Autism Spectrum Disorder Adolescents Research Articles

Review Article: The Autism Disease: Symptoms, Genomics, Causes and Pharmacological Therapy for the Behavioral associated with disease

One of the most confusing conditions is autism spectrum disorders (ASDs), for which neither a precise cause nor a conclusive cure has yet been discovered. Autism can be defined as a disorder that typically manifests in children at a young age and affects many areas of their development. It develops in an abnormal way, exhibiting an unbalanced social interaction style marked by recurring behavioral patterns and difficulties in verbal and nonverbal communication. The frequency of ASDs has dramatically increased over the past few decades, inspiring numerous researchers worldwide to investigate all facets of the condition, from origin to intervention and diagnosis. This study addresses ASDs, their causes, symptoms, diagnosis, modalities of therapy, and the counseling needs of Jordanian families. As one of the most common neurodevelopmental disorders, ASDs are characterized by stereotyped behaviors and poor social interaction. There is a significant and intricate genetic component to ASDs, with numerous patterns of familial inheritance and an estimated 1,000 potential genes. The past ten years have seen a rapid advancement in identifying the genes responsible for autism, thanks to genomic technologies. This study describes pharmaceutical treatments for the behavioral symptoms associated with ASDs in adolescents, children, and adults. The categories of symptoms include inattention and hyperactivity, social impairment, aggression, irritability, and stereotyped and repetitive behaviors. Medications covered in the list include α-2 agonists, atomoxetine, mirtazapine, memantine, serotonin reuptake inhibitors (SRIs), and antipsychotics. In children with ASDs, SRIs are generally less effective and less tolerated compared to adults. The most effective medications for treating irritability in ASDs are antipsychotics, which can also help with other symptoms. While psychostimulants show promise when used to treat inattention and hyperactivity in individuals with ASDs, they are less effective and have more side effects compared to their use in individuals with attention deficit and hyperactivity disorders (ADHDs). Although more research is needed, memantine and D-cycloserine appear to be beneficial in treating social impairment.

Brain functional gradient and structure features in adolescent and adult autism spectrum disorders.

Understanding how function and structure are organized and their coupling with clinical traits in individuals with autism spectrum disorder (ASD) is a primary goal in network neuroscience research for ASD. Atypical brain functional networks and structures in individuals with ASD have been reported, but whether these associations show heterogeneous hierarchy modeling in adolescents and adults with ASD remains to be clarified. In this study, 176 adolescent and 74 adult participants with ASD without medication or comorbidities and sex, age matched healthy controls (HCs) from 19 research groups from the openly shared Autism Brain Imaging Data Exchange II database were included. To investigate the relationship between the functional gradient, structural changes, and clinical symptoms of brain networks in adolescents and adults with ASD, functional gradient and voxel-based morphometry (VBM) analyses based on 1000 parcels defined by Schaefer mapped to Yeo's seven-network atlas were performed. Pearson's correlation was calculated between the gradient scores, gray volume and density, and clinical traits. The subsystem-level analysis showed that the second gradient scores of the default mode networks and frontoparietal network in patients with ASD were relatively compressed compared to adolescent HCs. Adult patients with ASD showed an overall compression gradient of 1 in the ventral attention networks. In addition, the gray density and volumes of the subnetworks showed no significant differences between the ASD and HC groups at the adolescent stage. However, adults with ASD showed decreased gray density in the limbic network. Moreover, numerous functional gradient parameters, but not VBM parameters, in adolescents with ASD were considerably correlated with clinical traits in contrast to those in adults with ASD. Our findings proved that the atypical changes in adolescent ASD mainly involve the brain functional network, while in adult ASD, the changes are more related to brain structure, including gray density and volume. These changes in functional gradients or structures are markedly correlated with clinical traits in patients with ASD. Our study provides a novel understanding of the pathophysiology of the structure-function hierarchy in ASD.

Role of the Peers Program for Social Skills Training for Adolescents with Autism Spectrum Disorder

This study aims to examine the efficacy of the PEERS intervention in enhancing social skills among adolescents diagnosed with Autism Spectrum Disorders (ASD). The current study employed an experimental research methodology to determine the effects of the variables. The sample size was determined using G power. 182 individuals were selected, including 60 ASD adolescents and 40 parents for the experimental group (EG). The control group (CG) consisted of 41 parents of 41 adolescents with ASD. A purposive sampling technique was employed to select individuals within the age range of 15 to 50 years old. The data were collected from two schools in Islamabad and one in Rawalpindi, Pakistan. The data was examined utilizing SPSS version 25, and the ANOVA test was employed to check the analysis results. The results demonstrated that the PEERS program is successful in improving the overall socialization of parents and adolescents with ASD. The present study indicated that PEERS has a crucial impact on improving socialization skills in parents and adolescents with ASD.

