Table 1.

DSM-5 Diagnostic Criteria and Behavioral Symptoms of ASD (APA, 2013) by Phenotype (Kopp & Gillberg, 2011; Lai et al., 2015; Young et al., 2018)

DSM Diagnostic Criteria	Male Phenotype Examples	Female Phenotype Examples
A.1. Social-emotional reciprocity	• Less likely to engage in social approach or has an abnormal social approach • Failure to initiate social interactions	• Passive; more likely to be labeled as “shy” • More advanced linguistic skills, especially in early childhood • Social difficulties masked by same-age caretaker in elementary school years
A.2. Deficits in nonverbal communication (e.g., eye contact)	• Total lack of facial expressions and nonverbal communication	• Frequently engages in verbal and nonverbal imitation of peers (might be exhausting for peers)
A.3. Forming relationships	• Difficulty or lack of interest in forming relationships	• Forms new relationships, but unable to maintain relationships • Able to engage in imaginative play, but frequently nonreciprocal, scripted, or controlled
B.1. Stereotypy (includes echolalia)	• Motor stereotypy, lining up objects, echolalia, idiosyncratic phrases	• Similar to males but less likely to engage in lining up objects
B.2. Insistence on sameness	• Extreme distress at small changes, difficulties with transitions, requirements to take same routes or eat same foods	• Similar to males, but more frequently reported • Difficulties with completing daily activities; perfectionist
B.3. Highly restricted, fixated interests	• Activities are less social; restricted interests tend to focus on objects	• Restricted interests tend to focus on animals or people (e.g., pop culture, fashion, horses)
B.4. Hyper- or hypo-reactivity to sensory input	No reported differences in the literature