PTOTSLPCohortAutism research : official journal of the International Society for Autism Research2026

Urban-Rural Differences and Sex-Specific Cognitive Effects on Autism Symptom Trajectories: A Longitudinal Study of Autistic Children in Taiwan.

Yun-Ju Chen, Hsiang-Yuan Lin, Ching-Lin Chu and 6 others

PMID 41635134

WHAT IT FOUND

Rural autistic children showed steeper increases in social communication difficulties over time than urban peers, despite similar starting points.

Higher verbal IQ was linked to fewer social symptoms in girls but not boys. Restricted behaviors remained stable across all groups.

Key findings

01Children from rural areas showed greater increases in total and social-affect symptoms over age compared to those from urban areas.

02Higher average IQ was associated with lower autism symptom severity, with a stronger negative association between verbal IQ and social-affect symptoms observed in girls than boys.

03Restricted and repetitive behaviors remained stable over time, with no significant change observed in the overall trajectory.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

Recruitment was staggered by region and DSM era, meaning the DSM-5 cohort was exclusively urban and the DSM-IV cohort included both regions. This confounds region with diagnostic criteria and historical time. The sample was predominantly male (158 of 180), limiting the power to detect sex-specific effects and generalizability to girls. Participants contributed at most three data points, preventing the modeling of non-linear trajectories. IQ measures were harmonized using ratio IQs, which may not fully capture conceptual equivalence across different instruments.

Declared interests

Funded by the National Science and Technology Council of Taiwan. No other conflicts declared.

The easy way to misread this

Do not interpret the urban-rural difference as solely due to service access. The urban cohort was recruited later and included DSM-5 diagnoses, while the rural cohort was all DSM-IV. The study authors note that these factors are entangled and cannot be fully disentangled.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →