New Study of Studies / Male to Female Ratio ASD

JAACAPJournal of the American Academy of Child and Adolescent Psychiatry

What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis

University College, London UK



To derive the first systematically calculated estimate of the relative proportion of boys and girls with autism spectrum disorder (ASD) through a meta-analysis of prevalence studies conducted since the introduction of the DSM-IV and the –International Classification of Diseases, Tenth Revision. (Thus – conclusions can only be as “accurate” as the data in the original studies) (Since DSM-V did away with Asperger’s as a diagnosis, how does this “deletion” affect this study?)


Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The Medline, Embase, and PsycINFO databases were searched, and study quality was rated using a risk-of-bias tool. Random-effects meta-analysis was used. The pooled outcome measurement was the male-to-female odds ratio (MFOR), namely the odds of being male in the group with ASD compared with the non-ASD group. In effect, this is the ASD male-to-female ratio, controlling for the male-to-female ratio among participants without ASD.


Fifty-four studies were analyzed, with 13,784,284 participants, of whom 53,712 had ASD (43,972 boys and 9,740 girls). The overall pooled MFOR was 4.20 (95% CI 3.84–4.60), but there was very substantial between-study variability (I2 = 90.9%). High-quality studies had a lower MFOR (3.32; 95% CI 2.88–3.84). Studies that screened the general population to identify participants regardless of whether they already had an ASD diagnosis showed a lower MFOR (3.25; 95% CI 2.93–3.62) than studies that only ascertained participants with a pre-existing ASD diagnosis (MFOR 4.56; 95% CI 4.10–5.07).


Of children meeting criteria for ASD, the true male-to-female ratio is not 4:1, as is often assumed; rather, it is closer to 3:1. There appears to be a diagnostic gender bias, meaning that girls who meet criteria for ASD are at disproportionate risk of not receiving a clinical diagnosis.

Hate to be snippy – but with the all the manipulation going on, is the “new” ratio of male / female ASD any more informative than a “good guess”? At least this group acknowledges the bias against clinical diagnoses of ASD in girls.


…And we are still expected to join the other inmates in the pink and purple social prison that confines female H. sapiens to low status.


The Childish Blame Game / Excuses


Human beings have expended great time and effort in the fashioning of moral and ethical systems, but beyond the common sense admonition, “Treat other people as you wish to be treated,” which is fundamental to cultures and religions worldwide and throughout history, not much has come of it. Maybe we could forget “the rest” of the instructions, and work on this one sufficient behavior.

Do any of these excuses made by school children for incidents of bullying sound familiar?

He started it. (The universal revenge response.)

He hit me first. (The universal violent revenge response.)

I only stole $10.00; Suzy took her iPhone. (“I’m not as bad as she is” blame shift)

I thought he was going to hit me, so I hit him first. (The preemptive strike rationalization)

She took my notebook so I had to punch her. (The out-of-proportion retaliation)

She’s a retard; she’s too stupid to even know that we tricked her. (Vulnerable people are fair game)

So I lied; big deal. I got what I wanted. (Narcissism – I’m the center of the universe.)

Everybody does it. (Spread the blame; normalize bad behavior)

He wouldn’t give me his laptop so I beat him up. (If people don’t do what I want, I have the right to hurt them.)

I didn’t do it anything. (The simple lie / bluff protest.)

My (Dad, Mom, teacher, the principal, boss) said I could do it. (The appeal to protection by an authority figure.)

How many adults get beyond this “excuse” stage of development? Social groups? Corporations? Nations?

Our leaders never do.


But… You may find yourself at the top of the social pyramid $$$ in government, business, the military, Big Pharma, the “helping, caring, fixing industry” or in law enforcement, advertising-media-entertainment and of course politics and the banking-financial industry.

I googled “kids draw bullies” but liked these better!








Brain development and Neoteny / Neuroscience

J Psychiatry Neurosci. 2011 Nov;36(6):412-21. doi: 10.1503/jpn.100138.

Can Asperger syndrome be distinguished from autism? An anatomic likelihood meta-analysis of MRI studies.

Yu KK1, Cheung C, Chua SE, McAlonan GM

Whereas grey matter differences in people with Asperger syndrome compared with controls are sparser than those reported in studies of people with autism, the distribution and direction of differences in each category are distinctive.


