Supporting our children through puberty can be challenging, but there is hope!
As parents, our main focus is the health and happiness of our children. For our children with autism spectrum disorder (ASD), the list of needs to ensure those things can be a bit longer. Milestones are one aspect of our kids with autism’s lives that we are particularly used to monitoring.
The milestone of puberty is one that I would like to discuss today. In this article, I will be exploring autism and puberty, how they affect each other, and how we can best support our children with autism as they traverse this complex time.
How does puberty affect people with autism?
Autistic children have enough going on without having to deal with the perils of puberty. However, it is something that they will have in common with their neurotypical peers. This time, as it is a normal part of growing up, they will be facing the “regular” symptoms, as well as the complications autism can bring to the “party”.
Let’s first explore puberty, its markers, and how autism spectrum disorder may or may not affect it. Here is a list of some of the signs and symptoms of puberty in girls and boys.
- breasts begin to develop
- growth of hair on body parts
- mood swings
- the beginning of menstruation
- voice changes
- wet dreams
- enlargement of testicles and penis
- muscle growth
- mood swings
Do kids with autism go through puberty faster?
Autism research has shown some variation between children with autism going through puberty
Precocious puberty is when the signs and symptoms appear in early childhood, before age eight in girls and age nine in boys. There is evidence to suggest that precocious puberty can occur more often in girls with autism. The research in the study titled, “Pubertal Timing During Early Adolescence: Advanced Pubertal Onset in Females with Autism Spectrum Disorder,” we learn:
“Historically, precocious puberty (onset < 8 years in females and 9 years in males) or early puberty (onset between 8 and 9 years in females and between 9 and 10.5 years in males) can be considered a normal variant (Winter, Durand, & Brauner, 2019). A portion of the females with ASD would likely meet criteria for precocious puberty and an even larger proportion would meet criteria for early puberty. Due to the observed higher percentage of early onset in ASD compared to TD females, the findings would be hard to dismiss as a normal variant.”
The same study also states: “For males, there were no differences across the groups in pubertal timing to include genital or pubic stage…”
So, it seems that autism can affect puberty’s timing. Delayed puberty can also happen, but it isn’t necessarily linked to autism.
Does autism get worse during puberty?
Autism does not “worsen”. However, the changes that can occur can be more challenging for autistic children.
Children with autism often have trouble with social aspects, and these challenges can intensify during what is already a confusing and difficult time for many. Rising and changing hormone levels may also affect comorbid conditions, compounding the difficulty autistic children experience. Things such as:
- anxiety and depression
- attention deficit hyperactivity disorder (ADHD) symptoms
- seizure activity
- gastrointestinal woes
Social connections are often strained for children who don’t usually struggle with social situations during puberty. The onset of acne and mood swings, as well as the comparison with their peers who may be further along in the process, can all take a toll on social function. For children with autism who already have differences in social skills, the time of puberty can pose extra concerns.
Communication can also play a role in how autistic children fare during puberty. Some children with autism spectrum disorders have trouble communicating verbally, have a hard time reading body language, speak in a monotone, or have selective mutism. During puberty, this lack of skills can make everything more difficult for them.
They may struggle to build skills, understand how to interact with their peers, or be isolated from their friends and families at this vulnerable time. This can lead to worsening depression, anxiety, and tummy troubles. The ability to communicate and build trust is one way that can lessen the negative aspects of the transition to adulthood.
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How to prepare your autistic child for puberty
In order to prepare our children with autism for puberty, we must first prepare ourselves. This can happen long before the first symptoms appear. In fact, the earlier we begin to prepare, the better.
Though we cannot anticipate every incident that may arise, we can be aware of the common issues, understand what to look for, set up support in advance, and most of all find out the fun things to look forward to. Younger children will need age appropriate preparation, while autistic teenagers who were prepared in advance will be much more ready to face the challenges.
Next, we can be available for open dialogue to be the standard for communications before, during, and after puberty. Our kids need to feel safe, informed, relatable, and celebrated, maybe more than ever during puberty. It is also important to note that we also need to feel that.
Here are some systems that we can set up for ourselves, as well as our children, as we prepare for them to enter puberty.
- therapy (for us, and our children with autism)
- information collection (sources like Autism Parenting Magazine, your child’s doctor, other parents, books, and podcasts)
- journaling (reflecting on our own experiences growing up and drawing wisdom from our own needs)
- alternative forms of communication and support (telehealth therapy, written communication, sign language, etc)
Feelings that can come from not being prepared can be negative and difficult to overcome while in the thick of it. We are not alone, our children are not alone.
Preparing our kids with autism for puberty begins with what every informed parent of a neurotypical child needs to prepare their own children. Additionally, it is helpful to understand how autistic children may struggle as their social skills, developmental needs, and comorbid conditions make the transition to becoming young adults more challenging.
Educating our children with autism about this transition is step one. Open, honest, straightforward, and non-emotionally charged exchanges are optimal.
