EU-AIMS Clinical Network: Evaluating Sex- and Age-Related Differences in ADI-R and ADOS Scores in a Large ASD Sample

Friday, May 12, 2017: 12:00 PM-1:40 PM
Golden Gate Ballroom (Marriott Marquis Hotel)
J. Tillmann1, M. Absoud2, A. de Bildt3, F. Bonnet-Brilhault4, S. Bolte5, S. Calderoni6, R. Canal-Bedia7, R. Canitano8, P. J. Hoekstra9, A. Kaale10, H. Klip11, H. McConachie12, A. Narzisi6, M. Pejovic-Milovancevic13, N. Polnareva14, M. Posada15, P. Garcia Primo16, H. Roeyers17, N. N. J. Rommelse18, S. Roux19, R. Sacco20, V. Scandurra8, I. J. Oosterling18, A. C. Stanfield21, E. L. Woodhouse22, M. Yaari23, N. Yirmiya24, E. Loth25, J. K. Buitelaar26, W. Spooren27, D. G. Murphy28 and T. Charman29, (1)King's College London, London, United Kingdom of Great Britain and Northern Ireland, (2)Newcomen Children's Neurosciences Centre, Evelina London Children's Hospital at Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom, (3)University Medical Center Groningen, Groningen, NETHERLANDS, (4)UMR930 Inserm, Université François-Rabelais de Tours, Tours, France, (5)Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Institutionen för kvinnors och barns hälsa (KBH), Karolinska Institutet, Stockholm, Sweden, (6)University of Pisa – Stella Maris Scientific Institute, Pisa, Italy, (7)Clinical Psychology, Universidad de Salamanca, Salamanca, SPAIN, (8)University hospital of Siena, Siena, ITALY, (9)University of Groningen and University Medical Center Groningen, Groningen, NETHERLANDS, (10)Department of Special Needs Education, University of Oslo, Oslo, Norway, (11)Radboud University, Nijmegen, Netherlands, (12)Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom, (13)School of Medicine, Institute of Mental Health, Belgrade, Serbia, (14)Aleksandrovska University Hospital, Sofia, Bulgaria, (15)Carlos III Health Institute, Madrid, SPAIN, (16)Carlos III National Health Institute, Madrid, SPAIN, (17)Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium, (18)Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Netherlands, (19)Université François Rabelais de Tours, INSERM U930, Tours, France, (20)Univ. Campus Bio-Medico, Rome, ITALY, (21)University of Edinburgh, Edinburgh, UNITED KINGDOM, (22)Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom, (23)The Hebrew University of Jerusalem, Jerusalem, Israel, (24)Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel, (25)Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom, (26)Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence-Based Practice, Nijmegen, NH, NETHERLANDS, (27)Roche Pharmaceutical Research and Early Development, NORD Discovery and Translational Area, Roche Innovation Center, Basel, Switzerland, (28)Department of Forensic and Neurodevelopmental Sciences, and the Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom, (29)Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
Background: Developing a greater understanding of the sex-and age-related differences in the severity of the core symptoms of Autism Spectrum Disorder (ASD) has been impeded by small sample sizes, variation between samples in age and IQ of participants and large heterogeneity in symptom expression both between and within individuals. Large-scale samples are therefore necessary to better understand these relationships. In response, we set up a platform as part of the EU-AIMS clinical network to collaboratively pool data from major ASD clinical and research institutions across Europe. 22 sites situated in 10 different European countries have already shared demographic (e.g. sex, age, diagnosis and ethnicity), phenotypic (e.g. ADI-R, ADOS), behavioural (Vineland) and cognitive data (IQ) for secondary analysis.

Objectives: (1) To describe the current sample in relation to between-site variability in demographic and clinical measures and (2) examine differences in core ASD symptomatology between males and females with ASD on diagnostic instruments.

Methods: This preliminary sample is composed of 1386 participants (males = 1151, females = 235; 80% male-female ratio) ranging in age from 12 months to 30 years. Autism symptom data were obtained from the Autism Diagnostic Interview–Revised (ADI-R) total and domain scores (social, communication, and restricted/repetitive behaviour) and Autism Diagnostic Observation Schedule (ADOS) Calibrated Severity Scores (CSS). Linear mixed-effects models were used to investigate variability between sites in relation to demographic information (age and sex) and Intraclass correlation coefficients (ICCs) reflecting the ratio of between-site variance to total variance were calculated. For sex and age-dependent analyses, a random effect for site was included in all models to take into consideration the multi-level nature of the data, as well as to account for site heterogeneity across outcome measures.

Results: Overall, there were significant site effects on all demographic and core characterisation measures reflecting the variable recruitment pattern across multiple sites and countries. While these site effects were very pronounced for age of participants (ICC=.67), they were less so for sex ratio (ICC=.02) and only moderate for core ASD symptom measures (e.g. ADI-R domain totals: all ICC <.20). On the core ASD measures, no significant effects of age or sex were found for ADI-R Social and Restricted, Repetitive and Stereotyped Behaviours and Interests (RRB) domain total scores (all p >.3). However, females scored significantly lower than males on the Communication domain, x2(1) = 5.78, p = .016, d= .24. Effects of age and sex on ADOS CSS Total, Social Affect and RRB will also be reported.

Conclusions: Pooling datasets across European clinical and research sites as part of EU-AIMS will help to establish a valuable resource for ASD research in Europe. In the future, this resource will not only boost research capacity, but also improve transparency, openness and research efficiency of autism research in Europe.