All ETDs from UAB

Advisory Committee Chair

Sarah O'Kelley

Advisory Committee Members

Anne Brisendine

Kristi C Guest

Sylvie Mrug

Document Type


Date of Award


Degree Name by School

Master of Arts (MA) College of Arts and Sciences


The current study aimed to examine sex differences in clinical profiles of children and adolescents referred for an ASD evaluation, including ASD symptoms and associated clinical features. Specifically, the study aimed to include females who may be mis- or un-der-diagnosed by current ASD diagnostic procedures in order to characterize this phenotypically diverse population. Participants included 1,099 children and adolescents who were referred for an ASD evaluation at a tertiary care clinic. In this sample, 276 participants (25.11%) were female, 602 participants (54.8%) were diagnosed with ASD, and the average age was 5.97 years old (SD = 3.60). Independent samples t-tests, two-way factorial ANOVAs, and chi-square tests of independence were used to evaluate group differences in ASD symptom presentation as measured by the ADOS and ADI-R, as well as group differences in cognitive, adaptive, language, and fine motor skills. Results indicated that females exhibited a greater gap between age of first concern and age at evalua-tion, and males were more likely to be diagnosed with ASD at the time of evaluation. Fe-males exhibited lower RRB and Social Affect severity scores on the ADOS as well as lower likelihood of reaching or exceeding the diagnostic cut-off for the RRB domain on the ADI-R compared to males. No sex differences were identified for associated clinical features. These findings suggest that there are quantifiable sex differences in ASD clinical presentation among individuals referred for an ASD evaluation, even when the iii sample is expanded to include those who may otherwise be missed by potentially male-biased diagnostic instruments. Future research should continue to examine sex differences in clinical presentation to elucidate characteristics of the female autism phenotype and promote early and accurate referral and evaluation.



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