Autism Spectrum Disorder Prediction in Children Using Machine Learning

Life symptoms associated with autism spectrum disorder (ASD) typically manifest during childhood and persist into adolescence and adulthood. ASD, which can be caused by genetic or environmental factors, can be significantly improved through early detection and treatment. Currently, standardized clinical tests are the primary diagnostic method for ASD. However, these tests are time consuming and expensive. Early detection and intervention are pivotal in enhancing the long-term prospects of children diagnosed with ASD. Machine-learning (ML) techniques are being utilized alongside conventional methods to improve the accuracy and efficiency of ASD diagnosis. Therefore, the paper aims to explore the feasibility of employing support vector machines, random forest classifier, naïve Bayes, logistic regression (LR), K-nearest neighbor, and decision tree classification models on our dataset to construct predictive models for predicting and analyzing ASD problems across different age groups: children, adolescents, and adults. The proposed techniques are assessed using publicly available nonclinical ASD datasets of three distinct datasets. The four ASD datasets, namely toddlers, adolescents, children, and adults, were obtained from publicly available repositories, specifically Kaggle and UCI ML. These repositories provide a valuable data source for research and analysis related to ASD. Our main objective is to identify the susceptibility to ASD in children during the early stages, thereby streamlining the diagnosis process. Based on our findings, LR demonstrated the highest accuracy for the selected dataset.

Medical and social problems of education and adaptation in children and adolescents with autism spectrum disorders

Introdution. The presented review revealed pronounced trends in the increase in the number of disabled children in the world, including those with autism spectrum disorders (ASD). The considered features of the psychological status in ASD children are characterized by difficulties in socialization and communication, reduced ability to establish emotional connections; impaired speech development, perception, motor skills, memory, low concentration of attention. The peculiarities of the interaction of ASD children and adolescents determine the difficulties of their adaptation in the conditions of inclusive education in schools, colleges and universities. The necessity of a comprehensive system of support for children and adolescents by tutors, social educators, as well as providing special training for teachers working with ASD children and adolescents is substantiated. Attention is paid to the issues of occupational orientation in ASD persons. The use of distance learning, which should be an auxiliary method so as not to interfere with the adaptation of ASD persons in the team, is considered.

The teacher-student relationship: A comparative study of the report of students with autism spectrum disorder and typical development

The teacher-student relationship (TSR) is an important factor for promoting academic success. Even though students with autism spectrum disorder (ASD) experience more educational difficulties, the TSR in ASD students has been understudied, and there is a significant empirical gap in the perception that ASD adolescent students themselves have of their relationships with their teachers. The present study followed a non-experimental, correlational, cross-sectional and comparative design to analyze the TSR in ASD adolescents in comparison to the TSR of their typically developing (TD) peers. Sixty-four students (33 females, 31 males) who were in their first year of secondary school ( participated in the study. 32 of them had ASD and 32 had TD. The TSR subscale of the SEI was applied (Appleton et al., 2006). The results show significant interaction effects between student condition and gender, where female ASD students reported a worse relationship than their male ASD peers. These findings differ from existing research indicating that ASD students experience worse TSR and that female students experience better relationships than male students. The important role of the existing school integration program in Chilean schools, and guidelines for future research to explain the gender differences found in this study are discussed.

Is it feasible to involve parents of teenagers with ASD in their language teaching? A case study in Greece

Autism spectrum disorder (ASD) as a lifelong neurodevelopmental disorder puts a significant strain on the family. During secondary education, when the brain is rewired, language learning becomes a challenge for ASD students and their parents. Using this as a foundation, this article’s main objective is to know the opinions and attitudes that characterize the parents of adolescents with ASD regarding the teaching of the Greek language to their children. Through a descriptive qualitative study, with a semi-structured interview of 32 items (n=30 parents) and an in-depth analysis, this goal has been accomplished. The main conclusion that has been reached is that participants-parents applaud their own assistance in the educational process, claiming though for special education teachers’ cooperation, support from the Greek State and availability of specialized staff and resources to carry out smoothly the language learning process, with the aim of optimal outcomes in the linguistic competencies for their ASD adolescents.

Prevalence and Characteristics of Adolescents with Autism Spectrum Disorder in the New York-New Jersey Metropolitan Area.

Almost all epidemiologic studies estimating autism spectrum disorder (ASD) prevalence have focused on school-age children. This study provides the first population-based data on the prevalence and expression of ASD among adolescents in a large US metropolitan region. Active multiple source ASD surveillance of adolescents aged 16-years was conducted according to the Autism and Developmental Disabilities Monitoring (ADDM) Network method in a four-county New Jersey metropolitan region. Prevalence estimates are provided, characteristics are described and comparison of the distribution and characteristics of ASD is offered for this cohort, at 8 and 16-years. ASD prevalence was 17.7 per 1000 (95% CI: 16.3-19.2)]. One-in-55 males and one in 172 females were identified with ASD. High-SES was positively associated with ASD and White adolescents had higher ASD prevalence (22.2 per 1000) than Hispanic adolescents (13.1 per 1000). One in four study-confirmed individuals with ASD did not have an ASD diagnosis. A majority of ASD adolescents (58.8%) had a co-occurring neuropsychiatric disorder. White and High-SES individuals had greater likelihood of co-occurring disorder. The demographic distribution and functional profile of ASD was similar in this cohort at 8 and 16-years. Approximately one-in-55 adolescents in our area had ASD, in 2014, and one-in-4 16-year-olds with ASD was not diagnosed. A majority (3-in-5) of the adolescents with ASD had a co-occurring neuropsychiatric disorder. ASD under-identification and the high frequency of co-disorders in adolescents with ASD pose significant challenges to care and support.

A review of dietary and nutritional interventions available for management of autism spectrum disorder symptoms in children and adolescents - Kenya

Research on the challenges of raising a child with autism is mostly reported from Europe, North America and Australia. There is limited autism spectrum disorder (ASD) research in Kenya and families lack support as the etiology is linked to witchcraft and sorcery. Research indicates an increase in ASD prevalence globally and in Africa. Malnutrition and neuro-disability are major public health problems in Africa. Approximately one billion people, 15% of the world’s population, have a disability of some kind and 80% live in Low- and Middle-Income countries (LMICs). Of these, 53 million are children aged below 5 years living in sub-Saharan Africa. In Kenya, 2.2% (0.9 million people) live with some form of disability. Children diagnosed with autism spectrum disorder (ASD) suffer from neuro disabilities eliciting: altered sensory processing, restricted interests, and behavioral rigidity. Autism spectrum disorders have no cure, management is by use of interventional targeting autistic symptoms such as linguistic development, non-verbal cognitive development, and motor development. The objectives of this review were: to identify dietary and nutritional interventions available for the management of ASD symptoms in children and adolescents - Kenya, and to analyze the results of existing research in this area in order to understand and describe the characteristics and results of these studies to enable their use in the management of ASD symptoms. Cochrane Library, PubMed, PMC, Google scholar, and Free Full databases were searched to identify studies published between September 2011 and September 2021. Included were studies on nutrition or dietary interventions given to ASD children and adolescents that assessed autistic behavior and/or gastrointestinal symptoms. Excluded were those articles that evaluated surrogate outcomes as the primary outcome such as urinary peptide excretion and other neuro-disabilities other than ASD. Eighteen articles were included: 12 randomized case-control trials, 3 open-label trials, one 2×2 factorial study, and 2 cross-over trials. The following dietary and nutritional interventions were evaluated: gluten and casein-free diet, ketogenic diets; probiotic supplements, specific carbohydrate diets, polyunsaturated fatty acids, vitamin and mineral supplantation (A, B6, B12, D, magnesium, folic acid), and alternative diets. Authors report improvements in the symptoms associated with ASD individuals receiving nutritional interventions such as vitamin and mineral supplementation however, their safety and efficacy needs to be evaluated. The study findings will help policymakers and implementers to understand the consistency and precision and impact of these interventions. These findings will contribute to improving the safety and efficacy of these interventions, positively impacting the health and nutrition outcomes of children and adolescents with ASD. These study findings indicate that more research targeting ASD dietary and Nutritional Interventions for management of ASD symptoms is required in Kenya and other resource constrained settings. Key words: autism spectrum disorder, nutritional intervention, diet therapy, child, adolescent, Kenya

Differential Diagnosis of ICD-11 Personality Disorder and Autism Spectrum Disorder in Adolescents.

