We aimed to describe the intellectual ability and ratio of boys to girls with average or higher IQ within autism spectrum disorder (ASD) cases identified in a population-based birth cohort. We hypothesized that research-identified individuals with ASD would be more likely to have average or higher IQ, compared to clinically diagnosed ASD. We also hypothesized the male to female ratio would decrease as the definition of ASD broadened.

ASD incident cases were identified from 31 220 subjects in a population-based birth cohort. Research-defined autism spectrum disorder, inclusive criteria (ASD-R_I) was based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, autistic disorder (AD), Asperger Disorder, and pervasive developmental disorder not otherwise specified criteria. Research-defined autism spectrum disorder, narrow criteria (ASD-R_N) was a narrower definition based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision AD criteria. Clinical diagnoses of ASD were abstracted from medical and school records. Intellectual ability was based on the last IQ score or on documented diagnoses of intellectual disability if no scores available. Average or higher IQ was defined as IQ ≥86.

A total of 59.1% of those with ASD-R_I (n = 890), 51.2% of those with ASD-R_N (n = 453), and 42.8% of those with clinically diagnosed autism spectrum disorder (n = 187) had average or higher IQ. Within the ASD-R_I and ASD-R_N groups, boys were more likely than girls to have an average or higher IQ (62.0% vs 51.3% [P = .004] and 54.1% vs. 42.5% [P = .03], respectively).

Our data suggest that nearly half of individuals with ASD have average or higher IQ. Boys with ASD are more likely to have average or higher IQ than girls. Patients with ASD and higher IQ remain at risk for not being identified.

我们旨在描述在基于人群的出生队列中发现的自闭症谱系障碍 (ASD) 病例中智商平均或更高的男孩与女孩的智力能力和比例。我们假设，与临床诊断的 ASD 相比，研究确定的 ASD 个体更有可能拥有平均或更高的智商。我们还假设随着 ASD 定义的扩大，男性与女性的比例会降低。

从基于人群的出生队列中的 31 220 名受试者中确定了 ASD 事件病例。研究定义的自闭症谱系障碍，包容性标准（ASD-RI _）基于精神障碍诊断和统计手册，第四版，文本修订，自闭症（AD），阿斯伯格障碍和广泛性发育障碍未另行指定的标准。研究定义的自闭症谱系障碍，狭义标准（ASD-R _N）是基于精神障碍诊断和统计手册，第四版，文本修订的更狭义的定义广告标准。ASD 的临床诊断是从医疗和学校记录中提取的。智力基于最后的 IQ 分数，如果没有分数，则基于记录在案的智力障碍诊断。平均或更高的智商被定义为智商≥86。

共有 59.1% 的 ASD-R _I ( n = 890)、51.2% 的 ASD-R _N ( n = 453) 和 42.8% 的临床诊断为自闭症谱系障碍的患者 ( n = 187)平均或更高的智商。在 ASD-R _I和 ASD-R _N组中，男孩比女孩更有可能拥有平均或更高的智商（62.0% 对 51.3% [ P = .004] 和 54.1% 对 42.5% [ P = .03 ]， 分别）。

我们的数据表明，近一半的自闭症患者智商平均或更高。患有 ASD 的男孩比女孩更有可能拥有平均或更高的智商。患有 ASD 和更高 IQ 的患者仍有未被识别的风险。