Letter to Editor. Report „An investigation of the ‘female camouflage effect’ in autism using a new computerized test showing sex/gender differences during ADOS-2”. IMFAR 2016, Baltimore, USA

IMFAR (International Meeting for Autism Research) is the biggest annual event where reports of autism (ASD) research from all over the world are presented. The conference is hosted by the International Society for Autism Research (INSAR). The conference presentation by Rynkiewicz et al. at IMFAR 2016 [1], based on the article published earlier in Molecular Autism [2], is valuable for several reasons and should be disseminated. The researchers have presented the results of their study of " female camouflage effect " in autism using a computerized ADOS-2 test [3] in the context of sex/gender differences and performed an in-depth analysis of the associated key issues. A unique computer-based technique was used for the first time ever, which enabled automated coding of gesture-based non-verbal communication. Owing to the high-end technology, it was possible to objectively evaluate the gesture activity of the study subjects, by quantifying the Gesture Index (GI), which eliminated the bias of subjective assessment by the diagnostician as it was independent on human judgment. The detailed description of the material and method can be found in the discussed papers [1, 2]. The analysis showed that ASD girls used gestures more vividly, that is, used longer gestures presented in shorter time, as compared to their male counterparts. As a result, such gestures may be perceived by a human observer (diagnostician) as more energetic, vivid and expressive, thus being attributed to the domain of non-verbal communication as a non-autistic trait. Next, the issue of credibility and reliability of parent-reported questionnaires assessment like Social Communication Questionnaire (SCQ) [4] or Autism Spectrum Quotient – Child (AQ) [5] is addressed, where parents are given the instrument and asked to answer the questions without direct supervision. Thus, the study also raises a question on the parent-report screening measures where parents are given the instrument and asked to answer the questions without direct supervision: Do parents take under consideration the non-verbal communication (gestures) when they judge their child's communication skills or perhaps parent's judgment is biased by only the verbal communication of their child? The discussed IMFAR 2016 conference presentation [1] indicates several key issues in diagnostic assessment of ASD. For the first time, the new diagnostic criteria of Autism Spectrum Disorder in DSM-5 [6] include the social communication as