About

Benjamin E. Yerys, Ph.D., is an Associate Professor of Psychiatry at the Children's Hospital of Philadelphia and a Scientist at the Center for Autism Research at the Children's Hospital of Philadelphia, affiliated with the University of Pennsylvania. He is a psychologist specializing in the assessment of neurodevelopmental disorders such as autism spectrum disorders, ADHD, and intellectual disorder. Dr. Yerys provides behavioral and cognitive-behavioral treatments aimed at reducing behavior problems, anxiety, and cognitive rigidity in youth with autism spectrum disorders. His research focuses on the non-social aspects of autism spectrum disorders, including core symptoms like repetitive behaviors and difficulties with attention and executive function. He is interested in uncovering the underlying biology of these conditions to develop more precise treatments for children with ASD. His methodological approaches include neurocognitive measures, functional MRI, resting state MRI, genetic analysis, and eye tracking methods.

Research topics

• Psychology
• Developmental psychology
• Clinical psychology
• Psychiatry
• Neuroscience

Selected publications

• Reference Trajectories of Extra-Axial Cerebrospinal Fluid during Childhood and Adolescence Defined in a Clinically Acquired MRI Dataset.

  Apollo (University of Cambridge) · 2026-01-01

  articleOpen access

  Purpose To build extra-axial cerebrospinal fluid (eaCSF) growth charts that define key diagnostic criteria for benign enlargement of the subarachnoid space (BESS) by providing an age-related reference benchmark to aid in assessing atypical eaCSF development. Materials and Methods In this retrospective study, T1-weighted MRI scans from patients who underwent imaging at a pediatric health care system between January 2004 and December 2023 were accessed to form a clinical control group. Nine scans from patients diagnosed with BESS by a board-certified pediatric neuroradiologist were also reviewed. T1-weighted scans were segmented into various tissue types, including eaCSF. Growth charts of eaCSF were modeled using the clinical control group. The results of patients with confirmed BESS were then benchmarked against these charts to test the performance of the eaCSF growth charts. Generalized additive models of location, scale, and shape were used. Results The eaCSF measurements were obtained for 1205 patients (619 female; age range, 0.19-19.6 years). Measurements show that eaCSF evolved dynamically with age, steadily decreasing from birth to 2 years, then trending upward in childhood. Seven of the nine patients with a clinical diagnosis of BESS had eaCSF measurements above the 97.5th percentile for at least one measurement. Percentile scores distinguished patients with BESS from controls with areas under the receiver operating characteristic curve of greater than 0.95. Conclusion MRI-derived eaCSF measurements evolved dynamically throughout early life. Patients with atypical CSF development could be differentiated from clinical controls using computational measurements paired with normative modeling. Keywords: MRI, Brain/Brain Stem, Pediatrics, Benign Enlargement of Subarachnoid Space Supplemental material is available for this article. © The Author(s) 2025. Published by the Radiological Society of North America under a CC BY-NC-ND license.

  PublisherOA PDFDOI

• The under-identification of autism in females: A review and analysis of sex-based scoring differences observed in Autism Diagnostic Observation Schedule (ADOS) Module 3

  2026-01-06

  articleOpen access

  Purpose: Emerging research highlights sex differences in autism presentation, which raises questions about the validity of clinician-administered diagnostic tools like the gold-standard Autism Diagnostic Observation Schedule (ADOS) for females. This study examines whether clinicians’ perceptions, potentially biased toward male-typical presentations, contribute to sex bias in ADOS item and the under-identification of autism in females.Methods: In a sample of 813 children, multidimensional item response theory graded response models were employed to analyze differential item functioning (DIF) of items in ADOS Module 3 (the version commonly administered to school-aged children with fluent spoken language).Results: Six items showed significant sex bias. On four social communication items, females tended to be underscored, meaning rated as showing fewer autistic features (e.g., more emotion talk) than males with equivalent levels of autism latent traits. In contrast, females tended to be overscored on two items related to restricted or repetitive behaviors and interests (i.e., more finger mannerisms, specific interests, or repetitive behaviors). The impact of sex bias on overall scores was small, ranging from 0.10 to 0.28 points on an item, and approximately 0.41 points on the overall test score.Conclusion: This analysis joins three previous reports of specific ADOS items that function differently in females than males, with converging evidence identifying two problematic items (D2 and D4). Overall, DIF was small and unlikely to affect ADOS classification; however, we speculate that the underlying phenomena (viz., masking and clinician bias) may obscure certain social communication symptoms and partially explain the underdiagnosis of autism in females. Abbreviations: Autism Diagnostic Observation Schedule (ADOS); differential item functioning (DIF)

