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Parent’s Guide to Understanding Autism in Teens

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT

Meet The Team >

Navigating an autism diagnosis for your teen can be daunting. With tons of misinformation about autism on the internet, it can be difficult to know what autism really is, or how you can help your teen through its challenges. 

At Evolve, we specialize in teen and adolescent treatment, including treatment for teen Autism Spectrum Disorder (ASD). This guide aims to shed light on various aspects of ASD, offering insights into symptoms, diagnosis, and effective strategies for helping teens navigate through their unique challenges.

Autism in Teens

What is Autism?

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition that affects individuals in various ways, especially during the challenging years of adolescence. It’s a form of neurodiversity that’s characterized by difficulties in social interaction, communication, and a tendency to engage in repetitive behaviors. In teenagers, these symptoms can present unique challenges as they navigate social complexities and educational demands. It’s Important to know that ASD is a spectrum, meaning it affects individuals differently, making each teen’s experience with autism unique.

What is Neurodiversity?

Neurodiversity encompasses a range of neurological variations often seen as natural and normal variations of the human brain. Commonly recognized neurodiversity types include Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Dyslexia, Dyspraxia, and Tourette Syndrome.

Neurodiversity symptoms will vary greatly from type to type. Individuals with ASD may experience challenges in social interaction, repetitive behaviors, and heightened sensitivities to sensory stimuli, while those with ADHD might show symptoms like inattention, hyperactivity, and impulsiveness. Dyslexia is characterized by difficulties with accurate and/or fluent word recognition and poor spelling and decoding abilities. Dyspraxia affects motor skill development, leading to clumsiness or coordination challenges. Tourette Syndrome manifests through repetitive, involuntary movements and vocalizations called tics. Each of these conditions reflects the diversity of human cognition and perception, contributing to the unique set of strengths and challenges experienced by neurodiverse individuals.

Understanding Autism in Teens

Autism in teens is complex and diverse, and each individual may exhibit varying degrees of symptoms. Some may have exceptional abilities in certain areas, while others may face significant challenges in everyday tasks. Recognizing this diversity is key to understanding and supporting a teen with autism.

Signs of Autism Spectrum Disorder 

Some common signs of ASD in teens include:

  1. Social Difficulties: Challenges in understanding social cues and difficulties in forming friendships.
  2. Repetitive Behaviors: Engaging in repetitive movements or routines.
  3. Sensory Sensitivities: Over or under-reactivity to sensory stimuli.
  4. Difficulty with Transitions: Struggling with changes in routine or transitions.

Criteria for Autism Spectrum Disorder in Adolescent

The criteria for Autism Spectrum Disorder (ASD) in adolescents, as outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), include:

  1. Persistent Deficits in Social Communication and Interaction Across Multiple Contexts: This includes difficulties in social-emotional reciprocity, nonverbal communicative behaviors used for social interaction, and developing, maintaining, and understanding relationships.
  2. Restricted, Repetitive Patterns of Behavior, Interests, or Activities: This criterion is characterized by at least two of the following:
    1. Stereotyped or repetitive motor movements, use of objects, or speech.
    2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior.
    3. Highly restricted, fixated interests that are abnormal in intensity or focus.
    4. Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment.

These are just a few of the symptoms of autism. Diagnosis requires a thorough evaluation by qualified healthcare professionals.

What Causes Autism Spectrum Disorders?

The exact cause of ASD is not known, but research suggests the following can impact the development of ASD:

  1. Genetics: A significant factor, with numerous genes identified that are associated with ASD. Family history of ASD also increases the risk.
  2. Environmental Factors: Research indicates certain environmental factors during pregnancy or early life might increase the risk of ASD. These include advanced parental age at the time of conception, complications during pregnancy or birth (like extreme prematurity or low birth weight), and prenatal exposure to certain drugs or chemicals.
  3. Brain Biology and Structure: Studies suggest differences in certain areas of the brain in individuals with ASD. These differences might be caused by abnormal brain growth early in development or by altered neural connections.
  4. Epigenetics: This refers to changes in gene expression that are not caused by changes in the DNA sequence. Epigenetic factors might influence how genes are turned on or off in brain development, potentially playing a role in ASD.
What Causes Disorders

