Autism spectrum disorders (ASD) are neurodevelopmental conditions characterized by impairment in social communication and presence of stereotyped/restricted behaviors. Children with ASD very often demonstrate co-morbid psychiatric problems, problems known to be affected by testosterone in neurotypical populations. However, there are few reports investigating relationships between testosterone and psychiatric conditions in children with ASD. The aim of this study was to determine the relationship between plasmatic levels of testosterone and behavioral/emotional problems in pre-pubertal boys with ASD. The study sample consisted of 31 pre-pubertal boys (ages 3-10) with ASD. Parents completed the Nisonger Child Behavior Rating Form (NCBRF) to assess specific behavioral/emotional problems as observed in the previous 2 months. Plasmatic testosterone levels were determined in boys according to standardized procedures. It was found that there were positive correlations between testosterone levels and the conduct problems subscale (p=0.034, rs=0.382) of NCBRF and also between testosterone levels and the hyperactive subscale (p=0.025, rs=0.402) of NCBRF. Findings in this study are in line with research conducted in the neurotypical population. This is the first large study investigating testosterone and emotional/behavioral problems in ASD and warrants further research in this field in order to clarify the etiopathogenesis of psychiatric co-morbidities and improve their treatment.

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Children with autism spectrum disorders (ASD) have a high rate of irritability and aggressive symptoms which have signifi cant impact on their lives, families and society. The etiology of aggression in humans is likely complex and includes both biological and behavioral causes. Biological approaches have focused on hormones and neurotransmitters that are hypothesized to contribute to the etiology and clinical manifestation of aggressive behavior in humans. Testosterone is a male sex hormone and some studies suggest that it can play a role in the complex etiology of aggressive behavior. Two specifi c subtypes of aggression have been identifi ed: explosive and non-explosive. Explosive aggression is accompanied by a raged affect and is usually more dangerous and not immediately responsive to behavioral treatment. We propose that individuals with ASD and explosive aggression will have higher androgen activity and higher arousal than neurotypical children and children with ASD without explosive aggression. We employed a unique method for aggression assessment-functional behavioral analysis-to obtain objective and quantitative measures of aggression and arousal signs. In our pilot study, we proposed to determine bio-behavioral model of explosive aggression in children with ASD which will predict which children will be most responsive to antiandrogen therapy and behavioral therapy (Tab. 1, Fig. 1

The aim of this study was to compare testosterone level with clinical features of problem behavior in children with ASD. Methods: The study sample consisted of 35 pre-pubertal boys with clinical diagnosis of ASD. In all children (ages 3-10) diagnosed as ASD, parents completed Nisonger Child Behavior Rating Form (NCBRF) (version for intellectual disabilities)-parent version.Rating scale assessed child´s behavior as observed in previous 1-2 months. Specific problem behavior was rated on subscales for conduct problems, anxiety, hyperactivity, self-injury/stereotypic behavior, self-isolated/ritualistic and overly sensitive. On this rating form parents also assessed social behavior: compliant behavior and adaptive social behavior. Total serum testosterone levels were determined after the parents completed rating forms, according to standardized procedure. Results:It was found positive correlation between total serum testosterone levels and conduct problem subscale (p=0.007, r=0.445) and as well as total serum testosterone levels and overly sensitive subscale (p=0.03, r=0.348) of NCBRF. In other subscalesof NCBRF(problem behavior or social behavior) were no significant correlations. Conclusions: The results suggest that there might be some relationship between problem behavior (specifically conduct problems and overal sensitivity) and testosterone levels in boys with ASD. Testosterone levels had no significant correlation with other subscales of NCBRF. However further research is needed for investigation of complex androgen activity (free TST levels, SHBD levels) and potential roles of other hormones in complex etiology of conduct problems and overall sensitivity in children with ASD. This findings rise interest in further investigation of relationship between testosterone and conduct problems and overall sensitivity in children with ASD and indicate that therapeutic strategies targeting testosteronecould be useful in the treatment of problem behaviors in children with ASD.