Advances in Autism Research
compiled by Teresa Binstock
for Autism Research Institute
April 2008
Autism and Hormones
An important thread in autism research explores the role of hormones. A subgroup of mothers and a subgroup of autistic children are described as having hormone imbalance shifted towards elevated testosterone. Three major concerns arise. Firstly, hormones shape how the CNS develops. Secondly, elevated testosterone has been linked with impaired detoxification of heavy metals. Thirdly, endocrine-disrupting chemicals (EDCs) merit attention because many autism parents - along with many other parents - are reporting either hypospadias in a male child or early puberty in girls.
Autism and Testosterone
1: Elevated rates of testosterone-related disorders in women with autism spectrum conditions
Ingudomnukul E et al.
Horm Behav. 2007 May;51(5):597-604.
The androgen theory of autism proposes that autism spectrum conditions (ASC) are in part due to elevated fetal testosterone (FT) levels, which are positively correlated with a number of autistic traits and inversely correlated with social development and empathy. A medical questionnaire was completed by n=54 women with ASC, n=74 mothers of children with ASC, and n=183 mothers of typically developing children to test whether women with ASC have an increased rate of testosterone-related medical conditions, and to see whether mothers of children with ASC show similar abnormalities, as part of the 'broader autism phenotype'. Compared to controls, significantly more women with ASC reported (a) hirsutism, (b) bisexuality or asexuality, (c) irregular menstrual cycle, (d) dysmenorrhea, (e) polycystic ovary syndrome, (f) severe acne, (g) epilepsy, (h) tomboyism, and (i) family history of ovarian, uterine, and prostate cancers, tumors, or growths. Compared to controls, significantly more mothers of ASC children reported (a) severe acne, (b) breast and uterine cancers, tumors, or growths, and (c) family history of ovarian and uterine cancers, tumors, or growths. These results suggest current hormone abnormalities in women with ASC and their mothers. Direct investigations of serum testosterone levels and genetic susceptibility to high testosterone production or sensitivity in women with ASC would illuminate the origin of these conditions. The relationship between FT and current testosterone levels also needs to be clarified. The present results may be relevant to understanding the increased male risk to developing autism.
PMID: 17462645
2. A prospective assessment of androgen levels in patients with autistic spectrum disorders: biochemical underpinnings and suggested therapies
Geier DA, Geier MR.
Neuro Endocrinol Lett. 2007 Oct;28(5):565-73.
Impairments in social relatedness and communication, repetitive behaviors, abnormal movement patterns, and sensory dysfunction characterize autism spectrum disorders (ASDs). Seventy consecutive patients with an ASD diagnosis (DSM-IV criteria, >/= 6 years-old) who presented to the Genetic Centers of America for outpatient genetic/developmental evaluations from 2005-2007 were examined. Patients were evaluated using CLIA-approved Laboratory Cooperation of America (LabCorp) testing for: serum testosterone, serum free testosterone, % free testosterone, serum/plasma dehydroepiandrosterone (DHEA), androstendione, and follicle-stimulating hormone (FSH). Morning blood samples collected following an overnight fast, compared to the pertinent reference means, showed significantly increased relative mean levels for: serum testosterone (158%), serum free testosterone (214%), percent free testosterone (121%), DHEA (192%), and androstenedione (173%). By contrast, compared to the pertinent reference mean, the relative mean level of FSH (51%) was significantly decreased. Additionally, at least one of the androgen attributes examined exceeded its recognized laboratory age- and sex-specific reference range in 81.4% (57 of 70) of the patients examined. With respect to their age- and sex-specific reference ranges, females had significantly higher overall mean relative testosterone and relative free testosterone levels than males. Increased androgens in patients diagnosed with ASDs may involve cyclical interactions between the androgen and the transsulfuration pathways, particularly following mercury exposure. A review of therapies that have significantly improved clinical outcomes in ASD patients indicates they share commonality in helping lower androgens. Thus, androgens should be routinely clinically measured in patients with an ASD diagnosis and appropriate androgen-lowering therapies considered for those who have significantly elevated levels.
PMID: 17984958
3: Fetal testosterone and sex differences in typical social development and in autism
Knickmeyer RC, Baron-Cohen S.
J Child Neurol. 2006 Oct;21(10):825-45.
