Brief Report: Sex Differences in Parental Concerns for Toddlers with Autism Risk
Open accessAbstract
Research on sex differences in autism spectrum disorder (ASD) suggests both higher prevalence and a more easily observable presentation of core ASD symptomology in males, which may lead to sex differences in parental concerns. The current study examined whether sex and diagnosis relate to the timing, number, and types of pre-diagnosis concerns for 669 (N male = 468) toddlers who screened at risk for ASD. No sex differences in parents' concerns emerged for toddlers diagnosed with ASD; however, in the overall at-risk sample, parents of boys endorsed ASD symptoms, including restricted and repetitive behaviors, more than parents of girls. Future research should examine why sex differences in pre-diagnosis concerns emerge and how they might impact early diagnosis for at-risk boys versus girls.
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Among parents of toddlers at higher likelihood of ASD who screened positive, there were two main gender effects in parental concerns: RRBIs and labelling ASD.
“Ramsey et al. (2018) examined the issues flagged by parents of toddlers at higher likelihood of ASD, who were screened for ASD, and they reported two main effects for gender, in terms of RRBIs and labelling ASD.”
From Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review (2021) · cites this paper as Ramsey et al. 2018
The Results report that parents of boys in the overall at-risk sample expressed restricted and repetitive behavior concerns significantly more often than parents of girls. Parents also named ASD as a concern more often for boys, but that difference was not statistically significant (p = .069), so describing both as gender effects overstates the finding. The Discussion also says no sex differences were found in the subsample later diagnosed with ASD. (LLM, conf=0.89)
Experimental — accuracy not yet measuredParents of boys were 2.43 times more likely than parents of girls to label ASD itself as a concern for their toddlers who screened positive on ASD questionnaires, regardless of subsequent diagnosis.
“highlighting that parents of boys were 2.43 times more likely than parents of girls to label ASD itself as a concern for their toddlers who screened positive on ASD questionnaires (again regardless of subsequent diagnosis).”
From Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review (2021) · cites this paper as Ramsey et al. 2018
The Results report that parents of boys in the overall at-risk sample were 2.43 times more likely to name ASD as a concern, regardless of subsequent diagnosis. The citing sentence omits the paper’s explicit qualification that this difference was not statistically significant (p = .069). (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe finding for labelling ASD did not reach significance.
“The finding for labelling ASD did not reach significance, but this may have been due to small numbers, as it was expressed by the parents of four girls and 22 boys”
From Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review (2021) · cites this paper as Ramsey et al. 2018
Overall parents expressed one or more concerns about ASD 1.46 times more often for boys than for girls.
“When looking at all concerns as a whole, the study found that overall parents expressed one or more concerns about ASD 1.46 times more often for boys than for girls.”
From Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review (2021) · cites this paper as Ramsey et al. 2018
Parents of boys expressed concern about RRBIs 1.74 times more than parents of girls, regardless of subsequent diagnosis.
“For RRBIs, parents of boys were found to express concern 1.74 times more than parents of girls, regardless of subsequent diagnosis of the child.”
From Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review (2021) · cites this paper as Ramsey et al. 2018
The non-significant labelling ASD finding may have been due to small numbers, as it was expressed by parents of four girls and 22 boys.
“The finding for labelling ASD did not reach significance, but this may have been due to small numbers, as it was expressed by the parents of four girls and 22 boys”
From Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review (2021) · cites this paper as Ramsey et al. 2018
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Cites
Validation of the Modified Checklist for Autism in Toddlers, Revised With Follow-up (M-CHAT-R/F)
Robins, D. L., Casagrande, K., Barton, M., Chen, C.-M. A., Dumont-Mathieu, T., & Fein, D. (2014) · Pediatrics · doi:10.1542/peds.2013-1813 · Cited by 1,081 · see citing works
Self-citationDworzynski, K., Ronald, A., Bolton, P., & Happé, F. (2012) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2012.05.018 · Cited by 633 · cited 1× · see citing works
“A previous study (Dworzynski et al. 2012) found that girls required a greater number of additional problems related to behavior and cognitive ability to meet diagnostic criteria for ASD compared to boys, even when both sexes displayed similar autistic traits.”