The International Classification of Diseases 11th Revision (ICD-11) introduces fundamentally new diagnostic descriptions for personality disorder and autism spectrum disorder. Instead of the traditional categorical taxonomies, both personality disorder and autism spectrum disorder are described as being on a continuum. Accumulating research has pointed out that, in some cases, adolescents with autism spectrum disorder are at risk of being confused with having a personality disorder, which particularly applies to female adolescents. Case reports describe how adult autistic women struggled with social and identity roles as children and adolescents, using compensatory strategies such as social imitation and other types of camouflaging. Furthermore, some adolescents with autism display emotion dysregulation and self-injury. The ICD-11 recognizes that features of autism spectrum disorder may resemble features of personality disorder, but the two diagnoses have not yet been formally compared to one another. The present article therefore sought to outline and discuss the overlap and boundaries between the ICD-11 definitions of personality disorder and autism spectrum disorder and propose guiding principles that may assist practitioners in differential diagnosis with female adolescents. We specifically highlight how aspects of the self and interpersonal functioning along with emotional, cognitive, and behavioral manifestations may overlap across the two diagnoses. Restricted, repetitive, and inflexible patterns of behavior, interests, and activities are core features of autism spectrum disorder, which may be masked or less pronounced in female adolescents. Collecting a developmental history of the early presence or absence of autistic features is vital for a conclusive diagnosis, including features that are typically camouflaged in females. A number of future directions for research and clinical practice are proposed.

Exploring intervention strategies to enhance face recognition abilities in adolescents with autism spectrum disorder: assessing the impact of verbalization and Navon tasks

PurposeThe purpose of this study is to examine the effectiveness of two intervention strategies – identifying the global letter of Navon letters and verbally describing a face – in improving face recognition abilities of adolescents with autism spectrum disorder (ASD).Design/methodology/approachA total of 15 adolescents with ASD and 15 typically developing (TD) adolescents participated in this study, which consisted of three experimental conditions: verbalization, Navon and control. Participants were presented with a target face for a short period of time, then completed a task specific to the condition in a counterbalanced order, followed by a face recognition task.FindingsThe results of this study showed no significant interaction effects between groups and conditions, either in accuracy or reaction time. However, TD adolescents performed better than ASD adolescents in terms of accuracy. In addition, the verbalization condition resulted in better performance with slower response times compared to the control condition.Originality/valueThese findings suggest that verbalization may be a useful strategy to enhance face recognition abilities in ASD and TD individuals.

Using simple economic games to assess social orienting and prosocial behavior in adolescents with autism spectrum disorder.

Deficits in socio-emotional reciprocity, in prosocial behavior and in developing social relationships are diagnostic criteria of autism spectrum disorder (ASD), usually assessed by self-report or observation. Simple social experiments developed by behavioral economists allow for quantification of ASD-related social behavior. In this study, we used such experiments to compare social-economic decision-making between ASD adolescents and neurotypical controls. Precisely, we analyzed social orienting and prosocial behavior in 17 adolescents with ASD (Asperger syndrome) and 24 matched neurotypical adolescents. We used a two-condition distribution game (possibility of punishment by fellow player versus no such possibility) and an impunity game to examine social orienting (distribution game) and prosocial behavior (both games). Participants with ASD exhibited less social orienting in the distribution game (p = 0.03, d = -0.61). In addition, there was a trend for ASD participants to behave in a more prosocial way than neurotypical participants in the impunity game (p = 0.08, d = 0.60), which was not the case in the no-punishment condition of the distribution game (p = 0.35, r = 0.17). These results demonstrate the potential of simple economic games to capture reduced social orienting in ASD. The unexpected finding of more prosocial behavior in adolescents with autism spectrum disorder than in neurotypical controls adds to the complexity of previously published results. We recommend meta-analytic efforts to determine average effect sizes across studies and elucidate the conditions for prosocial behavior in ASD to occur.

Brief Reports: Influence of Friendship on Loneliness Among Adolescents with Autism Spectrum Disorders in Japan.

Previous studies have reported that people with autism spectrum disorder (ASD) have higher levels of loneliness than neurotypical (NTP) people, most likely because of their difficulties in social communication with their predominantly NTP peers. However, direct investigations on the causal influence of friendship on their feelings of loneliness is scarce. In the current study, using the causal mediation analysis, we investigated whether friendship among ASD individuals influences their feelings of loneliness, especially during adolescence when the importance of friendship is typically most elevated. Furthermore, we examined whether individual differences in autistic behavioral features or age affect feelings of loneliness or the qualities of friendship with linear regression analyses. The results demonstrated that the higher levels of loneliness in adolescents with ASD were mediated by one aspect of friendship, companionship. We also found that positive aspects of friendship, but not negative aspects, influence the feelings of loneliness in both ASD and NTP populations. One subcategory of the measured autistic trait, difficulty in imagination, which is associated the ability to consider another's perspective, had a negative relationship with the positive aspects of friendship in the ASD group, but not in the NTP group. These findings indicate that the quality of the positive aspects of friendship is similarly important for both adolescents with ASD and NTP adolescents, but the autistic behavioral features could interfere with the experience of such positive friendships.

