Pubertal, Psychological and Physiological Development in Females with Autism

项目概要/摘要 青春期是人类一生中最复杂的发育过渡期之一。发病年龄（age of onset） 和青春期的克里思（变化率）可以显着和负面影响身体，心理社会和 生理功能，尤其是女性。自闭症谱系障碍（ASD）的特征是受损的 互惠的社会交流和对变化的适应能力差;因此，青春期的开始和过程标志着一个 关键的转变。在一系列的横断面研究中，研究小组的发现表明：1）先进的 患有ASD的女性青年与典型发育中的女性相比的青春期时间（即，乳房发育， 月经）使用严格的青春期分期评估; 2）ASD女性的不同发育行为 当与同龄人进行社交互动时; 3）患有ASD的早期青少年的抑郁症状较高，特别是 女性; 4）ASD青年神经社会情绪处理的性别差异; 5）压力升高 与同龄TD同龄人相比，ASD青年的觉醒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ASD女性的独特特征和潜在的 在这个脆弱的、未得到充分研究的人群和发育窗口中，青春期过早的有害影响。而 以前和正在进行的青春期发育研究是引人注目的，在开始招募时，80%的 10-与TD组的29%相比，患有ASD的10岁女性已经进入青春期;因此， 无法确定青春期的真正开始。此外，它是基于一个相对较小的女性样本， ASD 10-13岁（N = 35）。因此，全面探讨青春期成熟的大样本， 年轻的ASD女孩是需要的。首要目标是系统地检查精确的开始，克里思 以及ASD女性的青春期、心理社会和生理发育过程， 多方法加速纵向设计。ASD（n=120）和TD（n=120）女性的大样本 将在4年内随访6 - 15年：队列1在6年时入组（随访6-9年），队列2 8年时入组（随访8-11年），队列3 10年时入组（随访10-13年），队列4 12年时入组 （见第12-15段）。这些目标将涉及三个关键领域。目标1：青春期发育-将审查时间， 基于身体发育（坦纳阶段（TS），身体质量指数（BMI），身高， 线性生长速度（LGV））、激素（雌二醇、黄体生成素（LH））和月经周期。目标二： 心理社会概况-将检查互惠社会沟通（卡斯）和内化症状 （焦虑和抑郁）在青春期的开始和整个过程中的发展。目标3：生理 表征-将同时检查中枢神经系统（EEG）水平的社会功能 超扫描），HPA轴（皮质醇）和周围神经系统（RSA）在自然的社会互动 在同性同伴之间。研究结果将揭示青春期的开始、克里思和过程对 对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.