Autism in Teenagers

Physical, Intellectual, and Emotional Challenges

The teen years can be challenging for everyone; they can be far more challenging, however, for young people with autism—and their parents. As with most aspects of autism, the level of difficulty will vary radically depending on the individual on the spectrum, their family situation, their support system, and their school.

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

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Autism Challenges for Teens

Children with autism 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 children with autism 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 children with autism 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 typical teens. That's because many people with autism:

  • 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 person with autism 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 are unlikely to be prepared for puberty without clear, consistent, direct education. Neither hints nor wordy lectures will be as effective as they might be with typical children.

This means you must be graphic, specific, and hands-on in ways that may make you uncomfortable, but no one else will take on that role for your child. Some options for preparing your child for the onset of physical changes include:

  • Helping your child to choose a deodorant with a smell they prefer, and overseeing its use on a daily basis—even before it's needed
  • Getting your child into a routine of daily baths and showers, and ensuring that they are washing thoroughly
  • Teaching your 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 your child anticipate and manage erections, wet dreams, or the onset of menstruation
  • If you have a daughter, physically teaching her to use feminine hygiene products and checking to be sure she changes them regularly

While some younger children may masturbate in inappropriate places, the likelihood of this happening may increase as your 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 teenage boys who may be perceived as potential sexual predators.

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

Intellectual Expectations

Many people with autism 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 most 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, 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 your 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 needs classroom
  • Are enrolled in behavioral and/or pre-employment programs, either at their local schools or at specialized schools

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 teens with autism are overwhelmed with emotions during this period, but others slide through with less angst than their typical peers.

It is often the brightest 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, teens with autism 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 special needs ("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 your teen is not thriving in a public school setting, you may want to explore other options. For example, some autistic teens do better in technical high schools; others flourish in special needs high schools, and yet others are successful as homeschoolers.

Planning for Adulthood

You can begin planning for your child's adulthood while he or she is still a young teen. In fact, the earlier you begin your planning, the better your chances are of maximizing your child's opportunities. Now is the time to start:

  • Asking your school district to begin transition planning, which should include ongoing assessments of your child's particular needs and interests
  • Learning about adult service options in your state, and finding out what is available for adults with autism—with and without intellectual disabilities
  • Exploring options for post-secondary education including possibilities for district-funded programs between grade 12 and age 22 (when your 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 your family
  • Discussing living options that can range from institutional settings to group homes to semi-independent living to independent supported living
  • Deciding whether you want to continue to be your child's guardian when they turn 18, or whether you want to consider other options such as health proxy and power of attorney
  • Considering long-term financing of your 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 adults with autism are at higher risk than their typical 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 your teenage child's psychological and physical wellness as they grow toward adulthood.

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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.
  1. Autism Speaks. Autism in teens: Helping your child through puberty. 2018.

  2. Sarris M. The link between autism and suicide risk. Interactive Autism Network. 2018.

  3. Vohra R, Madhavan S, Sambamoorthi U. Comorbidity prevalence, healthcare utilization, and expenditures of Medicaid enrolled adults with autism spectrum disordersAutism. 2017;21(8):995-1009. doi:10.1177/1362361316665222