Pubertal stage, sex and behaviour in neurodevelopmental disorders versus typical development: a cross-sectional study

To determine the association between pubertal stage, sex and behavioural profile across and within neurodevelopmental disorders (NDDs) compared with typically developing (TD) youth.

This was a cross-sectional study from the Province of Ontario Neurodevelopmental Disorders network, including children/youth with various NDDs and TD controls. Caregivers completed the Child Behavior Checklist (CBCL). Participants were grouped into three puberty stages: prepuberty (Tanner stage 1), early puberty (Tanner stages 2-3) and late puberty (Tanner stages 4-5). The association between pubertal stage and CBCL scores was assessed controlling for sex and diagnosis.

The analysis included 1043 participants (male=733; 70.3%). A three-way interaction between pubertal status, sex and diagnosis was not significant for internalising or externalising behaviour. Diagnosis was significantly associated with CBCL scores for both internalising (p<0.0001) and externalising (p<0.0001) behaviours, with lower scores for TD children than for NDD groups. Late pubertal females showed higher levels of internalising behaviour compared with prepubertal females (p=0.001); males showed no differences. Early pubertal males showed lower levels of externalising behaviour compared with prepubertal males (p=0.01); early pubertal females trended towards higher levels compared with prepubertal females (p=0.051).

Internalising/externalising patterns of behaviours across pubertal stages did not differ based on diagnosis. Pubertal females are at higher risk for internalising behaviours.