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Gender Differences in Vineland Domain Scores in ASD
An understanding of gender differences in the presentation of ASD has important implications for tailoring assessment measures to the potentially unique presentations and needs of males and females. Adaptive behavior, which was incorporated into DSM5 criteria for the establishment of an ASD diagnosis, is a crucial area of assessment for individuals with autism spectrum disorder (ASD). Saulnier and Klin (2007) found no relationship between verbal IQ scores, severity of autism and adaptive functioning in older higher functioning children with ASD, supporting the necessity for including the assessment of adaptive functioning when evaluating ASD, as higher cognitive ability is not always related to real-life adaption. Paul et al. (2004) and Szatmari et al. (2015) found discrete correlations among Vineland domain scores and autism symptomatology by analyzing Vineland age equivalent scores rather than standard scores. Hartley and Sikora (2009) investigated gender differences in the presentation of ASD and found no differences in adaptive functioning in toddlerhood. The present study extends these studies by assessing older, newly-diagnosed ASD and IQ matched school-aged boys and girls using age equivalent domain scores as a method of identifying gender differences in adaptive functioning in ASD.
Objectives:
The aims of this study are (1) to examine similarities and differences in adaptive functioning in school-aged, newly-diagnosed boys and girls; (2) to investigate relationships between domain scores, autism severity, and behavior profiles in later diagnosed boys and girls with ASD.
Methods:
Participants included 30 newly-diagnosed school-aged children (M=9.378; SD=2.4; boys M=9.04; SD=1.83; girls M=9.53; SD=2.22) who are part of a larger study focused on comparing gender differences among children who receive a diagnosis of ASD for the first time when they are school-aged and those diagnosed as toddlers/preschoolers. A complete diagnostic evaluation included assessing intellectual and adaptive functioning, characterization of autism symptomatology and behavioral profiles. For the present study, the male and female participants were matched on chronological age and IQ functioning.
Results:
Significant gender differences were found in Vineland domain age equivalents only. Boys performed significantly better than girls overall (VABS composite: t(27)=1.738; p<0.05) and in activities of daily living (t(27)=2.677; p<0.01). Specifically, boys’ age equivalent scores were higher in domestic skills (t(24)=3.420; p<0.05), personal skills (t(24)=1.684; p<05), and the socialization domain in play skills (t(24)=2.438; p<0.05).
Distinct behavior profiles emerged for boys and girls, with the male profile revealing significant correlations among Vineland domain scores and severity of repetitive and restrictive behaviors. Behavior problems were significantly related to severity of symptoms on the ADOS social and affective scale for boys, while behavior problems were associated with Vineland scores for the girls.
Conclusions:
This research emphasizes the importance of adaptive functioning as an additional element in understanding the differences between boys and girls with ASD. Distinctive adaptive profiles emerge by focusing on school-aged children who receive an initial ASD diagnosis, pointing to the need to individualize interventions to the unique needs of males and females with ASD at this age.