Identifying Sex-Specific Cognitive And Diagnostic Profiles Of Children On The Autism Spectrum

Although there has been great interest in identifying sex differences in diseases or disorders that differentially affect males versus females, relatively less effort has been devoted to research on the differences between males and females with autism spectrum disorder (ASD), despite the known male preponderance in ASD. The identification of separate male and female phenotypes within ASD would help parents, teachers, and clinicians better identify girls who may need ASD-related intervention services, inform the targets and goals of such interventions, and lead to the refinement of diagnostic criteria and instruments designed to diagnose ASD in children. The current study sought to identify sex-specific cognitive and diagnostic profiles for children with ASD using a sample (N = 253, 213 males, 40 females; Mage = 10 years, Range = 4 - 16) of children from across the United States who are affected and severely affected by ASD (as defined by a complex algorithm developed by the National Database for Autism Research), and who are without intellectual disability or comorbid medical conditions. Well-validated, age-referenced, observational assessments were used to quantify cognitive ability and the clinical features of ASD. The Differential Ability Scales, Second Edition, School Age Battery was used to measure general conceptual ability, verbal ability, nonverbal reasoning ability, and spatial ability, and the Autism Diagnostic Observation Schedule, Second Edition was used to measure the clinical features of autism, including restricted or repetitive behaviors and interests, and deficits in reciprocal social interaction and communication. Results suggest that there are significant sex differences within ASD in the domains of nonverbal reasoning ability, spatial ability, the discrepancy between verbal and nonverbal reasoning abilities, and reciprocal social interaction, after controlling for age. Being affected versus severely affected by ASD also contributed to differences between males and females. Implications, limitations, and suggestions for future research are discussed. Acknowledgement: Data used in the preparation of this manuscript were obtained from the NIH-supported National Database for Autism Research (NDAR). DOI: 10.15154/1338302. This manuscript reflects the views of the author and may not reflect the opinions or views of the NIH or of the submitters of the original data