Autism In Teens: Signs, Risk Factors, Diagnosis And Treatment

Speech and behavioral therapy may help control the symptoms of autism.

Reviewed by Dr. Neha Mehta, MD Dr. Neha Mehta Dr. Neha MehtaMD facebook_icontwitter_iconyoutube_iconinsta_icon Specialty: Clinical psychologyExperience: 10 years
Written by Dr Bisny T. Joseph
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Autism or autism spectrum disorder (ASD) is a neurodevelopmental disorder that interferes with communication and behavior. It is known as a spectrum disorder as the symptoms and characteristics may vary in each child. Although autism can occur at any age, it is more prominent within the initial two years of life.

Autism is a lifelong developmental disorder without a specific cure. However, certain therapies may help improve a teen’s symptoms and functional abilities.

Read this post to learn about the social and behavioral signs, causes, risk factors, diagnosis, complications, and treatment options for autism or autism spectrum disorders in teens.

Signs Of Autism In Teenagers

In some cases, certain signs of autism may become noticeable in school-going children and teenagers. The school environment and social situations may trigger symptoms of autism or make them more noticeable.

Teens may experience the following signs of autism (1).

1. Social communication signs of autism

Teens with autism may face difficulties with verbal and nonverbal communications for social interactions. They may also face challenges in making friendships and enjoying age-appropriate interests with peers. You may notice the following verbal communication issues in a teen with autism.

  • Talks more about their favorite topics but finds difficulty talking about a range of issues or new topics.
  • May have difficulties understanding a language, such as confusion understanding idioms and phrases. For instance, if someone tells them “Pull your socks up” to improve their effort, they may literally pull up their socks.
  • May talk in an unusual tone of voice; for instance, they might speak loudly or in a specific accent or monotone voice.
  • Unable to follow instructions.
  • May continuously talk or find it difficult to answer questions during a conversation.
  • May talk in an informal or old-fashioned way although they have a good vocabulary.
  • Jumps from one toy to another.
  • Finds it difficult to understand the basic concepts.
  • More glued to entertainment.
  • Wishes to hear same rhyme or story.
  • Cant adjust to new things/toys/people.

Teens with autism may have the following nonverbal communication issues.

  • Difficulty understanding nonverbal cues such as tone of voice, facial expressions, or body language. They may also not understand the tone of voice that suggests their parents or teachers are angry and may not distinguish sarcasm or teasing from peers.
  • Unusual eye contact or no eye contact while speaking to someone
  • Uses few gestures to express something.
  • May not express emotions on the face and may not understand others’ emotions.

Teenagers with autism might also find problems in developing relationships. They might

  • Like to spend time alone than with other people.
  • Have difficulties understanding the social rules and may have very few or no friends.
  • Tend to play with their own set of rules and get upset if their peers do not follow them.
  • Prefer to play with younger children or adults than peers.
  • Invade others’ personal space.
  • Have issues adjusting to different social situations.

2. Behavioral signs of autism

Teenagers with autism may show certain repetitive behavior and interests. These may include

  • Compulsive behavior, including closing all the doors in the house and lining up things.
  • Attachments to objects, such as specific toys and chip packets.
  • Dislike for minor changes or obsession about routine, such as wanting to sit in the same place to eat.
  • Making repetitive noises, such as squealing, throat clearing, or grunting.
  • Making repetitive body movements, such as hand flapping.

The following sensory sensitivities may also be observed in some teens with autism.

  • Less pain response
  • Sensitivity to sensory experiences, such as getting upset by certain sounds, clothes, etc.
  • Seeking sensory stimulation by applying deep pressure, fluttering fingers on the side of the eye to watch something, etc.

3. Other signs of autism

Besides social and behavioral issues, teens with autism can also face various other issues such as

  • Anxiety: Teens with autism might feel overwhelmed or anxious to go to new places or social situations.
  • Sleeping problems: Broken sleep patterns and difficulty in falling asleep are usually seen in children with autism
  • Depression: Teens who are aware of their condition or know how others perceive them might have depressive thoughts.
  • Eating disorders: Some teens may develop eating disorders to cope with the anxiety of school change or some other events.
  • Aggressive behavior: Sudden aggressive behaviors can be due to sensory activities. Some teens with autism may become aggressive due to frustration. This may often occur when they cannot understand what is going on around them.
  • Refusal to go to school or participate in other activities: This can be due to bullying at school or difficulties in understanding and coping with the curriculum and other activities.
  • Gender dysphoria: This is a feeling of discomfort experienced by people whose gender identity differs from the sex given at birth.

Causes Of Autism

There is no single known cause of autism. Autism is believed to be a complex disorder with distinct causes that co-occur, and both genetic and environmental factors may play a role (2) (3).

  • Genetic factors: Several gene mutations and genetic disorders are known to increase the risk of autism spectrum disorder. These mutations can be inherited or occur spontaneously during development. Genetic disorders such as Rett syndrome (language and coordination impairment with repetitive movements) and fragile X syndrome (intellectual disability with long narrow face) are often associated with autism.
  • Environmental factors: Studies are ongoing on the role of environmental factors, such as air pollutants, medications, viral infections, and pregnancy complications, in triggering autism or autism spectrum disorder.
    Contrary to popular belief, extensive research has shown that there’s no link between autism and childhood vaccines (4) (5) (6). Avoiding vaccinations can put your child at risk of preventable, life-threatening diseases.

Risk Factors For Autism

The following factors may increase the risk for autism in children (2) (7).