  PublisherDOI

• The Under-Identification of Autism in Females: A Review and Analysis of Sex-Based Scoring Differences Observed in Autism Diagnostic Observation Schedule (ADOS) Module 3

  Journal of Autism and Developmental Disorders · 2026-02-24

  articleOpen access

  Emerging research highlights sex differences in autism presentation, raising questions about the validity of clinician-administered diagnostic tools like the gold-standard Autism Diagnostic Observation Schedule (ADOS). This study examines whether clinicians’ perceptions, potentially biased toward male-typical presentations, contribute to sex bias in ADOS items and the under-identification of autism in females. In a sample of 813 children, multidimensional item response theory graded response models were employed to analyze differential item functioning (DIF) of items in ADOS Module 3 (the version commonly administered to school-aged children with fluent spoken language). Six items showed significant sex bias. On four social communication items, females tended to be underscored, meaning rated as showing fewer autistic features (e.g., more emotion talk) than males with equivalent levels of autism latent traits. In contrast, females tended to be overscored on two items related to restricted or repetitive behaviors and interests (i.e., more finger mannerisms, specific interests, or repetitive behaviors). The impact of sex bias on overall scores was small, ranging from 0.10 to 0.28 points per item, and approximately 0.41 points on the overall test score. This analysis joins three previous reports of specific ADOS items that function differently in females than males, with converging evidence identifying two problematic items (D2 and D4). Overall, DIF was small and unlikely to affect ADOS classification. We speculate that the direction and consistency of DIF in social communication items might reflect underlying phenomena (viz., masking, clinician bias) that may relate to female underdiagnosis more generally.

  PublisherOA PDFDOI

• “Everyone Uses Different Skills and Resources to Live Independently”: A Brief Report on Autistic Young Adults’ Perspectives on Independence and Daily Living Skills

  Journal of Autism and Developmental Disorders · 2025-07-18 · 2 citations

  articleOpen accessSenior author
  PublisherOA PDFDOI

• Big Data, Small Bias: Harmonizing Structural Connectomes to Mitigate Site Bias in Data Integration

  Scholarly Commons (University of Pennsylvania) · 2025-01-01

  other

  Structural connectomes are commonly used to investigate connectivity changes related to various disorders. However, small sample sizes in individual studies and highly heterogeneous disorder-related manifestations underscore the need to pool datasets across multiple studies to identify coherent and generalizable patterns linked to disorders. Yet, combining datasets introduces site bias due to variations in scanner hardware or acquisitions. This highlights the necessity for data harmonization to mitigate site bias while preserving the biological integrity associated with participant demographics and the disorders. While several paradigms exist for harmonizing normally distributed imaging data, this study represents the first effort to establish a harmonization framework specifically for structural connectomes.

  Publisher

• Detecting Divergent Structural Connectivity in Autism Via Multisite Harmonization