In development, timing is of the utmost importance, and the timing of developmental processes often changes as organisms evolve. In human evolution, developmental retardation, or neoteny, has been proposed as a possible mechanism that contributed to the rise of many human-specific features, including an increase in brain size and the emergence of human-specific cognitive traits. We analyzed mRNA expression in the prefrontal cortex of humans, chimpanzees, and rhesus macaques to determine whether human-specific neotenic changes are present at the gene expression level. We show that the brain transcriptome (transcriptome includes all mRNA transcripts in the cell; it reflects the genes that are being actively expressed at any given time, with the exception of mRNA degradation phenomena such as transcriptional attenuation.) is dramatically remodeled during postnatal development and that developmental changes in the human brain are indeed delayed relative to other primates. This delay is not uniform across the human transcriptome but affects a specific subset of genes that play a potential role in neural development.


By comparing the gene expression profiles in human, chimpanzee, and rhesus macaque prefrontal cortices throughout postnatal development, we have found that there is no uniform shift in the developmental timing between humans and other primates. We find instead a significant excess of genes showing neotenic expression in humans. This result is in line with the neoteny hypothesis of human evolution (6) and provides insight into the possible functional role of neoteny in human brain development. Specifically, we show that at least in one of the 2 cortical regions studied, the neotenic shift is most pronounced at the time when humans approach sexual maturity, (body matures; brain does not) a process known to be delayed in humans relative to chimpanzees or other primates (6, 24). Furthermore, the neotenic shift particularly affects a group of genes preferentially expressed in gray matter. Intriguingly, the timing of the shift also corresponds to a period of substantial cortical reorganization characterized by a decrease in gray-matter volume, which is thought to be related to synaptic elimination (21, 25, 26). The developmental pace of changes in gray-matter volume has been associated with the development of cognitive skills among humans (e.g., linguistic skills) (27) as well as with the development of disorders (e.g., attention-deficit/hyperactivity disorder) (28).

Although the precise causes and consequences of the human neotenic shift remain unknown, together these observations suggest that ontogenetic timing differences between the human and the chimpanzee prefrontal cortex transcriptomes may reflect differences in sexual and cognitive maturation between the 2 species. According to this logic, delayed gray-matter maturation in the human prefrontal cortex may extend the period of neuronal plasticity associated with active learning, thus providing humans with additional time to acquire knowledge and skills.



Things to think about:

Maturation of gray matter in the human prefrontal cortex is delayed by neotenic shifts. Developmental delay is neotenic. There is a “fuzzy boundary” (?) between too much / too little grey matter volume for the brain to function well; there also seem to be 2 types of brain organization: social navigation vs. factual and problem-solving. (See today’s Temple Grandin post.) These are probably not ‘separate’ paths, but are developmental stages. (Social is juvenile; factual is adult.)

The gray matter volume in any specific human brain may vary between mature and neotenic states. Humans vary in degrees of neoteny. It might be more accurate to dump “Autism Spectrum” for an inclusive classification “The Neoteny Spectrum” which includes all contemporary homo sapiens.

How do we know which human brains (volume of grey matter) are mature and which are neotenic? What volume of grey matter is the reference for maturity vs. neoteny? We can begin with behavior.

Some changes in grey matter volume occur during puberty: therefore it would be useful to compare the pre-puberty and post-puberty states of grey matter in individuals, especially those diagnosed with a “brain disorder” in early childhood. Mixing data from before and after stages of brain reorganization may be completely misleading do to variations in timing.

Grey matter differences in individuals reflects maturity vs. neoteny (a spectrum of rates of development) and not fundamental developmental disability; if one is ONLY interested in “The Social Brain,” and designates this juvenile stage of development as the ONLY legitimate human brain, then the “problem” of Asperger’s is the product of inattentional blindness and ignorance. Bad science!

CASE IN POINT: It is said that Asperger’s have “less than normal” volumes of gray matter, but if this conclusion has been derived from pre-puberty testing, then it is entirely possible that Asperger children, in terms of specific brain development, (intellect, language, concrete – visual thinking, facts and problem-solving) simply MATURE FASTER – and gray matter volume is reduced to a more effective and efficient volume well before their peers.

