Abstract
Autism spectrum disorder (ASD) research is largely based on males, and females with ASD are at risk for under-identification. Research recommends listening to parent concerns since these are often predictive of a child’s eventual diagnosis. This study examined how patterns of parent concerns predicted sex differences and eventual child diagnosis (ASD or developmental delay [DD]). We performed a secondary analysis with n = 273 children ages 36–72 months. Results suggested males with ASD had a higher likelihood of repetitive behavior and speech and language concerns compared to females with ASD. Females with DD were significantly more likely to have problem-solving concerns; whereas, males with DD were significantly less likely to have social communication concerns compared to females with ASD.
This is a preview of subscription content, log in via an institution to check access.
References
Andersson, G. W., Gillberg, C., & Miniscalco, C. (2013). Pre-school children with suspected autism spectrum disorders: Do girls and boys have the same profiles? Research in Developmental Disabilities, 34(1), 413–422.
Baio, J., Wiggins, L., Christensen, D. L., Maenner, M. J., Daniels, J., Warren, Z., ... & Dowling, N. F. (2018). Prevalence of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 sites, United States, 2014. MMWR Surveillance Summaries, 67(6), 1. https://doi.org/10.15585/mmwr.ss6706a1.
Begeer, S., Mandell, D., Wijnker-Holmes, B., Venderbosch, S., Rem, D., Stekelenburg, F., & Koot, H. M. (2013). Sex differences in the timing of identification among children and adults with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43, 1151–1156. https://doi.org/10.1007/s10803-012-1656-z.
Conlon, O., Volden, J., Smith, I. M., Duku, E., Zwaigenbaum, L., Waddell, C., et al. (2019). Gender differences in pragmatic communication in school-aged children with autism spectrum disorders (ASD). Journal of Autism and Developmental Disorders, 49, 1937–1948. https://doi.org/10.1007/s10803-018-03873-2.
Dean, M., Harwood, R., & Kasari, C. (2016). The art of camouflage: Gender differences in the social behaviors of girls and boys with autism spectrum disorder. Autism, 21(6), 678–689. https://doi.org/10.1177/1362361316671845.
Frazier, T. W., Georgiades, S., Bishop, S. L., & Hardan, A. Y. (2014). Behavioral and cognitive characteristics of females and males with autism in the Simons Simplex Collection. Journal of the American Academy of Child & Adolescent Psychiatry, 53(3), 329–340. https://doi.org/10.1016/j.jaac.2013.12.004.
Guinchat, V., Chamak, B., Bonniau, B., Bodeau, N., Perisse, D., Cohen, D., & Danion, A. (2012). Very early signs of autism reported by parents include many concerns not specific to autism criteria. Research in Autism Spectrum Disorders, 6(2), 589–601. https://doi.org/10.1016/j.rasd.2011.10.005.
Hartley, S. L., & Sikora, D. M. (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, 1715. https://doi.org/10.1007/s10803-009-0810-8.
Hiller, R. M., Young, R. L., & Weber, N. (2016). Sex differences in pre-diagnosis concerns for children later diagnosed with autism spectrum disorder. Autism, 20(1), 75–84. https://doi.org/10.1177/1362361314568899.
Horovitz, M., Maston, J. L., & Turygin, N. (2012). The relationship between gender and age of first concern in toddlers with autism spectrum disorders. Autism Spectrum Disorders, 6(1), 466–471. https://doi.org/10.1016/j.rasd.2011.06.017.
Hyman, S. L., Levy, S. E., & Myers, S. M. (2020). Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics. https://doi.org/10.1542/peds.2019-3447.
IBM. (2017). IBM SPSS statistics for Mac. Armonk, NY: IBM Corp.
Lai, M. C., & Szatmari, P. (2020). Sex and gender impacts on the behavioral presentation and recognition of autism. Psychiatry, 33(2), 117–123. https://doi.org/10.1097/YCO.0000000000000575.
Lai, M. C., Lombardo, M. V., Auyeung, B., Chakrabarti, B., & Baron-Cohen, S. (2015). Sex/gender differences and autism: setting the scene for future research. Journal of the American Academy of Child & Adolescent Psychiatry, 54(1), 11–24. https://doi.org/10.1016/j.jaac.2014.10.003.
Little, L., Wallisch, A., Salley, B., & Jamison, R. (2016). Do early caregiver concerns differ for girls with autism spectrum disorders? Autism, 21(6), 728–732. https://doi.org/10.1177/1362361316664188.
Mahendiran, T., Dupuis, A., Crosbie, J., Georgiades, S., Kelley, E., Liu, X., et al. (2019). Sex differences in social adaptive function in autism spectrum disorder and attention-deficit hyperactivity disorder. Frontiers in Psychiatry, 10, 607. https://doi.org/10.3389/fpsyt.2019.00607.
Parish-Morris, J., Liberman, M. Y., Cieri, C., Herrington, J. D., Yerys, B. E., Bateman, L., et al. (2017). Linguistic camouflage in girls with autism spectrum disorder. Molecular Autism, 8, 48. https://doi.org/10.1186/s13229-017-0164-6.
Postorino, V., Fatta, L. M., De Peppo, L., Giovagnoli, G., Armando, M., Vicari, S., & Mazzone, L. (2015). Longitudinal comparison between male and female preschool children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(7), 2046–2055. https://doi.org/10.1007/s10803-015-2366-0.
Richards, M., Mossey, J., & Robins, D. L. (2016). Parents’ concerns as they relate to their child’s development and later diagnosis of autism spectrum disorder. Journal of Developmental Behavioral Pediatrics, 37(7), 532–540. https://doi.org/10.1097/DBP.0000000000000339.
Rynkiewicz, A., Schuller, B., Marchi, E., Piana, S., Camurri, A., Lassalle, A., & Baron-Cohen, S. (2016). An investigation of the ‘female camouflage effect’ in autism using a computerized ADOS-2 and a test of sex/gender differences. Molecular Autism, 7, 10. https://doi.org/10.1186/s13229-016-0073-0.
Szatmari, P., Georgiades, S., Duku, E., Bennett, T. A., Bryson, S., Fombonne, E., et al. (2015). Developmental trajectories of symptom severity and adaptive functioning in an inception cohort of preschool children with autism spectrum disorder. JAMA Psychiatry, 72(3), 276–283. https://doi.org/10.1001/jamapsychiatry.2014.2463.
Zablotsky, B., Cople, L. J., Pringle, B. A., Kogan, M. D., Rice, C., & Blumberg, S. J. (2017). Age of parental concerns, diagnosis, and service initiation among children with autism spectrum disorder. American Journal of Intellectual and Developmental Disabilities, 122(1), 49–61. https://doi.org/10.1352/1944-7558-122.1.49.
Acknowledgments
There is no funding or financial support affiliated with this study.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conceptualization and methodology. Data analysis was performed by Anna Wallisch and Sarah Behrens and reviewed and discussed with Brenda Salley, Rene Jamison, and Brian Boyd for further interpretation. The first draft of the manuscript was written by Anna Wallisch and all authors reviewed and edited the manuscript. All authors read and approved the final manuscript.
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Wallisch, A., Behrens, S., Salley, B. et al. Brief Report: Predicting Sex Differences and Diagnosis from Early Parent Concerns. J Autism Dev Disord 51, 4160–4165 (2021). https://doi.org/10.1007/s10803-020-04866-w
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-020-04866-w