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

Abstract

Objective To determine the association between pubertal stage, sex and behavioural profile across and within neurodevelopmental disorders (NDDs) compared with typically developing (TD) youth.Methods 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.Results 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).Conclusions Internalising/externalising patterns of behaviours across pubertal stages did not differ based on diagnosis. Pubertal females are at higher risk for internalising behaviours.