Adaptive Functioning, Sensory Processing, and Behavioral Problems in Autistic Children: The Moderating Role of Gender

Children with autism spectrum disorder (ASD) frequently experience elevated emotional and behavioral difficulties, yet factors associated with variability remain incompletely understood. Adaptive functioning and sensory processing differences have been linked to behavioral problems, but little is known about whether associations differ between boys and girls. This study examined relationships between adaptive functioning, sensory processing, and behavioral problems in children with ASD, focusing on gender as a moderator. The purposive sampling included 110 autistic children (M_age = 85.61 months, SD = 31.51; 50 boys and 60 girls) and their primary caregivers. Adaptive functioning was assessed using the Vineland Adaptive Behavior Scales-Third Edition, sensory processing using the Short Sensory Profile, and behavioral problems using the Child Behavior Checklist. Gender differences were examined with Mann-Whitney tests, associations with Spearman's correlations, and moderation analyses using PROCESS with bootstrap resampling. Girls demonstrated higher internalizing and externalizing behavioral problems than boys, whereas boys showed greater sensory processing differences. Correlational analyses revealed distinct patterns: adaptive functioning showed stronger associations with behavioral difficulties among girls, whereas sensory processing differences were associated with behavioral problems among boys. Moderation analyses indicated that gender moderated the relationship between adaptive functioning and behavioral problems, such that higher adaptive functioning was associated with fewer behavioral difficulties among girls but not boys. These findings highlight gender-specific patterns in associations between functional abilities and behavior profiles in autism, underscoring the importance of considering gender in developmental pathways and intervention approaches.