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Autism in Teens: Puberty, Symptoms, and Treatments

November 8, 2023

Autism in Teens: Puberty, Symptoms, and Treatments

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Autism in Teens: Puberty, Expectations, Symptoms, and Treatments

Signs of Autism in Teens

Autism in teens can be recognized during regular interaction with others at school and at home.

Verbal Signs of Autism in a Teen

  • Not knowing how to engage in a two-way conversation – usually talking about a single topic without allowing the other person to talk or respond
  • Only wanting to talk about a single topic and not wanting to talk about things that do not interest them
  • Taking things literally, such as holding a ball close to their eye when told to “Keep your eye on the ball.”
  • Speaking with an accent, in a monotone, or with a singsong voice
  • Using unusual vocabulary that can sometimes be old-fashioned
  • Having a hard time following instructions

Non-verbal Signs of Autism in a Teen

  • Difficulty reading non-verbal cues like tone of voice, gestures and body language
  • Using minimal eye contact, especially when talking to others
  • Very limited/few facial expressions

Behavioral Signs of Autism in a Teen

  • Want to spend time on their own rather than with friends
  • Want other children to play by the rules
  • Not understand social expectations, like making friends
  • Have few or no friends
  • Prefer to talk to people older than them
  • Stand too close; no concept of personal space

Diagnosing Autism in Teenagers

The process of getting diagnosed with autism during the teenage years is no different from that of getting a diagnosis at an early age, but it will involve more questions about the teen’s behavior in school and how he/she interacts with peers.

A formal diagnosis might involve one or more experts in the field of autism such as developmental pediatricians, psychiatrist, psychologists, occupational therapists, and speech pathologists.

The diagnostic procedures can include:

  • An interview with parent or caregiver
  • Actual observation of all interactions with others
  • A physical exam to rule out other medical conditions
  • A developmental screening (an assessment of developmental progress from infancy to present age)

Once a teen has been diagnosed, a qualified pediatrician can recommend how to move forward with beneficial behavioral therapies and treatments.

Differences Between Boys and Girls with Autism

Recent studies have suggested that there is a significant difference in how autism affects girls and boys, which often result in undiagnosed cases in girls with autism.

Autism in Teenage Girls

A study (behavioral and cognitive characteristics of females and males with autism in the Simons Simplex Collection) published in the Journal of the American Academy of Child and Adolescent Psychiatry concluded that autistic symptoms in girls could go unnoticed.

Girls who have normal intelligence levels can “mask” their symptoms. Because they are of average or above-average IQ, girls with autism can appear neurotypical even though they have poor verbal and non-verbal skills.

Another contributing factor is culture. A girl who is quiet and non-responsive can be considered feminine and well-behaved, while a boy who is quiet can be seen as unusual or different.

Autism in Teenage Boys

Boys are four times more likely to be diagnosed with autism than girls. There is no definite reason why this is, but some theories state that girls are genetically less likely to inherit autism. The research found that girls can handle genetic mutations and can handle more instances before they reach the diagnostic threshold for autism.

Autism and Puberty

From experiencing sexuality for the first time to asking a girl out to the prom, a teenager with autism needs constant support to enjoy this time of their life fully. Parents should be aware of the changes that will come once a child with autism hits puberty and beyond, as autism in the teenage years can have its challenges.

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It’s important to understand that puberty happens regardless of the developmental delays of a child with autism. Puberty typically starts at the age of 12 for girls and 14 for boys, but may be earlier for some.

Parents, family members, and caregivers of teenagers with autism will notice significant changes during puberty. These changes are mostly physical, but some are emotional and psychological.

The teenage years can be challenging, especially when it comes to the pressures of dating. Parents and caregivers are expected to guide teenagers with hygiene and understanding sexuality.


Unlike their peers, teenagers with autism might not see the importance of keeping their body clean. Other teens with autism might even have sensory aversions to taking a shower, so they avoid it altogether.

Parents and caregivers need to develop consistent strategies to help a teen with autism routinely wash and add hygiene routines like putting on deodorant and clean clothes. For girls, it’s important to share hygiene tips for menstruation, such as using a tampon/sanitary pads at this stage.


A teenager with autism will start feeling attracted to the opposite sex and develop sexual urges. It is not uncommon for autistic teens to masturbate, so it’s important that they are taught about the appropriate place where it is done.

This is also a good time to communicate the following points:

  • Do not expose yourself in public
  • Do not let people touch you or your privates
  • Do not join a group to participate in anything sexual

Whether or not a parent is okay with this topic, it cannot be ignored.

The Potential for Seizures Can Increase During Puberty

The chance of your autistic teen having seizures during puberty is four to one. The cause is not known but is believed to be brought about by hormonal changes in the body.

Teens with autism might also experience subclinical seizures during puberty. Subclinical seizures are seizures that are too faint that they can go unnoticed. Several diagnostic tests can be done to find out if a teen with autism is experiencing seizures, so if you have a concern, contact your child’s doctor.

How do Teens with Autism Communicate?

