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. 2016 Mar 30:7:21.
doi: 10.1186/s13229-016-0081-0. eCollection 2016.

Sex differences in the association between infant markers and later autistic traits

Rachael Bedford  1 , Emily J H Jones  2 , Mark H Johnson  2 , Andrew Pickles  1 , Tony Charman  3 , Teodora Gliga  2
Affiliations

Sex differences in the association between infant markers and later autistic traits

Rachael Bedford et al. Mol Autism. .

Erratum in

Abstract

Background: Although it is well established that the prevalence of autism spectrum disorder (ASD) is higher in males than females, there is relatively little understanding of the underlying mechanisms and their developmental time course. Sex-specific protective or risk factors have often been invoked to explain these differences, but such factors are yet to be identified.

Methods: We take a developmental approach, using a prospective sample of 104 infants at high and low familial risk for ASD, to characterise sex differences in infant markers known to predict emerging autism symptoms. We examine three markers previously shown to be associated with later autistic social-communication symptoms: the Autism Observation Scale for Infants (AOSI) total score, attention disengagement speed and gaze following behaviour. Our aim was to test whether sex differences were already present in these markers at 1 year of age, which would suggest sex-specific mechanisms of risk or protection.

Results: While no sex differences were found in any of the three markers investigated, we found sex differences in their relationship to 3-year autism traits; all three markers significantly predicted later autism traits only in the boys.

Conclusions: Previously identified 'early autism markers' were associated with later autism symptoms only in boys. This suggests that there may be additional moderating risk or protective factors which remain to be identified. Our findings have important implications for prospective studies in terms of directly testing for the moderating effect of sex on emerging autistic traits.

Keywords: Autism; Differential liability; High risk; Infants; Sex difference.

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Figures

Fig. 1
Fig. 1
Sex differences can appear in the expression of early autism markers or in the relationship between marker and outcome. a The marker differentiates between the boys and girls, but relates to later symptoms in the same way in both sexes; here, having lower levels of this marker is protective in girls. b The early marker is similarly expressed in boys and girls but only relates to later symptoms in boys; this is due to additional moderating factors (which are likely to be type of marker described in a) decreasing the impact of this marker in girls. A combination of the two models is also possible
Fig. 2
Fig. 2
a The relationship between infant AOSI and 3-year ADOS outcome with smoothed lowess curves for males and females. b The relationship between infant AOSI and 3-year ADOS outcome with linear fit for males and females
Fig. 3
Fig. 3
a The relationship between infant looking time in the gaze following task and 3-year ADOS outcome with smoothed lowess curves for males and females. For further analysis, the outlier was trimmed back to one point above the next highest value. b The relationship between infant looking time in the gaze following task and 3-year ADOS outcome with linear fit for males and females
Fig. 4
Fig. 4
a The relationship between infant disengagement in the gap-overlap task and 3-year ADOS outcome with smoothed lowess curves for males and females. For further analysis, the outlier was trimmed back to one point above the next highest value. b The relationship between infant disengagement in the gap-overlap task and 3-year ADOS outcome with linear fit for males and females
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