  Scholarly Commons (University of Pennsylvania) · 2025-01-01

  otherOpen access

  Background: Investigation of structural connectivity in autism using diffusion MRI (dMRI) based structural connectomes has not produced consistent findings, primarily due to small sample sizes of individual studies and high heterogeneity in autism. To maximize information gleaned from existing studies, it is essential to integrate data retrospectively while overcoming extensive site-related differences. Solving this need requires specialized harmonization paradigms to address statistical complexity of structural connectomes while preserving biological variability. We anticipate that harmonized data will facilitate robust detection of autism-related patterns by increasing pooled sample size. Objectives: To propose a harmonization paradigm for pooling structural connectomes from retrospective studies, and to investigate divergence in structural connectivity associated with autism in a large, pooled cohort. Methods: We analyzed dMRI of 1503 participants (1194 neurotypicals and 309 autism, aged 6-21 years) from 6 sites (Table1). Structural connectomes were created by parcellating the brain into 86 regions defined by Desikan-Killiany atlas and performing probabilistic tractography, with streamline counts used as connectivity weights, yielding 86x86 connectivity matrices. Since connectivity weights were non-gaussian distributed, we modeled edgewise weights using a gamma-distributed generalized linear model (gamma-GLM) with a log link, incorporating site, sex, age, and age² as covariates. Site-related coefficients were estimated edgewise from neurotypicals alone and applied to harmonize structural connectomes for autism and neurotypical groups. Removal of site effects was validated using ANOVA tests on harmonized edgewise weights and 6 graph topological measures, controlling for sex, age, and age². We assessed group-level differences and group-by-age interactions in graph measures in harmonized data between autistic and neurotypicals. Only males (n=890) were included in this analysis. We further tested Spearman correlations between graph measures and autism clinical assessments, controlling for age. We compared harmonized structural connectomes to unharmonized data where site covariate was regressed out at the level of graph measures. Results: Among 1480 edges after consistency-based thresholding, 1377 (93%) exhibited significant site effects pre-harmonization (p<0.05). Site effects at all edges were non-significant following gamma-GLM harmonization (Fig.1A). Additionally, all derived graph measures showed significant site effects before harmonization (p<0.05), while none were significant after harmonization (Fig.1B). Unharmonized data revealed no group-level differences in graph measures. A weak group-by-age interaction in clustering coefficients (standardized β=0.16, p=0.043) and a marginally significant interaction for global efficiency (standardized β=0.16, p=0.052) were noted (Fig.1C top), but no measures were linked to clinical scores. Post harmonization, males with autism showed significantly higher intra-hemispheric strength compared to neurotypicals (Cohen's d=0.37, p=0.041). Significant group-by-age interactions were observed for clustering coefficient (standardized β=0.27, p<0.001) and global efficiency (standardized β=0.26, p=0.002), with both measures increasing with age in autism but decreasing in neurotypicals (Fig.1C bottom). Intra-hemispheric strength positively correlated with SRS-2 t-score (R=0.12, p=0.012), while clustering coefficient (R=0.15, p=0.006) and global efficiency (R=0.14, p=0.013) correlated positively with VABS communication subscale. Conclusions: Our gamma-GLM harmonization can effectively remove site-related differences in structural connectomes for retrospective data integration. With gamma-GLM harmonized structural connectomes from 6 sites, we observed hyper intra-hemispheric connectivity and divergent age-related patterns in clustering coefficient and global efficiency in autistic children compared to neurotypicals.

  Publisher

• Racial Bias in the ADOS: Comparison of Differential Item Functioning and Moderated Nonlinear Factor Analysis Among More Than 4,000 Participants from NDAR and SSC

