Advisor(s)
Sarah O'Kelley
Committee Member(s)
Anne Brisendine
Kristi Guest
Snehal Khatri
Sylvie Mrug
School
College of Arts and Sciences
Document Type
Dissertation
Department (new version)
Psychology
Date of Award
9-11-2025
Abstract
The current study aimed to examine item-level sex differences in the diagnostic evaluation of ASD traits for children and adolescents referred for an ASD evaluation. By including all those referred for an ASD evaluation, the study aimed to include females who may be mis- or under-diagnosed by current ASD diagnostic procedures. Participants included 458 children and adolescents who were referred for an ASD evaluation at a tertiary care clinic. In this sample, 118 participants (25.8%) were female, 282 (61.6%) were diagnosed with ASD, and the average age was 6.67 years (SD = 3.65). MIMIC models were used to examine differential item functioning on the gold standard ASD diagnostic measures of the ADOS-2 and ADI-R. Within the context of domain-level sex differences in RRBs on both the ADI-R and ADOS-2, results indicated differential item functioning on a small proportion of ADI-R items across content areas, whereas there were no item-level sex differences identified on the ADOS-2. These findings suggest that there are nuanced sex differences in ASD trait presentation among children and adolescents presenting with concern for ASD, as measured by gold standard diagnostic assessment tools. Future research should continue to explore detailed patterns of sex differences in trait measurement using precise sampling and incorporating additional diagnostic instruments, as a well-informed understanding of sex differences in ASD trait presentation and measurement is critical for addressing the existing sex bias in ASD research and clinical settings, with the goal of ensuring appropriate ASD characterization, identification, and diagnosis.
ProQuest ID
Recommended Citation
Cottle, Jeremy John, "Sex Differences In Symptom Presentation Among Children And Adolescents Referred For An Autism Spectrum Disorder Evaluation" (2025). All ETDs from UAB. 7245.
https://digitalcommons.library.uab.edu/etd-collection/7245
