Commentary: Sex difference differences? A reply to Constantino Dr Meng-Chuan Lai

Daniel S. Messinger, Gregory S. Young, Sara Jane Webb, Sally Ozonoff, Susan E. Bryson, Alice Carter, Leslie Carver, Tony Charman, Katarzyna Chawarska, Suzanne Curtin, Karen Dobkins, Irva Hertz-Picciotto, Ted Hutman, Jana M. Iverson, Rebecca Landa, Charles A. Nelson, Wendy L. Stone, Helen Tager-Flusberg, Lonnie Zwaigenbaum

Research output: Contribution to journalReview articlepeer-review


Messinger et al. found a 3.18 odds ratio of male to female ASD recurrence in 1241 prospectively followed high-risk (HR) siblings. Among high-risk siblings (with and without ASD), as well as among 583 low-risk controls, girls exhibited higher performance on the Mullen Scales of Early Learning, as well as lower restricted and repetitive behavior severity scores on the Autism Diagnostic Observation Schedule (ADOS) than boys. That is, female-favoring sex differences in developmental performance and autism traits were evident among low-risk and non-ASD high-risk children, as well as those with ASD. Constantino (Mol Autism) suggests that sex differences in categorical ASD outcomes in Messinger et al. should be understood as a female protective effect. We are receptive to Constantino's (Mol Autism) suggestion, and propose that quantitative sex differences in autism-related features are keys to understanding this female protective effect.

Original languageEnglish (US)
Article number93
JournalMolecular Autism
Issue number1
StatePublished - Jun 29 2016


  • Autism spectrum disorder
  • Female protective effect
  • High-risk siblings
  • Sex differences

ASJC Scopus subject areas

  • Molecular Biology
  • Developmental Neuroscience
  • Developmental Biology
  • Psychiatry and Mental health


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