Sex Differences in Autism Spectrum Disorder: An Investigation on Core Symptoms and Psychiatric Comorbidity in Preschoolers

Findings regarding sex differences in autism spectrum disorder (ASD), as far as core symptoms and psychiatric comorbidities (PC) are concerned, are inconsistent, inconclusive, or conflicting among studies. The lower prevalence of ASD in females than in males and the age and intelligence quotient (IQ) heterogeneity among samples made it difficult to investigate these differences. This case–control study tries to deepen the impact of sex differences on core symptoms of autism and PC in 214 preschoolers with ASD (mean age, 45.26) without impairment in non-verbal IQ (nvIQ ≥70). A total of 107 ASD females (mean age, 44.51 ± 13.79 months) were matched one by one with 107 males (mean age, 46.01 ± 13.42 months) for chronological age (±6 months) and nvIQ (±6 points). We used the Autism Diagnostic Observation Schedule 2 (ADOS-2) and the Child Behavior Checklist (CBCL) 1.5–5 to explore autism severity and PC. The results highlight that ASD females did not significantly differ from ASD males regarding the severity of autism. Statistically significant lower levels of emotionally reactive (p = 0.005, η2 = 0.04), anxious-depressed (p = 0.001, η2 = 0.05), internalizing problems (p = 0.04, η2 = 0.02), and DSM-Oriented Scales anxiety problems (p = 0.02, η2 = 0.04) in ASD females than in ASD males were also detected. Our findings of no difference in the autism severity and lower internalizing problems in females than males with ASD extend the knowledge of autism in females during preschool years. Compared to other similar studies on this topic, we can state that these results are not supported by differences in nvIQ between sexes nor by the presence of cognitive impairment. It confirms the need for clinicians to consider sex differences when describing autism psychopathology.

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Sex differences in social communication behaviors in toddlers with suspected autism spectrum disorder as assessed by the ADOS-2 toddler module

Autism ◽

10.1177/13623613211047070 ◽

2021 ◽

pp. 136236132110470

Author(s):

Emily Ronkin ◽

Erin C Tully ◽

Lee Branum-Martin ◽

Lindsey L Cohen ◽

Christine Hall ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Sex Differences ◽

Social Communication ◽

Gold Standard ◽

Autism Diagnostic Observation Schedule ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Future Research ◽

Communication Behaviors ◽

Autism Diagnostic Observation

The Autism Diagnostic Observation Schedule, 2nd-edition (ADOS-2) Toddler Module is the current gold-standard measure of autism spectrum disorder (ASD), a neurodevelopmental condition more frequently diagnosed in toddler boys than girls. Some evidence suggests that behaviors assessed by the Toddler Module may capture an ASD phenotype that is more common among boys than girls. Focus on these behaviors may contribute to sex differences in ASD diagnoses. Particularly, the ADOS-2 may equivalently weight social communication behaviors on which boys and girls are expected to look similar and behaviors that which girls may, due to early socialization, perform differently than boys. As a consequence, the Toddler Module may fail to identify ASD in girls who should qualify for the diagnosis. The current study examined the possibility that some ADOS-2 items may function differently for boys and girls by testing the degree to which eight items equivalently related to a social communication latent factor across sexes in toddlers with suspected ASD. Inconsistent with hypotheses, tests of differential item functioning revealed no evidence of sex differences, suggesting that the Toddler Module assesses these eight items similarly for boys and girls. Examination of factor loadings point to Creativity/Imagination as an area of interest for future research. Lay Abstract When toddlers are suspected of autism spectrum disorder (ASD), the gold-standard assessment technique is with the Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) Toddler Module, a behavioral observation system. ASD is a neurodevelopmental condition more frequently diagnosed in toddler boys than in toddler girls. There is some evidence that the ADOS-2 assesses behaviors that are more characteristic of boys with ASD than girls. Thus, it is possible that focusing on these behaviors contributes at least in part to why more boys are diagnosed than girls. Specifically, girls may show more social skills than boys during the ADOS-2 assessment due to their socialization histories, which may lead to missed diagnoses of ASD in toddler girls. The current study examined eight social behaviors assessed by the ADOS-2 in a sample of toddlers with suspected ASD to see if they contributed differently to the total score of those items. Examination of those items suggested that those social communication behaviors work the same for boys and girls with suspected ASD, which was inconsistent with hypotheses. However, examination of particular items raises the possibility of examining creative/imaginative play as an area for future research.