Social brains are neotenic; the neurotypical neotenic brain never fully matures. Which means that the social orientation (obsession) of modern social humans is the product of extreme neoteny.   Neoteny is evident in a lack of logic, rationality, analytical thinking and effective problem-solving, which are absent in everyday life and most seriously, in our political leaders.

“Juvenile” neotenic behavior is evident in the inability to recognize that facts and physical reality exist. Instead, emotions are paramount; self absorption is rampant, magical thinking prevails, action is missing, narcissitic orientation is “normal”, and “worship of” childlike celebrities is a substitute for adult models and personal development. Adult children never leave home but remain dependent on parental support. Violence is characteristic of juvenile males; violent behavior usually decreases as males age, but today “frivolous” violence is the perpetual activity of neotenic males and is encouraged by popular culture.


Cerebral Asymmetry / Asperger Brain Differences

Philosophical Transactions of the Royal Society / Biological sciences

The evolution and genetics of cerebral asymmetry

Michael C Corballis

Fake “Nature” documentaries defended as better than “Reality”

How Nature Documentaries are Fake: A Filmmaker’s Perspective

Simon Cade is an English Filmmaker and Director who owns and runs the YouTube Channel, DSLRguide in which he teaches both aspiring and weathered Filmmakers the art of making movies. Cade is 19 years old, a “director” and teaches filmmaking. Jeez! His casual attitude about “reality” reveals a common, neotenic inability to distinguish “lies” from scientifically established facts, which is A-OK in the modern social “value” system.

Success Story / Asperger Females Disguised as Neurotypicals

From the Daily Mail:

They are successful career women in loving relationships – and they all live with an affliction that will surprise you!

by Jill Foster for the Daily Mail, August 2012 Check out a slew of “articles” directed at female readers!

How much talent is wasted because society doesn’t like the package it comes in?


In the day-to-day experience of an Asperger child, moments of peace are rare. Whatever you are thinking or doing, someone, either a parent or teacher, or maybe another child, will interrupt you, to ask that you participate in another activity, such as playing a game with a group of children. If you don’t respond, or you resist their prodding, or if you state clear and repeated rejections, sweet tones of persuasion turn to harsh words and insults. An adult will express personal disappointment in your reluctance to obey and will continue to pressure you, as if whatever you are occupied with is not only unimportant, but that preferring to be alone means that you are depressed or unhappy, and that joining the group will cheer you up, which isn’t true. If you persist in thinking that what you are reading, or drawing or building is more interesting than what the other children are doing, you are apt to be yelled at and physically relocated like a disobedient dog. When this happens, the waves of anger that were hidden beneath the adult’s nice words hit like a shock wave. The effect is visceral and devastating.

It is said that Asperger children can’t infer what is going on in another person’s mind, but the message is clear: people, especially adults, will only like you if you agree with their statements, however false or petty, and obey their instructions, and not when you get around to it, but now! Your willingness to conform must be expressed in signs made by body, face and words. It’s not enough that you act promptly as they wish, but a child or grown person must show his or her deference to a person of superior status. It soon becomes evident that no social interaction is neutral: this ‘status thing’ is the point of social interaction. What is often referred to as ‘busy work’ takes place in schools and workplaces day in and day out, simply to prove that a certain category of human is The Boss. Obedience is a social necessity because it demonstrates that a child or adult will subordinate its happiness and well-being to the group. Rules and instructions are often designed to insult and confuse people, to challenge their morality or sense of fair play and for no other purpose than to test their willingness to shed their individual humanity and to become a tool in the construction and maintenance of the Social Pyramid – to blindly believe that The Boss Knows Best.

The Asperger brain simply doesn’t understand this social compulsion, not because we are dumb, defective, dangerous or disabled, but because inequality of status is alien to our instinct for fair play, justice and reason. For us the world is integrated, coherent, and dynamic and is a continuous expression of Nature’s truths: the universe as described by social concepts is a sad and dreary spectacle of human arrogance and ignorance; a childish place maintained by violence, lies and deprivation; established by the denial of human worth and by denial of basic needs: water, food, shelter to those who “don’t count”. Those who are on top must imprison millions of human beings on the low levels of the Social Pyramid in order to feel good.