Virtual Reality for Social Skills Training of Children and Adolescents with ASD: A Systematic Review

Autism spectrum disorder (ASD) is characterized by an inability to identify facial expressions and recognize other people's emotions. Individuals with ASD would struggle to give appropriate answers and have effective communication in social interactions. As a result, children and adolescents with ASD are vulnerable to isolation at school and have fewer opportunities to develop social relationships with peers. Virtual Reality (VR) has been studied and widely used in education for quite a long time. It is evidenced as an effective tool in social skills training for children and adolescents with ASD by improving their emotion recognition ability and social reciprocity. Furthermore, by imitating real-world circumstances, VR can provide repeatable social scenarios for ASD children and adolescents to explore safely. This paper followed PRISMA systematic review design to analyze imperial studies on social skills training for children and adolescents with ASD. A total of 276 participants were analyzed in the five selected articles from two hundred and fifteen records. The result showed that VR was effective and feasible for social skills interventions in all five studies.

Age differences and brain maturation provide insight into heterogeneous results in autism spectrum disorder.

Studies comparing individuals with autism spectrum disorder (ASD) to typically developing (TD) individuals have yielded inconsistent results. These inconsistencies reflect, in part, atypical trajectories of development in children and young adults with ASD compared to TD peers. These different trajectories alter group differences between children with and without ASD as they age. This paper first summarizes the disparate trajectories evident in our studies and, upon further investigation, laboratories using the same recruiting source. These studies indicated that cognition improves into adulthood typically, and is associated with the maturation of striatal, frontal, and temporal lobes, but these age-related improvements did not emerge in the young adults with ASD. This pattern - of improvement into adulthood in the TD group but not in the group with ASD - occurred in both social and non-social tasks. However, the difference between TD and ASD trajectories was most robust on a social task, face recognition. While tempting to ascribe this uneven deficit to the social differences in ASD, it may also reflect the prolonged typical development of social cognitive tasks such as face recognition into adulthood. This paper then reviews the evidence on age-related and developmental changes from other studies on ASD. The broader literature also suggests that individuals with ASD do not exhibit the typical improvements during adolescence on skills important for navigating the transition to adulthood. These skills include execution function, social cognition and communication, and emotional recognition and self-awareness. Relatedly, neuroimaging studies indicate arrested or atypical brain maturation in striatal, frontal, and temporal regions during adolescence in ASD. This review not only highlights the importance of a developmental framework and explicit consideration of age and/or stage when studying ASD, but also the potential importance of adolescence on outcomes in ASD.

Resting Heart Rate Variability and Emotion Dysregulation in Adolescents with Autism Spectrum Disorder.

Emotion dysregulation is common among individuals with autism spectrum disorder (ASD). This study examined the relationship between emotion dysregulation and resting heart rate variability (HRV), a marker of the autonomic nervous system, in ASD adolescents. Resting HRV data were collected from ASD (n = 23) and typically developing (TD) adolescents (n = 32) via short-term electrocardiogram. Parents/caregivers reported participants' level of emotion dysregulation with the Emotion Dysregulation Inventory (EDI). Controlling for the effects of age and gender, regression analyses revealed moderating effects of group, suggesting that lower resting HRV was more strongly associated with greater emotion dysregulation in ASD than TD adolescents. The results support the view that disruptions in autonomic functioning may contribute to emotion dysregulation in ASD.

Effect of Emotional Valence on Emotion Recognition in Adolescents with Autism Spectrum Disorder

This study investigated how emotional valence of a perceived emotional state impacted performance on the Reading the Mind in the Eyes task (RMET) in adolescents with autism spectrum disorder (ASD) and typically developing (TD) controls. Valence of items on the RMET, Adult (RMET-A) and Child (RMET-C) versions, was first classified in a survey of 113 medical students. Adolescents with ASD (N = 33) and TD adolescents (N = 30) were administered both RMET versions. Individuals with ASD made more errors than TD controls on positive and negative, but not neutral, valence items. The difference in performance was accentuated on the RMET-A compared to the RMET-C. Both emotional valence and complexity of language contribute to RMET performance in individuals with ASD.