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The relationship between gestures and non-verbal communication and attentional processing in high-functioning adolescents with autism spectrum disorder

Autism & Developmental Language Impairments ◽

10.1177/2396941518787139 ◽

2018 ◽

Vol 3 ◽

pp. 239694151878713 ◽

Cited By ~ 1

Author(s):

Monika Pudło ◽

Ewa Pisula

Keyword(s):

Autism Spectrum Disorder ◽

Nonverbal Communication ◽

Structural Equation ◽

Autism Diagnostic Observation Schedule ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Executive Attention ◽

Attentional Processes ◽

Adolescents With Autism ◽

The Impact

Background and aims The links between gestures and various attentional processes in adolescents with autism spectrum disorder have not been studied sufficiently. Previous studies have highlighted the impact of orienting attention on the efficacy of gestures without exploring the influence of alerting and top–down attentional processes. The aim of the present study was to explore the links between attentional processes and indicators of descriptive, conventional and emotional gestures as well as other aspects of nonverbal communication in adolescents with autism spectrum disorder ( N = 46). Methods The attention network test and colour trails test were used to measure attentional processes, whereas descriptive, conventional and emotional gestures were assessed using the Autism Diagnostic Observation Schedule and the autism diagnostic interview . Analysis showed a significant correlation between gestures with alerting, orienting and executive attention. Conclusions The relevant structural equation model revealed that attentional processes have an impact on gestures, but gestures do not have an impact on attentional processes. Emotional gestures are linked to alerting. Spatial-visual search was related to facial expression and the integration of nonverbal communication with behaviour. There was no significant interaction between executive attention and gestures. Implications The obtained results are discussed with reference both to gesture development and studies on attention in adolescents with autism spectrum disorder.

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Sex differences in restricted repetitive behaviors and interests in children with autism spectrum disorder: An Autism Treatment Network study

Autism ◽

10.1177/1362361318786490 ◽

2018 ◽

Vol 23 (4) ◽

pp. 858-868 ◽

Cited By ~ 13

Author(s):

John Knutsen ◽

Morgan Crossman ◽

James Perrin ◽

Amy Shui ◽

Karen Kuhlthau

Keyword(s):

Autism Spectrum Disorder ◽

Sex Differences ◽

Repetitive Behavior ◽

Children With Autism ◽

Autism Diagnostic Observation Schedule ◽

Autism Spectrum ◽

Repetitive Behaviors ◽

Spectrum Disorder ◽

Restricted And Repetitive Behavior ◽

Autism Diagnostic Observation

Compared to the social communication domain, considerably less is known about the cause, development, and impact of restricted, repetitive behaviors interests and activities in children with autism spectrum disorder, including possible sex differences. This study examined sex differences in clinically identified (Autism Diagnostic Observation Schedule) restricted and repetitive behavior symptoms using the largest known sample (N = 1024) of age-matched and intelligence quotient–matched female and male children with autism spectrum disorder. More similarities than differences were observed; however, younger higher functioning and older lower functioning females presented reduced rates on the Autism Diagnostic Observation Schedule restricted and repetitive behavior subcategory unusually repetitive/excessive, stereotyped behaviors compared to similar males. These findings identify key restricted and repetitive behavior similarities and differences among young females and males with autism spectrum disorder and emphasize the need for a deeper understanding of the female autism phenotype.