Autism Spectrum Testing 

The testing and diagnostic process for Autism Spectrum Disorder (ASD) is comprehensive and involves several steps to ensure an accurate diagnosis. Here’s a general overview:

  1. Developmental Screening: This is often the first step, where general developmental progress is assessed. Pediatricians may use tools like the Modified Checklist for Autism in Toddlers (M-CHAT) during routine well-child checkups, particularly at 18 and 24 months.
  2. Developmental History: Gathering detailed information about the child’s developmental milestones, behavior, and family’s medical history.
  3. Physical Examination: Assessing overall health and ruling out other conditions with similar symptoms.
  4. Observations of the Child: Evaluating the child’s behavior, communication, and interaction in various settings.
  5. Cognitive and Language Testing: Assessing intellectual functioning and language skills.
  6. Standardized Diagnostic Tools: Using instruments specifically designed to assess ASD, such as the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R).
  7. Interdisciplinary Evaluation: Often, a team of specialists including pediatricians, neurologists, psychiatrists, psychologists, and speech and language therapists will collaborate in the evaluation process to provide a comprehensive assessment of the child’s strengths and challenges.
  8. Ruling Out Other Conditions: It’s important to differentiate ASD from other developmental disorders, mental health issues, or language delays. This may involve a series of tests or referrals to other specialists.
  9. Family Involvement: Throughout the process, open communication with the family is crucial. Families provide essential insights into the child’s behavior and history and are key partners in the diagnostic process.

The diagnostic process is thorough to ensure accuracy, as symptoms of autism can overlap with other conditions. Early and precise diagnosis is crucial as it opens the door to early intervention and support, which can significantly improve outcomes for individuals with ASD.

Sensory Issues 

Sensory issues are a common aspect of Autism Spectrum Disorder (ASD), and they can impact how individuals process and respond to sensory information. These issues can be categorized into two primary types: hypersensitivity and hyposensitivity.

Hypersensitivity

Definition: Hypersensitivity, or sensory over-responsivity, refers to an excessive or heightened reaction to sensory stimuli. Individuals with ASD who are hypersensitive may find certain sensory inputs overwhelming or distressing.

Common Manifestations:

Auditory Sensitivity: Sounds that might seem normal to others, like a vacuum cleaner or a ringing phone, can be perceived as unbearably loud or disturbing.

Tactile Sensitivity: A light touch or certain textures of clothing or food might feel uncomfortable or even painful.

Visual Sensitivity: Bright lights, flashing lights, or busy patterns can be overwhelming or cause discomfort.

Olfactory and Gustatory Sensitivity: Strong smells and tastes, even those that are generally pleasing or mild to others, can be overpowering or unpalatable.

Hyposensitivity

Definition: Hyposensitivity, or sensory under-responsivity, is characterized by an unusually low or muted response to sensory stimuli. Individuals with ASD who are hyposensitive may seek additional sensory stimulation to reach a level of sensory input that feels adequate.

Common Manifestations:

Seeking Sensory Input: This might include a preference for loud noises, intense tastes, or strong visual stimuli.

Physical Sensitivity: A reduced response to pain or temperature, which might lead to not recognizing injuries or temperature extremes.

Proprioceptive and Vestibular Seeking: A desire for activities that involve movement, pressure, or balance, such as spinning, jumping, or tight embraces.

The 7 Types of Autism 

Autism Spectrum Disorder (ASD) encompasses a range of neurodevelopmental conditions, each with its own unique characteristics. Here’s an overview of seven types often associated with or related to the autism spectrum:

1. Classic Autism

Description: Also known as Autistic Disorder, Classic Autism is what most people think of when they hear “autism.” It’s characterized by significant challenges in social interaction, communication, and behavior.

Symptoms: Individuals with Classic Autism often have limited verbal communication, engage in repetitive behaviors, and show limited interest in social interactions.

2. Asperger’s Syndrome

Description: Asperger Syndrome is on the milder end of the spectrum. Individuals with Asperger Syndrome typically have average or above-average intelligence and fewer issues with language.

