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Researchers find solutions to gender bias in autism diagnoses

Posted in Biological Psychiatrya multidisciplinary study conducted by the University of Minnesota has demonstrated that an equal number of girls and boys can be identified as having autism spectrum disorder (ASD) problems when screened earlier, correcting for the large differences gender in current diagnostics.

“The conventional wisdom is that more boys than girls have ASD,” said the study’s lead author. Casey Burrows, Ph.D., LP, assistant professor at the University of Minnesota Medical School and psychologist at M Health Fairview. “Our research shows that girls and boys have similar rates of concern for ASDs and identifies some of the biases contributing to inflated sex ratios. We hope this research brings relief to women and girls who have struggled socially without knowing why.

Using data from the Infant Brain Imaging Study Networkthe study used a less biased sample that followed a group of children more likely to develop ASD (for example, infant siblings of children with autism) from six to 60 months.

The study found that there are as many girls identified as having ASD-related problems when children are screened early and when they are corrected for gender-based biases in diagnostic instruments. This contrasts sharply with the current sex ratio of 4 to 1 when following standard clinical referral processes.

“We know that screening processes and diagnostic tools for ASDs are often lacking for many girls who are later diagnosed with ASDs,” said Burrows, who is also a member of the Masonic Institute for Brain Development. “This prevents many girls from receiving early intervention services at a time when they can have the greatest impact on early childhood. Most ASD studies focus on children after they are diagnosed, lacking information about symptoms in children that are missed by common screening practices.

The research team looked at whether girls and boys had similar symptoms and found subtle differences in the structure of core ASD symptoms. After correcting for these differences, subgroup analysis identified a “very concerning” group that had a male to female sex ratio of 1 to 1.

“This approach — unbiased verification, longitudinal evaluation, and ensuring that our instruments measure what we think they are measuring — can help address the current disparities in identifying autism,” said Jed Elison, Ph.D., associate professor in the College of Education and Human Development, Medical School and co-author of the article. “It is imperative to recognize and understand the limitations of traditional diagnostic and screening approaches and to generate creative solutions to identify all children who could benefit from early intervention services.”

The researchers plan to follow up on this work by examining how children in the high social concern group fare from primary to secondary school. They are also studying group differences in underlying brain structure and function.

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About University of Minnesota Medical School
The University of Minnesota Medical School is at the forefront of learning and discovery, transforming medical care and training the next generation of physicians. Our graduates and faculty produce high-impact biomedical research and advance the practice of medicine. We recognize that the U of M School of Medicine, both the Twin Cities Campus and the Duluth Campus, is located on the traditional, ancestral, and contemporary lands of the Dakota and Ojibwe, and dozens of other Indigenous peoples, and we affirm our commitment to tribal communities and their sovereignty as we seek to improve and strengthen our relationships with tribal nations. For more information about the U of M School of Medicine, please visit med.umn.edu.

About the College of Education and Human Development
The University of Minnesota College of Education and Human Development (CEHD) strives to teach, advance research, and engage with the community to increase opportunity for all individuals. As the third-largest college on the Twin Cities campus, CEHD’s research and specialties focus on a range of challenges, including: educational equity, innovations in teaching and learning, child mental health and development, family resilience and healthy aging. Learn more at cehd.umn.edu.

About the Masonic Institute for Brain Development
The Masonic Institute for the Developing Brain (MIDB) is a one-stop clinic, research and outreach facility specializing in children and youth with neurobehavioral disorders. By bringing together University of Minnesota experts in pediatric medicine, research, policy, and community support to understand, prevent, diagnose, and treat neurodevelopmental disorders in early childhood and adolescence, MIDB advances the health of the brain from the earliest stages of development throughout life, supporting each person’s journey as a valued member of the community. Learn more about midb.umn.edu.

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