Navigating adolescence: pubertal development in autism spectrum conditions and its relation to mental health

Adolescence is a period of social, psychological, and physiological change, including the onset of puberty. Differential pubertal onset has been linked to a myriad of problems, including mental health problems. Therefore, we aim to investigate deviating pubertal development in autism, and whether this is more pronounced in girls than in boys. A total of 68 individuals (n_ASC = 34, n_COM (comparisons) = 34) aged 12 to 16 years were administered test concerning pubertal development and mental health (i.e., sensory sensitivity, autistic traits, depression, anxiety, and externalizing problems). Frequentist and Bayesian ANOVA was used to examine deviations in pubertal development in ASC and possible sex effects. Regression analyses was used to test whether this asynchronicity was linked to mental health problems. Our (frequentist and Bayesian) analyses revealed earlier onset and slower development of pubertal development in ASC but we did not find any sex differences. Maturation disparity was linked to higher mental health problems in ASC, but not in COM. No sex differences in the relation with mental health outcomes was found. We found evidence for a slower development of "true" puberty in those with ASC compared to those without. Moreover, we show that disparities in pubertal development are related to mental health in ASC, suggesting a greater impact on mental health in autistic than in non-autistic teens. Longitudinal studies are necessary to elucidate important developmental trajectories in puberty in neurodiverse populations.