{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:49:06Z","timestamp":1792712946011,"version":"4.5.0"},"reference-count":56,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Disparities exist in age of diagnosis and prevalence of autism spectrum disorder (ASD) for female compared with male children. Correcting for sources of bias is critical for improving equitable ASD identification.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine whether sex differences exist in measurement of ASD symptoms using the Autism Diagnostic Observation Schedule (ADOS) among young children at high familial likelihood (HFL) and low familial likelihood (LFL) of ASD.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study collected longitudinal, prospective data from the Baby Siblings Research Consortium between January 1, 2003, and December 31, 2021. Participants included 3106 children who had an older sibling with ASD (HFL group) and 1444 without (LFL group). Data from as many as 3 visits when participants were aged 20 to 40 months were included. Analysis occurred between March 1, 2023, and May 29, 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Child sex and age and ASD diagnosis.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Measurement invariance by sex and age was examined across item-level ADOS data. Diagnostic group and sex differences were then examined using mixed-effect models on corrected scores.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Repeated visits (n\u2009=\u20097557) from 4550 participants (2548 [56.0%] male) were included, of whom 1444 (31.7%) were in the LFL and 3016 (68.3%) in the HFL groups. Confirmatory factor analysis indicated social communication and restricted and repetitive behaviors models fit the data well in the HFL group but poorly in the LFL group. In the HFL group, females were rated as less impaired in eye contact (differential item functioning estimate [SE]\u2009=\u20090.088 [0.033];\n P<\/jats:italic>\n \u2009=\u2009.01), and their response to joint attention (differential item functioning estimate [SE]\u2009=\u20090.290 [0.105];\n P<\/jats:italic>\n \u2009=\u2009.01) and quality of social overtures (differential item functioning estimate [SE]\u2009=\u20090.053 [0.019];\n P<\/jats:italic>\n \u2009=\u2009.005) was associated with less underlying social communication difficulties compared with males. Adjusting for differential item functioning by age and sex resulted in moderate levels of measurement differences. Females showed milder autistic traits than males, although this gap was smaller in the participants diagnosed with ASD.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n \n Sex differences exist in the general population in many social communication traits, yet ASD diagnostic thresholds do not account for these sex differences. Future instrument development, as well as clinician training, should acknowledge milder presentation (fewer difficulties with eye contact or quality of social impairments) in many females. This may help identify developmental differences earlier and improve outcomes for autistic females (estimate [SE]\u2009=\u2009\u22120.160 [0.061];\n P<\/jats:italic>\n \u2009=\u2009.009).\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.25887","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T15:30:37Z","timestamp":1754667037000},"page":"e2525887","source":"Crossref","is-referenced-by-count":8,"title":["Sex-Related Measurement Bias in Autism Spectrum Disorder Symptoms in the Baby Siblings Research Consortium"],"prefix":"10.1001","volume":"8","author":[{"given":"Catherine A.","family":"Burrows","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Minnesota, Minneapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sooyeon","family":"Sung","sequence":"additional","affiliation":[{"name":"Graduate School of Education, Kyung Hee University, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuting","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Texas at Austin, Austin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg S.","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tony","family":"Charman","sequence":"additional","affiliation":[{"name":"Department of Psychology, King\u2019s College London, London, UK, on behalf of the BASIS Network"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Klaiman","sequence":"additional","affiliation":[{"name":"Marcus Autism Center, Children\u2019s Healthcare of Atlanta and Emory University School of Medicine, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ami","family":"Klin","sequence":"additional","affiliation":[{"name":"Marcus Autism Center, Children\u2019s Healthcare of Atlanta and Emory University School of Medicine, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Marrus","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Washington University in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Ozonoff","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Piven","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, on behalf of the IBIS network"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana L.","family":"Robins","sequence":"additional","affiliation":[{"name":"A. J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca J.