Teens on the spectrum can still be delayed in speech or language skills even when they have normal to above-average intelligence. Teens diagnosed with Asperger’s syndrome, also known as high-functioning autism, typically don’t have delays in speech, motor, and physical skills. The delay is in social and communication skills, which are made more obvious once the child has been exposed to social situations.

Because of their social and verbal limitations, autistic teens might:

  • Not respond appropriately
  • Only talk about a specific interest
  • Not respond to jokes or sarcasm
  • Talk using a formal, business-like tone

While these communication gaps might not be severe, it can hurt a teen’s social life.

Different Types of Autism in Teens

There is not a lot of classification when it comes to autism in teens. Mild autism in teenagers is often the reason why teens can have a late diagnosis.

How does ASD affect a teen? ASD can greatly affect a teenager in all aspects of their life. At a time when one experiences physical changes and social milestones, autistic teens can have a hard time coping and dealing with multiple life events.

Some examples of potential challenges for a teen with autism are:

  • Difficulty following complex school routines
  • Rebellious demeanor at home and in school
  • Unable to make friends because of poor hygiene
  • Difficulty understanding romantic and sexual feelings
  • Giving in to peer pressure without realizing the consequences
  • Becoming a target of bullying due to poor social and communication skills

There is no telling what surprises await parents who have teenagers with autism, but keeping open communication between parent and child can make these challenges easier to manage. However, some teens can be stubborn and resist a parent’s guidance. In this case, parents can seek help from a counselor or psychologist.

Activities for Autistic Teens

Outdoor activities and sports can help teens with autism take a break from their routine. It can also help them learn new things outside the classroom, which is great for self-esteem.

Some structured activities that would be great for autistic teens are:

  • Summer camp
  • Swimming
  • Yoga
  • Soccer
  • Hiking
  • Horseback riding
  • Theater workshops
  • Art class

Safety should always be a priority when enlisting teens with autism in these activities. Because some teens with autism have no concept of danger, they need adult supervision when performing potentially dangerous tasks like swimming or wall climbing.

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Autism in Teens: Puberty, Expectations, Symptoms, and Treatments

Treatments for Autism in Teens

Treating autism in teens can sometimes be different from treating younger children. Specialized programs focus on the specific needs of teens with autism.

The treatments aim to:

  • Help the person go through puberty
  • Develop self-esteem and make new friends
  • Understand and manage sexual and romantic feelings
  • Manage mood changes

Treatment for teens with autism can include:

Social Skills Training

Social skills training will teach teens to deal with social situations and respond appropriately. Participants are taught to read non-verbal cues (body language, eye contact, facial expressions), solve social problems, and understand relationship rules.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) is a psychosocial intervention that seeks to improve mental health. This collaborative therapy can help people find new ways to behave by changing thought patterns. It focuses on changing unhelpful attitudes and thoughts. For instance, if you think, “I’m never going to have friends,” you may feel bad and perhaps not be open to friendships.

CBT’s strategy is to use this kind of thinking but with a positive twist. The teen might be instructed to think positive thoughts instead of negative ones to change how they feel and ultimately change behavior.


Modeling is simply showing someone how to do something. This approach can be used to teach how to act in social situations, like greeting someone or saying goodbye. The participant can also learn basic hygiene and self-care tasks.

Self-Management Techniques

Self-management techniques aim to help people with autism become independent as they navigate their daily tasks. Teens with autism can perform this technique on their own.

This approach lists goals on a notebook or other record-keeping tracker. Once they are met, they can be marked as done. This practice allows teens to gain independence while learning to regulate their behavior.


Understanding autism in teenagers during the challenging phase of puberty requires a special approach. By acknowledging the impact of hormonal changes, managing expectations, recognizing symptoms, and implementing tailored strategies for support, we can ensure that teenagers with autism thrive during this crucial stage of development.


Q: How does puberty affect teens with autism differently?

A: Puberty can lead to increased anxiety and sensory sensitivities in teens with autism, making it a challenging phase to navigate.

Q: What therapies are available to support teens with autism during their teenage years?

A: Speech therapy, occupational therapy, and applied behavior analysis are some of the therapies that can benefit teens with autism during adolescence.

Q: How can parents and schools collaborate to support teens with autism?

A: Effective communication and a collaborative approach between parents and schools are essential to create a supportive environment for teens with autism.

Q: What should I do if my teen with autism is struggling with emotional regulation?

A: Seeking guidance from a therapist or counselor specializing in autism can help teach emotional regulation strategies.

Q: How can I help my teen with autism develop social skills?

A: Encourage social interactions, provide opportunities for socialization, and consider enrolling them in social skills training programs to help them develop social skills.


A Higher Mutational Burden in Females Supports a “Female Protective Model” in Neurodevelopmental Disorders

Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020

Autism As a Disorder of High Intelligence

Behavioral and cognitive characteristics of females and males with autism in the Simons Simplex Collection

Sex Differences in Autism Spectrum Disorder: Focus on High Functioning Children and Adolescents

Cognitive Behavioral Therapy for Autism Spectrum Disorders: A Systematic Review

Meta-Analysis on Intervention Effects of Physical Activities on Children and Adolescents with Autism

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