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Sex-Based Differences in Autism Symptoms in a Large, Clinically-Referred Sample of Preschool-Aged Children with ASD

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Abstract

Previous research has identified possible sex-based differences in restricted and repetitive behaviors in autism spectrum disorder (ASD). However, this finding is mixed, particularly among preschool-aged children. We investigated the presence of sex-based differences in parent-rated ASD symptomatology, using the Autism Spectrum Rating Scale (ASRS). Participants consisted of a large (n = 481,100 female), clinically-referred sample of preschoolers (ages 2–5) diagnosed with ASD (NVIQ: M = 67.11, SD = 21.79). Females had less severe symptoms on the Total, Unusual Behaviors, DSM-5, and Stereotypy scales on the ASRS. The effects were small-to-medium, but statistically significant. There was evidence of differential relationships between nonverbal IQ and ASRS scores among males and females. This study provides additional evidence of sex-based differences in ASD symptoms present from an early age.

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Acknowledgments

We would like to thank the families who participated in the assessments used in this study as well as the psychologists and psychometricians for completing the assessments. Special thanks to Connor MacKenzie for his help in reviewing the literature in preparation for this manuscript.

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Authors and Affiliations

  1. Child Development Center, Nationwide Children’s Hospital, Columbus, OH, USA

    Kevin G. Stephenson, Megan Norris & Eric M. Butter

  2. Departments of Pediatrics and Psychology, The Ohio State University, Columbus, OH, USA

    Kevin G. Stephenson, Megan Norris & Eric M. Butter

Authors
  1. Kevin G. Stephenson
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  2. Megan Norris
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  3. Eric M. Butter
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Contributions

All authors contributed to the study conception and design. Data analysis was completed by KGS. The first draft of the manuscript was written by KGS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Kevin G. Stephenson.

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Stephenson, K.G., Norris, M. & Butter, E.M. Sex-Based Differences in Autism Symptoms in a Large, Clinically-Referred Sample of Preschool-Aged Children with ASD. J Autism Dev Disord 53, 624–632 (2023). https://doi.org/10.1007/s10803-020-04836-2

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