Symptoms: Challenges mainly lie in social interactions and nonverbal communication. They may have focused interests and find it hard to understand social rules or cues.

3. Childhood Disintegrative Disorder (CDD)

Description: CDD is a rare condition where a child develops normally for at least two years and then rapidly loses multiple social, language, and motor skills.

Symptoms: Besides the loss of skills, children may also show ASD-like symptoms, including difficulties in social interaction and repetitive behaviors.

4. Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS)

Description: PDD-NOS is used for individuals who do not fully meet the criteria for other specific disorders on the spectrum but still show significant challenges in social and communication skills.

Symptoms: They may have milder symptoms than those with Classic Autism, and the symptoms can vary widely from person to person.

5. Rett Syndrome

Description: Rett Syndrome is a rare genetic disorder seen almost exclusively in girls. It’s related to ASD but is distinct because of its genetic cause and progressive nature.

Symptoms: After a period of normal development, children with Rett Syndrome begin to lose motor skills and language abilities. They may have repetitive hand movements and slowed growth.

6. Sensory Processing Disorder (SPD)

Description: While not officially classified as a form of autism, SPD is commonly seen in individuals with ASD. It involves difficulties in processing sensory information.

Symptoms: Individuals may be overly sensitive to stimuli (hypersensitive) or underresponsive (hyposensitive). They may react strongly to lights, sounds, textures, or seek out intense sensory experiences.

7. Social Communication Disorder

Description: This disorder is characterized by difficulties with the social use of verbal and nonverbal communication. It is often seen in individuals with other conditions, including ASD.

Symptoms: Challenges include understanding and using language in social contexts, such as having conversations, understanding jokes or nonliteral language, and using language for different purposes (e.g., greeting, requesting).

Each of these conditions represents a unique facet on the autism spectrum, requiring tailored approaches to support and intervention. It’s important to note that the classification and understanding of these conditions continue to evolve with ongoing research and clinical practice.

Medications for Teens on the Autism Spectrum 

Managing symptoms of Autism Spectrum Disorder (ASD) in teenagers can sometimes involve the use of medication, particularly when certain behavioral symptoms are significant or when co-occurring mental health issues are present. Here’s an overview of common medication types prescribed for teens with ASD:

1. Antipsychotics

Purpose: These medications are primarily used to treat severe behavioral issues such as aggression, self-harm, or severe tantrums in teenagers with ASD.

Examples: Risperidone and Aripiprazole are two antipsychotics that have been approved by the FDA for treating irritability associated with autism in children and adolescents.

Considerations: Side effects can include weight gain, drowsiness, and hormonal changes. It’s important to monitor the teen’s health regularly when using these medications.

2. Stimulants

Purpose: Often used to address symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD), which can co-occur with ASD. Stimulants can help improve focus, attention, and impulsivity control.

Examples: Methylphenidate (Ritalin, Concerta) and Amphetamine-based stimulants (Adderall) are commonly prescribed.

Considerations: Side effects can include insomnia, decreased appetite, and increased anxiety. Their effectiveness and tolerability can vary in ASD, necessitating careful monitoring.

3. Selective Serotonin Reuptake Inhibitors (SSRIs)

Purpose: SSRIs are primarily prescribed for co-occurring anxiety or depression, which are common in teenagers with ASD. They can also help reduce obsessive behaviors.

Examples: Fluoxetine (Prozac) and Sertraline (Zoloft) are commonly used SSRIs.

Considerations: Side effects can include gastrointestinal symptoms, sleep disturbances, and in some cases, increased agitation or behavioral activation.

It’s essential to tailor medication choices to the individual needs of each teen, considering the specific symptoms, co-occurring disorders, and overall health profile. Medications are often most effective when used in combination with behavioral therapies, educational interventions, and family support.

Common Issues for Autistic Teenagers 

Autistic teenagers often navigate a complex array of challenges that extend beyond the immediate symptoms of their condition. One significant issue they face is bullying; due to their differences in social interaction and communication, they’re sometimes more vulnerable to being misunderstood, isolated, or targeted by peers. This social adversity can exacerbate academic difficulties, as autistic teens might struggle with conventional teaching methods, classroom environments, or organizational skills required in a typical school setting. Moreover, these experiences contribute to a heightened risk of mental health issues, such as anxiety and depression. The interplay of these factors – social challenges, educational obstacles, and emotional well-being – creates a unique set of hurdles for autistic teenagers, necessitating supportive, understanding, and tailored approaches in both educational and social contexts.

