Wiggins Lisa D, Rubenstein Eric, Windham Gayle, Barger Brian, Croen Lisa, Dowling Nicole, Giarelli Ellen, Levy Susan, Moody Eric, Soke Gnakub, Fields Victoria, Schieve Laura
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States.
Boston University, Department of Epidemiology, Boston, MA, United States.
Res Dev Disabil. 2021 May;112:103897. doi: 10.1016/j.ridd.2021.103897. Epub 2021 Feb 17.
Research in school-aged children, adolescents, and adults with autism spectrum disorder (ASD) has found sex-based differences in behavioral, developmental, and diagnostic outcomes. These findings have not been consistently replicated in preschool-aged children. We examined sex-based differences in a large sample of 2-5-year-old children with ASD symptoms in a multi-site community-based study.
Based on a comprehensive evaluation, children were classified as having ASD (n = 1480, 81.55 % male) or subthreshold ASD characteristics (n = 593, 70.15 % male). Outcomes were behavior problems, developmental abilities, performance on ASD screening and diagnostic tests, and parent-reported developmental conditions diagnosed before study enrollment.
We found no statistically significant sex differences in behavioral functioning, developmental functioning, performance on an ASD screening test, and developmental conditions diagnosed before study enrollment among children with ASD or subthreshold ASD characteristics. Males in both study groups had more parent reported restricted interests and repetitive behaviors than females, but these differences were small in magnitude and not clinically meaningful.
Preschool males and females who showed risk for ASD were more similar than different in the outcomes assessed in our study. Future research could examine sex-based differences in ASD phenotypes as children age.
针对患有自闭症谱系障碍（ASD）的学龄儿童、青少年及成人的研究发现，在行为、发育及诊断结果方面存在基于性别的差异。这些发现在学龄前儿童中并未得到一致的重复验证。在一项多中心社区研究中，我们对大量2至5岁有ASD症状的儿童样本进行了基于性别的差异研究。
基于全面评估，将儿童分为患有ASD（n = 1480，男性占81.55%）或亚阈值ASD特征（n = 593，男性占70.15%）两类。研究结果包括行为问题、发育能力、ASD筛查及诊断测试表现，以及家长报告的在研究入组前诊断出的发育状况。
我们发现，在患有ASD或亚阈值ASD特征的儿童中，在行为功能、发育功能、ASD筛查测试表现以及研究入组前诊断出的发育状况方面，不存在统计学上显著的性别差异。两个研究组中的男性比女性有更多家长报告的兴趣受限和重复行为，但这些差异程度较小且无临床意义。
在我们的研究中，显示有ASD风险的学龄前男性和女性在所评估的结果方面相似之处多于差异。未来研究可以考察随着儿童年龄增长，ASD表型中基于性别的差异。