Experiments in animals leave no doubt that androgens, including testosterone, produced by the testes in fetal and/or neonatal life act on the brain to induce sex differences in neural structure and function. In human beings, there is evidence supporting a female superiority in the ability to read nonverbal signals, specific language-related skills, and theory of mind. Even more striking than the sex differences seen in the typical population is the elevated occurrence of social and communicative difficulties in human males. One such condition, autism, occurs four times more frequently in boys than in girls. Recently, a novel theory known as the "extreme male brain" has been proposed. It suggests that the behaviors seen in autism are an exaggeration of typical sex differences and that exposure to high levels of prenatal testosterone might be a risk factor. In this article, we argue that prenatal and neonatal testosterone exposures are strong candidates for having a causal role in sexual dimorphism in human behavior, including social development, and as risk factors for conditions characterized by social impairments, particularly autism spectrum conditions.
PMID: 17005117
4: Androgens and autistic traits: A study of individuals with congenital adrenal hyperplasia
Knickmeyer R et al.
Horm Behav. 2006 Jun;50(1):148-53.
Testosterone promotes male-typical neural and behavioral development in non-human mammals. There is growing evidence that testosterone exerts similar influences on human development, although the range of behaviors affected is not completely known. This study examined the hypothesis that autistic traits are increased following prenatal exposure to abnormally high levels of testosterone caused by congenital adrenal hyperplasia (CAH). Sixty individuals with CAH (34 female, 26 male) and 49 unaffected relatives (24 female, 25 male) completed the Autism Spectrum Quotient (AQ). Females with CAH scored significantly higher than unaffected females on total AQ score, largely due to enhanced scores on subscales measuring social skills and imagination. These results suggest that prenatal exposure to high levels of testosterone influences some autistic traits and that hormonal factors may be involved in vulnerability to autism.
PMID: 16624315
5. Sex differences in the brain: implications for explaining autism
Baron-Cohen S et al.
Science. 2005 Nov 4;310(5749):819-23.
Empathizing is the capacity to predict and to respond to the behavior of agents (usually people) by inferring their mental states and responding to these with an appropriate emotion. Systemizing is the capacity to predict and to respond to the behavior of nonagentive deterministic systems by analyzing input-operation-output relations and inferring the rules that govern such systems. At a population level, females are stronger empathizers and males are stronger systemizers. The "extreme male brain" theory posits that autism represents an extreme of the male pattern (impaired empathizing and enhanced systemizing). Here we suggest that specific aspects of autistic neuroanatomy may also be extremes of typical male neuroanatomy.
PMID: 16272115
6. Further evidence that some male-based neurodevelopmental disorders are associated with high intrauterine testosterone concentrations
James WH.
Dev Med Child Neurol. 2008 Jan;50(1):15-8.
It has been suggested that reading disability (RD), autism spectrum disorder (ASD), and attention-deficit-hyperactivity disorder (ADHD) share a measure of genetic overlap. They also share some epidemiological features, and have all been suspected of multifactorial (genetic and environmental) threshold origins. It has also been hypothesized that ASD, pervasive developmental disorder - not otherwise specified, and ADHD are partially caused by high maternal intrauterine testosterone levels. Here I offer a new method of testing this latter hypothesis on some of these disorders (RD, ADHD, and ASD). All these disorders occur more commonly in males. If the intrauterine testosterone hypothesis was correct, then probands should have a statistically significant excess of brothers among their siblings. Data are adduced here to test this. When treated as individual disorders, the data are significant only in the case of RD. However, the data are highly significant when pooled as RD + ADHD or RD + ADHD + ASD. Taken alone, the data on ASD are not significant. These results suggest that: (1) taxonomically, RD and ADHD are more similar to one another than either is to ASD; and (2) probands in the pooled samples have a very highly significant excess of brothers. This result stands in need of explanation. Provisionally, the data may be interpreted as suggesting that RD may be caused by high intrauterine testosterone levels, and confirming the hypothesis that ADHD is partially caused by high intrauterine testosterone.
PMID: 18173623
7. Sex-typical Play: Masculinization/Defeminization in Girls with an Autism Spectrum Condition
Knickmeyer RC, Wheelwright S, Baron-Cohen SB.
