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Mol Autism. 2016 Jun 29;7:31. doi: 10.1186/s13229-016-0093-9. eCollection 2016.

Commentary: sex difference differences? A reply to Constantino.

Author information

1
University of Miami, Coral Gables, USA.
2
University of California, Davis, Davis, USA.
3
Seattle Children's Research Institute, Seattle, USA ; University of Washington, Seattle, USA.
4
Izaak Walton Killam Health Centre, Halifax, Canada ; Dalhousie University, Halifax, Canada.
5
University of Massachusetts, Boston, Boston, USA.
6
University of California, San Diego, La Jolla, USA.
7
King's College London, London, UK.
8
Yale University School of Medicine, New Haven, USA.
9
University of Calgary, Calgary, Canada.
10
University of California, Los Angeles, Los Angeles, USA.
11
University of Pittsburgh, Pittsburgh, USA.
12
Kennedy Krieger Institute, Baltimore, USA ; John Hopkins School of Medicine, Baltimore, USA.
13
Harvard Medical School, Boston, USA ; Harvard Graduate School of Education, Cambridge, USA ; Boston Children's Hospital, Boston, USA.
14
University of Washington, Seattle, USA.
15
Boston University, Boston, USA.
16
University of Alberta, Edmonton, Canada.

Abstract

Messinger et al. found a 3.18 odds ratio of male to female ASD recurrence in 1241 prospectively followed high-risk (HR) siblings. Among high-risk siblings (with and without ASD), as well as among 583 low-risk controls, girls exhibited higher performance on the Mullen Scales of Early Learning, as well as lower restricted and repetitive behavior severity scores on the Autism Diagnostic Observation Schedule (ADOS) than boys. That is, female-favoring sex differences in developmental performance and autism traits were evident among low-risk and non-ASD high-risk children, as well as those with ASD. Constantino (Mol Autism) suggests that sex differences in categorical ASD outcomes in Messinger et al. should be understood as a female protective effect. We are receptive to Constantino's (Mol Autism) suggestion, and propose that quantitative sex differences in autism-related features are keys to understanding this female protective effect.

KEYWORDS:

Autism spectrum disorder; Female protective effect; High-risk siblings; Sex differences

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