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"School of Medicine, Public Health Sciences, University of California, Davis, Davis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. J.","family":"Schwichtenberg","sequence":"additional","affiliation":[{"name":"Department of Human Development and Family Science, Purdue University, West Lafayette, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara Jane","family":"Webb","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lonnie","family":"Zwaigenbaum","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie J.","family":"Carver","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of California, San Diego, San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Chawarska","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of California, San Diego, San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Curtin","sequence":"additional","affiliation":[{"name":"Department of Child and Youth Studies, Brock University, St Catharines, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shafali S.","family":"Jeste","sequence":"additional","affiliation":[{"name":"Departments of Neurology and Pediatrics, Children\u2019s Hospital Los Angeles, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana M.","family":"Iverson","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca J.","family":"Landa","sequence":"additional","affiliation":[{"name":"Center for Autism Services, Science and Innovation, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland"},{"name":"Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel S.","family":"Messinger","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Miami, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane E.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of South Carolina, Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy L.","family":"Stone","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Tager-Flusberg","sequence":"additional","affiliation":[{"name":"Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy N.","family":"Esler","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Minnesota, Minneapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Somer L.","family":"Bishop","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jed T.","family":"Elison","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Minnesota, Minneapolis"},{"name":"Institute of Child Development, University of Minnesota, Minneapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"issue":"1","key":"zoi250731r1","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s13229-015-0027-y","article-title":"Early sex differences are not autism-specific: a Baby Siblings Research Consortium (BSRC) study.","volume":"6","author":"Messinger","year":"2015","journal-title":"Mol Autism"},{"issue":"5","key":"zoi250731r2","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1097\/CHI.0b013e31819b3848","article-title":"Timing of identification among children with an autism spectrum disorder: findings from a population-based surveillance study.","volume":"48","author":"Shattuck","year":"2009","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"5","key":"zoi250731r3","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1080\/15374416.2020.1823850","article-title":"Sex differences in age of diagnosis and first concern among children with autism spectrum disorder.","volume":"50","author":"McDonnell","year":"2021","journal-title":"J Clin Child Adolesc Psychol"},{"issue":"6","key":"zoi250731r4","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1016\/j.jaac.2017.03.013","article-title":"What is the male-to-female ratio in autism spectrum disorder? a systematic review and meta-analysis.","volume":"56","author":"Loomes","year":"2017","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"3","key":"zoi250731r5","first-page":"217","article-title":"Autistic disturbances of affective contact.","volume":"2","author":"Kanner","year":"1943","journal-title":"Nerv Child"},{"issue":"2","key":"zoi250731r6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.ss7202a1","article-title":"Prevalence and characteristics of autism spectrum disorder among children aged 8 years\u2014Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2020.","volume":"72","author":"Maenner","year":"2023","journal-title":"MMWR Surveill Summ"},{"issue":"12","key":"zoi250731r7","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1016\/S2352-4642(23)00221-3","article-title":"Improving autism identification and support for individuals assigned female at birth: clinical suggestions and research priorities.","volume":"7","author":"Lai","year":"2023","journal-title":"Lancet Child Adolesc Health"},{"issue":"1","key":"zoi250731r8","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1111\/jcpp.13242","article-title":"Sex differences in scores on standardized measures of autism symptoms: a multisite integrative data