Patterns and Stability of Repetitive and Restricted Behaviors in Chinese Children With Autism: A 1-3 Year Follow-Up Study.

This study followed over 2,000 Chinese children with autism to understand repetitive behaviors (like hand-flapping or obsessive interests). Girls showed less severe repetitive behaviors than boys. When researchers checked back 1-3 years later, boys' repetitive behaviors stayed consistent over time, but girls showed more variation. This suggests girls and boys with autism may experience these behaviors differently, which could help improve how autism is diagnosed in different children.

This study examined patterns and stability of repetitive and restricted behaviors (RRBs) in 2,110 Chinese children with autism aged 4-17 years using the Social Responsiveness Scale-2. Cross-sectional analysis revealed that females showed lower severity and incidence of RRBs compared to males, both overall and at individual symptom levels. However, the conceptual framework of RRBs was similar across sexes. A longitudinal follow-up of 207 participants (1-3 years later) found that RRB symptoms remained stable over time in males, while only specific symptoms showed consistency in females.

The findings suggest sex-dependent variations in RRB presentation and stability among Chinese children with autism, potentially informing sex-specific diagnostic approaches.

Findings support developing sex-specific considerations in autism assessment and monitoring. Clinicians should be aware that repetitive behaviors may present differently and change over time in females versus males. This may help reduce under-diagnosis in females and inform personalized intervention planning based on individual stability patterns.

The study relied on one assessment tool (SRS-2) and had a relatively small longitudinal follow-up sample (207 participants). The follow-up period varied (1-3 years), which may affect stability interpretations. Cultural specificity to Chinese populations may limit generalizability to other ethnic groups.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by significant clinical heterogeneity. Sex-based 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-sectional comparisons, researchers recruited 1760 male and 350 female participants whose ages ranged from 4 to 17 years.

The Social Responsiveness Scale-2 (SRS-2) 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-related differences did not significantly affect the conceptualization of RRBs. An online follow-up 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-related differences in RRBs among Chinese individuals with ASD and revealed sex-dependent variations in symptom-level presentation patterns and stability. These findings may contribute to a better understanding of the mechanisms underlying sex-related differences and aid in the development of sex-specific diagnostic criteria.