Temporal processing deficit in children and adolescents with autism spectrum disorder: An online assessment.

The sensory deficit has been considered as one of the core features in children and adolescents with autism spectrum disorder (ASD). The present study aimed to examine the temporal processing of simple and more complex auditory inputs in ASD children and adolescents with an online assessment that can be conducted remotely. One hundred fifty-eight children and adolescents aged 5-17 years participated in this study, including 79 ASD participants and 79 typically developing (TD) participants. The online assessment consisted of two temporal-order judgment tasks that required repeating the sequence of two pure tones or consonant-vowel (CV) syllabic pairs at varying interstimulus intervals (ISIs). Significantly lower accuracy rates were found in ASD than TD participants in the pure tone and the CV conditions with both short and long ISI. In addition, ASD participants (M = 245.97 ms) showed a significantly higher passing threshold than TD participants (M = 178.84 ms) in the CV task. Receiver operating characteristic analysis found that the age × ISI passing threshold composite yielded a sensitivity of 74.7% and a specificity of 50.6% at the cutoff point of -0.307 in differentiating ASD participants from TD participants. In sum, children and adolescents with ASD showed impaired temporal processing of both simple and more complex auditory stimuli, and the online assessment seems to be sensitive in differentiating individuals with ASD from those with TD.

Learning and generalization of repetition-based rules in autism

Rule Learning (RL) allows us to extract and generalize high-order rules from a sequence of elements. Despite the critical role of RL in the acquisition of linguistic and social abilities, no study has investigated RL processes in Autism Spectrum Disorder (ASD). Here, we investigated RL in high-functioning autistic adolescents with ASD, examining whether their ability to extract and generalize rules from a sequence of visual elements is affected by the social vs. non-social nature of the stimulus and by visual working memory (WM). Using a forced-choice paradigm, ASD adolescents and typically developing (TD) peers were tested for their ability to detect and generalize high-order, repetition-based rules from visual sequences of simple non-social stimuli (shapes), complex non-social stimuli (inverted faces), and social stimuli (upright face). Both ASD and TD adolescents were able to generalize the rule they had learned to new stimuli, and their ability was modulated by the social nature of the stimuli and the complexity of the rule. Moreover, an association between RL and WM was found in the ASD, but not TD group, suggesting that ASD might have used additional or alternative strategies that relied on visual WM resources.

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

BackgroundPuberty is characterized by significant physical, hormonal, and psychological changes, which may be especially challenging for individuals with autism spectrum disorder (ASD). Although the etiology of ASD remains uncertain, studies suggest imbalances in hormones, such as testosterone, may modulate the autism phenotype. While differences in fetal and postnatal testosterone have been reported, there is limited literature regarding testosterone variations during adolescence in ASD. We investigated morning salivary testosterone levels in youth with ASD and typical development (TD) to explore hypothesized differences, expecting elevated hormonal levels in ASD compared to TD.MethodsYouth with ASD (n = 140) and TD (n = 104), ages 10 to 13 years, were enrolled as part of a longitudinal study on pubertal development. Pubertal stage was determined by gold standard physical examination, and salivary testosterone was collected in the morning immediately upon waking and 30 min after waking and averaged across 3 days. Diagnostic (ASD/TD) and sex (male/female) differences, as well as interactions with age and puberty, were examined using robust linear mixed effect models.ResultsYouth with ASD showed significantly elevated testosterone concentrations compared to same-age TD peers. After the inclusion of natural cubic splines to account for nonlinearity in age, a significant age-by-sex interaction emerged with distinct developmental slopes for males and females. At younger ages, females had higher testosterone, until about 11.5 years of age, when levels began to plateau, while male testosterone concentrations continued to rapidly increase and surpass females. As expected, more advanced pubertal development was associated with elevated testosterone. In contrast, no significant effect of parent-reported social communication symptoms was observed.LimitationsLimitations include an unequal sex distribution, non-representative sample (e.g., cognition and race/ethnicity), and inability to examine afternoon/evening testosterone due to detection limits.ConclusionsTestosterone may play a unique role in the presentation of ASD, especially during periods of dynamic hormonal changes including puberty. Inherent developmental (age, puberty) and sex-based (male, female) factors play a more prominent role in changes in testosterone levels during adolescence. Even so, future research is warranted to determine the differential expression and impact of exposure to excess testosterone during the pubertal transition for youth with ASD.