Skip to main content
Top
Published in: Neuroscience Bulletin 2/2017

Open Access 01-04-2017 | Original Article

Sex Differences in Diagnosis and Clinical Phenotypes of Chinese Children with Autism Spectrum Disorder

Authors: Shihuan Wang, Hongzhu Deng, Cong You, Kaiyun Chen, Jianying Li, Chun Tang, Chaoqun Ceng, Yuanyuan Zou, Xiaobing Zou

Published in: Neuroscience Bulletin | Issue 2/2017

Login to get access

Abstract

The aim of this study was to explore the differences between boys and girls in the diagnosis and clinical phenotypes of autism spectrum disorder (ASD) in China's mainland. Children diagnosed with ASD (n = 1064, 228 females) were retrospectively included in the analysis. All children were assessed using the Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS). The results showed that girls scored significantly higher in ADI-R socio-emotional reciprocity than boys, and also scored lower in ADI-R and ADOS restricted and repetitive behaviors (RRBs). Meanwhile, the proportions of girls who satisfied the diagnostic cut-off scores in the ADI-R RRBs domain were lower than in boys (P < 0.05). Our results indicated that girls with ASD show greater socio-emotional reciprocity than boys. Girls also tended to show fewer RRBs than boys, and the type of RRBs in girls differ from those in boys. The ADI-R was found to be less sensitive in girls, particularly for assessment in the RRBs domain.
Literature
2.
go back to reference Elsabbagh M, Divan G, Koh YJ, Kim YS, Kauchali S, Marcín C, et al. Global prevalence of autism and other pervasive developmental disorders. Autism Res 2012, 5: 160–179.CrossRefPubMedPubMedCentral Elsabbagh M, Divan G, Koh YJ, Kim YS, Kauchali S, Marcín C, et al. Global prevalence of autism and other pervasive developmental disorders. Autism Res 2012, 5: 160–179.CrossRefPubMedPubMedCentral
3.
go back to reference Kim YS, Leventhal BL, Koh YJ, Fombonne E, Laska E, Lim EC, et al. Prevalence of autism spectrum disorders in a total population sample. Am J Psychiatry 2011, 168: 904–912.CrossRefPubMed Kim YS, Leventhal BL, Koh YJ, Fombonne E, Laska E, Lim EC, et al. Prevalence of autism spectrum disorders in a total population sample. Am J Psychiatry 2011, 168: 904–912.CrossRefPubMed
4.
go back to reference Blumberg SJ, Bramlett MD, Kogan MD, Schieve LA, Jones JR, Lu MC. Changes in prevalence of parent-reported autism spectrum disorder in school-aged U.S. children: 2007 to 2011–2012. Natl Health Stat Report 2013, 20: 1–11. Blumberg SJ, Bramlett MD, Kogan MD, Schieve LA, Jones JR, Lu MC. Changes in prevalence of parent-reported autism spectrum disorder in school-aged U.S. children: 2007 to 2011–2012. Natl Health Stat Report 2013, 20: 1–11.
5.
go back to reference Fombonne E. Epidemiology of autistic disorder and other pervasive developmental disorders. J Clin Psychiatry 2005, 66 Suppl 10: 3–8.PubMed Fombonne E. Epidemiology of autistic disorder and other pervasive developmental disorders. J Clin Psychiatry 2005, 66 Suppl 10: 3–8.PubMed
6.
go back to reference Beacher FD, Minati L, Baron-Cohen S, Lombardo MV, Lai MC, Gray MA, et al. Autism attenuates sex differences in brain structure: a combined voxel-based morphometry and diffusion tensor imaging study. AJNR Am J Neuroradiol 2012, 33: 83–89.CrossRefPubMed Beacher FD, Minati L, Baron-Cohen S, Lombardo MV, Lai MC, Gray MA, et al. Autism attenuates sex differences in brain structure: a combined voxel-based morphometry and diffusion tensor imaging study. AJNR Am J Neuroradiol 2012, 33: 83–89.CrossRefPubMed
