Parent-Child Concordance on the Pubertal Development Scale in Typically Developing and Autistic Youth.
Autistic boys and their parents often disagree on puberty milestones, so always gather both reports before making clinical choices.
01Research in Context
What this study did
Clawson et al. (2020) asked parents and their sons to fill out the Pubertal Development Scale. The group had autistic boys and typically-developing boys aged 8-18.
They wanted to know if the two sides tick the same boxes for body hair growth, voice change, skin changes, and growth spurts.
What they found
Overall, both groups showed the same level of parent-son match. But when they looked item-by-item, autistic sons agreed less with their parents on adrenal signs (body hair, skin oil) and gonadal signs (voice, growth).
The gap was big enough to matter in clinic notes.
How this fits with other research
Johnson et al. (2009) and Lerner et al. (2012) already showed autistic youth often rate themselves as more socially skilled than parents see. Clawson et al. (2020) extends that pattern into physical development.
James et al. (2023) found the same sex-linked gap in toddlers: parents of boys with ASD rate language lower than testers do. The male-specific disagreement starts early and stays.
Sirao et al. (2026) will pool all puberty-in-ASD papers and say most kids follow typical timing. Ann’s work warns that even when timing is normal, the data you trust may differ by informant.
Why it matters
If you use the Pubertal Development Scale to track hormones or plan interventions, collect both parent and youth forms. When scores clash, ask follow-up questions instead of picking one. This guards against missing early adrenal signs in autistic males and keeps treatment plans grounded in real body changes, not just one point of view.
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02At a glance
03Original abstract
BACKGROUND: Characterizing puberty in autism spectrum disorder (ASD) is critical given the direct impacts of pubertal progression on neural, cognitive, and physical maturation. Limited information is available about the utility and parent-child concordance of the self-report and parent-report Pubertal Development Scale (PDS) in ASD, an economical and easily administered measure. METHOD: The primary aim of this study was to examine the concordance between self-report and parent-report PDS ratings in autistic males and females ages 8-17y compared to typically developing (TD) youth, including using the PDS to derive informant-based estimates of adrenal and gonadal development. We hypothesized that there would be greater parent-youth discrepancies in pubertal ratings among autistic males. Our second aim was exploratory; we examined whether individual characteristics impact PDS concordance and hypothesized that lower intellectual and adaptive skills, higher autistic traits, and reduced self-awareness/monitoring would correlate with lower concordance. RESULTS: There were no significant diagnostic group differences in parent-youth concordance for overall PDS scores among males and females. Autistic males had significantly lower inter-item agreement with their parents than TD males and had lower agreement for both adrenal and gonadal aspects of pubertal maturation (adrenal κ=.48; gonadal κ=.55). CONCLUSIONS: The PDS is a feasible measure in ASD. Greater parent-youth discrepancies in autistic males may be due to reduced parental awareness or reduced insight into pubertal maturation among autistic males. Future research is needed to further elucidate individual and/or environmental characteristics that influence youth- and parent-reported PDS scores, including differences in self-perception and insight.
Research in autism spectrum disorders, 2020 · doi:10.1037//0022-006X.68.6.1038