In the aforementioned study we learn,“While the challenges and long-term consequences are understudied, a recent study of autistic females, highlighted that young women would benefit from more education pertaining to menstruation before and during menses to assist with understanding factors related to health, duration, pain, hygiene and changes in mood status (Steward et al., 2018). Additionally, psychological and sexual education training such as the Tackling Teenage program (Dekker et al., 2015; Visser et al., 2017) may be beneficial.
Knowledge can make the differences that help our autistic children feel their most confident, connected, and celebrated selves throughout their lives. Age appropriate enlightenment about the changes coming, the assurance that what they will be experiencing being natural, and a heads up about what their autism may bring to the table can all be helpful.
How to help your autistic child during puberty
Once we have done all we can to prepare for puberty, we can turn our attention to what to do when it actually begins. Adolescence is a complex time, brain development is happening quickly. Parents can do a lot for their children with autism during this time.
Social stories can be a very useful tool starting at a young age and continuing through pre-teen and teen years. They can be an indirect way to address very personal, uncomfortable, or awkward topics. This time of transition can feel like a roller coaster. Understanding it from the perspective of someone else’s experience can take some of the vulnerability out of it.
Most teenagers need more than they let on. They may not want to talk, though they need it. It is important to lay a good foundation, to explain that you are always there for them, and to make an effort to communicate with them.
It is also important to lead by example, modeling healthy emotional, mental, and behavioral coping skills.
The physical changes of puberty can be alarming for some. For other children, they may seem virtually unnoticed. It is important for each child to have an understanding of these changes. They need to know that these changes are natural, healthy, and though they can feel gross or unwanted, they are not bad.
Mental health issues
Children with autism are more prone to anxiety and depression. All children are at a higher risk for mental health issues during puberty, even if they are temporary. Mood swings, social complications, and new body changes can be scary.
If they are not already attending, providing your child with mental health therapy can go a long way during this time. They may need extra support and treatment in the form of medication, telehealth visits, or an increase in session frequency.
Part of growing up is self-exploration. Puberty can bring new self-awareness. An increase in sexual urges, or lack thereof, can suddenly draw the child’s attention to others in a way they have never experienced before.
During this time, it is important for our children to understand that we are there for them, that their sexual development is valid, and that we will love them and help them through this time in a nonjudgmental way.
Romantic relationship training is important as it will ensure our children with autism are as equipped as possible to navigate relationships with their chosen partners. The need for privacy, the reality of autonomy over their bodies, and understanding the function of body parts are all crucial bits of information our children need.
Some things are private and should only happen with the door closed. However, things like wet dreams and masturbation should not be taboo.
Wet dreams happen because bodies are working properly. This is a good thing.
Autonomy over the body, education about relationship safety, and the knowledge of when and where it is ok to engage in sexual matters is important for all children. Children with autism may need extra communication as reading body language, missing social cues, and misunderstanding intentions can be areas of struggle.
School staff, though they deal with children all day every day, may not realize your specific student needs extra support. When supporting our children with autism through puberty, enlisting the help of school staff can help. Reaching out to them to find out what they offer, teach, and protocols they provide can be a great resource.
School libraries may also provide resources in the form of books, audio books, and other materials that can help your child understand what is going on from a less personal perspective. Many children learn about these sensitive topics through books.
Puberty can be a terrifying time for anyone. There are ways we can make it easier.
Preparing ourselves and our kids beforehand, gaining an understanding of what the needs and challenges might be, and providing helpful resources can all make the transition easier. For our kids, knowing they are loved and understood, not judged, is key.
Reaching out to all available aids will meet many needs. From home, to school, to social engagements, our kids can practice what they learn and gain the confidence and love within themselves to take on the world.
The relationship we build with them from babyhood and adolescence will strengthen them. When provided with knowledge and love, they will come through it.
I hope this brief overview has helped. You are doing a great job!
Here are some resources you can check out. These are just my own recommendations.
Celebrate Your Body (and Its Changes, Too!): The Ultimate Puberty Book for Girls (Celebrate You, 1) Book.
This book, What’s Happening to Tom, I found had some controversial illustrations, however I believe that each parent has the right to decide for themselves what is best for their family. I would also like to offer, this could be a book that you use as more of a guide for yourself, not necessarily have to be read with your child. I wanted to include it because I also believe in taking a direct, realistic approach to sensitive subjects; this was that for me.
These, along with the links throughout this article, I hope will provide you with some ideas and encouragement as you prepare for this new life transition with your child.
Corbett, B. A., Vandekar, S., Muscatello, R. A., & Tanguturi, Y. (2020). Pubertal Timing During Early Adolescence: Advanced Pubertal Onset in Females with Autism Spectrum Disorder. Autism research : official journal of the International Society for Autism Research, 13(12), 2202–2215. https://doi.org/10.1002/aur.2406