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Moderators of Age of Diagnosis in > 20,000 Females with Autism in Two Large US Studies

Abstract

The objective of this study was to determine the clinical features that moderate a later age at ASD diagnosis in females in a large sample of females with ASD. Within two large and independent ASD datasets (> 20,000 females), females were first diagnosed with ASD 14-months later relative to males. This later age at diagnosis was moderated by a mild or atypical presentation, wherein repetitive behaviors were limited, IQ and language were broadly intact, and recognized symptoms emerged later in development. Females are at risk for a later age at ASD diagnosis and treatment implementation, and modification of early childhood ASD screening methods for females may be warranted.

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Fig. 1

Data Availability

SFARI Data Use: We are grateful to all of the families in SPARK, the SPARK clinical sites and SPARK staff. We appreciate obtaining access to the phenotypic data on SFARI base. Approved researchers can obtain the SPARK population dataset described in this study (https://www.sfari.org/resource/spark/) by applying at https://base.sfari.org.

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Funding

This work was supported by the Simons Foundation Autism Research Initiative (286756 and 454555), the Norman Prince Neurosciences Institute at Lifespan, the Hassenfeld Child Health Innovation Institute at Brown University, and the Robert J. and Nancy D. Carney Institute for Brain Science at Brown University. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Authors

Contributions

EM MD PhD, BK PsyD, SS PhD; Methodology: EM MD PhD, BK PsyD; Formal analysis and investigation: BK PsyD, CS, RJ ScD; writing—original draft preparation: BK PsyD; writing—review and editing: EM MD PhD, CS, RJ ScD, CB MPH, SS PhD; funding acquisition: EM MD PhD, SS PhD; resources: EM MD PhD, SS PhD; supervision: EM MD PhD, CB MPH. All authors read and approved the final manuscript. Additional Contributions: We thank families who participated in the RI-CART project, Hannah Marsland, BA, Rebecca Bradley, BS, Elaine Clarke, BS, and Molly Goldman, MS, all of Emma Pendleton Bradley Hospital, for technical assistance, and to Hasmik Tokadjian, MS, of Women and Infants Hospital of Rhode Island for technical assistance. We would also like to thank Stephanie Vartany for her assistance as part of her undergraduate work.

Corresponding author

Correspondence to Eric M. Morrow.

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Conflict of interest

Dr. Sheinkopf reported grants from the Simons Foundation for Autism Research Initiative (SFARI) during the conduct of the study. Dr. Morrow reported grants from SFARI, as well as other support from Norman Prince Neurosciences Institute at Lifespan, Hassenfeld Child Health Innovation Institute at Brown University, and Robert J. and Nancy D. Carney Institute for Brain Science at Brown University during the conduct of the study; and personal fees from Autism Science Foundation, Charles H. Hood Foundation, University of Rochester Medical Center, Eagles Autism Challenge, Simons Foundation/SFARI, Simons Foundation/SPARK Medical Genetics Committee, LLC/Autism BrainNet, and the National Institutes of Health outside the submitted work. There are no other disclosures.

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Kavanaugh, B.C., Schremp, C.A., Jones, R.N. et al. Moderators of Age of Diagnosis in > 20,000 Females with Autism in Two Large US Studies. J Autism Dev Disord (2021). https://doi.org/10.1007/s10803-021-05026-4

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Keywords

  • Autism spectrum disorder (ASD)
  • Females
  • Restricted, repetitive behaviors
  • Child psychiatry