How to Talk to Family and Friends About Your Teen’s Diagnosis 

Talking to your family and friends about your teen’s autism diagnosis requires sensitivity, clarity, and sometimes, a bit of education. Here are some guidelines:

  1. Be Open and Honest: Explain what autism is, emphasizing that it’s a neurodevelopmental disorder that affects communication, behavior, and social interactions. Be clear that it’s not caused by anything anyone did or didn’t do.
  2. Share Specifics About Your Teen: Describe how autism affects your teen specifically, as it manifests differently in each person. Highlight their strengths, challenges, and any unique quirks or traits that make them who they are.
  3. Discuss the Spectrum Nature of Autism: Make it clear that autism is a spectrum disorder, meaning it has a wide range of symptoms and levels of severity. This helps in breaking down stereotypes or misconceptions.
  4. Talk About What Support Your Teen Needs: Explain the kind of support and understanding your teen requires. This might include patience with communication, understanding sensory sensitivities, or the need for routine.
  5. Provide Resources for Learning More: Recommend websites, books, or articles that offer more information about autism. This can help family and friends to understand the condition better.
  6. Encourage Questions: Let them know that it’s okay to ask questions. Open dialogue can dispel myths and foster a supportive environment.
  7. Express Your Feelings and Needs: Share your own experiences and feelings about having a teen with autism. This can help in building empathy and understanding.
  8. Request Their Support: Be specific about how they can help or support you and your teen. It might be listening when you need to talk, helping out with practical tasks, or just being a friend.
  9. Keep the Conversation Going: Let them know that this is an ongoing journey and that you’ll continue to share information and insights as you learn more.

Remember, the goal is not just to inform but also to build a supportive network for you and your teen. Being open and inviting dialogue can help in creating a more understanding and inclusive environment for your teenager.

How to Help Your Autistic Teen Navigate Social Challenges

Want to support your autistic teenager in developing social skills? 

Social skills training is a structured program that often uses techniques like role-playing to simulate social scenarios, teaching teens how to interpret and respond to social cues, understand and manage emotions, and improve communication skills. Role-playing, in particular, offers a safe and controlled environment for practicing interactions, helping teens to build confidence and competence in various social settings. Additionally, connecting your teen with peer groups or activities that align with their interests can be helpful because it immerses them in an environment of shared experiences. Such peer interactions provide not just opportunities for social learning, but also for forming friendships. Through these combined efforts, parents of autistic children can actively assist them in navigating the complexities of social interaction, enhancing their ability to connect with others and participate more fully in life.

How to Seek Help for Your Teen With Autism 

Finding the right professional help for a teenager with Autism Spectrum Disorder (ASD) is crucial in supporting their development and well-being. Here are a few ways to support your teen:

Developmental Pediatricians: These are pediatricians with special training in child development and behavior. They can provide comprehensive evaluations and guidance on treatment plans.

Speech and Language Therapists: They help improve communication skills, including both verbal and nonverbal communication, which is often a challenge for teens with ASD.

Occupational Therapists: They focus on improving daily living skills and sensory integration, helping teens become more independent.

Behavioral Therapists: Utilizing approaches like Applied Behavior Analysis (ABA), these therapists work on reducing problematic behaviors and teaching new skills.

Special Education Teachers: In school settings, they provide tailored educational strategies to meet the unique learning needs of autistic teens.

Parent Support Group: Both for teens and parents, these groups offer a platform to share experiences, challenges, and strategies.

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Evolve Treatment Centers: A Specialized Approach

Evolve Treatment Centers stand out as a specialized option for teens with ASD. Evolve offers a holistic and personalized approach, understanding that each teen’s journey is unique. Our programs provide:

Individualized Therapeutic Plans: Tailored to address the specific challenges and strengths of each teen.

A Multidisciplinary Team: Comprising therapists, psychiatrists, and educators experienced in ASD.

