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Sex differences were examined in 3-year-olds with autism spectrum disorders (ASD) ascertained from a high-risk cohort, and high- and low-risk comparison groups. Participants included 319 high-risk siblings and 129 low-risk controls. Eighty-five siblings were diagnosed with ASD, including 57 of 176 boys (32.4 %) and 28 of 143 girls (19.6 %), implying a relative odds of ASD of 1.65 in boys versus girls. There were modest sex differences on cognitive and adaptive skills and ASD symptom severity at age 3, but differences between boys and girls with ASD mirrored those in the non-ASD groups. The lower than expected male-to-female ratio, and the relatively high cognitive level among diagnosed children, suggest that we have identified an unanticipated number of higher-functioning girls with ASD.

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Children with autism spectrum disorder (ASD) are diagnosed, on average, around the age of 4 years. However, previous research has shown that the diagnosis can be made as early as 2 years, and that if the child is seen a year or more later, it is highly likely that the diagnosis will be confirmed. In this study, to examine whether diagnoses made as early as 18 months of age are also "stable," we followed a group of younger siblings of children with ASD (who are known to be at higher risk). We also examined whether the age of ASD diagnosis within this high-risk group was related to the severity of children's ASD symptoms or developmental delays. Participants (n = 381) were seen at three ages: 18 months, 24 months, and 3 years. ASD symptoms, general development, and adaptive functioning were assessed at each time point. Twenty-three children were diagnosed with ASD at 18 months and a total of 61 at 24 months. Of these diagnoses, 19/23 (82.6%) and 56/61 (91.8%), respectively, were confirmed independently at 3 years. However, 45 children were diagnosed with ASD at 3 years who had not been identified at earlier visits. Children diagnosed at 18 months, in comparison to those diagnosed at 24 months, had less advanced language and adaptive skills at 18 months. Children not diagnosed with ASD until 3 years, compared with those diagnosed earlier, had more advanced language and adaptive skills, and milder ASD symptoms. Autism Res 2016, 9: 790-800. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Attentional–inhibitory control and social–behavioral regulation are two outcome domains commonly impaired after childhood closed head injury (CHI). We compared neuropsychological tests of attentional–inhibitory control (vigilance, selective attention, response modulation) and social discourse and intentionality (inferencing, figurative language, and speech acts) with parent ratings of attention and behavioral regulation in relation to four injury- related variables: age at CHI, time since CHI, CHI injury severity, and frontal lobe injury moderated by CHI severity. Participants were 105 school-aged children in the chronic stage of CHI, divided into mild, moderate, and severe injury severity groups, and further subdivided according to frontal lobe injury. Outcome indices were imperfectly correlated in the group as a whole, although several relations between neurocognitive tests and parent ratings were observed within CHI subgroups. Different domains of cognitive function had different predictors. For attentional–inhibitory control, age at injury and time since injury were most predictive of outcome; for social discourse, predictors were injury severity and frontal lobe injury moderated by injury severity. Variability in cognitive outcome after childhood CHI is not random, but appears related to age, time, and biological features of the injury. (JINS, 2001, 7, 683–692.)