Sex Differences on the ADOS-2.
Hannah M Rea, Roald A Øien, Frederick Shic and 2 others
PMID 35451672WHAT IT FOUND
Autistic females scored lower than males on most social communication items during ADOS-2 assessments.
This difference disappeared when controlling for overall symptom severity. Clinicians should not rely solely on these lower scores, as they may reflect camouflaging rather than a lack of impairment.
Key findings
01Females scored significantly lower than males on total, social affect, and restricted and repetitive behavior calibrated severity scores.
02Males were significantly more likely to show challenges in verbal and nonverbal social communication items compared to females.
03When controlling for overall symptom severity, no individual ADOS-2 items showed significant sex differences.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study only included individuals with IQs of 70 or higher, so results may not apply to those with intellectual disability. Participants were aged 8 to 18, excluding toddlers and adults. The sample was largely from the United States and tested in English. Reliability between raters and sites could not be calculated due to limited data on administrators. Ascertainment bias may exist as the sample consisted of individuals already diagnosed with ASD.
Declared interests
The study utilized data from the GENDAAR consortium (NIMH funded) and a clinic-based sample. No specific conflicts of interest were declared in the provided text, though the GENDAAR study is a multi-site research initiative.
The easy way to misread this
Do not assume that lower ADOS-2 scores in females indicate less severe autism. The sex differences in individual items disappeared when controlling for overall symptom severity, suggesting that the lower scores may reflect how females present or camouflage their symptoms rather than a true difference in underlying impairment.