Family Involvement: Recognizing the vital role families play, Evolve engages parents and siblings in the therapeutic process.

Integration of Evidence-Based Practices: Utilizing proven methods like CBT, ABA, and teen mindfulness to support overall development.

To discover how Evolve Treatment Centers can make a difference in your teen’s life, contact us directly. Together, we can pave a path towards growth, learning, and a more fulfilling life for your teenager.

Frequently Asked Questions (FAQs) About Teen Autism

How prevalent is autism among teenagers?

Autism is prevalent in approximately 1 in 54 children, including teenagers, with the condition often being more commonly diagnosed in males than females.

Can autism be diagnosed in the teenage years?

Yes, autism can be diagnosed in the teenage years, although it is often identified in early childhood; late diagnosis can occur due to subtler manifestations of symptoms or lack of earlier detection.

Are there environmental factors contributing to autism in teens?

Environmental factors, such as prenatal exposures and birth complications, may contribute to the risk of developing autism, alongside strong genetic influences.

Are there specific challenges faced by autistic teens in school?

Autistic teens in school may face challenges such as difficulty with social interactions, sensory sensitivities, and coping with changes in routine or environment.

What is an Individualized Education Program (IEP) for autistic teenagers?

An Individualized Education Program (IEP) for autistic teenagers is a tailored educational plan that addresses their unique needs, goals, and accommodations required for effective learning.

How can parents of autistic children support their kids academically?

Parents can support their autistic teenagers academically by collaborating with educators to ensure their IEP is followed, providing a structured home environment, and offering encouragement and support in their areas of difficulty.

Are there different communication styles observed in autistic teens?

Autistic teens can exhibit a range of communication styles, from nonverbal or limited verbal communication to very articulate speech, often with challenges in understanding social nuances.

How can parents foster communication skills in their autistic teens?

Parents can foster communication skills in their autistic teens by engaging in consistent, patient communication, using visual aids or technology when helpful, and encouraging social interaction in comfortable settings.

Do autistic teenagers experience anxiety or depression more frequently?

Autistic teenagers often experience anxiety and depression more frequently than their non-autistic peers, due to factors like social challenges and sensory sensitivities.

How can parents help their autistic teens develop independence?

Parents can help their autistic teens develop independence by teaching them life skills in a step-by-step manner, encouraging self-advocacy, and providing opportunities for them to make choices and solve problems.

Are there specific vocational challenges for autistic teenagers?

Autistic teenagers may face specific vocational challenges, including difficulties with social communication in the workplace and adapting to changes or unstructured environments.

Do autistic teenagers have unique strengths and talents?

Many autistic teenagers have unique strengths and talents, such as detailed focus on areas of interest, strong memory skills, and unique problem-solving abilities.

How can educators create an inclusive environment for autistic teens?

Educators can create an inclusive environment for autistic teens by implementing tailored teaching strategies, promoting understanding and acceptance among peers, and providing necessary accommodations and support.

How can siblings and peers best support their autistic teenage friends?

Siblings and peers can best support their autistic teenage friends by showing empathy, including them in activities, respecting their need for routine or quiet time, and learning about autism to better understand their perspective.

Are there gender differences in how autism presents in teenagers?

There are gender differences in how autism presents in teenagers, with females often exhibiting less obvious or different symptoms compared to males, leading to underdiagnosis or misdiagnosis in some cases.

Do hormonal changes during adolescence affect autism symptoms?

Hormonal changes during adolescence can affect autism symptoms, potentially exacerbating challenges related to emotional regulation and social interactions.

How do sleep patterns differ for autistic teenagers?

Autistic teenagers often have altered sleep patterns, including difficulties with sleep onset, maintaining sleep, and irregular sleep-wake cycles.

Can autism be “outgrown” or does it persist into adulthood?

Autism is a lifelong condition and cannot be “outgrown”; however, individuals can develop coping strategies and skills to manage and adapt to their symptoms over time.

What is the role of occupational therapy in supporting autistic teenagers?

The role of occupational therapy in supporting autistic teenagers includes helping them develop daily living skills, improve sensory processing, and enhance their ability to participate in school and community activities.

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