Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina.
Department of Pediatrics, Medical University of South Carolina.
J Clin Child Adolesc Psychol. 2019 Nov-Dec;48(6):840-854. doi: 10.1080/15374416.2018.1437734. Epub 2018 Mar 30.
Autism spectrum disorder (ASD) is diagnosed more often in boys than in girls; however, little is known about the nature of this sex/gender discrepancy or how it relates to diagnostic assessment practices. This study examined the performance of the Social Communication Questionnaire (SCQ) in screening for ASD among boys and girls. Data were drawn from the South Carolina Children's Educational Surveillance Study, a population-based study of ASD prevalence among children 8-10 years of age. Analyses were conducted using SCQ data from 3,520 children, with direct assessment data from 272 with elevated SCQ scores. A bifactor model based on the 's (5th ed.) two ASD symptom domains fit the data well and performed slightly better for girls. In the general population sample, girls exhibited fewer social communication/interaction and restricted-repetitive behavior symptoms than boys. In the direct assessment sample, however, girls with ASD showed greater impairment in social communication/interaction than boys with ASD. Items pertaining to social communication/interaction problems at ages 4-5 were among the most diagnostically efficient overall and particularly for girls. Similarly, receiver operating characteristic analyses suggested that the SCQ performs adequately among boys and well among girls. Results support the use of the SCQ in screening for ASD but do not indicate sex/gender-specific cutoffs. Girls with ASD may exhibit pronounced intraindividual deficits in social communication/interaction compared to male peers with ASD and female peers without ASD. Although more research is needed, careful attention to social communication/interaction deficits around 4-5 years of age may be especially useful for assessing ASD in girls.
自闭症谱系障碍 (ASD) 在男孩中的诊断率高于女孩；然而，对于这种性别差异的性质及其与诊断评估实践的关系知之甚少。本研究考察了社交沟通问卷 (SCQ) 在筛查男孩和女孩 ASD 中的表现。数据来自南卡罗来纳州儿童教育监测研究，这是一项针对 8-10 岁儿童 ASD 患病率的基于人群的研究。分析使用了来自 3520 名儿童的 SCQ 数据，其中 272 名 SCQ 得分较高的儿童有直接评估数据。基于 's (5th ed.) 的两个 ASD 症状领域的双因素模型很好地拟合了数据，并且对女孩的表现略好。在普通人群样本中，女孩的社交沟通/互动和受限重复行为症状比男孩少。然而，在直接评估样本中，患有 ASD 的女孩在社交沟通/互动方面的障碍比患有 ASD 的男孩更为严重。与 4-5 岁时的社交沟通/互动问题相关的项目总体上具有最高的诊断效率，特别是对女孩而言。同样，接收者操作特征分析表明，SCQ 在筛查 ASD 方面表现良好，无论是男孩还是女孩。研究结果支持使用 SCQ 筛查 ASD，但不表明存在特定于性别的截止值。与患有 ASD 的男性同龄人以及没有 ASD 的女性同龄人相比，患有 ASD 的女孩可能在社交沟通/互动方面表现出明显的个体内缺陷。尽管需要进一步研究，但在 4-5 岁左右仔细关注社交沟通/互动缺陷可能对评估女孩的 ASD 特别有用。