J Autism Dev Disord. 2007 Nov 6
We tested the hypothesis that prenatal masculinization of the brain by androgens increases risk of developing an autism spectrum condition (ASC). Sex-typical play was measured in n = 66 children diagnosed with an ASC and n = 55 typically developing age-matched controls. Consistent with the hypothesis, girls with autism did not show the female-typical play preferences, though this was only seen on non-pretence items. Boys with autism showed a preference for male play on non-pretence items, in keeping with their sex. Girls with autism engaged in more pretend play than boys with autism, suggesting that pretence is relatively more protected in females with autism. We conclude that play preference studies in ASC provide partial support for the fetal androgen theory.
PMID: 17985222
8: Effects of perinatal exposure to PCBs and dioxins on play behavior in Dutch children at school age
Vreugdenhil HJ et al.
Environ Health Perspect. 2002 Oct;110(10):A593-8.
http://www.ehponline.org/members/2002/110pA593A598vreugdenhil/EHP110pa593PDF.PDF
Polychlorinated biphenyls (PCBs) and dioxins are known as neurotoxic compounds that may modulate sex steroid hormones. Steroid hormones play a mediating role in brain development and may influence behaviors that show sex differences, such as childhood play behavior. In this study we evaluated the effects of perinatal exposure to environmental levels of PCBs and dioxins on childhood play behavior and whether the effects showed sex differences. As part of the follow-up to the Dutch PCB/dioxin study at school age, we used the Pre-School Activity Inventory (PSAI) to assess play behavior in the Rotterdam cohort (n = 207). The PSAI assesses masculine or feminine play behavior scored on three subscales: masculine, feminine, and composite. Prenatal exposure to PCBs was defined as the sum of PCB 118, 138, 153, and 180 in maternal and cord plasma and breast milk. For breast milk we measured additional PCBs as well as 17 dioxins. Respondents returned 160 questionnaires (age 7.5 years +/- 0.4). Effects of prenatal exposure to PCBs, measured in maternal and cord plasma, on the masculine and composite scales were different for boys and girls (p <.05). In boys, higher prenatal PCB levels were related with less masculinized play, assessed by the masculine scale (p(maternal) =.042; p(cord) =.001) and composite scale (p(cord) =.011), whereas in girls higher PCB levels were associated with more masculinized play, assessed by the composite scale (p(PCBmilk) =.028). Higher prenatal dioxin levels were associated with more feminized play in boys as well as girls, assessed by the feminine scale (p =.048). These effects suggest prenatal steroid hormone imbalances caused by prenatal exposure to environmental levels of PCBs, dioxins, and other related organochlorine compounds.
PMID: 12361940
9: The systemizing quotient: an investigation of adults with Asperger syndrome or high-functioning autism, and normal sex differences
Baron-Cohen S et al.
Philos Trans R Soc Lond B Biol Sci. 2003 Feb 28;358(1430):361-74.
http://journals.royalsociety.org/content/7qualqx5ftwj6e94/fulltext.pdf
Systemizing is the drive to analyse systems or construct systems. A recent model of psychological sex differences suggests that this is a major dimension in which the sexes differ, with males being more drawn to systemize than females. Currently, there are no self-report measures to assess this important dimension. A second major dimension of sex differences is empathizing (the drive to identify mental states and respond to these with an appropriate emotion). Previous studies find females score higher on empathy measures. We report a new self-report questionnaire, the Systemizing Quotient (SQ), for use with adults of normal intelligence. It contains 40 systemizing items and 20 control items. On each systemizing item, a person can score 2, 1 or 0, so the SQ has a maximum score of 80 and a minimum of zero. In Study 1, we measured the SQ of n = 278 adults (114 males, 164 females) from a general population, to test for predicted sex differences (male superiority) in systemizing. All subjects were also given the Empathy Quotient (EQ) to test if previous reports of female superiority would be replicated. In Study 2 we employed the SQ and the EQ with n = 47 adults (33 males, 14 females) with Asperger syndrome (AS) or high-functioning autism (HFA), who are predicted to be either normal or superior at systemizing, but impaired at empathizing. Their scores were compared with n = 47 matched adults from the general population in Study 1. In Study 1, as predicted, normal adult males scored significantly higher than females on the SQ and significantly lower on the EQ. In Study 2, again as predicted, adults with AS/HFA scored significantly higher on the SQ than matched controls, and significantly lower on the EQ than matched controls. The SQ reveals both a sex difference in systemizing in the general population and an unusually strong drive to systemize in AS/HFA. These results are discussed in relation to two linked theories: the 'empathizing-systemizing' (E-S) theory of sex differences and the extreme male brain (EMB) theory of autism.
