TraCS KL2 Scholar awarded NIH grant to study sex-specific trajectories in Autism Spectrum Disorder

Clare Harrop receives 5-year NIH award to study sex-specific trajectories in Autism Spectrum Disorder

Clare Harrop, Assistant Professor in the Department of Allied Health Sciences, has received a 5-year, $3.28 million R01 award from the NIH (Eunice Kennedy Shriver National Institute of Child Health & Human Development) to chart the impact of assigned sex at birth on developmental trajectories in young autistic children. The objective of the project is to characterize how development in autism varies by assigned sex with the goal of informing future sex-sensitive screening protocols and providing evidence for sex- and gender-sensitive interventions that better address the needs of autistic females.

"Autism is diagnosed at a rate of four males to one female, so we know considerably less about the profiles and trajectories of autistic females," says Harrop. "However, there is a growing consensus that females are underdiagnosed and understudied, potentially due to differences in how autism presents in females. What we do know comes from small, single time-point studies which prevent our understanding of how autistic males and females may differ over time and during different developmental periods."

Harrop, with UNC-Chapel Hill collaborators Daniel Bauer (Psychology and Neuroscience), Heather Hazlett (Psychiatry) and Rebecca Grzadzinski (Psychiatry), will study the developmental trajectories of young autistic females and males, as well as non-autistic peers, using multiple methods within an accelerated longitudinal design.

"Such a design allows us to extend our previous findings to a larger sample and provide a novel way to chart development in harder to reach groups, such as autistic females," says Harrop.

The project will also collaborate with John Strang (Children's National Hospital) to study how gender impacts development, and with Julia Parish-Morris (Children's Hospital of Philadelphia) to chart the emergence of camouflaging behaviors in autism.

"Autistic youth and adults are more likely to experience gender diversity than non-autistic youth. But no study has charted the early development of gender in autism," says Harrop. "Additionally, autistic individuals, particularly females, are more likely to employ certain behaviors, such as making eye contact or small talk, to mitigate some of their day-to-day challenges. We know this can have profound downstream effects on mental health."

Harrop's project builds on her previous work funded by the Autism Science Foundation and a NC TraCS Career Development Award (KL2). She and her team will begin recruitment for the study in early 2022.

"We are incredibly excited to start this research. Our goal for a number of years has been to recruit and follow a large, longitudinal cohort of females through key developmental periods. This is the first stage and we hope to extend our work to non-binary youth in the future. We hope this work can contribute in meaningful ways to the lives of autistic females and their families."