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Relations among activity participation, friendship, and internalizing problems in children with autism spectrum disorder

Autism ◽

10.1177/1362361318775541 ◽

2018 ◽

Vol 23 (3) ◽

pp. 750-758 ◽

Cited By ~ 8

Author(s):

Kristen N Dovgan ◽

Micah O Mazurek

Keyword(s):

Autism Spectrum Disorder ◽

Internalizing Problems ◽

Social Engagement ◽

Social Activity ◽

Children With Autism ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Activity Participation ◽

Social Deficits ◽

The Impact

Social interaction difficulties in children with autism spectrum disorder can be challenging, especially during adolescence. In addition, high rates of comorbid internalizing disorders in autism spectrum disorder can lead to social isolation. With limited social activity participation, social deficits and internalizing problems in autism spectrum disorder may be related to participation, exposure, and practice with friends. The purpose of this study was to evaluate the relations among friendship, activity participation, and internalizing problems. Participants included 129 children with autism spectrum disorder between the ages of 6 and 18 years. Measures of friendship, sport, hobby, and club participation, and internalizing problems were assessed. Results showed that activity participation was related to more friendships, even after controlling for intelligence quotient. This study sheds light on the impact of social engagement with peers in developing and maintaining friendships as well as managing internalizing problems.

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Autism Spectrum Disorder and Anorexia Nervosa. Is There a Link? An Italian Experience

10.21203/rs.3.rs-122221/v1 ◽

2020 ◽

Author(s):

Jacopo Pruccoli ◽

Altea Solari ◽

Letizia Terenzi ◽

Elisabetta Malaspina ◽

Marida Angotti ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Anorexia Nervosa ◽

Gold Standard ◽

Young Patients ◽

Autistic Traits ◽

Autism Diagnostic Observation Schedule ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Compulsive Disorder ◽

The Impact

Abstract Background: Potential overlaps exist between psychopathological features of Anorexia Nervosa (AN) and Autism Spectrum Disorder (ASD). The impact of malnutrition on autistic traits in patients with AN should be considered. This study aims to investigate possible associations between Eating Disorders (ED) psychopathology, ASD traits and BMI in a group of young patients with AN, using the EDI-3 (Eating Disorder Inventory-3) test and gold-standard measures for ASD.Methods: Prospective study involving 23 inpatients admitted to an Italian Centre for paediatric ED. ASD traits and ED psychopathology were assessed administering ADOS-2 (Autism Diagnostic Observation Schedule-2), AQ (Autism Quotient) and EDI-3 tests. Both present and past autistic traits were investigated using different versions of AQ. Possible effect of BMI, Obsessive Compulsive Disorder (OCD) comorbidity and psychopharmacological treatments on results were evaluated with multiple linear regressions.Results: An ASD diagnosis was possible in 22% of patients. EDI-3 Interpersonal Problems (IPC), Affective Problems (APC), and Global Psychological Maladjustment (GPMC) subscales showed correlations with different ASD measures on ADOS-2 and AQ. Scores for ASD and their correlations with EDI-3 subscales were independent of BMI, age, OCD and psychopharmacological treatments.Conclusions: ASD traits presented high prevalence in a group of young inpatients with AN. These traits were significantly correlated to 3 specific EDI-3 subscales and independent of BMI. This is the first study to investigate the relationship between ASD traits as measured with gold-standard measures, EDI-3 scores, and BMI.

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Sex Differences in Internalizing Problems During Adolescence in Autism Spectrum Disorder

Journal of Autism and Developmental Disorders ◽

10.1007/s10803-015-2608-1 ◽

2015 ◽

Vol 46 (2) ◽

pp. 624-636 ◽

Cited By ~ 26

Author(s):

Tasha M. Oswald ◽

Mary Ann Winter-Messiers ◽

Brandon Gibson ◽

Alexandra M. Schmidt ◽

Cynthia M. Herr ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Sex Differences ◽

Internalizing Problems ◽

Autism Spectrum ◽

Spectrum Disorder

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Increasing the Awareness of Autism Spectrum Disorder with Training of Pre-School Teachers and School Counselors in Turkey

Journal of Child Science ◽

10.1055/s-0040-1721514 ◽

2020 ◽

Vol 10 (01) ◽

pp. e246-e257

Author(s):

Halil Kara ◽

Mehmet Semih Demirtaş

Keyword(s):

Autism Spectrum Disorder ◽

School Counselors ◽

Preschool Teachers ◽

Autism Diagnostic Observation Schedule ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Diagnostic And Statistical Manual ◽

Ritualistic Behaviors ◽

Core Symptoms ◽

The Relationship

AbstractTraining programs for the awareness of autism for professions are supported under the leadership of the United Nations. Misinformation can cause socially destructive results as that which is incorrect is assumed to be known correctly. This study included a total of 308 participants comprising 226 (73.4%) preschool teachers and 82 (26.6%) school counselors. The basic questions related to the awareness and knowledge of autism spectrum disorder (ASD) were selected based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). It was attempted to categorize the questions into four fields: (1) social interaction, (2) social communication and speech, (3) limited interest pattern with stereotypical and ritualistic behaviors, and (4) comorbidities, etiological characteristics, and the relationship between vaccinations and autism. The results of the study indicate that the awareness of ASD, including core symptoms, was extremely lacking in preschool teachers and school counselors. Moreover, they had extreme prejudice to information known to be incorrect.

