar 4, 2019
• Online Publication Date: Jul 3, 2019
• Publication Date: Jul 3, 2019
• Deposit Date: Mar 5, 2019
• Publicly Available Date: Jul 9, 2019
• Journal: Advances in Autism
• Print ISSN: 2056-3868
• Publisher: Emerald
• Volume: 5
• Issue: 3
• Pages: 171-186
• DOI: https://doi.org/10.1108/AIA-09-2018-0030
• Publisher URL: https://doi.org/10.1108/AIA-09-2018-0030
• Related Public URLs: https://www.emeraldinsight.com/loi/aia