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Purpose <p>To examine trajectories of parent-reported internalizing and externalizing behaviors at 18 months, 36 months, and 5 years among children with autism spectrum disorder (ASD) compared with children with no recorded diagnosis (NoDx), and to test whether these patterns differed by sex.</p> Methods <p>CBCL-derived internalizing and externalizing scores were constructed from harmonized MoBa items available across the three waves. Linear mixed-effects models tested time x diagnosis x sex effects in the ASD-vs-NoDx sample (<i>N</i> = 61,553), with a secondary ASD-only sex analysis.</p> Results <p>ASD-NoDx differences were not clearly evident at 18 months, but emerged by 36 months and were clearest at 5 years. Internalizing and externalizing showed significant time x diagnosis effects, but no evidence that diagnosis differences varied by sex. In ASD-only models, sex differences were modest; boys showed higher externalizing than girls only at 5 years.</p> Conclusion <p>Broad CBCL-derived emotional and behavioral differences associated with ASD became more detectable across the toddler-to-preschool transition. Sex differences were small relative to diagnosis-related developmental divergence.</p>

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Sex Differences in Early Childhood Trajectories of Internalizing and Externalizing Behaviors in Autism: Findings From the Norwegian Mother, Father and Child Cohort Study (MoBa)

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月23日

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  • Celine Erlid,
  • Sreoshi Hossain Adhora,
  • Fred R. Volkmar,
  • Ragnhild E. Brandlistuen,
  • Kenneth Larsen,
  • Roald A. Øien

摘要

Purpose

To examine trajectories of parent-reported internalizing and externalizing behaviors at 18 months, 36 months, and 5 years among children with autism spectrum disorder (ASD) compared with children with no recorded diagnosis (NoDx), and to test whether these patterns differed by sex.

Methods

CBCL-derived internalizing and externalizing scores were constructed from harmonized MoBa items available across the three waves. Linear mixed-effects models tested time x diagnosis x sex effects in the ASD-vs-NoDx sample (N = 61,553), with a secondary ASD-only sex analysis.

Results

ASD-NoDx differences were not clearly evident at 18 months, but emerged by 36 months and were clearest at 5 years. Internalizing and externalizing showed significant time x diagnosis effects, but no evidence that diagnosis differences varied by sex. In ASD-only models, sex differences were modest; boys showed higher externalizing than girls only at 5 years.

Conclusion

Broad CBCL-derived emotional and behavioral differences associated with ASD became more detectable across the toddler-to-preschool transition. Sex differences were small relative to diagnosis-related developmental divergence.