Receiving an Autism Diagnosis in the Teen Years

Many autistic children are diagnosed in early childhood, but for others their signs and symptoms do not become apparent until adolescence. If a teenager is capable and academically able, they may not receive a diagnosis as a young child. This can sometimes occur more often in girls than in boys because girls are generally more adept at copying neuro-typical behaviors, including verbal and non-verbal communication in order to mask their autism.

Some teens may have other co-occurring conditions such as ADHD, anxiety, or behaviors of concern which present as the prevalent need for support. Children may be able to cope better in the elementary school environment, but once they get into secondary school the demands and surroundings become overwhelming and stressful. Their struggles may become more evident as social relationships become more central in a teen’s life. Autistic teens can be prone to isolation and low moods, which can appear very intense and be hard to read.

Parents and teens may feel fearful about seeking a diagnosis at this stage of life, but it can help everyone understand a person’s strengths and abilities, the difficulties, and what supports and services are needed to foster a teenager’s well-being. It won’t change how a parent feels about their child, but knowing why a person is the way they are can foster acceptance, empathy, and strengthen the relationship.

What are some of the signs of autism in teens?

This list of signs for parents, carers, and teachers comes from the Aspris Children’s Services website.

Difficulty with social interaction and communication

• Problems forming friendships
• Mistaking social cues or body language
• Misinterpretation of conversations
• Finding it easier to form friendships online
• Poor eye contact
• Expressing that they ‘don’t fit in’

Inflexibility or rigidity of thought (‘black and white’ thinking)

Sensory processing difficulties

• Experiencing sensory overload e.g. finding the noise of school overwhelming
• Being unable to cope with line ups or crowds
• Sensitive to touch
• Having difficulties with the planning and organization of their work, backpack, or school day

Emotional difficulties

• Low self-esteem
• Difficulty or reluctance to express or label their own emotions
• Levels of anxiety which seem excessive compared to the situation triggering them
• Low mood or depression
• A desire to withdraw from the outside world

How is autism diagnosed in teens?

There is not a single test to diagnose autism. A team of professionals and specialists called a multidisciplinary team perform a variety of tests and assessments. A multidisciplinary team will usually include a pediatrician, a psychologist, a speech pathologist, occupational therapist, and sometimes a child psychiatrist. Members of this team may see the young person several times and ask questions about current and past development and behavior. There may also be some assessments done at school by a educational professionals such as an educational psychologist. Assessments will explore a person’s strengths and abilities in areas like daily living skills, communication and thinking.

Talking with Teenagers About an Autism Diagnosis

Parents are often unsure of what or how much to tell their child about an autism diagnosis. It’s important to talk about it to help them think more positively about themselves and their autistic identity. Be prepared for questions and answer them honestly at a level the teen will understand. This will be a process and not a single discussion.

Autistic teens usually realize they’re different from other people their own age. Focus on their strengths, abilities and their unique qualities. It’s OK to talk about their struggles too. Young people need to have trusted, accepting adults in their lives who they can go to for help and guidance.

Every young person will react differently to receiving their diagnosis. Some may feel relieved because they now understand more about themselves. Others may need time to adjust and come to terms with a new diagnosis. They may feel scared or confused about who they are now. This is an identity shift.

Parents should also educate themselves about autism. Some topics to focus on could be:

• autism and its nuances
• what’s happening in a neurodivergent brain
• how you can advocate for your teen when others don’t understand, accept who they are, or give them the support they need

New information is coming out all the time so keep reading and stay current. Good books for parents to read are:

Autism and the Predictive Brain – Absolute Thinking in a Relative World – Peter Vermeulen
Hidden Brilliance – Unlocking the Intelligence of Autism – Lynn Kern Koegel, Claire LaZebnik
Uniquely Human – Barry Prizant
Visual Thinking – The Hidden Gifts of People Who Think in Pictures, Patterns, and Abstractions – Temple Grandin

Disclosing the Diagnosis

Who should be told about an autism diagnosis? What is this decision based on? There will be some trial and error in disclosing because there’s no way to predict another person’s reaction; some reactions will be positive and others will be negative. Negativity often stems from fear so an initial negative reaction can turn positive once a person is more comfortable in understanding autism and what it’s all about. Knowing about a diagnosis can lead to a better understanding of the individual by other people and get the right supports in place in an educational setting, community organization, living arrangement, or job. Caregivers, friends and extended family members can often be more understanding and effective in supporting the individual.

It’s not enough to simply tell the facts about autism. For understanding to happen, disclosure must include personal information about how autism affects the person, their strengths, their challenges, and how being autistic affects their daily living.

Tell people who can be trusted, have the person’s best interest at heart, and can keep the information confidential. The need for self-advocacy can also be the basis for disclosing a diagnosis. For example, a teen may need extra time to take an exam due to anxiety issues or poor handwriting skills or have to type their answers on a computer. Most people are understanding when they know the circumstances involved.

Disclosure can be a positive thing because it can make a good change in a relationship, end stereotypes, and get the right supports in the home, school, community or workplace. It’s hard to see a person struggle all because no one knows they are autistic and the autistic person doesn’t know how to ask for help.

5 Tips for Raising an Autistic Teen

Keep in mind that autistic teens are individuals with likes, dislikes, and specific needs that have nothing to do with their diagnosis. Here are a few ideas that can help support them.

1. Find suitable leisure activities and social outlets – These activities can be around a person’s interests. My autistic daughter loves cats and enjoys attending cat shows and volunteering at a cat charity twice a week. She has met like-minded people there who share her interest. Look for clubs, organizations or meetings around specific interests.
2. Don’t force friendships – Many teens are happy with one or two close friends. Support social skill development and provide appropriate opportunities for socializing.
3. Teach life skills – Life skills may not be learned simply by watching other people do a task. Explicit instruction is needed and repeated practice to learn the skill. Focus on skills that will support a healthy and balanced life such as money management, household chores, cooking, shopping for groceries, self-care skills, and safety.
4. Build emotional awareness – Understanding emotions comes through interoceptive awareness. Knowing one’s emotions can help with self-regulation and lead to better well-being.
5. Engage in regular physical activity – Regular exercise lessens anxiety, improves sleep, increases endurance, builds muscles, develops motor skills and offers opportunities for socializing.

References

Jewell, T. (November 12, 2021). What Are the Signs of Autism in Teenagers? Healthline

(October 26, 2022). Late autism diagnosis: older children and teenagers. raisingchildren.net.au

Late Autism Diagnosis: Older Children and Teenagers . Luke Priddis Foundation

Wendt, T. (August 25, 2022). What to Know About Autism Spectrum Disorder in Teens. WebMD