Adolescence and Autism

Just as with other children, a child with autism who begins to experience the changes that come with adolescence experiences a transitional time of physical and psychological development. This is a period that can be particularly confusing or frightening for those with an autism spectrum disorder. Not only are their own bodies changing, but so are the people around them, and so are all the rules that seemed so constant and dependable for so many years in school.

For a teacher of students with autism who are entering adolescence, there are a number of things that might be useful to know or to recognize.

1. Children with autism model their peers. Typically children with higher functioning forms of autism try to model or act like their peers. During early adolescence, however, erratic and less predictable changes in mood and behavior in themselves and their peers can confuse the individual with autism. This adolescent may go off by himself/herself and brood or otherwise be upset because “something is not right.”
2. “Precourtship” behaviors are often misunderstood. I had a client who came home from school one day and asked his mother why his best friend, a girl whom he knew from childhood, now hated him. It seems the 13-year-old started to lightly or playfully punch the boy in the shoulder as a form of “precourtship” behavior, which the boy did not understand and interpreted as the girl being upset with him.
3. Sensory changes occur, and management techniques need to be adjusted. During adolescence, individuals with autism who have managed sensory issues (food, sound, light, texture, etc.) may need to have new or different management strategies as old strategies no longer seem to work or are not as effective. I often recommend updated sensory evaluations by occupational therapists for children during this time of life, so that they may obtain updated management strategies.
4. Labile moods are exaggerated, particularly with anxiety, and at times anger appears more extreme. It can be useful to have an updated functional behavioral analysis, if available, to help recognize potential triggers. Although quick, explosive periods of anger are not uncommon in young adolescents, it is important to address these behaviors as early as possible for teens with autism before “new rules” are established, likely making the angry behaviors more difficult to address later.
5. Adolescents don’t know their own strength. Children with autism sometimes don’t recognize their own growing strength. I worked with one teen who had been taught to slam doors instead of hitting walls when he was angry. This was a very effective strategy when he was young, but when he was a middle teen and slammed a door so hard that it broke off the hinge, a new strategy was needed. Replacement behaviors that are “shaped in” are fluid and need to be periodically re-examined to see if they need to be altered in any way. Slamming doors at age 15 or 16 may not be the best management technique for expressions of anger; something less aggressive might be more appropriate.
6. They may think something is seriously wrong with them and don’t realize that everyone goes through these changes. This is a most sensitive area of concern as it often leads to clinical anxiety and depression if not recognized or if intervention is not forthcoming. Too often the teen with autism knows that, somehow, he or she is different but doesn’t know why or how to ask the right questions. Here it is important for a teacher to ask the adolescent if something is wrong—not what is wrong, as the young person probably can’t name what it is.

Adolescents with autism typically can’t recognize the changes that are occurring at this time of life right away. Once they do see the changes in the rules, their peers, and their bodies, they are often overwhelmed and have difficulty responding to them. What can help them at these times are proactive and simple interventions including clear structure, clear written rules (when possible), and good communication with their families. With these interventions, although the student with autism will still experience some distress with the changes of adolescence, he or she will at least know who to go to for help in understanding what is happening.