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Autism diagnosis age differed by gender, symptom severity
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SAN DIEGO — Girls are diagnosed with autism spectrum disorder later than boys, possibly due to the fact that boys have more difficulties with social awareness and communication while girls exhibit less severe symptoms that may be missed by early screening.
“This and other studies suggest that girls with ASD, as well as perhaps older women with this disorder, differ from males in key symptoms and behaviors, particularly around social interactions,” Paul Lipkin, MD, an Infectious Diseases in Children Editorial Board member and director of the Interactive Autism Network at Kennedy Krieger in Baltimore, said in a press release. “We must determine if the less recognizable symptoms in girls are leading not only to delayed diagnosis, but also under-identification of the condition.”
Paul Lipkin
To examine gender differences in age at diagnosis and measure symptom severity between genders, Lipkin and colleagues at the Kennedy Krieger Institute in Baltimore, Md., analyzed data from the Interactive Autism Network, a Web-based family-powered registry for autism spectrum disorders.
Researchers gathered registry data from November 2006 to January 2013 for children with ASD aged younger than 18 years, including age of first diagnosis (n=9,932) and children who had completed the Social Responsiveness Scale (n=5,103) to isolate the presence and severity of social impairment.
Lipkin and colleagues performed two sample t-tests to assess age means by gender, and chi-square test to evaluate gender variations based on diagnostic year, age of diagnosis, ASD categories and symptom severity.
According to study results, the mean age of diagnosis of Asperger’s Syndrome was significantly different in girls, at an age of 4 years vs. 3.8 years for boys. The difference was consistent in girls diagnosed with pervasive developmental disorder in which girls were diagnosed at a mean age of 7.6 years compared with 7.1 years for boys.
When researchers stratified the diagnostic age into age groups (year 0-5, 5-10, 10-15 and 15-18), they observed a trend of increasing female ratio in age of diagnosis (P = .02), with significant differences in both Asperger’s Syndrome (P < .01) and pervasive developmental disorder (P = .036).
Boys aged 10 to 15 years exhibited greater difficulties with social awareness and social communication (P < .05), while girls experienced greater difficulty with social cognition. In addition, Lipkin and colleagues observed the development of increased proportion of girls by year of registry enrollment (P = 0.02), which increased over time (P<0.05) when matching early registrants (2006-2009) to later ones (2010-2013).
“As part of their responsibility for ongoing developmental surveillance, pediatric clinicians should be monitoring all children for the social and communication problems related to autism. However, they should be especially attuned to the young girl who has difficulties in social situations, as these may be missed by screening and may not noticed by preschool teachers and parents,” Lipkin told Infectious Diseases in Children. “When such a problem is noted, a child should be further evaluated by an appropriate medical or developmental specialist, as well as possibly to therapists knowledgeable in ways to improve these social skills and understanding.” – by Bob Stott
Reference:
Lipkin PH. Abstract # 4545.2. Presented at: Pediatric Academic Societies 2015; April 25-28, 2015; San Diego.
Disclosure: The researchers report no relevant financial disclosures.