  • Boys are four times more likely to get autism spectrum disorder than girls.
  • A child born into a family with a history of autism may have an increased risk for autism. Sometimes parents, siblings, or close relatives of a child with autism can have minor symptoms such as issues with social or communication skills.
  • Infants born before 26 weeks (extremely preterm) may have an increased risk for autism.
  • Children with certain medical conditions such as fragile X Syndrome and Rett syndrome may have an increased risk for autism-like symptoms.
  • Advanced parental age is shown to increase the risk in some cases. However, more studies are needed to establish this connection.

Can Autism Be Prevented?

Autism spectrum disorder cannot be prevented (2). However, intervention at any age can benefit the child, and early diagnosis and therapies may help improve language development, behavior, and other skills. Also, teens may not outgrow autism, but they may learn to function well with proper training.

Diagnosis Of Autism

There is no specific medical diagnostic test for autism. Pediatricians or primary care physicians may refer the child to child psychologist or clinical psychologist who applies psychological assessment like Mchat-R or CAST (Childhood Autism Spectrum Test). The report confirms the condition or the specialist may evaluate the following factors to diagnose autism in your teen (2).

  • Observe the teen and evaluate their communication skills and behaviors. Doctors may also ask you a few questions about your teen’s social interactions, developmental skills, and medical history.
  • Tests may be done to analyze speech and language skills and identify any delay.
  • Structured communication and social interactions tests are given, and the performance score is analyzed to identify the severity.
  • Use the criteria given in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to identify mental health issues.
  • Genetic testing is often done in some teens with symptoms of Rett syndrome or fragile X syndrome.
    Referrals to specialists and additional tests are often required for some teens to exclude the possibility of other disorders that may cause similar signs and symptoms.

Treatment For Autism

There is no cure for autism but regular therapies prove to be helpful. These children can study and have normal social circle along with ongoing therapies. Not all teens fit into a single therapy regime since the severity may vary. The existing treatment options aim to improve the functions, support learning and development, and reduce the symptoms. Autism therapies may include (8)

1. Behavioral and communication therapies help address a range of social, behavioral, and language problems. These programs may train the teen to behave or communicate in proper ways. A common approach is applied behavioral analysis (ABA) that teaches new skills and encourages good behavior via reward-based motivations.

2. Educational therapies include structured educational programs to help the teen learn and overcome their difficulties.

3. Speech therapy is often recommended to improve communication skills.

4. Occupational therapies teach everyday skills to make the teen independent and improve their quality of life.

5. Physical therapy may provide more movement and balance to teens with physical symptoms.

6. Psychotherapies are often needed for teens to understand and cope with autism.

7. Family therapies help the teen and their families play and interact in ways that improve communication.

8. Medications: There are no specific medications to improve autism. Some medications are prescribed to control specific symptoms. Antipsychotics are often needed for hyperactivity and other behavioral problems. In the case of anxiety, antidepressant therapy may be required.

Always keep a record of therapies and medications your teen had received previously during the next visit. This may help the doctors plan therapies more effectively. You may also seek your doctor’s approval before giving any alternative medication.

Frequently Asked Questions

1. Can autism be triggered by puberty?

Autism develops before the age of three. However, the symptoms such as social impairment, stress, and anxiety may be triggered during adolescence (9) (10).

2. Is autism caused by trauma?

No, factors such as trauma, mental stress, or parental neglect cannot cause autism (11).

3. Does stress worsen autism?

Yes, stressful situations may trigger autism and cause them to withdraw or shut down under pressure (12).

Autism in teenagers may present itself as communication issues, repetitive behaviors, or other signs such as sleep disturbances and anxiety. Since autism is diagnosed in the first two years of life in most cases, you may have been aware of your teen’s diagnosis for quite some time now. While there is no treatment for autism, therapies can help you manage the symptoms better and enable your child to live comfortably in a structured and predictable atmosphere. However, since it may be difficult to care for your teenager with autism, do not hesitate to seek help from professionals or support groups.

Key Pointers

  • Difficulty in verbal and non-verbal communication, challenges in developing relationships, and inability to follow basic instructions are a few signs of autism in teens.
  • Autism has no definite cause, but those with a family history are at a higher risk.
  • You cannot prevent austism, but early diagnosis and regular therapies might improve the overall quality of life.

References

1. Signs of autism in older children and teenagers;Raising Children Network
2. Autism spectrum disorder; St. Clair Health
3. Teens with Autism;Autism Society
4. Frank DeStefano, Cristofer S. Price, and Eric S. Weintraub;Increasing Exposure to Antibody-Stimulating Proteins and Polysaccharides in Vaccines Is Not Associated with Risk of Autism; The Journal of Pediatrics (2013).
5. Institute of Medicine;Adverse Effects of Vaccines: Evidence and Causality;The National Academies Press (2012).
6. Autism and Vaccines;Centers for Disease Control and Prevention
7. Autism Spectrum Disorder;The National Institute of Mental Health
8. Treatment and Intervention Services for Autism Spectrum Disorder;Centers for Disease Control and Prevention
9. What is Autism Spectrum Disorder?Centers for Disease Control and Prevention
10. Blythe A. Corbett and David Simon (2014); Adolescence, Stress and Cortisol in Autism Spectrum Disorders; NCBI
11. What is Autism? Forum For Autism
12. Causes of Autism; Synapse
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Gold medalist Neha Mehta is an RCI-registered psychologist, certified relationship and child psychologist, and a well-known parenting coach practicing in Haryana. She has ten years of experience in the field of counseling.

Read full bio of Dr. Neha Mehta
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