There is an old maxim in neuroscience, which states that anything that affects the normal brain affects the neurologically impaired brain to a greater extent. So usually fatigue, fever, injury, etc. will show up sooner and be more detrimental to a child with autism or other neurodevelopment disorders. Puberty, with its unleashing of hormones, is a difficult time for all children, but sometimes has a greater impact on children with autism. Longitudinal studies on children with autism find a setback in less than a forth of the children followed by recovery. In males I see an increase in aggression and in females difficulty in making decisions. I set up or re-initiate the ABA programs for compliance, which we run we often run with children with autism and related disorders when they first come into our clinic. In females I have found that birth control pills in addition to the compliance programs usually help.