The Asperger outlook on people is nearly the opposite: people are just people. Instead of a steep pyramid on which millions of human beings struggle for dominance, we have a visual landscape of reality in our minds. Each human, animal, plant, and object in the landscape is distinct and “counts” because our perception of the environment is concrete: humans live with their feet on the ground, not above or below, but as equal agents of Nature. Cooperation, not competition for status, makes sense to us. Let each human fulfill his or her gifts; don’t waste resources. How much talent is wasted because Society doesn’t like the package it comes in?

The Lunch Theory of Human Social Cognition

You are a “student” of human evolutionary development; you are curious about how “humans” came to be Who we are today – Masters of the Universe. You come to this quest with certain assumptions in mind, which you probably are not “consciously” using, but which form a “filter system” that will not only prejudice the “evidence” you “discover” but which pre-classifies what “evidence” is. This is the way it is, for Homo sapiens.

It is obvious to you that “you” (your thoughts, habit, lifestyle, beliefs) are the culmination of “human” excellence; “you” are where evolution was headed all along. “You” includes all the wonders of Western Civilization, which “you” take to be evidence of “your” intelligence, inventiveness, superior intellect, diligence, eagle-eyed observation and analysis, literacy, artist accomplishment, etc. because “you” studied these things in school and look a lot like all the “big-brained males” (this includes female students today) who have “built” Western Civilization (U.S. version) and proven that, well frankly, It’s the best damn civilization EVER!

1. Homo sapiens (males) have big-brains; size is everything. Therefore, any and all evidence” for “evolutionary progress” depends on signs and omens of “cognitive abilities” in those “fossil species” that LED to US. “Dumb” species, de facto, cannot be our ancestors.

fig. 1 The Supreme Species. If wealthy, individuals from subspecies of various skin color may be included.

Fig. 1 The “supreme” species and attendant females and offspring. The prime evolutionary question is, “How did this glorious species come to be?” It used to be simple enough: A Supreme Male created everything in the universe, including Man, to whom he handed over all of Creation, with “Man” as the master of all Nature. But the invention of Science threw a monkey-wrench into the plot: it seems “man” was not really the center of the Universe, after all… unless… of course, all 3.5 billion years of life on earth could be directed into producing “The Last Ape Standing” What a coup – even better than “special creation” by a supreme male God! We’ll prove that all the forces and processes at work in the universe were necessary to produce “US”.

2. Let’s get to work establishing our superiority to all other species. We can automatically dismiss any life form previous to “humanoids” as unimportant, and fossil humanoids “that count” as ancestors can be identified by “signs”  which point in our direction. We can easily define “humanoid” by the categorizing “things we eat”. (Cannibalism is a no-no. You can’t eat the Supreme Species, like it was just another food source)

Fig 2. Lunch. This organized, processed and prepared “nutrition” demonstrates “cognitive abilities” found in no other life form. The sheer amount of brain-power needed to exploit natural resources (fossil fuels) to design, manufacture and transport “plastic” containers, with uniform subdivisions, that create the illusion that $1.50 worth of “food items” is worth $39.95″ is genius! And what about decorating two sacrificial crab claws elevated on a slice of bread with wildflowers sourced from a meadow in Mongolia? Just $49.95. Brilliant.

Let’s see what “the rest of” American humanoids are having for lunch.

Another sign of superior intelligence: The American food industry is paid billions $$ to transform “surplus storage” food into meals for children; and it’s free. How much more compassionate can a supreme species become? Why waste “good brain food” (and good education) on “lesser beings” who will never be intelligent anyway? In fact, we can guarantee impaired cognitive function and stunted development using this brilliant strategy. Note the wonderful array of fossil fuel containers provided, which can be used once and disposed of immediately into landfills. More profit! More socially savvy behavior that creates environmental destruction and millions of defective, low status humanoids. No Neanderthal could accomplish that. Thank God and evolution that we exterminated them just in time!

