Autistic Teenagers

Physical, Mental, and Emotional Traits and Needs

The teen years can be challenging for everyone; they can be far more challenging, however, for autistic children. As with most autistic people, the experiences and struggles of every autistic teenager depend on their specific mix of autistic characteristics, age of diagnosis, the level of acceptance and inclusion of neurodiversity in their family, their support system, and their school environment.

Fortunately, there are many ways parents and guardians can prepare for and ease the transition to teenagehood. The teen years are also a great time to start preparing for adulthood.

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Autism Challenges for Teens

Autistic children may be nonverbal or chatty. They may do well in school or find it challenging. They may have extreme behaviors or none at all. But all autistic children have these challenges in common:

  • Difficulty understanding and expressing themselves with spoken and body language
  • Challenges with executive functioning (the ability to plan and organize their time)
  • Difficulty with "reading" and responding appropriately to social situations
  • Lack of flexibility and preference for routine

Most autistic children also struggle with:

  • Sensory challenges (over- or under-responsiveness to light, sound, smells, and physical sensations)
  • Delays in physical coordination and low muscle tone
  • Learning disabilities
  • Difficulty with grasping abstract concepts
  • Emotional dysregulation
  • Anxiety
  • Continued fascination with childish interests (they are "young for their age")

Add to all of these issues the onset of puberty and physical changes, new academic and social challenges, and higher intellectual and social expectations, and it's not surprising that the teenage years can be especially tough for kids on the autism spectrum.

How Autism May Reduce Teen Stress

Yes, the teen years can be particularly rough for autistic youngsters. But for some on the autism spectrum, puberty can actually be less painful than it is for neurotypical teens. That's because many autistic individuals:

  • Don't judge themselves based on what the media presents or what others think of them
  • Are not stressed by the need to prove themselves academically or physically
  • Have more personal interests and hobbies that they can pursue with or without same-age peers
  • Are able to quickly learn new routines (shaving, for example)

Of course, not every autistic person fits the same mold, but for some teens, the lack of self-judgment or hyper-awareness of others' opinions can be a great plus.

Physical Changes

Even very high-functioning autistic children may be unprepared for puberty without clear, consistent, direct education. Neither hints nor wordy lectures will be as effective as they might be with neurotypical children.

This means you must be graphic, specific, and hands-on in ways that are most comfortable for your autistic loved one. It is important to be this way because no one else may take on that role for an autistic child. Some options for preparing an autistic child for the onset of physical changes include:

  • Helping the child to choose a deodorant with a smell they prefer, and overseeing its use on a daily basis—even before it's needed
  • Getting the child into a routine of daily baths and showers, and ensuring that they are washing thoroughly
  • Teaching the child to use electric razors (which are safer than other razors) for appropriate shaving
  • Using simple books, videos, social stories, and other teaching tools to supplement sex education programs offered in schools
  • Using simple books, videos, social stories, and other teaching tools to help the child anticipate and manage erections, wet dreams, or the onset of menstruation
  • If you have a child who could get periods, physically teach them to use period hygiene products (tampons and pads) and check to be sure they change them regularly

While some younger children may masturbate in inappropriate places, the likelihood of this happening may increase as a child enters puberty. While there is nothing intrinsically wrong with masturbation in private, it can become a serious issue in public. This is particularly true for teenagers, who may be perceived as potential sexual predators.

It is therefore very important to teach a child where and when they can masturbate privately. If public masturbation is an issue with a child, a parent or guardian may decide to work with a behavioral therapist to help manage the problem.

Intellectual Expectations

Many autistic people are unusually intelligent; others are of average intelligence. Over 30%, however, have intellectual disabilities and about half have learning disabilities. Many have attentional issues such as ADHD, and many have difficulty grasping and discussing abstract concepts.

Skills such as memorization, repetition, and basic math are highly prized in the early years—skills that are often areas of strength among autistic children. But reading comprehension, verbal discussion, writing, and analytical thinking are expected as children get older, and these may be very challenging for teens on the spectrum.

Fortunately, parents, guardians, teachers, and therapists know ahead of time that these challenges are coming up, so they can plan to support autistic teens as needed. Supports, special settings, and unique services become part of a child's individualized educational plan (IEP).

