A Two-Hit Model of Autism: Adolescence As the Second Hit

Overview

Journal Clin Psychol Sci

Publisher Sage Publications

Specialty Psychiatry

Date 2015 Nov 27

PMID 26609500

Citations 85

Authors

Giorgia Picci

K Suzanne Scherf

Affiliations

Soon will be listed here.

Abstract

Adolescence brings dramatic changes in behavior and neural organization. Unfortunately, for some 30% of individuals with autism, there is marked decline in adaptive functioning during adolescence. We propose a two-hit model of autism. First, early perturbations in neural development function as a "first hit" that sets up a neural system that is "built to fail" in the face of a second hit. Second, the confluence of pubertal hormones, neural reorganization, and increasing social demands during adolescence provides the "second hit" that interferes with the ability to transition into adult social roles and levels of adaptive functioning. In support of this model, we review evidence about adolescent-specific neural and behavioral development in autism. We conclude with predictions and recommendations for empirical investigation about several domains in which developmental trajectories for individuals with autism may be uniquely deterred in adolescence.

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