Trajectories of autism symptom severity for boys and girls across childhood.

The study included 183 children, with 55 girls and 30%, and more than twice as many boys than girls, so it may be harder to detect change for girls and for specific items. A higher proportion of girls contributed ADOS data at two timepoints than at three, partly because many had not yet reached age 11 when the study was conducted. Children were assessed with different ADOS modules over time, so the analysis used only 16 items that could be compared across modules. The study described trajectories separately for boys and girls rather than formally comparing them, so apparent differences should not be treated as a direct test of sex differences. Individual ADOS items may be less reliable than summary scores, so item-level findings need replication. The analysis focused on sex and did not evaluate other factors such as cognitive ability, language level, or adaptive functioning that may also shape change. All girls met autism diagnostic criteria between ages 2 and 3.5, so late-diagnosed girls were not included. Girls with early higher severity showed more improvement but did not necessarily reach better outcomes by age 11.

The paper is listed as supported by NIH and non-U.S. government research support, and the authors declared no potential conflict of interest.

Do not read girls' decreasing total severity as proof that their social communication needs have resolved. Total scores can mask changes in specific behaviors, and girls with early high severity did not necessarily reach better outcomes by age 11.