What to Know About Autism Spectrum Disorder in Teens

Medically Reviewed by Dany Paul Baby, MD on August 25, 2022
5 min read

People with autism spectrum disorder may meet similar diagnostic criteria, but the way their symptoms present in daily life can be very different. If you’re concerned about your autistic teen’s transition through puberty and into adulthood, you’re not alone. Growing independence and increased social pressure make many parents worry for their teenagers with ASD.

Practical help for autism in teens may include school counseling and classroom interventions as well as life skills you can teach at home. Learn more about how to help your child prepare for the teen years if they’re already diagnosed with autism and gain an understanding of signs and symptoms of autism in a teenager who you suspect might need a diagnosis.

How do parents distinguish between normal teenage behavior and autistic teenager behavior? There is no quick teenage autism test — and teenagers, after all, are infamously moody and withdrawn. Learn more about traits of ASD that might show up during the teenage years.

Teenage-specific symptoms. Social skill deficits might be more pronounced during the teenage years. The following are more signs to look out for in your teen with autism:

  • Difficulty with puberty: A teen girl with ASD might need to be told directly what a period feels like, when to expect one, and how to use sanitary products for menstruation. She might not pick up this information from friends or peers. Both teen boys and girls might also need explicit instruction on when sexual topics and body issues are and aren’t appropriate to talk about. 
  • Seizures: Seizures and epilepsy are more common in people with ASD than in neurotypical people. Due to hormonal changes around puberty, many teens with ASD will have their first seizure. Teens who already have seizures may have them more frequently, which can be alarming to them and their parents.
  • Trouble in school: Even exceptionally smart kids with ASD might struggle when transitioning to a more conceptual framework in school. In middle and high school, your child will be asked to write essays, think critically, and form opinions. Dealing with this educational change in the midst of everything else going on can be extremely difficult.
  • Loss of friends: Teens with autism are at risk of being bullied by peers because of repetitive behaviors, unusual interests, or not having age-appropriate social skills.
  • Mood disorders: Due to the chaos of puberty and the increased social expectations from their peers, autistic teens often struggle with their emotions. Some develop depression or anxiety. Anxiety is common in teens with ASD: Around 39% of youth with ASD have a diagnosed anxiety disorder.

Gender differences. Girls with autism may seem different than boys, and research is finding that this stereotype is true — on the surface. Girls tend to hide their ASD symptoms to appear neurotypical more than boys do. They’re often able to “fake it” when it comes to the back-and-forth nature of social interactions, but this doesn’t mean that they aren’t struggling. 

If you have a teenage daughter with ASD who seems socially competent, she might be exhausted from camouflaging her autism. If she has ASD traits but her doctor has told you that she seems “too social” to be evaluated, get a second opinion. Delayed diagnosis of autism could put your daughter at risk for severe mental health issues.

In a word: stress. ASD symptoms might seem more severe during the teenage years because of all the changes that come with this time of life. Transitions are already difficult for people with ASD, and adolescence is full of them.

Teenagers can't develop autism out of the blue. Your child’s ASD traits would have been evident since early childhood. Experts now recommend evaluating children with autistic traits as early as 2 years old — and in some children, autism can be detected as early as 18 months. 

If your teen becomes socially withdrawn and fixated on repetitive behaviors for the first time in adolescence, it's probably not autism. It's more likely that there's something else going on. Ask your doctor for more information if you're concerned.

It’s important to remember that autism is not a personality type. While your teen has traits of autism, they’re an individual with likes, dislikes, and specific needs that have nothing to do with their diagnosis. 

Provide appropriate social outlets. Many teens and young adults with autism don’t pursue activities with other people. Encourage your teen to pursue social activities that align with their interests. For example, a teenager who enjoys painting might be interested in a local art group for teens. Another teen might excel at playing a particular instrument in a youth group band or participating in community theater productions.

Don’t force friendships. While you might wish for your teen to have a thriving social life, they might truly be happier with one or two friends — alternatively, they might be a social butterfly and not know where to put all that extroverted energy. You should, of course, teach your teen age-appropriate social skills and provide outlets for friendships to form.

Teach concrete life skills. Neurotypical teens learn a lot from their friends — and much of what they pick up from peers is not explicitly said or taught. Your teen with ASD needs to be taught concrete life skills that will serve them throughout high school and into adulthood. Think about the following and add to your list as you think of more skills specific to your child’s life and developmental level:

  • Physical self-care skills: These include hygiene, exercise, eating a healthy diet, and getting enough sleep. You might need to remind your teen to wear deodorant, shave, or complete any puberty-specific personal hygiene tasks they’re not used to yet.
  • Emotional skills: Teach your teen with ASD to identify emotions, recognize when someone else is upset, and self-soothe in times of distress. Learning how to calm an autistic teenager is helpful, but it's more beneficial in the long term if you teach skills they can use when on their own.
  • Safety skills: These may include crossing a street, asking for help, and not going places with people they don’t know.
  • Social skills: Help your teen learn skills they will use with peers. These might include having a conversation, asking how another person is doing, and using traditional “good manners” like greeting someone, saying thank you, and holding the door open for others.
  • Financial skills: Teach your teen how to order and pay for food at a café or restaurant, manage a simple budget, use a debit card, and write a check.

Autism in teens comes with unique strengths and very specific challenges in understanding the world. Your teenager will benefit from an evaluation for autism spectrum disorder if they’re having trouble with social skills, sensory processing, and inflexibility when it comes to routines.