Adaptive Functioning, Sensory Processing, and Behavioral Problems in Autistic Children: The Moderating Role of Gender.

The study measured everything at one time, so it cannot tell whether low adaptive skills or sensory differences caused behavior problems, or whether behavior problems affected daily functioning. Most outcomes came from caregiver report, so parents' perceptions may have influenced the links between adaptive skills, sensory responses, and behavior. The sample was modest (110 children), and the authors said it was powered mainly for medium effects, so smaller differences should be treated cautiously. All children were being evaluated for autism for the first time, and the authors noted girls may be referred only when they have more emotional, behavioral, or functional difficulties, so the girls may not represent all autistic girls. Gender was recorded only as male or female, so the findings do not cover nonbinary or other gender identities. The ADOS-2 may be less sensitive to some female autism presentations, although it was used as a standardized observed measure.

Do not conclude that improving adaptive skills will reduce behavior problems for every autistic child. The study measured associations at one diagnostic evaluation, mostly by parent report, and the girls were clinically referred, so it cannot show cause or generalise to all autistic girls.