7.
go back to reference Lai MC, Lombardo MV, Suckling J, Ruigrok AN, Chakrabarti B, Ecker C, et al. Biological sex affects the neurobiology of autism. Brain 2013, 136: 2799–2815.CrossRefPubMedPubMedCentral Lai MC, Lombardo MV, Suckling J, Ruigrok AN, Chakrabarti B, Ecker C, et al. Biological sex affects the neurobiology of autism. Brain 2013, 136: 2799–2815.CrossRefPubMedPubMedCentral
8.
go back to reference Lai MC, Lombardo MV, Ruigrok AN, Chakrabarti B, Wheelwright SJ, Auyeung B, et al. Cognition in males and females with autism: similarities and differences. PLoS One 2012, 7: e47198.CrossRefPubMedPubMedCentral Lai MC, Lombardo MV, Ruigrok AN, Chakrabarti B, Wheelwright SJ, Auyeung B, et al. Cognition in males and females with autism: similarities and differences. PLoS One 2012, 7: e47198.CrossRefPubMedPubMedCentral
9.
go back to reference Bölte S, Duketis E, Poustka F, Holtmann M. Sex differences in cognitive domains and their clinical correlates in higher-functioning autism spectrum disorders. Autism 2011, 15: 497–511.CrossRefPubMed Bölte S, Duketis E, Poustka F, Holtmann M. Sex differences in cognitive domains and their clinical correlates in higher-functioning autism spectrum disorders. Autism 2011, 15: 497–511.CrossRefPubMed
10.
go back to reference Hattier MA, Matson JL, Tureck K, Horovitz M. The effects of gender and age on repetitive and/or restricted behaviors and interests in adults with autism spectrum disorders and intellectual disability. Res Dev Disabil 2011, 32: 2346–2351.CrossRefPubMed Hattier MA, Matson JL, Tureck K, Horovitz M. The effects of gender and age on repetitive and/or restricted behaviors and interests in adults with autism spectrum disorders and intellectual disability. Res Dev Disabil 2011, 32: 2346–2351.CrossRefPubMed
11.
go back to reference Banach R, Thompson A, Szatmari P, Goldberg J, Tuff L, Zwaigenbaum L, et al. Brief report: relationship between non-verbal IQ and gender in autism. J Autism Dev Disord 2009, 39: 188–193.CrossRefPubMed Banach R, Thompson A, Szatmari P, Goldberg J, Tuff L, Zwaigenbaum L, et al. Brief report: relationship between non-verbal IQ and gender in autism. J Autism Dev Disord 2009, 39: 188–193.CrossRefPubMed
12.
go back to reference Carter AS, Black DO, Tewani S, Connolly CE, Kadlec MB, Tager-Flusberg H. Sex differences in toddlers with autism spectrum disorders. J Autism Dev Disord 2007, 37: 86–97.CrossRefPubMed Carter AS, Black DO, Tewani S, Connolly CE, Kadlec MB, Tager-Flusberg H. Sex differences in toddlers with autism spectrum disorders. J Autism Dev Disord 2007, 37: 86–97.CrossRefPubMed
13.
go back to reference Frazier TW, Georgiades S, Bishop SL, Hardan AY. Behavioral and cognitive characteristics of females and males with autism in the simons simplex collection. J Am Acad Child Adolesc Psychiatry 2014, 53: 329–340.CrossRefPubMed Frazier TW, Georgiades S, Bishop SL, Hardan AY. Behavioral and cognitive characteristics of females and males with autism in the simons simplex collection. J Am Acad Child Adolesc Psychiatry 2014, 53: 329–340.CrossRefPubMed
14.
go back to reference Hiller RM, Young RL, Weber N. Sex differences in autism spectrum disorder based on DSM-5 criteria: evidence from clinician and teacher reporting. J Abnorm Child Psychol 2014, 42: 1381–1393.CrossRefPubMed Hiller RM, Young RL, Weber N. Sex differences in autism spectrum disorder based on DSM-5 criteria: evidence from clinician and teacher reporting. J Abnorm Child Psychol 2014, 42: 1381–1393.CrossRefPubMed