There are a range of options available; the choice will depend on the teen's level of academic ability. For example, some autistic teens:

  • Participate in general education with 1-to-1 or tutoring support
  • Participate in the typical curriculum in classes that move at a slower rate
  • Are not able to participate in the typical curriculum but can follow a modified curriculum in a special education classroom
  • Are enrolled in behavioral and/or pre-employment programs, either at their local schools or at schools centering education for people living with disabilities

One particularly tricky aspect of American high school education is the requirement that all high school students pass standardized tests. While some autistic students have little trouble with standardized tests, others find them extremely stressful and difficult. Autistic teens do qualify for extra time and other supports, but only if they are requested.

Emotional Challenges and Differences

The teenage years can be an emotional rollercoaster. Some autistic teens are overwhelmed with emotions during this period, but others slide through with less angst than their neurotypical peers.

It is often the bubbliest and most capable autistic teens who are most impacted by the emotional challenges of puberty; that's because they are most likely to actively want social acceptance and to be keenly aware of rejection.

In addition to the usual teenage ups and downs, autistic teens may experience some of these additional challenges:

  • Emotional immaturity that manifests itself in childish interests or emotional responses that would be expected in a much younger child
  • High levels of anxiety, especially when faced with unexpected demands or changes in routine
  • Difficulty reading social signals which can result in accusations of inappropriate blurting, interrupting, touching, or stalking
  • Bullying, teasing, and/or social exclusion based on "weird" behavior, speech patterns, and/or interests
  • Extreme emotional responses to stress that can manifest in aggression, tantrums (meltdowns), and/or "bolting" (running away)
  • Depression (especially among higher functioning teens) which can lead to suicidal intentions or actions

Many of these issues can be mitigated or even resolved if they are addressed early and creatively. Some options include:

  • Social skills groups and training to improve teens' ability to recognize and respond appropriately to verbal and non-verbal social cues
  • Direct instruction on topics such as "what to discuss at the lunch table," or "topics to keep to yourself;
  • Appropriate medication and therapy for anxiety and depression
  • Participation in social groups that support students with disabilities ("Lunch Bunch," Best Buddies, Challenger Club, etc.)
  • Development of interests and skills that can be shared in typical peer groups (musical skills, theatrical skills, video gaming, arts clubs, sports, etc.)
  • Behavioral intervention and therapy

If a teen is not thriving in a public school setting, try exploring other options. For example, some autistic teens do better in technical high schools; others flourish in high schools tailored to people living with disabilities, and yet others are successful as homeschoolers.

Planning for Adulthood

One can begin planning for an autistic child's adulthood while they are still a young teen. In fact, the earlier one begins planning, the better the chances are of maximizing an autistic child's opportunities. Now is the time to start:

  • Asking the local school district to begin transition planning, which should include ongoing assessments of a child's particular needs and interests
  • Learning about adult service options in the state, and finding out what is available for autistic adults—with and without intellectual disabilities
  • Exploring options for post-secondary education including possibilities for district-funded programs between grade 12 and age 22 (when an autistic child will no longer qualify for IDEA funding)
  • Discussing college if it's appropriate, and beginning to look into autism-friendly college programs if that's of interest to a family
  • Discussing living options that can range from institutional settings to group homes to semi-independent living to independent supported living
  • Deciding whether to continue to be a child's guardian when they turn 18, or if one wants to consider other options such as health proxy and power of attorney
  • Considering long-term financing of an autistic child's needs through a special needs trust, insurance policy, or other means

A Word From Verywell

In addition to the topics discussed in this article, it's important to note that young autistic adults are at higher risk than their neurotypical peers for several chronic issues. These include epilepsy, schizophrenia, and skin disorders, as well as ongoing risk of gastrointestinal problems.

It's important to keep a close eye on a teenage child's psychological and physical wellness as they grow toward adulthood.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Conner CM, Golt J, Righi G, Shaffer R, Siegel M, Mazefsky CA. A Comparative Study of Suicidality and Its Association with Emotion Regulation Impairment in Large ASD and US Census-Matched Samples. J Autism Dev Disord. 2020 Oct;50(10):3545-3560. doi: 10.1007/s10803-020-04370-1

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By Lisa Jo Rudy
Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism.