Gender Differences: Confirmatory Factor Analysis of the ADOS-II
Ingrid S Tien1, Junok Kim2, Amanda R Johnson2
1University of California, Los Angeles Department of Education, 300 Charles E. Young Blvd, Room 208A, Los Angeles, CA, 90095, USA. istien@g.ucla.edu.
Journal of Autism and Developmental Disorders
|April 23, 2024
Summary
Autism diagnostic criteria may need sex-specific adjustments. The Autism Diagnostic Observation Schedule, Second Edition (ADOS-II) Module 3 shows different item responses between genders, suggesting distinct underlying factor structures for males and females.
Area of Science:
- Neurodevelopmental Disorders
- Psychometrics
- Child Psychology
Background:
- Autism Spectrum Disorder (ASD) presentation can vary by sex.
- Previous studies indicate females may score lower on the Autism Diagnostic Observation Schedule, Second Edition (ADOS-II).
- Systematic examination of gender differences in the ADOS-II's latent structure is lacking.
Purpose of the Study:
- To investigate sex differences in the latent factor structure of the ADOS-II Module 3.
- To determine if diagnostic criteria for autism need to be sex-differentiated.
- To analyze item response trends by gender in a large cohort of youth diagnosed with autism.
Main Methods:
- Secondary data analysis of 4,100 youth diagnosed with autism (813 female, 3287 male; mean age = 9.9).
- Utilized Multi-Group Confirmatory Factor Analysis on ADOS-II Module 3 data.
- Examined item response trends and factor loadings across genders.
Main Results:
- Significant gender differences were found in the factor loadings of four ADOS-II items.
- One social communication and difficulties (SCD) item and one restricted, repetitive behavior (RRB) item showed stronger associations with the latent factor in females.
- Two RRB items demonstrated larger factor loadings in males.
Conclusions:
- The assumption of a uniform latent factor structure for the ADOS-II Module 3 across genders may not be valid.
- Findings suggest potential implications for sex-differential diagnostic criteria in autism.
- Further research is needed to explore the clinical utility of sex-specific ADOS-II interpretations.
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