Begeer, S., Mandell, D., Wijnker-Holmes, B., Venderbosch, S., Rem, D., Stekelenburg, F., & Koot, H. M. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1656-z · Cited by 402 · see citing works
Sex differences in the evaluation and diagnosis of autism spectrum disorders among children
Giarelli, E., Wiggins, L. D., Rice, C. E., Levy, S. E., Kirby, R. S., Pinto-Martin, J., & Mandell, D. (2010) · Disability and Health Journal · doi:10.1016/j.dhjo.2009.07.001 · Cited by 398 · see citing works
Lord, C., Schopler, E., & Revicki, D. (1982) · Journal of Autism and Developmental Disorders · doi:10.1007/bf01538320 · Cited by 303 · see citing works
Large-Scale Use of the Modified Checklist for Autism in Low-Risk Toddlers
Chlebowski, C., Robins, D. L., Barton, M. L., & Fein, D. (2013) · Pediatrics · doi:10.1542/peds.2012-1525 · Cited by 258 · see citing works
Self-citationEarly sex differences are not autism-specific: A Baby Siblings Research Consortium (BSRC) study
Messinger, D. S., Young, G. S., Webb, S. J., Ozonoff, S., Bryson, S. E., Carter, A., Carver, L., Charman, T., Chawarska, K., Curtin, S., et al. (2015) · Molecular Autism · doi:10.1186/s13229-015-0027-y · Cited by 207 · see citing works
Do early caregiver concerns differ for girls with autism spectrum disorders?
Little, L. M., Wallisch, A., Salley, B., & Jamison, R. (2017) · Autism · doi:10.1177/1362361316664188 · Cited by 32 · see citing works
Flagged first, then by citations
Research works printed but not linked: 21
- Christensen DL Bilder DA Zahorodny W Pettygrove S Durkin MS Fitzgerald RT 2016 Prevalence and characteristics of autism spectrum disorder among 4-year-old children in the autism and developmental disabilities monitoring network Journal of Developmental and Behavioral Pediatrics 37 1 1 8 10.1097/DBP.0000000000000235 26651088 · DOI
- Donohue MR Childs AW Richards M Robins DL 2017 Race influences parent report of concerns about symptoms of autism spectrum disorder Autism 1362361317722030 10.1177/1362361317722030 PMC5930138 29100475 · DOI
- Ehlers S Gillberg C 1993 The epidemiology of Asperger syndrome. A total population study J Child Psychol Psychiatry 34 8 1327 1350 8294522
- Gillberg C 1993 Autism and related behaviours J Intellect Disabil Res 37 Pt 4 343 372 8400719
- Gillberg C Coleman M 2002 Review of The Biology of Autistic Syndromes Journal of the American Academy of Child & Adolescent Psychiatry 41 1 104 105 10.1097/00004583-200201000-00022 · DOI
- Haney JL 2016 Autism, females, and the DSM-5: Gender bias in autism diagnosis Social Work in Mental Health 14 4 396 407 10.1080/15332985.2015.1031858 · DOI
- Hartley SL Sikora DM 2009 Sex differences in autism spectrum disorder: An examination of developmental functioning, autistic symptoms, and coexisting behavior problems in toddlers Journal of Autism and Developmental Disorders 39 12 1715 1722 10.1007/s10803-009-0810-8 19582563 PMC3590797 · DOI · Paper page
- Hiller RM Young RL Weber N 2014 Sex differences in autism spectrum disorder based on DSM-5 criteria: Evidence from clinician and teacher reporting Journal of Abnormal Child Psychology 42 8 1381 1393 10.1007/s10802-014-9881-x 24882502 · DOI
- Hiller RM Young RL Weber N 2016 Sex differences in pre-diagnosis concerns for children later diagnosed with autism spectrum disorder Autism 20 1 75 84 10.1177/1362361314568899 25717130 · DOI · Paper page
- Horovitz M Matson JL Turygin N Beighley JS 2012 The relationship between gender and age of first concern in toddlers with autism spectrum disorders Research in Autism Spectrum Disorders 6 1 466 471 10.1016/j.rasd.2011.06.017 · DOI
- Hull L Mandy W Petrides KV 2017 Behavioural and cognitive sex/gender differences in autism spectrum condition and typically developing males and females Autism 21 6 706 727 10.1177/1362361316669087 28749232 · DOI · Paper page
- McLennan JD Lord C Schopler E 1993 Sex differences in higher functioning people with autism J Autism Dev Disord 23 2 217 227 8331044