PMID: 12639333
10: Sex differences in eye gaze and symbolic cueing of attention
Bayliss AP et al.
Q J Exp Psychol A. 2005 May;58(4):631-50.
Observing a face with averted eyes results in a reflexive shift of attention to the gazed-at location. Here we present results that show that this effect is weaker in males than in females (Experiment 1). This result is predicted by the 'extreme male brain' theory of autism (Baron-Cohen, 2003), which suggests that males in the normal population should display more autism-like traits than females (e.g., poor joint attention). Indeed, participants' scores on the Autism-Spectrum Quotient (Baron-Cohen, Wheelwright, Stott, Bolton, & Goodyear, 2001) negatively correlated with cueing magnitude. Furthermore, exogenous orienting did not differ between the sexes in two peripheral cueing experiments (Experiments 2a and 2b). However, a final experiment showed that using nonpredictive arrows instead of eyes as a central cue also revealed a large gender difference. This demonstrates that reduced orienting from central cues in males generalizes beyond gaze cues. These results show that while peripheral cueing is equivalent in the male and female brains, the attention systems of the two sexes treat noninformative symbolic cues very differently.
PMID: 16104099
11: Gaze and arrow cueing of attention reveals individual differences along the autism spectrum as a function of target context
Bayliss AP, Tipper SP.
Br J Psychol. 2005 Feb;96(Pt 1):95-114.
Observing averted gaze results in a reflexive shift of attention to the gazed-at location. In two experiments, participants scoring high and low on the Autism-Spectrum Quotient questionnaire (AQ; Baron-Cohen, Wheelwright, Skinner, Martin, & Clubley, 2001) observed arrow and gaze cues to investigate cueing effect magnitude as a function of the context in which peripheral targets could appear. While identical cueing effects were found with gaze and arrow cues, the more striking results concerned target stimuli. In Experiment 1, targets could appear on a peripheral face, or on scrambled face parts. Overall, greater cueing effects were found when the target appeared on a face. However, this face bias was only observed in participants with low AQ scores, whereas high AQ scorers oriented more to scrambled features. Experiment 2 found equal cueing to targets appearing on tools, as compared with tool parts. However, individual differences were again observed, where low AQ scorers showed larger cueing towards tools, while high scorers oriented more to scrambled parts, as in Experiment 1. These results support the idea that low AQ individuals orient strongly to objects attended by others. However, since the same results were found for arrow cues, this effect may generalize to all central cues to attention. High AQ scorers possessing many more autistic-like traits tended to orient more to scrambled shapes, perhaps reflecting a bias for orienting to local details.
PMID: 15826326
12: Social stimuli interfere with cognitive control in autism
Dichter GS, Belger A.
Neuroimage. 2007 Apr 15;35(3):1219-30. free online
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1885863&blobtype=pdf
Autism spectrum disorders are characterized by cognitive control deficits as well as impairments in social interactions. However, the brain mechanisms mediating the interactive effects of these deficits have not been addressed. We employed event-related functional magnetic resonance imaging (fMRI) to examine the effects of processing directional information from faces on activity within brain regions mediating cognitive control. High-functioning individuals with autism and age-, gender-, and IQ-matched neurotypical individuals attended to the direction of a centrally-presented arrow or gaze stimulus with similar flanker stimuli oriented in the same ("congruent") or opposite ("incongruent") direction. The incongruent arrow condition was examined to assess functioning of brain regions mediating cognitive control in a context without social-cognitive demands, whereas the incongruent gaze condition assessed functioning of the same brain regions in a social-cognitive context. Consistent with prior studies, the incongruent arrow condition recruited activity in bilateral midfrontal gyrus, right inferior frontal gyrus, bilateral intraparietal sulcus, and the anterior cingulate relative to the congruent arrow condition in neurotypical participants. Notably, there were not diagnostic group differences in patterns of regional fMRI activation in response to the arrow condition. However, while viewing the incongruent gaze stimuli, although neurotypical participants recruited the same brain regions, participants with autism showed marked hypoactivation in these areas. These findings suggest that processing social-cognitive stimuli interferes with functioning of brain regions recruited during cognitive control tasks in autism. Implications for research into cognitive control deficits in autism are discussed.