3. Evidence that Neanderthal didn’t stand a chance of being intelligent enough to compete with us. When the supreme species “goes wild” they do it with superior social cognition. Who needs survival skills when amazing fossil fuel-based non-recyclable immortal plastic products can be purchased at a “wilderness” adventure store? Stupid Neanderthals!

fig. 3a AMH “outsmarting” Neanderthals using superior social skills: “You bring the hot dogs and Gatorade, we’ll bring the tent” social strategy.

Fig. 3a, 3b Lunch ca. 40,000 y.a. Anatomically Modern Humans (just like Modern Social Humans in every way) take over Eurasia from the Neanderthals with superior social networking.

fig 4b No evidence has been found for AMH having developed smart phones, but the “conceptual” ability to communicate effectively was just like that of modern humans.

Neanderthals: too dumb to make Margaritas for brunch guests. Lack of social cognition led to extinction. (BTW – Thanks for the casual sex!)

4. Social behavior explains why AMC became Masters of the Universe: Neanderthals had open “caves” while highly social AMH had open “concept” floor plans with kitchen islands and granite counter tops that facilitated the acquisition of social status. How could Neanderthals have competed with such advanced innovation, which clearly depends on social networking, direct eye contact, empathy, “mind-reading” and high-end finishes?

fig. 4a Neanderthal “open” cave. Primitive housing = primitive brain.

fig. 4b “Primitive” Neanderthal cave under renovation with advanced AMH upgrades: Open concept floor plain for “flow” when entertaining, and high-end finishes; granite countertops and slate flooring.

WOW! “Scientific” proof that not even GOD could create a species that’s as intelligent as modern social humans.

File this video under, “What Asperger’s mean when we say that neurotypicals are stooopid.”


Graphic Novels for Visual Thinkers / Educating Aspergers

Support a new Middle School project in New York! (from a site offering funding for teacher proposals)

Graphic Novels Motivate Readers With Asperger Syndrome

My students need a library of graphic novels to motivate readers because these books provide the visual cues kids with Asperger and autism need to truly understand characters.


My ten students are middle-schoolers who have Asperger Syndrome.

Students in my classroom have difficulty understanding people, so it’s not surprising that they also struggle to infer characters’ motives and purpose in books. Nonfiction, full of facts? No problem! But fiction? The majority of my students with Asperger Syndrome could leave it completely.

Vintage “graphic novels” were aimed at boys who didn’t like to read.

They like to follow rules – but they make a lot of their own. They like to be right, so they hate to admit when they don’t know something, and they avoid things that are difficult. Tough concepts, like characterization, theme and tone in a novel, make them feel uncomfortable – so they’d rather not read fiction. And, as educators know, the only thing that really improves reading once the school day ends, is more reading. Then I found the novel, The Inventions of Hugo Cabret. We only have one copy – I borrowed it from our library, and they want it back! But the students were riveted. Not only were they fascinated by the format of the book – half graphic novel, half traditional – but they understood Hugo’s emotions, portrayed as they were with matching drawings, moving incrementally forward! Experiments with other graphic novels are also proving successful, but we don’t have a lot of them to go around.

I am requesting class sets of popular graphic novels for my self-contained English class of students with Asperger Syndrome (and High-Functioning Autism.) The novels I request will be taught in the same manner as traditional literature, and I will compare each work with a traditional novel, which we will also read. This will help my students be on equal footing with their peers, because they will have more insight into concepts about characterization (as well as plot, theme, tone, etc.) when they rejoin their peers in high school reading more traditional works. I hope that, ultimately, these graphic novels lead them to enjoy literature in a way that many people without autism do – for the love of the story and the characters we would otherwise not know.

I was a MAD Magazine addict and a sucker for cats and rabbits dressed in charming clothing.

Please help me bridge the “understanding gap” for my students, who are so smart and fun and have so much potential. Help them understand literature by opening the door, using pictures with the text, and engendering a level of understanding that their disability would otherwise prevents them from obtaining. Thank you so much for reading my proposal.

Remember when all childhood schoolbooks had plenty of beautiful illustrations – stylized but realistic (not infantilized and deformed neotenic blobs) FOR ALL CHILDREN? Maybe our “old-fashioned” predecessors in publishing and education knew a lot more than we do about visual thinking being basic to the human ability to learn…