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Sex\u2010based differences are observed in the core symptoms of ASD. This study investigated the patterns and stability of restricted and repetitive behaviors (RRBs) among Chinese children with ASD. For cross\u2010sectional comparisons, researchers recruited 1760 male and 350 female participants whose ages ranged from 4 to 17\u2009years. The Social Responsiveness Scale\u20102 (SRS\u20102) was used to measure the core symptoms of ASD. Compared with males, females exhibited lower severity and incidence rates of RRB both overall and at the symptom level. Furthermore, multigroup confirmatory factor analyses demonstrated that sex\u2010related differences did not significantly affect the conceptualization of RRBs. An online follow\u2010up study involving a subset of participants (166 males and 41 females) revealed that RRB symptoms remained stable between the two visits for males; however, only specific symptoms were highly consistent over time for females. This study revealed potential sex\u2010related differences in RRBs among Chinese individuals with ASD and revealed sex\u2010dependent variations in symptom\u2010level presentation patterns and stability. These findings may contribute to a better understanding of the mechanisms underlying sex\u2010related differences and aid in the development of sex\u2010specific diagnostic criteria.<\/jats:p>","DOI":"10.1002\/aur.70130","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T04:56:38Z","timestamp":1761022598000},"page":"2409-2418","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Patterns and Stability of Repetitive and Restricted Behaviors in Chinese Children With Autism: A 1\u20133\u2009Year Follow\u2010Up Study"],"prefix":"10.1002","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1168-5661","authenticated-orcid":false,"given":"Yanting","family":"Hou","sequence":"first","affiliation":[{"name":"Department of Psychiatry, and National Clinical Research Center for Mental Disorders The Second Xiangya Hospital of Central South University  Changsha Hunan 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