Researchers discover solutions to gender bias in autism diagnoses

Summary: The study reports that girls and boys display similar rates of anxiety about autism spectrum disorder and identifies several biases that contribute to the inflated sex ratio of an autism diagnosis. The findings could aid in the early identification of girls on the autism spectrum.

source: University of Minnesota

Posted in Biological Psychiatrya multidisciplinary study led by the University of Minnesota showed that an equal number of girls and boys could be identified as having autism spectrum disorder (ASD) concerns when screened beforehand, correcting for large gender differences in current diagnoses.

“The conventional wisdom has been that more boys than girls have autism,” said the study’s lead author. Casey BurroughsPhD, LP, assistant professor at the University of Minnesota School of Medicine and a psychologist at M Health Fairview.

“Our research shows that girls and boys show similar rates of anxiety about ASD and identifies some biases that contribute to inflated sex ratios. We hope this research brings relief to women and girls who struggled socially without knowing why.”

using data from Infant Brain Imaging Study NetworkThe study used a less biased sample that followed a group of children with a higher likelihood of developing an autism spectrum disorder (for example, siblings of children with autism) from six to 60 months of age.

The study found that an equal number of girls were identified as having autism-related concerns when screening children early and when correcting for gender bias in diagnostic tools. This is in sharp contrast to the current 4 to 1 sex ratio when standard clinical referrals are followed.

said Dr. Burroughs, who is also a member of Masonic Institute for Brain Development.

This prevents many girls from receiving early intervention services when they can have the greatest impact in early childhood. Most studies in ASD focus on children after they have been diagnosed, and information about symptoms is missing in children who have missed common screening practices.”

The research team looked at whether girls and boys showed similar symptoms and found slight differences in the structure of core symptoms of autism spectrum disorder. After correcting for these differences, subgroup analysis identified a “highly anxious” group that had a 1 to 1 male to female ratio.

The study found that an equal number of girls were identified as having autism-related concerns when screening children early and when correcting for gender bias in diagnostic tools. The image is in the public domain

“This approach — making sure that is unbiased, making sure that our tools measure what we think they measure — may help address current discrepancies in identifying autism,” according to Good EllisonPh.D., associate professor at the Child Development Institute and College of Medicine and co-author of the paper.

“It is essential to recognize and understand the limitations of traditional diagnostic and screening methods and to find innovative solutions to identify all children who can benefit from early intervention services.”

The researchers plan to follow up on this work by examining how children in the high social interest group fare from primary to high school age. They also investigate collective differences in basic brain structure and function.

Financing: This study was supported by grants from the National Institutes of Health (R01-HD055741, R01-MH118362-01, R01-MH118362-02S1, U54-HD079124, P50-HD103573 (Project ID 8084), U54-HD086984), Autism Speaks, and the Simmons Foundation ( 140209). Dr. Burroughs received a Career Development Award from the National Institutes of Health (K12-HD055887).

About this research on autism news

author: Dodge cat
source: University of Minnesota
Contact: Cat Dodge – University of Minnesota
picture: The image is in the public domain

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Data-driven approach in an unbiased sample reveals a sex-equivalent percentage of autism spectrum disorder associated with early childhood impairmentBy Casey Burroughs et al. Biological Psychiatry


Summary

Data-driven approach in an unbiased sample reveals a sex-equivalent percentage of autism spectrum disorder associated with early childhood impairment

background

Gender differences in the prevalence of neurodevelopmental disorders are particularly evident in Autism Spectrum Disorder (ASD). Presentation of heterogeneous symptoms and the possibility of measurement bias impedes early detection of autism spectrum disorder in females, and may contribute to the divergent prevalence estimates. We examined social communication pathways (SC) and restricted and repetitive behaviors (RRBs) in a sample of infant siblings of children with autism, adjusting for measurement bias based on age and gender. We hypothesized that taking advantage of a potentially high family probability sample, deriving data-driven behavioral constructs, and accounting for measurement bias would reveal less variable sex ratios than is typically seen in ASD.

Methods

We performed direct assessments of autism spectrum disorder symptoms at 6-9, 12-15, 24, and 36-60 months of age (total NNotes= 1254) with infant siblings of children with autism (n = 377) and a low autism spectrum disorder likelihood comparison group (N = 168; NNotes= 527). We established measurement stability across age and gender for separate models of SC and RRB. We then performed latent layer growth mixture modeling with longitudinal data and assessed gender differences in pathway membership.

consequences

We identified two latent classes in the SC and RRB models with equal sex ratios in the group of high interest for both SC and RRB. Gender differences were also noted in the subcommittee’s high interest group, indicating that girls classified as ‘high social fears’ display milder symptoms than boys in this group.

Conclusions

This new approach to characterizing the development of ASD symptoms highlights the utility of assessing and modifying sex-related measurement bias and identifying sex-specific patterns of symptom onset.