analysis.","volume":"62","author":"Kaat","year":"2021","journal-title":"J Child Psychol Psychiatry"},{"issue":"3","key":"zoi250731r9","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1016\/j.jaac.2013.12.004","article-title":"Behavioral and cognitive characteristics of females and males with autism in the Simons Simplex Collection.","volume":"53","author":"Frazier","year":"2014","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"7","key":"zoi250731r10","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1007\/s10803-011-1356-0","article-title":"Sex differences in autism spectrum disorder: evidence from a large sample of children and adolescents.","volume":"42","author":"Mandy","year":"2012","journal-title":"J Autism Dev Disord"},{"issue":"5","key":"zoi250731r11","doi-asserted-by":"publisher","first-page":"1282","DOI":"10.1177\/13623613211047070","article-title":"Sex differences in social communication behaviors in toddlers with suspected autism spectrum disorder as assessed by the ADOS-2 toddler module.","volume":"26","author":"Ronkin","year":"2022","journal-title":"Autism"},{"issue":"6","key":"zoi250731r12","doi-asserted-by":"publisher","first-page":"768","DOI":"10.1016\/j.jaac.2020.08.444","article-title":"Extracting latent subdimensions of social communication: a cross-measure factor analysis.","volume":"60","author":"Zheng","year":"2021","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"9","key":"zoi250731r13","doi-asserted-by":"publisher","first-page":"2770","DOI":"10.1007\/s10803-017-3176-3","article-title":"Examining the role of race, ethnicity, and gender on social and behavioral ratings within the Autism Diagnostic Observation Schedule.","volume":"47","author":"Harrison","year":"2017","journal-title":"J Autism Dev Disord"},{"issue":"4","key":"zoi250731r14","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.9498","article-title":"Analysis of race and sex bias in the Autism Diagnostic Observation Schedule (ADOS-2).","volume":"5","author":"Kalb","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"10","key":"zoi250731r15","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.42218","article-title":"Autism diagnosis among US children and adults, 2011-2022.","volume":"7","author":"Grosvenor","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"5","key":"zoi250731r16","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1111\/jcpp.12008","article-title":"Early diagnosis of autism spectrum disorder: stability and change in clinical diagnosis and symptom presentation.","volume":"54","author":"Guthrie","year":"2013","journal-title":"J Child Psychol Psychiatry"},{"issue":"6","key":"zoi250731r17","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-3596","article-title":"Clinical features of children with autism who passed 18-month screening.","volume":"141","author":"\u00d8ien","year":"2018","journal-title":"Pediatrics"},{"issue":"2","key":"zoi250731r18","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-2314","article-title":"Primary care autism screening and later autism diagnosis.","volume":"146","author":"Carbone","year":"2020","journal-title":"Pediatrics"},{"issue":"3","key":"zoi250731r19","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1007\/s10803-009-0874-5","article-title":"The medical home for children with autism spectrum disorders: parent and pediatrician perspectives.","volume":"40","author":"Carbone","year":"2010","journal-title":"J Autism Dev Disord"},{"issue":"2","key":"zoi250731r20","doi-asserted-by":"publisher","first-page":"S88","DOI":"10.1097\/00004703-200604002-00006","article-title":"Autism spectrum disorder screening and management practices among general pediatric providers.","volume":"27","author":"Dosreis","year":"2006","journal-title":"J Dev Behav Pediatr"},{"issue":"1","key":"zoi250731r21","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1097\/DBP.0b013e3182040aea","article-title":"Autism spectrum disorder screening in primary care.","volume":"32","author":"Gura","year":"2011","journal-title":"J Dev Behav Pediatr"},{"issue":"8","key":"zoi250731r22","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1016\/j.biopsych.2022.05.027","article-title":"A data-driven approach in an unbiased sample reveals equivalent sex ratio of autism spectrum disorder-associated impairment in early childhood.","volume":"92","author":"Burrows","year":"2022","journal-title":"Biol Psychiatry"},{"issue":"4","key":"zoi250731r23","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.1017\/S0954579420000723","article-title":"Genetic architecture of reciprocal social behavior in toddlers: implications for heterogeneity in the early origins of autism spectrum disorder.","volume":"32","author":"Marrus","year":"2020","journal-title":"Dev Psychopathol"},{"issue":"5","key":"zoi250731r24","doi-asserted-by":"publisher","first-page":"1542","DOI":"10.1007\/s10803-017-3062-z","article-title":"Brief report: characteristics of preschool children with ASD vary by ascertainment.","volume":"47","author":"Sacrey","year":"2017","journal-title":"J Autism Dev