Pubertal, Psychological and Physiological Development in Females with Autism

项目摘要/摘要 青春期是人类一生中最复杂的发育转变之一。发病时间(发病年龄) 和青春期的节奏(变化率)可以显著地和负面地影响身体、心理社会和 生理机能，尤指女性的生理机能。自闭症谱系障碍(ASD)的特征是受损 相互的社会交流和对变化的较差适应能力；因此，青春期的开始和进程标志着 关键过渡。在一系列横断面研究中，研究小组的发现表明：1)先进 与典型发育中的女性相比，患有自闭症的年轻女性的青春期时机(即，乳房发育， 月经)使用青春期分期的严格评估；2)ASD女性明显的伪装行为 与同龄人交往时；3)ASD早期青少年抑郁症状较高，尤其 女性；4)青少年自闭症患者神经社会情绪处理的性别差异；5)压力增加 与同年龄段的TD同龄人相比，患有ASD的青少年的性唤醒能力随着年龄和青春期的增长而增加 发展。在这些研究中，一致的是患有ASD的女性的独特概况和潜在的 在这个脆弱、研究不足的人口和发展窗口，青春期早期的有害影响。而当 之前和正在进行的青春期发育研究在入学之初就令人信服，80%的 患有自闭症的10岁女性已经进入青春期，而患有自闭症的女性只有29%；因此， 青春期的真正开始无法确定。此外，它是基于相对较小的女性样本。 房间隔缺损10~13年(N=35)。因此，对青春期成熟的大样本进行了全面的探索 需要患有自闭症的年轻女孩。首要目标是系统地检查准确的起跳、节奏 以及女性自闭症患者的青春期、心理社会和生理发育过程， 多方法，加速纵向设计。女性ASD(n=120)和TD(n=120)的大样本 将在四年内跟踪6到15年的时间：队列1在6年内入学(跟随6-9年)，队列2 8岁入学(8-11岁)，3组入学10年(10-13岁)，4年级12岁 (关注12-15)。这些目标将涉及三个关键领域。目标1：青春期发育-将检查时机， 青春期的速度和进程基于身体发育(晒黑阶段(TS)、体重指数(BMI)、身高、 直线生长速度(LGV)、激素(雌二醇、黄体生成素(LH))和月经周期。目标2： 心理社会概况-将检查相互社会沟通(CASS)和内在化症状 (焦虑和抑郁)在青春期发育初期和整个过程中。目标3.生理学 定性-将同时检查中枢神经系统(EEG)水平的社会功能 高扫描)、HPA轴(皮质醇)和外周神经系统(RSA) 在同性同龄人之间。这些发现将揭示青春期的开始、节奏和进程的影响 关于患有自闭症的女性，改善教育，提供信息服务，并制定干预措施，这些都是缺乏的。

Project Summary/Abstract Puberty is among the most complex developmental transitions over the human lifetime. The timing (age of onset) and tempo (rate of change) of puberty can significantly and negatively impact physical, psychosocial and physiological functioning, especially in females. Autism spectrum disorder (ASD) is characterized by impaired reciprocal social communication and poor adaptation to change; thus, the onset and course of puberty marks a pivotal transition. In a series of cross-sectional studies, findings from the study team have shown: 1) advanced pubertal timing for female youth with ASD compared to typically developing females (i.e., breast development, menses) using rigorous assessment of pubertal staging; 2) distinct camouflaging behaviors in females with ASD when socially interacting with peers; 3) higher depressive symptoms in early adolescents with ASD, especially females; 4) sex-based differences in neural socioemotional processing in youth with ASD; and 5) elevated stress and arousal in youth with ASD compared to same-age TD peers that increases with age and pubertal development. Consistent across these studies is the unique profile of females with ASD and the potential deleterious impact of early puberty in this vulnerable, understudied population and developmental window. While the previous and ongoing pubertal development research is compelling, at the start of enrollment, 80% of the 10-year old females with ASD had already entered puberty compared to 29% of the TD group; therefore, the true onset of puberty could not be determined. Moreover, it was based on a relatively small sample of females with ASD 10-13 years (N = 35). Thus, a comprehensive exploration of pubertal maturation in a large sample of younger girls with ASD is needed. The overarching goal is to systematically examine the precise onset, tempo and course of pubertal, psychosocial and physiological development in females with ASD using a multimodal, multimethod, accelerated longitudinal design. A large sample of females with ASD (n=120) and TD (n=120) spanning 6 to 15 years will be followed over four years: Cohort 1 enrolled at 6-years (follow 6-9), Cohort 2 enrolled at 8-years (follow 8-11), Cohort 3 enrolled at 10-years (follow 10-13) and Cohort 4 enrolled at 12-years (follow 12-15). The aims will address three key areas. Aim 1: Pubertal development - will examine the timing, tempo and course of puberty based on physical development (Tanner stage (TS), body mass index (BMI), height, linear growth velocity (LGV)), hormones (Estradiol, Luteinizing Hormone (LH)), and menstrual cycle. Aim 2: Psychosocial profiles - will examine reciprocal social communication (CASS) and internalizing symptoms (anxiety and depression) at the onset and over the course of pubertal development. Aim 3. Physiological characterization - will simultaneously examine social functioning at the level of the central nervous system (EEG hyperscanning), HPA axis (cortisol) and peripheral nervous system (RSA) during naturalistic social interactions between same-sex peers. The findings will reveal the impact of the onset, tempo and course of puberty on females with ASD to improve education, inform services, and develop interventions, which are lacking.