  2025-06-24

  preprintOpen accessSenior author

  Background: The Autism Diagnostic Observation Schedule (ADOS) is one of the most highly regarded autismevaluations. Unfortunately, multiple studies have demonstrated significant differential itemfunctioning (DIF) for individuals from different racial groups, and the mechanism for racial bias inthe ADOS remains unknown because DIF effects are inconsistently replicated across items.Although the ADOS consists of 5 modules and 2 historical versions (ADOS and ADOS-2), studiessearching for bias using item response theory-based DIF analyses often compromise statisticalpower to account for these differences by subdividing their samples. A moderated nonlinear factoranalysis (MNLFA) is more appropriate because it allows for the presence of multiple moderators,where there may be multiple sources of bias, and it allows the specification of bias receptors (e.g.,item-level, factor-level). To date, six studies have used MNLFA to assess differential itemfunctioning in the ADOS for age or sex. No study has used MNLFA to examine racial bias, nor hasit been used to examine differences across the different modules and versions of the ADOS.Objectives: To test for differential functioning in the ADOS items across race (African-American, Asian,White), module (1-4), and version (ADOS and ADOS-2).Methods:The current study is the largest examination of DIF in the ADOS to date (N = 4354+), utilizing datafrom the Simons Simplex Collection (n = 2851) and the NIMH Data Archive (n = 1503). Datacollection is complete for Module 3 and forthcoming for Modules 1, 2, and 4 (due to a recentshutdown of the NIMH Data Archive). First, item response theory-based DIF was conducted on the14 algorithm items using the lordif package in R. A graded response model was selected given theordinal response data. Chi-square significance tests were used to detect significant uniform andnon-uniform DIF, with an alpha cutoff value of 0.05. DIF analysis will be further conducted withdata from all modules and versions aggregated. Second, measurement invariance will be tested viaMNLFA, using the OpenMx package in R. A confirmatory one-factor model, specified with the 14algorithm ADOS items as manifest variables and with race, version, and module as moderatingeffects for the factor loadings and item intercepts in Figure 1, will be used.Preliminary Results:Within Module 3 aggregated across versions 1 and 2, four algorithm items showed significant DIF:B1 “Eye Contact” (Pr(χ212)=0.117, Pr(χ223)=0.001), B4 “Shared Enjoyment’ (Pr(χ212)=0.709,Pr(χ223)=0.004), B11 “Quality Rapport” (Pr(χ212)=0.001, Pr(χ223)=0.267), and D2 “ComplexMannerisms” (Pr(χ212)=0.021, Pr(χ223)=0.675). The item characteristic curves of B11 and D2suggest uniform DIF, whereas DIF in B1 and B4 is non-uniform (Figure 2).Conclusion:In the largest sample to date, we have identified bias in four ADOS Module 3 algorithm items. Wewill conduct a larger analysis with MNLFA to determine whether the source of racial bias is due tospecific modules or versions of the ADOS. This analysis will allow us to pinpoint specific moduleitems and offer solutions to improve the measure and thereby diagnostic accuracy and equity fordiverse individuals.

  PublisherDOI

• NF1-specific growth charts for head circumference over the first three years of life

  medRxiv · 2025-06-23

  preprintOpen access

  Abstract Background and objectives Macrocephaly is among the most common findings in neurofibromatosis type 1 (NF1) and may be associated with other clinical manifestations of the genetic syndrome. NF1-specific growth charts that account for expected macrocephaly may increase sensitivity to detect atypical growth. We aimed to produce NF1-specific growth charts of head circumference for the age range of 0 to 3 years and to assess their potential clinical impact. Methods Using electronic health records from the Children’s Hospital of Philadelphia, we collected head circumference measurements from children with NF1 and a community control cohort seen at scheduled well-child visits. We compared head circumference normed using Center for Disease Control (CDC) growth charts between these groups over time. We constructed NF1-specific growth charts using two independent methods. Finally, we used mixed-effects models to relate the resulting centile scores with developmental delay assessed with the Survey of Well-being of Young Children. Results Our dataset contained 2180 observations from 305 individuals (167 male) with NF1, and 104,750 observations from 16,742 individuals (8809 male) in the community control cohort, all aged 0 to 3 years old. Head circumference was significantly elevated in NF1 throughout the age range ( P adjusted &lt;0.05), but the effect sizes varied nonlinearly with age, starting moderate at 1 month ( d = 0.56), then small at four months ( d = 0.28), moderate again at 15 months ( d = 0.58), and finally large at 28 months ( d = 0.8). NF1-specific growth curves demonstrated slower rate-of-growth for head circumference in the first two months of life yet more sustained growth over time. Although none of the children with NF1 met the standard for microcephaly according to CDC charts, smaller head circumference benchmarked against NF1-specific charts was correlated with developmental delay (standardized beta = 0.24; P = 0.013). Discussion We present the first NF1-specific growth charts for head circumference covering ages 0 to 3 years. Macrocephaly in NF1 becomes more exaggerated over time as rate-of-growth is sustained compared to controls. Smaller head size relative to NF1 growth expectations is not captured by CDC charts yet nevertheless relates to developmental delay, suggesting that NF1-specific charts may increase sensitivity to clinically concerning patterns of growth in children with NF1.

