Although the average age of autism diagnosis is about four years old, there are times when a child may be especially high functioning or good at imitation and may not receive a diagnosis until he or she becomes a teenager. Many of the symptoms of autism are not age-specific, but there are some signs that appear or become more noticeable during the teen years.
Difficulty Taking Turns When Talking
Taking turns is part of regular conversation, but figuring out when these turns stop and start can be challenging for people with autism spectrum disorder (ASD). Problems with turn-taking, such as talking too long about a topic or not holding up one end of the conversation, can be a sign of autism in anyone. Increases in social demands can make this more obvious in teens.
Trouble Organizing Things or Breaking Tasks Into Steps
Challenges with executive functioning, or the ability to plan, prioritize, or break a task into smaller parts, is part of ASD for many people, no matter what their age. However, as the demands on teens increase and they are expected to change classes, manage home and school activities, and take more responsibility, a deficit in this area may become more apparent. A teen with ASD may struggle to complete and keep track of homework assignments, get ready for school, change classes on time, have the appropriate materials for a particular class, or manage time.
Very Few Friends
According to a 2011 study on social skills and teens, teenagers on the spectrum are far less likely than peers to get invited to join in activities or to spend time socially outside of school. In fact, many teens with autism have one friend or no friends at all. While this may have been true all through elementary school, it may become more obvious during the teen years when socialization with peers becomes more of a focus.
Taking Things Literally or Being "Gullible"
A teen with ASD may struggle to tell if someone is joking and may be teased for being gullible. That's because literal thinking is part of ASD for many people. During the teen years, joking and teasing may become more common and elaborate, causing this difference in interpretation to become more noticeable.
Struggle With Depression
Up to 37% of teens with ASD struggle with major depression, compared to only 5% of their neurotypical peers. This can be difficult to recognize in kids who are often already withdrawn, but it may include focus on mistakes or differences, moodiness, aggression, less focus on self-care, or changes in behavior. If you suspect a teen may be depressed, whether or not there's an ASD diagnosis, you should always check in.
Interests or Toys That Are Not Age-Appropriate
Kids on the autism spectrum don't always mature at the same rate as their peers. They may still play with dolls or toys or watch television shows designed for much younger kids. A teen with autism may be passionately interested in something that seems immature or babyish to kids his own age.
Avoidance of School
School refusal or attempts to avoid going to school are common in kids on the spectrum, especially in the teen years when social pressure may become more intense. Bullying can also add to the stress of school and make the teen try harder to avoid attending. This can take the form of direct refusal or psychosomatic illness.
History of Eating Disorders
Eating disorders like anorexia have been linked with autism. In fact, dozens of studies have examined the connection. Findings indicate that up to 33% of people with anorexia may also have diagnosable characteristics of ASD. Eating disorders become more apparent during the teen years, and the average age of diagnosis is between 16 and 19.
Trouble With Transitions
Changing from one activity to another can be hard for anyone with ASD, but this becomes a real issue during the teen years. Bodies and roles are changing quickly, as are expectations and social requirements. This is a time when routines that have been established for many years may be replaced with new activities, and it can be a source of stress. Teens struggling with transitions may act out or avoid situations that require this skill.
Spot the Signs to Be Able to Help
Knowing how to spot the signs of ASD in older kids can help them get the help they need to function at their best and feel comfortable in the world. If you suspect a teen may have autism, refer him or her to a pediatrician or psychiatrist who can help with a diagnosis.