Barriers to an autistic identity: How RRBs may contribute to the underdiagnosis of females / Aparajita RAO ; Erin Stephanie Misato MATSUBA ; Natalie RUSSO in Research in Autism Spectrum Disorders, 109 (November 2023)  

Public ISBD [article]  inResearch in Autism Spectrum Disorders > 109 (November 2023) . - 102275 Titre : Barriers to an autistic identity: How RRBs may contribute to the underdiagnosis of females Type de document : Texte imprimé et/ou numérique Auteurs : Aparajita RAO, Auteur ; Erin Stephanie Misato MATSUBA, Auteur ; Natalie RUSSO, Auteur Article en page(s) : 102275 Langues : Anglais (eng) Mots-clés : Autistic identity, females, RRBs  Sensory  Diagnosis Index. décimale : PER Périodiques Résumé : Background Autistic females are frequently underdiagnosed, misdiagnosed, and/or diagnosed later in life. Restricted and Repetitive Behaviors (RRBs) are increasingly critical for diagnosis and yet are commonly rated lower in females. Whether this reflects genuinely lower levels of these traits, or if female-typical RRBs have a different phenotypic presentation that may not register on current quantitative measurement tools is unclear. Methods Twenty-one autistic females and 21 autistic males matched on chronological age and FSIQ completed the AQ, ADOS-2, and ADI-R. Items from the ADOS-2 and ADI-R were selected that were relevant to the four area s of restricted and repetitive behavior in the DSM-5 diagnostic criteria of autism. Using a mixed-methods analytical approach, scores and comments on these measures were compared between sexes to better characterize RRBs in autistic females. Results There were no sex differences on the AQ, which broadly assesses autistic traits. When analyzed by the four DSM-5 RRB criteria, there were no sex differences on the ADI-R when using traditional algorithm scoring that narrows questions down to those that are more sensitive and specific in capturing autism in research samples with a high proportion of males. When incorporating additional items relevant to the DSM-5 to identify sex differences in a broader pool of items, females scored higher on stereotyped movements and speech. Females also engaged in more sensory behaviors during the ADOS-2. Qualitative analyses indicated that females were more likely to engage in stereotyped body rocking and spinning, stereotyped behaviors when anxious, to show major reactions to changes, repetitive language including listing and counting, and sensory behaviors, especially in the tactile domain. Conclusion Exploratory findings highlight sex differences in RRBs that may help enhance diagnostic clarity for females. Higher tactile sensory behaviors in females suggests there may be increased diagnostic sensitivity for females with the updated DSM-5 that now includes sensory components as part of the diagnostic criteria. En ligne : https://doi.org/10.1016/j.rasd.2023.102275 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=517 [article] Barriers to an autistic identity: How RRBs may contribute to the underdiagnosis of females [Texte imprimé et/ou numérique] / Aparajita RAO, Auteur ; Erin Stephanie Misato MATSUBA, Auteur ; Natalie RUSSO, Auteur . - 102275. Langues : Anglais (eng) in Research in Autism Spectrum Disorders > 109 (November 2023) . - 102275 Mots-clés : Autistic identity, females, RRBs  Sensory  Diagnosis Index. décimale : PER Périodiques Résumé : Background Autistic females are frequently underdiagnosed, misdiagnosed, and/or diagnosed later in life. Restricted and Repetitive Behaviors (RRBs) are increasingly critical for diagnosis and yet are commonly rated lower in females. Whether this reflects genuinely lower levels of these traits, or if female-typical RRBs have a different phenotypic presentation that may not register on current quantitative measurement tools is unclear. Methods Twenty-one autistic females and 21 autistic males matched on chronological age and FSIQ completed the AQ, ADOS-2, and ADI-R. Items from the ADOS-2 and ADI-R were selected that were relevant to the four area s of restricted and repetitive behavior in the DSM-5 diagnostic criteria of autism. Using a mixed-methods analytical approach, scores and comments on these measures were compared between sexes to better characterize RRBs in autistic females. Results There were no sex differences on the AQ, which broadly assesses autistic traits. When analyzed by the four DSM-5 RRB criteria, there were no sex differences on the ADI-R when using traditional algorithm scoring that narrows questions down to those that are more sensitive and specific in capturing autism in research samples with a high proportion of males. When incorporating additional items relevant to the DSM-5 to identify sex differences in a broader pool of items, females scored higher on stereotyped movements and speech. Females also engaged in more sensory behaviors during the ADOS-2. Qualitative analyses indicated that females were more likely to engage in stereotyped body rocking and spinning, stereotyped behaviors when anxious, to show major reactions to changes, repetitive language including listing and counting, and sensory behaviors, especially in the tactile domain. Conclusion Exploratory findings highlight sex differences in RRBs that may help enhance diagnostic clarity for females. Higher tactile sensory behaviors in females suggests there may be increased diagnostic sensitivity for females with the updated DSM-5 that now includes sensory components as part of the diagnostic criteria. En ligne : https://doi.org/10.1016/j.rasd.2023.102275 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=517

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