Table 1 Comprehensive list of research priorities, challenges, recommendations, and implications of recommendations of research

Better identification and diagnosis of females

Diagnostic norms developed in adolescent males

Clinical guidelines or recommendations for clinicians, encouragement of clinicians to observe both males and females with ASD in training

Changes in M:F bias in prevalence

Societal and cultural expectations of males and females

Provide comparisons between ASD females and typical females across studies

Understanding of specific needs of females with ASD

Compensatory mechanisms in social behaviors in females, masking symptoms and hiding diagnosis

Reduced reliance on clinical samples for data collection

Improvement in services and resources available for females with ASD

Qualitative differences in symptoms between males and females in development

Examination of early signs and symptoms, including trajectories in at risk infants.

Earlier detection of ASD in females

Characterization of male: female differences in core and associated symptoms

Low sample sizes of females enrolled in research studies

Data sharing, pooling, repository efforts

Improved representation of females in ASD research and specific recommendations for females with ASD

Restriction of signs and symptoms to ASD diagnosis

Including ASD associated symptoms, broader phenotype, and understanding of heterogeneity

Potential sex specific diagnostic criteria

Biological differences between males and females

Variability introduced with inclusion of females in research

Sex included as a covariate in research studies, especially animal models

Identification of protective mechanisms for translational impact.

Limited understanding of human sexual dimorphism at a molecular, cellular or anatomical level

Basic science focused specifically on human sexual dimorphism

Understanding role of male/female physiological differences in protection of some ASD symptoms