Your child is always growing and changing. One day, they're merry little people who can't wait to chatter about their days with you. The next, they're sullen creatures who won't make eye contact or talk with you at all. Could you be seeing signs of autism in teens?
Most autism cases are diagnosed during childhood. People can't develop the disorder later in life. But mild autism symptoms can be overlooked when people are young, and they may cause added concern during adolescence.
A teen autism diagnosis can be freeing. Some people appreciate the deeper understanding that comes with a label and therapy. Be prepared to support your child through this process.
Autism Develops Early in Life
There's a lot researchers don't know about autism. How much responsibility sits with genes? How much comes from the environment? Studies are ongoing, and we all hope the answers will come soon. Experts agree that autism symptoms stem from issues that begin long before adolescence.
An autism expert explains it this way: Genetic mutations and the environment combine to cause autism-related difficulties. The brain can compensate to a point. But when the brain can no longer overcome the deficiencies, symptoms either appear or become more prominent.
Research backs up this interpretation. For example, in a 2017 study, researchers found brain scan differences in very small children that predicted an autism diagnosis. When the scans showed these abnormalities, the children had autism. When the scans were clear, the children did not have autism.
Studies like this suggest that autism starts very early in life, but most parents don't notice autism symptoms until a child is older. Childhood autism symptoms rely on communication and behavior, and babies rarely speak or act independently. When the child begins to grow, parents may notice:
- Difficulties with eye contact.
- Few spoken words.
- Low responses to body language, including pointing.
Experts say most children with autism aren't diagnosed until after age 3, even though their parents may see problems much earlier.
Some Teens Are Overlooked
How do teens end up with a diagnosis so late in life if autism doesn't develop during adolescence? Researchers work hard to answer that question, and there's a lot at stake.
We know that early interventions, including appropriate therapy, can help to ensure a healthy and happy life for people with autism. The sooner we know, the better. But some cases are simply passed by.
Research suggests that cases are missed due to:
- Parental concern. Many parents don’t see an issue. When parents worry over their children, and they press for answers from medical professionals, they tend to get earlier diagnoses than children of parents who don't make waves.
- Economics. Children from wealthy families tend to get a diagnosis earlier than children from poorer families.
- Symptom severity. Children with autism signs that are hard to ignore are easier to diagnose than children with mild or moderate symptoms.
Put all of this research together, and it suggests that some children could pass through their early years with autism signs that go unrecognized. When that happens, they could enter one of the most difficult moments of life without the help they need to thrive.
Common Signs of Autism in Teens
Your child can't grow out of autism. If the disorder is present at birth, it's likely to persist throughout their lifespan, but symptoms can morph and change as your child does. The signs parents look for in their infants are very different from those you might see in adolescence.
Signs of autism in teens include those relating to:
- Verbal communication. Your child might struggle with taking turns during a conversation, using sarcasm, or using a typical tone of voice.
- Nonverbal communication. Your child might resist eye contact. Understanding how people feel by looking at them could also be challenging.
- Relationships. Your child may have few or no real friends. Your child may prefer to be alone or with younger children.
- Repetitive behavior. Your child might be unusually attached to objects, including collecting specific types of things or statistics. Your child might also feel most comfortable when routines are consistent.
- Sensory input. Your child might struggle with bright light or loud noises.
Teen peers — including siblings, cousins, and friends — may also notice some unusual attributes in your child. They may tell you that your child:
- Behaves strangely during a conversation. They may stand too close or speak too loudly. They may stick to one topic while talking instead of shifting to things others might like to discuss.
- Seems rude. They may complain that your child tells them they smell bad or they have a terrible haircut. Your child may seem unaware that these comments hurt feelings.
- Lacks self-protection skills. Teens with autism are bully targets, but your child may not attempt to stop the harassment.
- Struggles with change. Your child might grow unusually upset at class disruptions or shifts in their schedule.
Listen to these comments carefully, and follow up with a conversation with your child's teacher. Are those same issues apparent to professionals who spend all day with your child?
How Teen Autism Is Diagnosed
While researchers say they can spot autism in brain scans, doctors don't offer these tests to their patients. Instead, they use interviews and observations to determine if a child's symptoms are caused by autism.
The interviews you conducted with friends and teachers will help your child's doctor. Sometimes, doctors ask teachers and peers to fill out formal questionnaires of behavior, so they can get develop a well-rounded picture of how the child behaves throughout the day.
If your child's pediatrician spots issues of concern, a referral to an expert is in order. During a series of appointments, your child will:
- Talk. The doctor will ask how they think, feel, and behave.
- Test. The doctor may use self-assessment quizzes to understand how your child's mind works.
- Screen. The expert may suggest other tests to rule out an underlying health problem that could cause autism symptoms.
Doctors need time to come to an autism diagnosis. Typically, professionals require a few appointments to rule out underlying conditions. But for some teens, the wait is worthwhile.
In studies, teenagers with autism describe a feeling of freedom that came with their diagnosis. They have a deeper understanding of why they behave as they do, and they have a stronger sense of self-worth because of that knowledge. Rather than feeling unusual and strange, they feel empowered.
Some teenagers don't feel this way, of course. An autism diagnosis can be upsetting or even scary. It's important for parents to stay in touch with their children during this process. And it's critical to move into therapy as soon as possible.
How Teen Autism Is Treated
Therapists are adept at helping their patients to process strong emotions. Teens who feel upset or worried about an autism diagnosis may enjoy talking through those feelings with a professional. They may emerge from these sessions feeling more confident and capable.
Treatment does more than help people feel comfortable with a diagnosis. For example, researchers report that people diagnosed with autism often struggle with:
- Peer relationships.
- Conversation skills.
- Unusual speech.
Any or all of these features could be a target for a therapeutic intervention. Applied behavior analysis (ABA) therapy is made to help people with autism both identify and amend a specific behavior.
A teen who talks in a high, strangled voice might aim to talk at a reasonable pitch. A therapist could identify that pitch and hold many practice sessions to help the teen master that skill. With that addressed, the two could move on to making friends or handling the give and take of conversation.
These sessions aren't punitive. They're made to give teens with autism tangible, real-world skills they can put to use in their everyday lives. The sessions will certainly be helpful, and your teen may even find them fun.
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Autism Starts Months Before Symptoms Appear, Study Shows. (February 2017). Scientific American.
When Do Children Usually Show Symptoms of Autism? (January 2017). National Institutes of Health.
Explaining Differences in Age at Autism Spectrum Disorder Diagnosis: A Critical Review. (June 2013). Autism.
Age at Autism Spectrum Disorder (ASD) Diagnosis by Race, Ethnicity, and Primary Household Language Among Children With Special Health Care Needs, United States, 2009-2010. (February 2015). Maternal and Child Health Journal.
Signs of Autism Spectrum Disorder in Older Children and Teenagers. Raising Children Network.
Growing Up Together: Teens with Autism. Autism Society.
"I'm a Normal Autistic Person, Not an Abnormal Neurotypical": Autism Spectrum Disorder Diagnosis as Biographical Illumination. (January 2018). Social Science and Medicine.
Frequency and Pattern of Documented Diagnostic Features and the Age of Autism Identification. (April 2013). Journal of the American Academy of Child and Adolescent Psychiatry.