Autism in Teenage years - What to expect?
It is no surprise that every parent struggles tremendously at some point when their child transitions into a teenager. However, it is even more challenging if the teenager has Autism Spectrum Disorder (ASD). Granted that ASD symptoms (lack of eye contact, social awareness and more) can go either way with maturation, the combination of typical teenage behaviors with autism is still a major source of difficulty for many. In light of this difficulty, what should parents of teenagers with ASD expect?
Things will not go according to plan. While a child with ASD may go through intensive behavioral interventions at a young age and shows huge improvements, adolescence affects each individual with ASD differently. For example, there may be changes to a number of areas, ranging from communication, social skills, and ongoing behaviors to the added demands of secondary school, relationships, and changes in one’s body. Therefore, we need to first have realistic expectations, meaning that no matter what, to keep in mind that your child with ASD has a diagnosis, and comparing your teenager with ASD to others will not benefit anyone. Instead, we should focus on the development of each individual, note the progress made and specific behaviors, and work from there.
With the help of behavioral intervention at a young age, it is shown that there is a decrease in irritability and hyperactivity problems with age (Anderson, Deborah K et al., 2011), meaning that even if a teenager with ASD were to encounter an issue that is frustrating or is experiencing restlessness, he or she should be able to utilize a better approach to this uncomfortable feeling, such as regulating themselves with strategies (i.e. using words to explain one’s feelings or taking a 5-minute break). This may be due to a better understanding of one’s emotions and the various ways of addressing feelings of irritability and hyperactivity. However, withdrawal is shown to increase during adulthood. It is especially important to note that physiological changes associated with puberty may be particularly detrimental when combined with increased social expectations in adolescence from adults and peers. (Anderson, Deborah K et al., 2011) If some form of behavioral intervention is disregarded, negative effects of maladaptive behaviors for teenagers with ASD may reoccur. These effects are extensive and long-lasting, resulting in an unhealthy manner of externalizing and internalizing problems.
The need to belong is an essential characteristic of human beings and a strong motive to guide how one behaves. (Deckers, Anne et al., 2017) Likewise, teenagers with ASD wrestle with social isolation due to a lack of incentives in building meaningful relationships and taking part in social activities. Hence, they are often victims of bullying, experience poorer quality of friendships, spend less time interacting with others, and are at an increased risk of feeling lonely. But do not fret! The ability to develop social skills, such as empathy, starting a conversation, sharing interests through sports, skills training groups, and community engagement (religious/cultural events) allows teenagers with ASD to be more integrated in a peer social group. With a consistent routine, such as meeting on a weekly basis, teenagers with ASD may develop an interest in these activities, enhance their ability to engage socially, and foster a social understanding of how to relate to other people.
Furthermore, while teenagers with ASD may have a basic understanding of how one’s body works, it is crucial to explain the importance of what it means to them as an individual, the physical changes occurring to different genders, why it is important to protect oneself, and the implications relating to future dating or social behaviors with others. Even though therapists would be able to cover this topic during therapy sessions, it is also the parent’s responsibility to observe and encourage their teenagers to practice learned principles at home, encourage ongoing practice, and provide emotional support from a parent’s perspective. In comparison to simply lecturing for an extended amount of time, breaking down huge biological concepts into realistic visuals, social stories, videos, and roleplaying can better aid in their comprehension of their own bodies. For girls, mothers can suggest to them to try wearing a mini-pad to get used to the feeling and even use a calendar to show when her period should be coming by marking around those dates. It could also be helpful to use a visual schedule to show the times of the day at which to shower, change and bathe. For boys, it may help to teach about the deepening of their voices, nocturnal emissions, and expected body changes. By preparing them for puberty and teaching about sexual development at an earlier age, teenagers with ASD would likely display fewer behaviors and attend to natural body changes with clear expectations.
Finally, daily life skills in the areas of personal care (showering), housekeeping (chores), and meal-related activities (warming up food) are found to improve during the teenage years. However, this does not guarantee that as they approach adulthood, they will be able to achieve the same level of independence (Smith, Leann E et al., 2012). In fact, the rate of change is expected to decline as individuals age in the early 30s. Therefore, gestural prompts, verbal reminders, or visuals may need to be implemented continuously to break instructions down into simpler steps for them to understand. This serves as a reminder of the need for continued focus on interventions aimed at facilitating social skills in ASD across the development spectrum.
The common anticipated behaviors mentioned above only begin to scratch the surface of the innumerable possibilities for teenagers with ASD. The transition from childhood to adolescence is no doubt demanding not only for themselves but also excruciatingly taxing for family members who are on the same journey. Hopefully, with appropriate attention, further research and more social support provided, teenagers with ASD can attain a reasonable quality of life, develop essential life skills and achieve independence. Let us do our part in highlighting the need for services and interventions aimed at enhancing social functioning for adolescents with ASD.
Written by Hannah Ng.
Anderson, D. K., Maye, M. P., & Lord, C. (2011). Changes in maladaptive behaviors from midchildhood to young adulthood in autism spectrum disorder. American journal on intellectual and developmental disabilities, 116(5), 381–397. https://meridian.allenpress.com/ajidd/article/116/5/381/12787/Changes-in-Maladaptive-Behaviors-From-Midchildhood
David Preece & Marie Howley (2018) An approach to supporting young people with autism spectrum disorder and high anxiety to re-engage with formal education – the impact on young people and their families, International Journal of Adolescence and Youth, 23:4, 468-481, DOI: https://www.tandfonline.com/doi/full/10.1080/02673843.2018.1433695
Deckers, A., Muris, P., & Roelofs, J. (2017). Being on Your Own or Feeling Lonely? Loneliness and Other Social Variables in Youths with Autism Spectrum Disorders. Child psychiatry and human development, 48(5), 828–839. https://link.springer.com/article/10.1007/s10578-016-0707-7
Orsmond, G. I., & Kuo, H.-Y. (2011). The daily lives of adolescents with an autism spectrum disorder: Discretionary time use and activity partners. Autism, 15(5), 579–599. https://journals.sagepub.com/doi/10.1177/1362361310386503
Smith, L. E., Maenner, M. J., & Seltzer, M. M. (2012). Developmental trajectories in adolescents and adults with autism: the case of daily living skills. Journal of the American Academy of Child and Adolescent Psychiatry, 51(6), 622–631. https://jaacap.org/article/S0890-8567(12)00193-1/fulltext