  PublisherOA PDFDOI

• An Examination of Racial Bias in Scoring the Autism Diagnostic Observation Schedule (ADOS) Module 3

  2025-06-23

  preprintOpen access

  Introduction: Given the rising prevalence of autism among racial minority children in the U.S., but persistent service use disparities, this study examines potential bias in specific items from the Autism Diagnostic Observation Schedule (ADOS), a highly regarded autism evaluation. Method: We leveraged unidimensional item response theory graded response models and a sample of 735 children to analyze the differential item functioning (DIF) of items within ADOS Module 3. Results: Three items showed significant signs of racial bias: A1 (overall language level), A5 (offers information), and D5 (compulsions and rituals). On these items, Black/African American and Asian children were usually more likely to be rated as showing autistic behaviors than White children with similar autism levels. The impact of racial bias on the item score was small, and impact on the overall test score was even smaller: on a scale of 0-48 points, the effect of racial bias was estimated at 0.23 total points for Black/African American children, and 0.16 points for Asian children. Furthermore, none of the items showing significant bias contribute to the autism classification algorithm. Discussion: This analysis suggests a small but detectable amount of bias in several specific ADOS items, but not in items central to informing an autism diagnosis. Thus, bias appears statistically, but not clinically, significant. This study provides the third racial bias analysis of the ADOS, the first analysis of Asian children, and the first in-depth look at all items in the most commonly used version among school-aged children.Abbreviations: Autism Diagnostic Observation Schedule (ADOS); differential item functioning (DIF)Keywords: autism, racial bias, item response theory, differential item functioning, ADOS

  PublisherOA PDFDOI

• An Examination of Racial Bias in Scoring the Autism Diagnostic Observation Schedule (ADOS) Module 3

  2025-06-23

  preprintOpen access

  Introduction: Given the rising prevalence of autism among racial minority children in the U.S., but persistent service use disparities, this study examines potential bias in specific items from the Autism Diagnostic Observation Schedule (ADOS), a highly regarded autism evaluation. Method: We leveraged unidimensional item response theory graded response models and a sample of 735 children to analyze the differential item functioning (DIF) of items within ADOS Module 3. Results: Three items showed significant signs of racial bias: A1 (overall language level), A5 (offers information), and D5 (compulsions and rituals). On these items, Black/African American and Asian children were usually more likely to be rated as showing autistic behaviors than White children with similar autism levels. The impact of racial bias on the item score was small, and impact on the overall test score was even smaller: on a scale of 0-48 points, the effect of racial bias was estimated at 0.23 total points for Black/African American children, and 0.16 points for Asian children. Furthermore, none of the items showing significant bias contribute to the autism classification algorithm. Discussion: This analysis suggests a small but detectable amount of bias in several specific ADOS items, but not in items central to informing an autism diagnosis. Thus, bias appears statistically, but not clinically, significant. This study provides the third racial bias analysis of the ADOS, the first analysis of Asian children, and the first in-depth look at all items in the most commonly used version among school-aged children.Abbreviations: Autism Diagnostic Observation Schedule (ADOS); differential item functioning (DIF)Keywords: autism, racial bias, item response theory, differential item functioning, ADOS

  PublisherDOI

Recent grants

• NIH Grant R21MH092615

  NIH · $427k · 2014

• NIH Grant K23MH086111

  NIH · $394k · 2014

Frequent coauthors

• Lauren Kenworthy

  123 shared

• Allison E. Curry

  University of Pennsylvania

  55 shared

• John D. Herrington

  Children's Hospital of Philadelphia

  47 shared

• Kathryn F. Jankowski

  University of Oregon

  43 shared

• Robert T. Schultz

  University of Pennsylvania

  43 shared

• Chandan J. Vaidya

  Children's National

  42 shared

• John F. Strang

  George Washington University Hospital

  36 shared

• Gregory L. Wallace

  36 shared