{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:27:18Z","timestamp":1786980438469,"version":"build-2736575974"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Assessment of autism spectrum disorder (ASD) relies on both parent-reported questionnaires and clinician-administered observational instruments. Although discrepancies between informants are common, their implications for autism severity evaluation remain unclear. This study examined informant discrepancies across parent-reported and clinician-rated measures, focusing on sex- and age-related effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Children and adolescents with ASD and typically developing (TD) controls were assessed using parent-reported measures, including the Social Responsiveness Scale, Second Edition (SRS-2), and the Japanese version of the Autism-Spectrum Quotient (AQ-J). Clinician-rated autism severity was assessed using the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). Two-way analyses of variance were used to examine the diagnostic and sex-related effects. Hierarchical regression analyses were used to evaluate the associations between parent-reported subscales and ADOS-2 severity within the ASD group. Spearman's rank correlations were used to assess age-related changes in discrepancy scores separately by sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Parent-reported measures robustly differentiated the ASD and TD groups but showed few sex-related differences. In contrast, the ADOS-2 total score differed significantly by sex within the ASD group, with males exhibiting higher clinician-rated autism severity; however, most domain-level scores were not significant. Hierarchical regression analyses indicated limited associations between parent-reported subscales and clinician-rated severity. Sex remained a consistent predictor of ADOS-2 total scores. Age was negatively associated with SRS-2\u2013ADOS-2 discrepancy scores among females, suggesting reduced parent\u2013clinician discrepancy with increasing age in girls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Parent-reported and clinician-rated measures captured overlapping but distinct aspects of autism-related characteristics. The ADOS-2 total score identified a sex-related difference in clinician-rated severity that was not apparent in parent-reported measures; however, these findings should be interpreted cautiously, given documented limitations of the ADOS-2 in detecting some autistic female presentations. Overall, these findings highlight the complementary contributions of parent-reported and clinician-rated assessments and underscore the importance of considering informant perspectives when interpreting autism-related characteristics across contexts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1823090","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:57:31Z","timestamp":1786978651000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Discrepancies between parent-reported and clinician-rated autism severity: roles of sex and age"],"prefix":"10.3389","volume":"17","author":[{"given":"Rio","family":"Ishida","sequence":"first","affiliation":[{"name":"Department of Neuropsychiatry, Kumamoto University","place":["Kumamoto, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiko","family":"Yamamuro","sequence":"additional","affiliation":[{"name":"Center for Health Control, Nara Medical University","place":["Kashihara, Japan"]},{"name":"Department of Psychiatry, Nara Medical University School of Medicine","place":["Kashihara, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natsuko","family":"Kashida","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry, Kumamoto University","place":["Kumamoto, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsutomu","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry, Kumamoto University","place":["Kumamoto, Japan"]},{"name":"Department of Psychiatry, Nara Medical University School of Medicine","place":["Kashihara, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michihiro","family":"Toritsuka","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry, Kumamoto University","place":["Kumamoto, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Nara Medical University School of Medicine","place":["Kashihara, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manabu","family":"Makinodan","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry, Kumamoto University","place":["Kumamoto, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"B1","volume-title":"Diagnostic and Statistical Manual of Mental Disorders: DSM-5","year":"2013"},{"key":"B2","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1016\/S0140-6736(13)61539-1","article-title":"Autism","volume":"383","author":"Lai","year":"2014","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31129-2","article-title":"Autism spectrum disorder","volume":"392","author":"Lord","year":"2018","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1007\/s10803-011-1184-2","article-title":"Progress in understanding autism: 2007\u20132010","volume":"41","author":"Rutter","year":"2011","journal-title":"J Autism Dev Disord"},{"key":"B5","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.jaac.2014.10.003","article-title":"Sex\/gender differences and autism: setting the scene for future research","volume":"54","author":"Lai","year":"2015","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"B6","first-page":"34","article-title":"Missed diagnosis or misdiagnosis? 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