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Examining Diagnostic Trends and Gender Differences in the ADOS-II

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Abstract

Approximately 3–4 boys for every girl meet the clinical criteria for autism in studies of community diagnostic patterns and studies of autism using samples of convenience. However, girls with autism have been hypothesized to be underdiagnosed, possibly because they may present with differing symptom profiles as compared to boys. This secondary data analysis used the National Database of Autism Research (NDAR) to examine how gender and symptom profiles are associated with one another in a gold standard assessment of autism symptoms, the Autism Diagnostic Observation Schedule II (ADOS-II; Lord, C., Luyster, R., Guthrie, W., & Pickles A. (2012a). Patterns of developmental trajectories in toddlers with autism spectrum disorder. Journal of Consulting and Clinical Psychology, 80(3):477–489. https://doi.org/10.1037/a0027214. Epub 2012 Apr 16. PMID: 22506796, PMCID: PMC3365612). ADOS-II scores from 6183 children ages 6–14 years from 78 different studies in the NDAR indicated that gender was a significant predictor of total algorithm, restrictive and repetitive behavioral, and social communicative difficulties composite severity scores. These findings suggest that gender differences in ADOS scores are common in many samples and may reflect on current diagnostic practices.

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Notes

  1. Autism is used to denote anyone who identifies as having autism within the context of the citation or study’s diagnostic criteria and is synonymous with Autism Spectrum Disorder (ASD) or the DSM-V’s current definition of autism. The use of identity-first language are to acknowledge multiple perspectives from autistic advocates and the neurodiversity movement.

  2. Note that we use the term “sex/gender” to be consistent with Lai et al. (2015b), given that the concepts of “sex” and “gender” may be ambiguous and have different meanings for different people. For example, “sex” traditionally refers to one’s biological sex at birth, whereas “gender” refers to one’s identity as male, female, or non-binary. However, these traditional distinctions may not apply to everyone, so we choose not to make the distinction in order to be more inclusive. Additionally, sex and gender were not differentially distinguished in the sample from the original data collect methods.

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  1. University of California, Los Angeles Department of Education, 300 Charles E. Young Blvd, Room 208A, 90095, Los Angeles, CA, USA

    Ingrid S. Tien, Amanda R. Johnson, Junok Kim & Jeffrey J. Wood

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  1. Ingrid S. Tien
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Tien, I.S., Johnson, A.R., Kim, J. et al. Examining Diagnostic Trends and Gender Differences in the ADOS-II. J Autism Dev Disord (2023). https://doi.org/10.1007/s10803-023-06191-4

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