Sex, Gender, and Camouflage in Autism Spectrum Disorder: A Multimodal, Accelerated Longitudinal Design

自闭症谱系障碍中的性、性别和伪装：多模式、加速纵向设计

• 批准号: 10681433
• 负责人: Clare Elizabeth Harrop
• 金额: $ 67.78万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-14 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10681433
• 关键词: Acceleration; Adaptive Behaviors; Address; Adolescence; Adult; Age; Behavior; Behavioral; Biological Assay; Birth; Characteristics; Child; Classification; Cognition; Data; Development; Diagnosis; Diagnostic; Early Intervention; Early identification; Eligibility Determination; Etiology; Exhibits; Feeling suicidal; Female; Friendships; Functional disorder; Gender; Gender Identity; Gestures; Goals; Individual; International; Intervention; Knowledge; Linguistics; Link; Longitudinal Studies; Longitudinal cohort; Measurement; Measures; Mental Depression; Mental Health; Methodology; Methods; Modality; Modeling; Motivation; Neuropsychology; Outcome; Parents; Patient Self-Report; Pattern; Phenotype; Play; Positioning Attribute; Reporting; Research; Risk; Role; Sampling; Series; Sex Differences; Site; Smiling; Time; Variant; Work; adolescent with autism spectrum disorder; adult with autism spectrum disorder; aged; autism spectrum disorder; autistic; autistic children; biological sex; cohort; diagnostic signature; early childhood; executive function; experience; externalizing behavior; gender difference; gender diversity; individuals with autism spectrum disorder; innovation; interest; longitudinal design; male; multimodality; novel; protective effect; recruit; repetitive behavior; sex; sex assigned at birth; social; social attention; therapy design; visual tracking

PROJECT SUMMARY Autism spectrum disorder (ASD) is diagnosed at a rate of four males to one female. Autistic females are diagnosed later than males and present with a nuanced profile of strengths and weaknesses that vary by developmental stage. In early childhood, our team, and others, have identified social motivation (SM) and restricted and repetitive behaviors (RRBs) as distinguishing features between autistic males and females. It has also been hypothesized that these differences serve as potential mechanisms that underlie autistic camouflage. Also critical to the study of sex differences in ASD is the study of gender and gender diversity. A number of international studies have identified higher rates of gender diversity in autistic adolescents and adults, with potentially higher rates in autistic females. No study has charted the trajectories of these interwoven characteristics (sex, gender, camouflaging) together or in early childhood. Representative, longitudinal studies are required to elucidate the developmental and etiological significance of previously observed sex differences and to characterize gender diversity and camouflaging in early childhood. We will conduct an Accelerated Longitudinal Design (ALD) across two sites (UNC and CHOP) in a sample of 140 neurotypical (NT) and 140 autistic children, equally split by sex, aged 4 to 8 recruited in 5 cohorts and studied over four timepoints. ALDs have been identified as a promising methodology to study development in ASD and recruit hard to reach groups. This multi-site effort will enable us to recruit sufficient autistic females to examine age- and sex-linked developmental trajectories. Our team is uniquely positioned to study how biological sex (Harrop, Parish-Morris) and gender (Strang, Harrop) impact the trajectories of young autistic children through multimodal measures (parent-report, direct observation, eye tracking) that can probe the mechanisms that underlie cross–sectionally observed sex differences in ASD. Our study has two aims: Aim One: Evaluate the impact of biological sex on developmental trajectories of young autistic children. We will probe phenotypic and mechanistic sex differences overtime, focusing on SM and RRBs. We will also chart the emergence of behavioral markers of camouflage. Aim Two: Characterize trajectories of congruence/incongruence between biological sex and gender in young autistic children. We will identify early signs of gender diversity in young autistic and NT children through parent and self-report. We will also examine the role of gender in predicting SM and RRBs and common phenotypic variables to understand how biological sex at birth (Aim One) and gender (Aim Two) differentially predict trajectories in autistic youth. This R01 project will chart the dynamic interplay between emergent ASD symptomology, biological sex, and gender in early childhood. This work will inform sex-sensitive screening protocols and provide evidence for sex- and gender-sensitive interventions to better address the needs of autistic females.

项目概要 自闭症谱系障碍 (ASD) 的诊断率为 4 名男性和 1 名女性自闭症患者。 比男性更晚被诊断出来，并且表现出微妙的优点和缺点，这些特征因人而异 在儿童早期，我们的团队和其他人已经确定了社会动机（SM）和 限制性和重复性行为（RRB）是自闭症男性和女性之间的区别特征。 人们还探讨了这些差异是自闭症的潜在机制 对自闭症谱系障碍性别差异的研究也至关重要的是性别和性别多样性的研究。 大量国际研究表明，自闭症青少年的性别多样性比例较高， 成年人中，自闭症女性的发病率可能更高，目前还没有研究绘制出这些人的轨迹。 交织在一起的特征（性别、性别、伪装）或在幼儿期代表， 需要进行纵向研究来阐明先前的发育和病因学意义 观察性别差异并描述幼儿时期的性别多样性和伪装。 我们将在两个地点（UNC 和 CHOP）进行加速纵向设计 (ALD) 样本由 140 名神经正常 (NT) 儿童和 140 名自闭症儿童组成，按性别平均分配，年龄 4 至 8 岁，分为 5 组 队列并在四个时间点进行研究已被确定为一种有前途的研究方法。 ASD 的发展并招募难以接触到的群体。这种多地点的努力将使我们能够招募到足够的人。 我们的团队具有独特的优势，可以帮助患有自闭症的女性检查与年龄和性别相关的发展轨迹。 研究生物性别（Harrop，Parish-Morris）和性别（Strang，Harrop）如何影响年轻人的轨迹 通过多模式措施（家长报告、直接观察、眼球追踪）可以探测自闭症儿童 横断面观察到的自闭症谱系障碍性别差异背后的机制。 我们的研究有两个目标： 目标一：评估生物性别对发育轨迹的影响 我们将长期探讨自闭症儿童的表型和机制性别差异，重点关注 SM。 我们还将绘制伪装行为标记的出现情况。目标二：表征。 年轻自闭症儿童的生理性别和性别之间一致/不一致的轨迹我们将。 我们将通过家长和自我报告来识别年轻自闭症和 NT 儿童性别多样性的早期迹象。 还检查性别在预测 SM 和 RRB 以及常见表型变量中的作用，以了解 出生时的生物性别（目标一）和性别（目标二）如何不同地预测自闭症青少年的轨迹。 该 R01 项目将绘制自闭症谱系障碍 (ASD) 症状、生物性别、 这项工作将为性别敏感的筛查方案提供信息并提供证据。 对性别和性别敏感的干预措施，以更好地满足自闭症女性的需求。