ASD and teenagers, what are the signs?

Let’s talk about ASD in adolescence. Signs of ASD may become apparent as children move into their teens,  as their social and academic demands increase. Social awkwardness is a part of puberty but if it is sustained it may be worth taking a look at. The diagnosis of girls with ASD is very low and they often slip through a childhood diagnosis because they are generally quiet and don’t cause many problems. The teen years may be the time that differences become apparent as social demands cause anxiety and isolation. Boys respond differently to the demands of secondary school and therefore there are other considerations that may be worth investigating. Teenagers are easily distracted, busy and may have trouble attending to tasks but if this is an ongoing issue and causing a concern to learning and social interactions, it could be a sign of something that may be worth investigating such as Attention Deficit Hyperactivity Disorder (ADHD).


The following information may assist if you have or if anyone has raised concerns about your teenager having an ASD. Two observable areas for consideration are; Social interaction and reciprocal communication; Unusual or limited  interests and/or rigid and repetitive behaviours. If a number of these indicators exist, you may wish to gain a formal assessment.

Social Interactions and reciprocal communication

Spoken language may be unusual in several ways:

  • Very limited use
  • Monotonous tone
  • Repetitive speech, frequent use of stereotyped (learnt) phrases, content dominated by excessive information on topics of own interest
  • Talking ‘at’ others rather than sharing a two-way conversation
  • Responses to others can seem rude or inappropriate

Interacting with others

  • Reduced or absent awareness of personal space, or unusually intolerant of people entering their personal space
  • A history of difficulties in two-way social communication and interaction-  only few close friends
  • Reduced or absent understanding of friendship
  • Social isolation and a preference for being alone
  • Reduced or absent greeting and farewell repsonses
  • Lack of awareness and understanding of socially expected behaviour
  • Problems losing at games, turn-taking and understanding ‘changing the rules’
  • Unaware or uninterested in what other teens his or her age are interested in
  • Unable to adapt style of communication to social situations, for example may be overly formal or inappropriately familiar
  • Subtle difficulties in understanding other’s intentions; may take things literally and misunderstand sarcasm or metaphor
  • Makes comments without awareness of social niceties or hierarchies

Eye contact, pointing and other gestures

  • Poor use of gestures, facial expressions, body positioning, eye contact (not looking at people’s eyes when speaking) assuming adequate vision

Ideas and imagination

  • History of a lack of flexible social imaginative play and creativity, although scenes seen on visual media (television, movies, technology games) may be re-enacted

Unusual or restricted interests and/or rigid and repetitive behaviours

  • Repetitive movements such as stepping over a doorway for a designated number of times before proceeding through, body rocking while sitting or standing
  • Preference or fixations on highly specific interests or hobbies
  • A strong adherence to rules or fairness that leads to argument
  • Highly repetitive behaviours or rituals that negatively affect the young person’s daily activities
  • Excessive emotional distress at what seems trivial to others, for example change in TV channel, replacement teacher
  • Dislike change, which often leads to anxiety or other forms of distress including aggression
  • Over or under reaction to sensory stimuli, for example textures, sounds, smells

What is important now is to remember that your teenager is unique and development will occur for them at their pace. A diagnosis at this stage will present you and your teenager with challenges as the normal demands of puberty may heighten their anxiety around obtaining a diagnosis. If after reading this you, your teen or a teacher have concerns you may wish to seek further information located in Diagnosing ASD  article and our ASD Planning Flowchart within this website.

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