15.
go back to reference Reinhardt VP, Wetherby AM, Schatschneider C, Lord C. Examination of sex differences in a large sample of young children with autism spectrum disorder and typical development. J Autism Dev Disord 2015, 45:697–706.CrossRefPubMedPubMedCentral Reinhardt VP, Wetherby AM, Schatschneider C, Lord C. Examination of sex differences in a large sample of young children with autism spectrum disorder and typical development. J Autism Dev Disord 2015, 45:697–706.CrossRefPubMedPubMedCentral
16.
go back to reference Goin-Kochel RP, Abbacchi A, Constantino JN. Lack of evidence for increase genetic loading for autism among families of affected females: a replication from family history data in two large samples. Autism, 2007; 11: 279–286.CrossRefPubMed Goin-Kochel RP, Abbacchi A, Constantino JN. Lack of evidence for increase genetic loading for autism among families of affected females: a replication from family history data in two large samples. Autism, 2007; 11: 279–286.CrossRefPubMed
17.
go back to reference Koenig K, Tsatsanis KD. Pervasive developmental disorders in girls. In Bell DJ, Foster SL, Mash EJ (Eds.), Handbook of behavioral and emotional problems in girls. New York, NY, US: Kluwer Academic/Plenum Publishers, 2005, 211–237.CrossRef Koenig K, Tsatsanis KD. Pervasive developmental disorders in girls. In Bell DJ, Foster SL, Mash EJ (Eds.), Handbook of behavioral and emotional problems in girls. New York, NY, US: Kluwer Academic/Plenum Publishers, 2005, 211–237.CrossRef
18.
go back to reference American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, revised (4th ed.). Washington, DC: American Psychiatric Association, 2000. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, revised (4th ed.). Washington, DC: American Psychiatric Association, 2000.
19.
go back to reference Rutter M, Le Couteur A, Lord C. Autism Diagnostic Interview-Revised Manual. Los Angeles: Western Psychological Services, 2003. Rutter M, Le Couteur A, Lord C. Autism Diagnostic Interview-Revised Manual. Los Angeles: Western Psychological Services, 2003.
20.
go back to reference Lord C, Rutter M, DiLavore PC, Risi S. Autism Diagnostic Observation Schedule: ADOS manual. Los Angeles, CA: Western Psychological Services, 2002. Lord C, Rutter M, DiLavore PC, Risi S. Autism Diagnostic Observation Schedule: ADOS manual. Los Angeles, CA: Western Psychological Services, 2002.
21.
go back to reference Holtmann M, Boelte S, Poustka F. Autism spectrum disorders: sex differences in autistic behaviour domains and coexisting psychopathology. Dev Med Child Neurol 2007, 49: 361–366.CrossRefPubMed Holtmann M, Boelte S, Poustka F. Autism spectrum disorders: sex differences in autistic behaviour domains and coexisting psychopathology. Dev Med Child Neurol 2007, 49: 361–366.CrossRefPubMed
22.
go back to reference Howe YJ, O’Rourke JA, Yatchmink Y, Viscidi EW, Jones RN, Morrow EM. Female autism phenotypes investigated at different levels of language and developmental abilities. J Autism Dev Disord 2015, 45: 3537–3549.CrossRefPubMedPubMedCentral Howe YJ, O’Rourke JA, Yatchmink Y, Viscidi EW, Jones RN, Morrow EM. Female autism phenotypes investigated at different levels of language and developmental abilities. J Autism Dev Disord 2015, 45: 3537–3549.CrossRefPubMedPubMedCentral
23.
go back to reference Bhasin TK, Schendel D. Sociodemographic risk factors for autism in a US metropolitan area. J Autism Dev Disord 2007, 37: 667–677.CrossRefPubMed Bhasin TK, Schendel D. Sociodemographic risk factors for autism in a US metropolitan area. J Autism Dev Disord 2007, 37: 667–677.CrossRefPubMed