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Phonic and Motor Stereotypies in Autism Spectrum Disorder: Video Analysis and Neurological Characterization

Brain Sciences ◽

10.3390/brainsci11040431 ◽

2021 ◽

Vol 11 (4) ◽

pp. 431

Author(s):

Evamaria Lanzarini ◽

Jacopo Pruccoli ◽

Irene Grimandi ◽

Chiara Spadoni ◽

Marida Angotti ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Video Analysis ◽

Autism Diagnostic Observation Schedule ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Verbal Abilities ◽

Children With Asd ◽

Clinical Impairment ◽

Core Symptoms ◽

Autism Diagnostic Observation

Stereotypies are among the core symptoms of Autism spectrum disorder (ASD) and can cause significant clinical impairment. At present, phonic stereotypies in ASD have been scarcely explored. This study investigates the frequency, variability, and typologies of phonic and motor stereotypies in children with ASD and their association with clinical neurological variables. We examined 35 patients by recording standardized video sessions and administering the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2). Phonic stereotypies were present in 83.0% of the patients. The most prevalent subtypes were noncommunicative vocalizations (60.0%), single syllables (37.1%), and echolalic stereotypies (22.9%). Noncommunicative vocalizations were more frequent in nonverbal patients (OR = 4.629, p = 0.008), while echolalic stereotypies were more represented in verbal patients (OR = 0.279, p = 0.028). Patients with intellectual disability (ID) showed a higher number (F(1,26) = 9.406, p = 0.005) and variability (F(1,25) = 7.174, p = 0.013) of motor stereotypies, with a higher number (F(1,26) = 13.268, p = 0.005) and variability (F(1,26) = 9.490, p = 0.005) of stereotypies involving the head/trunk/shoulders category. Patients with guttural stereotypies showed a higher variability of total motor stereotypies (OR = 1.487, p = 0.032) and self-directed motor stereotypies (OR = 4.389, p = 0.042). These results, combined with a standardized video-analysis, document the frequency and variability of phonic stereotypies among children with ASD. Correlations between specific phonic stereotypies and verbal abilities should be investigated further.

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Effectiveness of Equine-Assisted Activities and Therapies for Improving Adaptive Behavior and Motor Function in Autism Spectrum Disorder

Journal of Clinical Medicine ◽

10.3390/jcm10081726 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1726

Author(s):

Leonardo Zoccante ◽

Michele Marconi ◽

Marco Luigi Ciceri ◽

Silvia Gagliardoni ◽

Luigi Alberto Gozzi ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Motor Function ◽

Adaptive Behavior ◽

Preliminary Evidence ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Parental Distress ◽

Effective Option ◽

The Impact ◽

Equine Assisted

Equine-assisted activities and therapies (EAAT) have been suggested to improve adaptive behavior, and possibly motor function, in autism spectrum disorder (ASD). This study investigated the effects of EAAT on adaptive behavior and motor function in 15 children with ASD (13 males) aged 7–15 years as well as the impact of EAAT on the magnitude of stress in the parent–child system and the evolution in the child interaction with both the trained therapist and the therapeutic animal through the 20 weekly sessions of EAAT. EAAT were associated with greater adaptive behavior and coordination (all p ≤ 0.01) as well as a progressive improvement in the child’s abilities to respond to the increasing complexity of such form of positive behavioral support (all p < 0.001). However, EAAT did not prove to be effective in reducing parental distress. Collectively, preliminary evidence presented here may have important public health implications and gives reason to hope that EAAT could possibly be an effective option in ASD, warranting further investigation of its potential benefits in clinical trials among larger samples.

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