Examination of pubertal timing and tempo in females and males with autism spectrum disorder compared to typically developing youth

Abstract

Autism spectrum disorder (ASD) is characterized by impaired social communication and poor adaptation to change; thus, pubertal development may be precarious. Pubertal timing and tempo were measured in 244 youth (7.9% Black, 83.3% White, and 8.7% multiracial) with ASD (N = 140) and typical development (N = 104). Pubertal development was measured using Tanner staging of Genital (G, males), Breast (B, females), and pubic hair (PH) in both sexes at Year 1 (10–13 years), Year 2 (11–14 years), and Year 3 (12–15 years). Nonlinear mixed effects models analyzed interindividual differences in timing and tempo. For both sexes, ASD and higher body mass index were associated with earlier pubertal timing. Males generally exhibited faster tempo than females. Linear regression models did not show associations between pubertal timing and internalizing symptoms at time three. Findings showing advanced pubertal maturation in ASD youth suggest greater risk of psychological, social, and physiological challenges. Lay Summary Youth with ASD have difficulty in social communication and adaption to change, thus puberty may be a challenging transition. The study examined onset (timing) and progression (tempo) of puberty over three years, using physical exam, in 244 adolescents with and without ASD, enrolled at ages 10–13. ASD youth started puberty earlier, while males generally progressed at a faster pace. Further examination of puberty in ASD should identify impact on social, behavioral, and mental health outcomes.

Salivary testosterone in male and female youth with and without autism spectrum disorder: considerations of development, sex, and diagnosis

“…Notably, the females with ASD in the current sample evidenced advanced pubertal timing compared to TD females during early adolescence when the sample was 10 to 13 years of age [69], which may correspond with their higher levels of testosterone observed at these younger ages. Earlier pubertal timing was also observed in males with ASD albeit during middle adolescence [70]}, which again seems to align with the rise in testosterone in males. Despite this intriguing connection between pubertal testosterone, autism, and sex, there are notable differences in methods between the current study and Dooley et al (2022), which include: sample differences (confirmed ASD diagnosis vs. self/parent-report of autistic traits), sample age (10-13 years vs. 13-21 years), testosterone effects (pubertal/activational vs. prenatal/organizational), and pubertal development (Physical Exam Tanner staging vs. PDS questionnaire), respectively.…”

“…It is plausible there exists a more nuanced effect in which elevations in testosterone are observed in a subset of youth, such as those with earlier pubertal onset. Indeed, advanced pubertal onset has been observed in females with ASD during early adolescence [69] and more recently reported in females and males with ASD during early-to-middle adolescence [70].…”

Identification and analysis of autism spectrum disorder via large‐scale dynamic functional network connectivity

“…Thirdly, we should consider different sample characteristics (i.e., IQ, adaptive function, and drug treatment) to better understand the individual heterogeneity and to improve the performance of the classification model in future work. Additionally, puberty status (developmental levels) may impact ASD symptoms (Corbett et al, 2020; Corbett et al, 2022) and brain structural and functional development (Lange et al, 2015; Padmanabhan et al, 2015). In the current study, due to the limitations of sample characteristics, we did not control the variables of pubertal characteristics.…”

Special considerations for assessing and caring for autism in girls and women

“…Research on pubertal development in autism is only emerging, with few new studies noting differences in pubertal timing and development. Autistic girls are reported to have earlier pubertal onset as measured by genital and pubic stages compared to autistic boys and typically developing girls [40 ▪▪ ]. Longitudinal data on pubertal tempo showed no significant difference between autistic girls and nonautistic girls, though a higher BMI is associated with earlier sexual maturity ratings [41].…”