Autism Spectrum Disorder in Adolescence

Adolescence is a challenging time even for typically developing teens. For adolescents with ASD, it becomes a period where biological and social changes intersect, calling for extra attention.

Growing Social Complexity

In adolescence, peer relationships become far more complex than in childhood: new layers appear, such as unspoken social rules, group dynamics, the expectation of mutual emotional sharing in friendships, romantic interest, and social media use. Even a Level 1 teen who adapted relatively well in childhood may again face clear difficulty in the face of this growing social complexity.

Identity Development and Self-Awareness

Adolescence is a time when young people question "who they are." During this period, teens with ASD may become more and more aware of their differences and may compare themselves to their peers. For some, this comparison can lead to a loss of self-confidence; for others, it can lead to embracing their autistic identity in a positive way. Talking about autism openly, honestly, and in age-appropriate language (see Chapter 38) matters a great deal here.

When to Seek Advice

Rates of anxiety and depression are markedly higher in adolescents with ASD than in the general population. If you notice social withdrawal, disrupted sleep, a sudden loss of interest in things they used to enjoy, or thoughts of self-harm, seek help from a mental health professional without delay.

The Physiology of Adolescence and Sensory Changes

The hormonal changes of adolescence can temporarily affect sensory sensitivities and the ability to regulate emotions in some teens with ASD. In adolescent girls, emotional and sensory fluctuations linked to the menstrual cycle can be especially noticeable (see Chapter 46).

Building Independence Skills

Adolescence is a critical time to begin systematically teaching independent living skills such as self-care, time management, managing money, and using public transportation. In typically developing teens, these skills often develop on their own through observation and trial and error, but for teens with ASD they usually require explicit, step-by-step teaching with visual supports. This topic is covered in detail in Chapter 37.

Tip / Practical Suggestion

During adolescence, involve your child in everyday decisions (choosing clothes, weekend plans, therapy goals) as much as possible. Independence skills develop much more effectively when there are chances to practice making decisions.