PMID: 17321151
13: The empathy quotient: an investigation of adults with Asperger syndrome or high functioning autism, and normal sex differences
Baron-Cohen S, Wheelwright S.
J Autism Dev Disord. 2004 Apr;34(2):163-75.
Empathy is an essential part of normal social functioning, yet there are precious few instruments for measuring individual differences in this domain. In this article we review psychological theories of empathy and its measurement. Previous instruments that purport to measure this have not always focused purely on empathy. We report a new self-report questionnaire, the Empathy Quotient (EQ), for use with adults of normal intelligence. It contains 40 empathy items and 20 filler/control items. On each empathy item a person can score 2, 1, or 0, so the EQ has a maximum score of 80 and a minimum of zero. In Study 1 we employed the EQ with n = 90 adults (65 males, 25 females) with Asperger Syndrome (AS) or high-functioning autism (HFA), who are reported clinically to have difficulties in empathy. The adults with AS/HFA scored significantly lower on the EQ than n = 90 (65 males, 25 females) age-matched controls. Of the adults with AS/HFA, 81% scored equal to or fewer than 30 points out of 80, compared with only 12% of controls. In Study 2 we carried out a study of n = 197 adults from a general population, to test for previously reported sex differences (female superiority) in empathy. This confirmed that women scored significantly higher than men. The EQ reveals both a sex difference in empathy in the general population and an empathy deficit in AS/HFA.
PMID: 15162935
14. Visuo-spatial Processing in Autism-Testing the Predictions of Extreme Male Brain Theory
Falter CM et al.
J Autism Dev Disord. 2008 Mar;38(3):507-15.
It has been hypothesised that autism is an extreme version of the male brain, caused by high levels of prenatal testosterone (Baron-Cohen 1999). To test this proposal, associations were assessed between three visuo-spatial tasks and prenatal testosterone, indexed in second-to-fourth digit length ratios (2D:4D). The study included children with Autism Spectrum Disorder, ASD (N = 28), and chronological as well as mental age matched typically-developing children (N = 31). While the group with ASD outperformed the control group at Mental Rotation and Figure-Disembedding, these group differences were not related to differences in prenatal testosterone level. Previous findings of an association between Targeting and 2D:4D were replicated in typically-developing children and children with ASD. The implications of these results for the extreme male brain (EMB) theory of autism are discussed.
PMID: 17674175
15. Differences in finger length ratio between males with autism, pervasive developmental disorder-not otherwise specified, ADHD, and anxiety disorders
de Bruin EI et al.
Dev Med Child Neurol. 2006 Dec;48(12):962-5.
Children with autism have a relatively shorter index finger (2D) compared with their ring finger (4D). It is often presumed that the 2D:4D ratio is associated with fetal testosterone levels and that high fetal testosterone levels could play a role in the aetiology of autism. It is unknown whether this effect is specific to autism. In this study, 2D:4D ratios of 144 males aged 6 to 14 years (mean age 9y 1 mo [SD 1y 11 mo]) with psychiatric disorders were compared with those of 96 males aged 6 to 13 years from the general population (mean age 9y 1 mo [SD 1y 10 mo]). Psychiatric disorders were divided into autism/Asperger syndrome (n=24), pervasive developmental disorder-not otherwise specified (PDD-NOS; n=26), attention-deficit-hyperactivity disorder (ADHD)/oppositional defiant disorder (ODD; n=68), and anxiety disorders (n=26). Males with autism/Asperger syndrome (p<0.05) and ADHD/ODD (p<0.05) had significantly lower (though not significantly; p=0.52) ratios than males with an anxiety disorder, and males with autism/Asperger syndrome had lower ratios than those in the comparison group. These results indicated that higher fetal testosterone levels may play a role, not only in the origin of autism, but also in the aetiology of PDD-NOS and of ADHD/ODD. Males with anxiety disorders might have been exposed to lower prenatal testosterone levels.
PMID: 17109783
16: Maternal smoking during pregnancy and possible effects of in utero testosterone: evidence from the 2D:4D finger length ratio
Rizwan S et al.
Early Hum Dev. 2007 Feb;83(2):87-90.
