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Autism in Teens: Signs, Expectations, and Treatment

May 24, 2024

The teenage years are a time of transformation, and for teens on the spectrum, they can be especially challenging. If you’re concerned about your teen’s journey through puberty – you are not alone. Don’t worry, though – dealing with autism in teens can be tricky, but it’s not impossible.

Unfortunately, autism doesn’t take a backseat during the tumultuous teenage years. Because of that, this article will help you gain a better understanding of autism in teens and share some useful tips on how to make this phase easier for both you and your teen.

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

Signs of Autism in Teens

Teens may show autistic traits through communication and behavior at school and home. But what are some of the most common signs?

Verbal signs of autism in teens:

  • difficulty engaging in two-way conversations,
  • talking about specific topics and refusing to talk about things that do not interest them
  • taking things literally,
  • speaking with an accent, in a monotone, or with a singsong voice,
  • using unusual vocabulary,
  • having a hard time following instructions.

Common non-verbal signs of autism in teens:

  • 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 teens:

  • wanting to spend time on their own rather than with friends,
  • not understanding social expectations, like making friends,
  • having few or no friends,
  • preferring to talk to people older than them,
  • having no concept of personal space.
Teenager with headphones alone

How Is Autism Diagnosed In Teens?

The process of getting diagnosed with autism during the teenage years is no different from that of getting a diagnosis at an early age. Still, testing for autism in teens may involve more questions about the teen’s behavior in school and how they interact with peers.

A formal diagnosis might involve one or more experts in the field of autism, such as:

  • developmental pediatricians,
  • psychiatrists,
  • psychologists,
  • occupational therapists, and
  • speech pathologists.

The diagnostic procedures can include the following:

  • an interview with a parent or caregiver;
  • actual observation of all interactions with others;
  • a physical exam to rule out other medical conditions;
  • a developmental screening (assessing developmental progress from infancy to the present.)

Once a teen is diagnosed, a qualified pediatrician can recommend how to proceed with beneficial behavioral therapies and treatments.

Differences in Autism Between Boys and Girls

Recent studies highlight significant gender differences in how autism manifests, often leading to undiagnosed cases in girls.

A study published in the Journal of the American Academy of Child and Adolescent Psychiatry found that autistic symptoms in girls can go unnoticed, especially when they have normal intelligence levels, allowing them to “mask” their symptoms.

Cultural perceptions also play a role, as quiet and non-responsive behavior in girls might be considered feminine and well-behaved, whereas similar behavior in boys may be seen as unusual or different.

Boys are four times more likely to receive an autism diagnosis. Theories suggest genetic factors may contribute, as girls may be genetically less prone to inherit autism, demonstrating resilience to genetic mutations.

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Autism and Puberty Challenges

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 should be prepared for physical, emotional, and psychological changes. On top of that, it’s important to help teenagers understand sexuality and the importance of hygiene.

Teenagers with autism experience attraction and sexual urges. It’s common for them to masturbate, so it’s crucial to teach them about appropriate places for these activities.

It’s also important to communicate key points, such as:

  • not exposing themselves in public,
  • setting boundaries for physical contact, and
  • avoiding participation in inappropriate sexual activities in groups.

On top of sexual challenges, some autistic teens may struggle with hygiene. Unlike their peers, teenagers with autism might not see the importance of keeping their bodies clean. 

For girls, it’s important to share hygiene tips for menstruation, such as using a tampon/sanitary pads at this stage.

Behavioral Challenges in Autistic Teens

Autism can greatly affect a teenager in all aspects of their lives. 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
Mother talking to her upset son

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. When autistic behavior in teenagers becomes too much to handle, parents can seek help from a counselor or psychologist.

Activities for Autistic Teens

Outdoor activities and sports can help autistic teens 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.

Therapy Methods 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

Explore a range of treatment options designed for teens with autism, including:

  • Social Skills Training: Teaches teens to deal with social situations appropriately. Participants are taught to read non-verbal cues, solve social problems, and understand relationship rules.
  • Cognitive-Behavioral Therapy (CBT): Psychosocial intervention that seeks to improve mental health. This collaborative therapy can help people find new ways to behave by changing thought patterns.
  • Modeling: Demonstrates appropriate behavior in social contexts, guiding teens on social interactions, greetings, goodbyes, and essential self-care tasks.
  • Self-Management Techniques: Aim to help people with autism become independent as they navigate their daily tasks.
  • Applied Behavior Analysis: ABA therapy for autistic teens focuses on enhancing social skills, communication, and behavior management through personalized and evidence-based interventions. 

Advice for Parents of Autistic Teens

Navigating the teenage years with an autistic child may present unique challenges, but it’s crucial for parents to stay informed, foster open communication, and seek support from professionals and communities.

Embracing autism, understanding individual strengths and needs, and providing a supportive environment can empower both parents and autistic teens on their journey toward adulthood and a fulfilling life.

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


Q: What are the signs of Asperger’s syndrome in teenagers?

A: In teenagers with Asperger syndrome, signs may include challenges in social interactions, difficulty understanding non-verbal cues, repetitive behaviors or intense interests, and a preference for routine and structure. Additionally, they may exhibit limited eye contact, struggle with changes in routine, and face challenges in forming and maintaining friendships.

Q: Is there a test for autism in teens? 

A: There isn’t a single definitive “autism in teens test,” but professionals may use various assessments, interviews, and observations to evaluate a teenager’s behavior, communication, and social interactions. If there are concerns about autism, consider talking to a healthcare professional or a specialist experienced in autism assessments.

Q: Can you develop autism as a teen?

A: No, autism doesn’t develop during the teenage years. Signs of autism are usually present since early childhood, and it’s recommended to assess children with possible autistic traits as early as age 2.

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.


Abnormal speech spectrum and increased pitch variability in young autistic children

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

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

Changes and Challenges of Puberty in Adolescents with Autism Spectrum Disorder, 2022.

Meta-Analysis on Intervention Effects of Physical Activities on Children and Adolescents with Autism, 2020.

Perception of Social Cues of Danger in Autism Spectrum Disorders

Treatment of Autism Spectrum Disorder in Children and Adolescents

Cognitive Behavioral Therapy for Autism Spectrum Disorders: A Systematic Review, 2020.

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