Sex differences on the ADOS-2

Rea, Hannah M.; Øien, Roald A.; Shic, Frederick; Webb, Sara Jane; Ratto, Allison B.

doi:10.1007/s10803-022-05566-3

Cited by 58Autism Spectrum Disorder ResearchChild Nutrition and Feeding IssuesGenetics and Neurodevelopmental Disorders

Sex differences on the ADOS-2

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Rea, Hannah M., Øien, Roald A., Shic, Frederick, Webb, Sara Jane, Ratto, Allison B.·2023·Journal of Autism and Developmental Disorders

DOI 10.1007/s10803-022-05566-3PMC PMC10074828

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Abstract

The sex difference in the prevalence of autism spectrum disorder (ASD) may be magnified by sex differences on diagnostic measures. The current study compared autistic males and females on items on the gold-standard diagnostic measure, the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). In a sample of 8-to-17-year old autistic individuals from research (n = 229) and clinical settings (n = 238), females were less likely to show atypicalities on most items related to social-communication behaviors and on total and subscale scores. When controlling for overall intensity of symptomatology, no sex differences survived statistical corrections. Diagnostic criteria and/or gold-standard assessments may be less sensitive to female presentations of ASD and/or autistic females may exhibit fewer or less intense behaviors characteristic of ASD.

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Because diagnostic criteria are based on the much more prevalent male presentation, girls who present somewhat differently are likely underdiagnosed.
“Since diagnostic criteria are based on the much more prevalent male presentation, it is likely that girls, who present somewhat differently, are underdiagnosed (38).”
From Where Sex Meets Gender: How Sex and Gender Come Together to Cause Sex Differences in Mental Illness (2022) · cites this paper as [38]
The Introduction reports a male-to-female autism diagnosis ratio of 3.5–4 to 1 and describes female presentations that may be missed by criteria or assessments hypothesized to be based on males. The Discussion and Summary and Conclusions say existing assessment algorithms may underdiagnose females. The claim overstates the paper’s qualified account by treating the male basis of diagnostic criteria, rather than criteria or assessments, as established. (LLM, conf=0.84)
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Additional file 2 of Whole genome sequencing analysis identifies sex differences of familial pattern contributing to phenotypic diversity in autism
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Additional file 1 of Whole genome sequencing analysis identifies sex differences of familial pattern contributing to phenotypic diversity in autism
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Additional file 5 of Whole genome sequencing analysis identifies sex differences of familial pattern contributing to phenotypic diversity in autism
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Additional file 7 of Whole genome sequencing analysis identifies sex differences of familial pattern contributing to phenotypic diversity in autism
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Additional file 3 of Whole genome sequencing analysis identifies sex differences of familial pattern contributing to phenotypic diversity in autism
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Additional file 6 of Whole genome sequencing analysis identifies sex differences of familial pattern contributing to phenotypic diversity in autism
Kim, S.-W., Lee, H., Song, D. Y., Lee, G. Q., Ji, J., Park, J. W., Han, J. H., Lee, J. W., Byun, H. J., Son, J. H., et al. (2024) · Figshare · doi:10.6084/m9.figshare.27124231
Additional file 4 of Whole genome sequencing analysis identifies sex differences of familial pattern contributing to phenotypic diversity in autism
Kim, S.-W., Lee, H., Song, D. Y., Lee, G. Q., Ji, J., Park, J. W., Han, J. H., Lee, J. W., Byun, H. J., Son, J. H., et al. (2024) · Figshare · doi:10.6084/m9.figshare.27124222
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Item-Level Sex Differences in Autism Spectrum Disorder Measures: A MIMIC Model Analysis of ADOS-2 and ADI-R in a Referred Pediatric Sample
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Authors: Rea, H. M., Øien, R. A., Shic, F., Webb, S. J., & Ratto, A. B.
Affiliations: University of Washington (US)
Yale University (US)
Children's National (US)
Corresponding author: Ratto, Allison B.
ORCID: Rea, Hannah M.
Øien, Roald A.
Shic, Frederick
Webb, Sara Jane
Ratto, Allison B.
Venue: Journal of Autism and Developmental Disorders
Publisher: Springer Science and Business Media LLC
Published: 2022-04-22
Volume: 53
Issue: 7
Pages: 2878-2890
ISSN: 0162-3257 (ISSN-L)
1573-3432
DOI: 10.1007/s10803-022-05566-3
PMC: PMC10074828
OpenAlex: W4224237433
Cited by: 50
References: 74
Citations by year: 2026: 7 · 2025: 9 · 2024: 20 · 2023: 8 · 2022: 6
FWCI: 6.58
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Journal of Autism and Developmental Disorders (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: Yale University
Isadore and Bertha Gudelsky Family Foundation
Children's National Hospital
National Institutes of Health (MH10028, R01 MH10028)
Intellectual and Developmental Disabilities Research Center (1U54HD090257)
National Institute of Mental Health (R01MH10028, MH10028, R01MH100028)
National Institute for Occupational Safety and Health (R01OH010028)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (U54HD090257, P50HD103524)
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
Keywords: autism spectrum disorder, sex differences, autistic females, Autism Diagnostic Observation Schedule, ADOS-2, social communication, symptom intensity, autism prevalence
MeSH terms: Autism Spectrum Disorder, Adolescent, Autistic Disorder, Child, Communication, Female, Humans, Male, Sex Characteristics, Social Behavior

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