Disord"},{"issue":"7","key":"zoi250731r25","doi-asserted-by":"publisher","first-page":"2112","DOI":"10.1177\/13623613231154728","article-title":"Sex differences in early autism screening using the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R\/F).","volume":"27","author":"Eldeeb","year":"2023","journal-title":"Autism"},{"issue":"3","key":"zoi250731r26","doi-asserted-by":"publisher","first-page":"e488","DOI":"10.1542\/peds.2010-2825","article-title":"Recurrence risk for autism spectrum disorders: a Baby Siblings Research Consortium study.","volume":"128","author":"Ozonoff","year":"2011","journal-title":"Pediatrics"},{"issue":"2","key":"zoi250731r27","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2023-065297","article-title":"Familial recurrence of autism: updates from the Baby Siblings Research Consortium.","volume":"154","author":"Ozonoff","year":"2024","journal-title":"Pediatrics"},{"issue":"1","key":"zoi250731r28","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1002\/aur.1669","article-title":"Non-ASD outcomes at 36 months in siblings at familial risk for autism spectrum disorder (ASD): a Baby Siblings Research Consortium (BSRC) study.","volume":"10","author":"Charman","year":"2017","journal-title":"Autism Res"},{"issue":"3","key":"zoi250731r29","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/j.jaac.2012.12.011","article-title":"Beyond autism: a Baby Siblings Research Consortium study of high-risk children at three years of age.","volume":"52","author":"Messinger","year":"2013","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"4","key":"zoi250731r30","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/j.jaac.2013.12.020","article-title":"The broader autism phenotype in infancy: when does it emerge?","volume":"53","author":"Ozonoff","year":"2014","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"3","key":"zoi250731r32","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1023\/A:1005592401947","article-title":"The Autism Diagnostic Observation Schedule\u2013Generic: a standard measure of social and communication deficits associated with the spectrum of autism.","volume":"30","author":"Lord","year":"2000","journal-title":"J Autism Dev Disord"},{"issue":"1","key":"zoi250731r33","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s13229-016-0072-1","article-title":"Parent-reported and clinician-observed autism spectrum disorder (ASD) symptoms in children with attention deficit\/hyperactivity disorder (ADHD): implications for practice under DSM-5.","volume":"7","author":"Grzadzinski","year":"2016","journal-title":"Mol Autism"},{"issue":"3","key":"zoi250731r34","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1111\/j.1469-7610.2004.00346.x","article-title":"Prevalence of pervasive developmental disorders in children and adolescents with mental retardation.","volume":"46","author":"de Bildt","year":"2005","journal-title":"J Child Psychol Psychiatry"},{"issue":"6","key":"zoi250731r35","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1097\/CHI.0b013e31816bffb7","article-title":"A replication of the Autism Diagnostic Observation Schedule (ADOS) revised algorithms.","volume":"47","author":"Gotham","year":"2008","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"5","key":"zoi250731r37","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1352\/1944-7558-124.5.438","article-title":"Brief report: calculation and convergent and divergent validity of a new ADOS-2 expressive language score.","volume":"124","author":"Mazurek","year":"2019","journal-title":"Am J Intellect Dev Disabil"},{"issue":"5","key":"zoi250731r38","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1007\/s10803-008-0674-3","article-title":"Standardizing ADOS scores for a measure of severity in autism spectrum disorders.","volume":"39","author":"Gotham","year":"2009","journal-title":"J Autism Dev Disord"},{"key":"zoi250731r39","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.addbeh.2018.10.031","article-title":"Simplifying the implementation of modern scale scoring methods with an automated R package: automated moderated nonlinear factor analysis (aMNLFA).","volume":"94","author":"Gottfredson","year":"2019","journal-title":"Addict Behav"},{"issue":"2","key":"zoi250731r40","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.ss7402a1","article-title":"Prevalence and early identification of autism spectrum disorder among children aged 4 and 8 years\u2014Autism and Developmental Disabilities Monitoring Network, 16 sites, United States, 2022.","volume":"74","author":"Shaw","year":"2025","journal-title":"MMWR Surveill Summ"},{"issue":"11","key":"zoi250731r41","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1016\/j.jaac.2018.07.872","article-title":"Emotional expressivity in toddlers with autism spectrum disorder.","volume":"57","author":"Macari","year":"2018","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"6","key":"zoi250731r42","doi-asserted-by":"publisher","first-page":"2124","DOI":"10.1007\/s10803-023-05990-z","article-title":"Objective measurement of social gaze and smile behaviors in children with suspected autism spectrum