OBJECTIVES: Maternal smoking during pregnancy is linked to high fetal testosterone (FT), and an increased risk in offspring for autism, ADHD, conduct disorder, antisocial behaviour and criminal outcomes. The ratio of the length of the 2nd and 4th fingers (2D:4D) is thought to be negatively related to FT concentration, and is related to autism, hyperactivity, poor social behaviour, and physical aggression. We compare the 2D:4D ratio of children whose mothers smoked during pregnancy with the 2D:4D of children whose mother did not smoke. METHOD: Cross-sectional survey in two primary schools. Questionnaires were distributed to 710 children and 546 were returned. Of these the 2nd and 4th digits of 520 children (259 females and 261 males) were measured. The main outcome measures were 2nd and 4th digit length, smoking history of mother and father. RESULTS: Boys had lower mean 2D:4D than girls and right 2D:4D was lower than left. Among boys, those whose mother's smoked during pregnancy had lower right hand 2D:4D ratio than those whose mother did not smoke. The difference remained significant after the effects of age, height, weight and birth weight were removed. Other household smoking patterns were not associated with male offspring 2D:4D. Female offspring 2D:4D did not differ on the basis of maternal smoking. CONCLUSIONS: Maternal smoking during pregnancy was associated with low right 2D:4D in children, but the effect was restricted to boys. A link between maternal smoking during pregnancy and 2D:4D supports a causal association between FT and such behaviours as hyperactivity and conduct disorder.
PMID: 16814493
17. Motion and form coherence detection in autistic spectrum disorder: Relationship to motor control and 2:4 digit ratio
Milne E et al.
J Autism Dev Disord. 2006 Feb;36(2):225-37
Children with autistic spectrum disorder and controls performed tasks of coherent motion and form detection, and motor control. Additionally, the ratio of the 2nd and 4th digits of these children, which is thought to be an indicator of foetal testosterone, was measured. Children in the experimental group were impaired at tasks of motor control, and had lower 2D:4D than controls. There were no group differences in motion or form detection. However a sub-group of children with autism were selectively impaired at motion detection. There were significant relationships between motion coherence detection and motor control in both groups of children, and also between motion detection, fine motor control and 2D:4D in the group of children with autistic spectrum disorder.
PMID: 16477516
18. Fetal testosterone and empathy
Knickmeyer R et al.
Horm Behav. 2006 Mar;49(3):282-92.
BACKGROUND: In animals, fetal testosterone (fT) plays a central role in organizing the brain and in later social behavior. In humans, exposure to atypical levels of prenatal androgens may result in masculine behavior and ability patterns. Normal inter-individual variation in fT levels has also been correlated with later sex-typed behavior. METHODS: In the current study, 38 children (24 male, 14 female), whose fT was analyzed in amniotic fluid, were followed up at age 4. They were asked to describe cartoons with 2 moving triangles whose interactions with each other suggested social relationships and psychological motivations. RESULTS: Females used more mental and affective state terms to describe the cartoons than males. fT was not associated with the frequency of mental or affective state terms. Females also used more intentional propositions than males. fT was negatively correlated with the frequency of intentional propositions, taking sex differences into account. fT was also negatively correlated with the frequency of intentional propositions when males were examined separately. Males used more neutral propositions than females. fT was directly correlated with the frequency of neutral propositions, taking sex differences into account. This relationship was not seen when males and females were examined separately. CONCLUSIONS: These findings implicate fT in human social development. The relevance of our findings to the 'extreme male brain' theory of autism is also discussed.
PMID: 16226265
19: Foetal testosterone, social relationships, and restricted interests in children
Knickmeyer R et al.
J Child Psychol Psychiatry. 2005 Feb;46(2):198-210.
BACKGROUND: Sex-differences exist in some areas of human social behaviour. In animals, foetal testosterone (fT) plays a central role in organising the brain and in later social behaviour. fT has also been implicated in language development, eye-contact, and spatial ability in humans. METHODS: Fifty-eight children (35 male and 23 female), whose fT was analysed in amniotic fluid, were followed up at age 4. Their mothers completed the Children's Communication Checklist, a questionnaire assessing language, quality of social relationships and restricted interests. RESULTS: fT was negatively correlated to quality of social relationships, taking sex-differences into account. fT was also positively correlated with restricted interests in boys. CONCLUSIONS: These findings implicate fT in both social development and attentional focus. They may also have implications for understanding the sex ratio in autism.
PMID: 15679528
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