- Mussey JL Ginn NC Klinger LG 2017 Are males and females with autism spectrum disorder more similar than we thought? Autism 21 6 733 737 10.1177/1362361316682621 28749236 · DOI
- Ozonoff S Young GS Steinfeld MB Hill MM Cook I Hutman T 2009 How early do parent concerns predict later autism diagnosis? J Dev Behav Pediatr 30 5 367 375 19827218 PMC2919345
- Reinhardt VP Wetherby AM Schatschneider C Lord C 2015 Examination of sex differences in a large sample of young children with autism spectrum disorder and typical development Journal of Autism and Developmental Disorders 45 3 697 706 10.1007/s10803-014-2223-6 25189824 PMC4342305 · DOI · Paper page
- Richards M Mossey J Robins DL 2016 Parents’ concerns as they relate to their child’s development and later diagnosis of autism spectrum disorder Journal of Developmental and Behavioral Pediatrics 37 7 532 540 10.1097/DBP.0000000000000339 27541581 PMC5003704 · DOI
- Robins DL Fein D Barton ML 2009 The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) Self-published PMC3876182 24366990
- Sacrey LAR Zwaigenbaum L Bryson S Brian J Smith IM Roberts W 2015 Can parents’ concerns predict autism spectrum disorder? A prospective study of high-risk siblings from 6 to 36 months of age Journal of the American Academy of Child & Adolescent Psychiatry 54 6 470 478 10.1016/j.jaac.2015.03.014 26004662 · DOI
- Stone WL Coonrod EE Ousley OY 2000 Brief report: screening tool for autism in two-year-olds (STAT): development and preliminary data J Autism Dev Disord 30 6 607 612 11261472
- Thompson T Caruso M Ellerbeck K 2003 Sex matters in autism and other developmental disabilities Journal of Learning Disabilities 7 4 345 362 10.1177/1469004703074003 · DOI
- Wing L 1981 Sex ratios in early childhood autism and related conditions Psychiatry Research 5 2 129 137 10.1016/0165-1781(81)90043-3 6945608 · DOI
Cited by
Sorted by citations
Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review
Lockwood Estrin, G., Milner, V., Spain, D., Happé, F., & Colvert, E. (2021) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-020-00225-8 · Cited by 357 · see citing works
Sex and gender impacts on the behavioural presentation and recognition of autism
Lai, M.-C., & Szatmari, P. (2020) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000575 · Cited by 237 · see citing works
- Authors
- Ramsey, R. K., Nichols, L., Ludwig, N. N., Fein, D., Adamson, L. B., & Robins, D. L.
- Affiliations
- Georgia State University (US)
- Kennedy Krieger Institute (US)
- University of Connecticut (US)
- Drexel University (US)
- Corresponding author
- Ramsey, Riane K.
- Venue
- Journal of Autism and Developmental Disorders
- Published
- 2018-04-26
- Volume
- 48
- Issue
- 12
- Pages
- 4063-4069
- ISSN
- 0162-3257 (ISSN-L)
- 1573-3432
- PMC
- PMC6203663
- OpenAlex
- W2801520664
- Cited by
- 18
- References
- 8
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 1 · 2020: 6 · 2019: 2
- FWCI
- 1.34
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Autism and Developmental Disorders (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD039961)
- Maternal and Child Health Bureau (R40MC00270)
- U.S. Department of Education Student-Initiated Research Grant
- University of Connecticut’s Research Foundation Faculty Grant
- National Institute of Mental Health Predoctoral Fellowship (F31MH12550)
- Autism Speaks Targeted Research Award (8368)
- National Alliance of Autism Research
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
- Keywords
- sex differences, autism spectrum disorder, toddlers, parental concerns, autism risk, restricted and repetitive behaviors, early diagnosis
- MeSH terms
- Autism Spectrum Disorder, Adult, Child, Preschool, Female, Humans, Infant, Male, Parents, Risk Factors, Sex Characteristics, Prevalence, Early Diagnosis
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