Article Sidebar

Download
Requires Subscription PDF
Statistic
Read Counter : 0 Download : 0

Downloads

Download data is not yet available.

Main Article Content

Abstract

BACKGROUND


Children with autism spectrum disorder exhibit significantly higher levels of both internalising and externalising behaviours compared to typically developing peers. The severity of autism is associated with increasing internalising and externalising problems, i.e., more severe autism correlates with higher behavioural difficulties. Gender also plays a role in behavioural problems, females with ASD (Autism Spectrum Disorder) tend to exhibit more of internalising behaviours and males with ASD exhibit more externalising behaviours. There are limited Indian studies focussing on these areas. This study explores internalising and externalising behaviours in children with ASD and examines their relationship with the severity of autism and gender.


 METHODS


A cross sectional analytical study of 60 children and adolescents between 7 and 18 years of age who are diagnosed with ASD is included in the study. The Indian Scale for Assessment of Autism scale was used to assess the severity of the autism and the CBCL (Child Behaviour Checklist) scale was used to assess the internalising and externalising behaviours. The association between the clinically significant behavioural problems and the severity of autism was analysed. The gender differences in the behavioural patterns are also analysed.


 RESULTS


This study examined 60 children with ASD, revealing a predominance of males and with most of the cases classified as mild to moderate severity. Higher rates of behavioural and emotional problems were identified. About 40% had clinical-range internalising behaviours, 36.7% externalising problems and 66.7% showed elevated total CBCL scores. Externalising behaviours were significantly associated with autism severity (p = 0.02) and male gender (p = 0.04), whereas internalising behaviours showed no significant association.


 CONCLUSIONS


This study highlights the need to address behavioural issues in children with ASD through a multidisciplinary approach.

Keywords

Autism Spectrum Disorder (ASD), Child Behaviour Check List (CBCL), Internalising and Externalising Behaviours.

Article Details

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to Cite
Saravana Jothi Ramalingam, Sathya Prabha Rajalingam, & Malaiappan Meenakshisundram. (2026). Analysis of Internalising and Externalising Behaviours in Children with Autism Spectrum Disorder and Their Relationship with Severity and Gender in a Tertiary Care Hospital. Journal of Evolution of Medical and Dental Sciences, 15(2), 53–57. https://doi.org/10.14260/jemds.v15i2.842
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX
Crossref
Scopus
Google Scholar
Europe PMC

References

  1. American Psychiatric Association, editors. Diagnostic and statistical manual of mental disorders: DSM-5. 5th edn. Washington, D.C: American Psychiatric Association 2013: p. 947.
  2. Achenbach TM, Rescorla LA. Child behaviour checklist for ages 6-18 [Internet]. American Psychological Association (APA); 2023 [cited 2025 Jul 28]. (PsycTESTS Dataset). https://doi.apa.org/doi/10.1037/t47452-000
  3. Kaat AJ, Gadow KD, Lecavalier L. Psychiatric symptom impairment in children with autism spectrum disorders. J Abnorm Child Psychol 2013;41(6):959–69.
  4. Margari L, Palumbi R, Peschechera A, et al. Sex-gender comparisons in comorbidities of children and adolescents with high-functioning autism spectrum disorder. Front Psychiatry 2019;10:159.
  5. Zahn-Waxler C, Shirtcliff EA, Marceau K. Disorders of childhood and adolescence: gender and psychopathology. Annu Rev Clin Psychol 2008;4(1):275–303.
  6. Sisk CL, Zehr JL. Pubertal hormones organize the adolescent brain and behaviour. Front Neuroendocrinol 2005;26(3–4):163-74.
  7. Crick NR, Zahn–Waxler C. The development of psychopathology in females and males: Current progress and future challenges. Dev Psychopathol 2003;15(3):719-42.
  8. Dean M, Harwood R, Kasari C. The art of camouflage: Gender differences in the social behaviour s of girls and boys with autism spectrum disorder. Autism 2017;21(6):678-89.
  9. Mayes SD, Calhoun SL, Mayes RD, et al. Autism and ADHD: overlapping and discriminating symptoms. Res Autism Spectr Disord 2012;6(1):277-85.
  10. Lai MC, Lombardo MV, Auyeung B, et al. Sex/gender differences and autism: setting the scene for future research. J Am Acad Child Adolesc Psychiatry 2015;54(1):11-24.
  11. Fombonne E. Epidemiology of pervasive developmental disorders. Pediatr Res 2009;65(6):591-8.
  12. Loomes R, Hull L, Mandy WPL. What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry 2017;56(6):466-74.
  13. Simonoff E, Pickles A, Charman T, et al. Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry 2008;47(8):921-9.
  14. Mandy W, Chilvers R, Chowdhury U, et al. Sex differences in autism spectrum disorder: evidence from a large sample of children and adolescents. J Autism Dev Disord 2012;42(7):1304-13.