24.
go back to reference Lai MC, Lombardo MV, Auyeung B, Chakrabarti B, Baron-Cohen S. Sex/gender differences and autism: setting the scene for future research. J Am Acad Child Adolesc Psychiatry 2015, 54: 11–24.CrossRefPubMedPubMedCentral Lai MC, Lombardo MV, Auyeung B, Chakrabarti B, Baron-Cohen S. Sex/gender differences and autism: setting the scene for future research. J Am Acad Child Adolesc Psychiatry 2015, 54: 11–24.CrossRefPubMedPubMedCentral
25.
go back to reference Halladay AK, Bishop S, Constantino JN, Daniels AM, Koenig K, Palmer K, et al. Sex and gender differences in autism spectrum disorder: summarizing evidence gaps and identifying emerging areas of priority. Mol Autism 2015, 13: 6–36. Halladay AK, Bishop S, Constantino JN, Daniels AM, Koenig K, Palmer K, et al. Sex and gender differences in autism spectrum disorder: summarizing evidence gaps and identifying emerging areas of priority. Mol Autism 2015, 13: 6–36.
26.
go back to reference Wilson CE, Murphy CM, McAlonan G, Robertson DM, Spain D, Hayward H, et al. Does sex influence the diagnostic evaluation of autism spectrum disorder in adults? Autism 2016, 20: 808–819.CrossRefPubMed Wilson CE, Murphy CM, McAlonan G, Robertson DM, Spain D, Hayward H, et al. Does sex influence the diagnostic evaluation of autism spectrum disorder in adults? Autism 2016, 20: 808–819.CrossRefPubMed
27.
go back to reference Szatmari P, Liu XQ, Goldberg J, Zwaigenbaum L, Paterson AD, Woodbury-Smith M, et al. Sex differences in repetitive stereotyped behaviors in autism: implications for genetic liability. Am J Med Genet B Neuropsychiatr Genet 2012, 159B: 5–12.CrossRefPubMed Szatmari P, Liu XQ, Goldberg J, Zwaigenbaum L, Paterson AD, Woodbury-Smith M, et al. Sex differences in repetitive stereotyped behaviors in autism: implications for genetic liability. Am J Med Genet B Neuropsychiatr Genet 2012, 159B: 5–12.CrossRefPubMed
28.
go back to reference Tsai L, Stewart MA, August G. Implication of sex differences in the familial transmission of infantile autism. J Autism Dev Disord 1981, 11: 165–173.CrossRefPubMed Tsai L, Stewart MA, August G. Implication of sex differences in the familial transmission of infantile autism. J Autism Dev Disord 1981, 11: 165–173.CrossRefPubMed
29.
go back to reference Shattuck PT, Durkin M, Maenner M, Newschaffer C, Mandell DS, Wiggins L, et al. Timing of identification among children with an autism spectrum disorder: findings from a population-based surveillance study. J Am Acad Child Adolesc psychiatry 2009, 48: 474–483.CrossRefPubMedPubMedCentral Shattuck PT, Durkin M, Maenner M, Newschaffer C, Mandell DS, Wiggins L, et al. Timing of identification among children with an autism spectrum disorder: findings from a population-based surveillance study. J Am Acad Child Adolesc psychiatry 2009, 48: 474–483.CrossRefPubMedPubMedCentral
Metadata
Title
Sex Differences in Diagnosis and Clinical Phenotypes of Chinese Children with Autism Spectrum Disorder
Authors
Shihuan Wang
Hongzhu Deng
Cong You
Kaiyun Chen
Jianying Li
Chun Tang
Chaoqun Ceng
Yuanyuan Zou
Xiaobing Zou
Publication date
01-04-2017
Publisher
Springer Singapore
Published in
Neuroscience Bulletin / Issue 2/2017
Print ISSN: 1673-7067
Electronic ISSN: 1995-8218
DOI
https://doi.org/10.1007/s12264-017-0102-9

Other articles of this Issue 2/2017

Neuroscience Bulletin 2/2017 Go to the issue