However, the male bias is much more pronounced in ASC, especially in the case of AS. This male bias could simply reflect the difficulty of diagnosing AS in females. Though classic autism would not be missed in females, AS could be if it presented as some other condition, such as anorexia
[11] or borderline personality disorder
[12], both of which involve the exercise of excessive control over the environment or other people, and a certain degree of a self-centeredness. Equally, AS in females could be under-diagnosed if females are more motivated to learn to conform socially or have better imitation skills that allow them to “pretend to be normal”
[13]. Finally, this male bias might reflect the inability of the widely used diagnostic instruments (the Autism Diagnostic Observation Schedule (ADOS) or Autism Diagnostic Interview-Revised (ADI-R)) to detect the more subtle ways in which AS may present in females.