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

Autism Res. 2022 Oct;15(10):1894-1908. doi: 10.1002/aur.2786. Epub 2022 Aug 1.


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.

Keywords: adolescence; autism; development; female; puberty.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Autism Spectrum Disorder*
  • Body Mass Index
  • Child
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Puberty / physiology
  • Sexual Behavior