disorder during administration of the Autism Diagnostic Observation Schedule.","volume":"54","author":"Ahn","year":"2024","journal-title":"J Autism Dev Disord"},{"issue":"1","key":"zoi250731r43","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1146\/annurev.ps.38.020187.002333","article-title":"Social motivation.","volume":"38","author":"Pittman","year":"1987","journal-title":"Annu Rev Psychol"},{"issue":"1","key":"zoi250731r45","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s11689-020-09335-0","article-title":"Longitudinal change in restricted and repetitive behaviors from 8-36?months.","volume":"13","author":"Sifre","year":"2021","journal-title":"J Neurodev Disord"},{"issue":"1","key":"zoi250731r46","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1146\/annurev.clinpsy.3.022806.091532","article-title":"The diagnosis of mental disorders: the problem of reification.","volume":"6","author":"Hyman","year":"2010","journal-title":"Annu Rev Clin Psychol"},{"issue":"2","key":"zoi250731r47","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1097\/YCO.0000000000000770","article-title":"Towards equitable diagnoses for autism and attention-deficit\/hyperactivity disorder across sexes and genders.","volume":"35","author":"Lai","year":"2022","journal-title":"Curr Opin Psychiatry"},{"issue":"5","key":"zoi250731r48","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1111\/jcpp.13802","article-title":"Commentary: best practices and processes for assessment of autism spectrum disorder\u2014the intended role of standardized diagnostic instruments.","volume":"64","author":"Bishop","year":"2023","journal-title":"J Child Psychol Psychiatry"},{"issue":"6","key":"zoi250731r49","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1016\/j.jaac.2018.12.010","article-title":"The need for a developmentally based measure of social-communication skills.","volume":"58","author":"Bishop","year":"2019","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"3","key":"zoi250731r50","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(23)00344-9","article-title":"Better measures needed to mitigate sex bias in autism identification.","volume":"8","author":"Burrows","year":"2024","journal-title":"Lancet Child Adolesc Health"},{"issue":"10","key":"zoi250731r51","first-page":"1","article-title":"Prevalence of autism spectrum disorders\u2014Autism and Developmental Disabilities Monitoring Network, United States, 2006.","volume":"58","author":"Autism and Developmental Disabilities Monitoring Network Surveillance Year 2006 Principal Investigators","year":"2009","journal-title":"MMWR Surveill Summ"},{"issue":"11","key":"zoi250731r52","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-012799","article-title":"STARD 2015 guidelines for reporting diagnostic accuracy studies: explanation and elaboration.","volume":"6","author":"Cohen","year":"2016","journal-title":"BMJ Open"},{"issue":"7","key":"zoi250731r53","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.1002\/aur.3182","article-title":"Mid-childhood autism sibling recurrence in infants with a family history of autism.","volume":"17","author":"Bazelmans","year":"2024","journal-title":"Autism Res"},{"issue":"11","key":"zoi250731r54","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1016\/j.jaac.2018.06.022","article-title":"Diagnosis of autism spectrum disorder after age 5 in children evaluated longitudinally since infancy.","volume":"57","author":"Ozonoff","year":"2018","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"1","key":"zoi250731r55","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1007\/s10803-020-04526-z","article-title":"Trajectories of autism symptom severity change during early childhood.","volume":"51","author":"Waizbard-Bartov","year":"2021","journal-title":"J Autism Dev Disord"},{"issue":"11","key":"zoi250731r56","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.1001\/jamapediatrics.2023.4003","article-title":"Persistence of autism spectrum disorder from early childhood through school age.","volume":"177","author":"Harstad","year":"2023","journal-title":"JAMA Pediatr"},{"key":"zoi250731r31","volume-title":"Autism Diagnostic Observation Schedule","author":"Lord","year":"2012","edition":"2nd ed"},{"key":"zoi250731r36","volume-title":"Improving Inquiry in Social Science","author":"Meehl","year":"1991"},{"key":"zoi250731r44","doi-asserted-by":"crossref","unstructured":"Fenson? L. MacArthur-Bates communicative development inventories. 2007. Accessed May 16, 2025. https:\/\/www.uh.edu\/class\/psychology\/dcbn\/research\/cognitive-development\/_docs\/mcdigestures.pdf","DOI":"10.1037\/t11538-000"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2837366\/burrows_2025_oi_250731_1753980321.16759.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T15:30:38Z","timestamp":1754667038000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2837366"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,8]]},"references-count":56,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.25887","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,8]]}}}