Understanding Autism in Kids & Teens: Signs and Support Strategies

Autism Fast Facts

Autism is not a rare condition. According to the Centers for Disease Control (CDC), the governmental organization’s Autism and Developmental Disabilities Monitoring (ADDM) Network has identified autism in one out of every 36 children. This correlates to roughly 3% of the population. That means almost all of us know someone who has at least been mildly affected.

Co-occurring conditions are not rare in those with autism either, sometimes complicating diagnosis. According to a review study published in the European Archives of Psychiatry and Clinical Neuroscience, 20% of those with autism also had anxiety disorders of some kind, while 11% experienced some kind of depression. Obsessive compulsive disorder (OCD) was present in 9%, bipolar disorder in 5%, and schizophrenia in 4% of those studied.

Autism is not distinguished ethnically. According to the CDC, it is common in all ethnic groups. There is some indication that lower socioeconomic status may correlate with higher autism rates. However, this was true only in a small number of situations studied.

One of the biggest problems with diagnosing autism is how different it can look from individual to individual. Additionally, it is hard to pinpoint its origins. That means researchers cannot point to specific socioeconomic or other traits to help narrow it down.

What Causes Autism?

Whether you have a child with autism or are concerned with autism in teens, you’re likely curious about what causes the disorder. Unfortunately, signs of autism are easier to pinpoint than causes. Research indicates that genetics and the environment may both factor in.

It is important to separate causes from risk factors. Causes are factors that may lead to the development of autism. Risk factors are conditions present in the family that may indicate a higher chance of having a child with autism.

Causes of Autism

Genetically, scientists have not yet identified what exactly could cause autism. However, certain mutations and gene patterns do seem to indicate a genetic link.

Researchers at McLean Hospital have also found that activation of the immune system in utero or right at birth may cause autism-like symptoms in mice. The study used a virus or bacteria to cause a baby mouse’s immune system to respond. Then, scientists looked back at the mouse later, around the time a human would be a young adult. They frequently found changes in neural circuits that correlated with autism. The most notable among these were those that control social interaction and anxiety.

Current research into inflammatory factors may reveal further causes. Other studies are beginning to show the role of synaptic pruning in autism—the process in which the brain eliminates unnecessary neurons and synapses to enhance its function and efficiency.

Synapses form in response to all kinds of stimuli. However, we don’t need them all long-term. The brain has mechanisms to go through periodically and clear out or “prune” the unnecessary ones. According to research in the journal Nature Neuroscience, REM sleep is particularly important for pruning in all humans.

When synapses aren’t pruned, the important ones fail to grow strong. This may have something to do with the issues presented by autism spectrum disorder. Thus far, mouse studies seem to indicate this to be a solid research path.

According to the National Institute of Environmental Health Sciences (NIEHS), other potential contributors to the development of autism include:

• Exposure to air pollution or pesticides in utero
• Maternal health issues, such as obesity or diabetes
• Immune system issues in the mother
• Oxygen deprivation during birth

Risk Factors for Autism

It’s important to understand risk factors to help identify autism. Early intervention is crucial for success, and knowing the risks helps you be on the lookout for signs of autism.

According to NIEHS, some of the most common risk factors include older parents or a sibling with the disorder. Some genetic conditions, such as Down, Rett, and Fragile X Syndrome, may also increase the risk. Lastly, low birth weight can be a red flag for many health conditions down the road.

The Myth of Vaccinations and Autism

Across the board, the idea that childhood vaccinations cause autism has been debunked. Neither vaccines nor their ingredients cause autism. According to an analysis by the Children’s Hospital of Philadelphia, the extremely limited studies on which this conclusion was based are “critically flawed.”

Sadly, the misinformation proclaimed by these studies entered the public sphere. It has proven very hard to eliminate this misinformation, but it is nevertheless utterly false. Vaccinating children helps keep deadly diseases such as measles, polio, and diphtheria (among others) extinct.

How To Tell if a Child Has Autism

As a general rule, people with autism share some typical symptoms. While these may vary somewhat with age, many of them cross age barriers, from the toddler years to adulthood. Therefore, there are multiple possible answers to the question, “How do you know if your child has autism?”

Challenges with social interaction are big clues, as well as repetitive behaviors and sounds. Trouble with sensory processing and trouble with breaking away from preferred activities can also be good indicators. These may persist throughout life.

However, every one of these signs of autism may also stem from a different cause. At times, children with anxiety and/or those who have experienced trauma may present in a similar manner to a child with autism.

Part of the problem is that autism can so often look like something else. This can lead to missed diagnoses and misdiagnoses. Further complicating the matter, many people who have autism also have other conditions. That means a clinician would need to correctly identify multiple conditions to get the diagnosis right, and teasing out symptoms in children and teens can be tricky.

According to research in the Journal of Autism and Developmental Disorders, more than 95% of children with autism had at least one other condition. This was more likely to be true with older children.

Those conditions range widely, and can include alone or in combination with:

• Attention-deficit/hyperactivity disorder
• Avoidant personality disorder
• Social anxiety disorder
• Obsessive compulsive disorder
• Disorders on the schizophrenia spectrum
• Eating disorders
• Mood and anxiety disorders
• Learning disabilities
• Intellectual disabilities
• Developmental regression without explanation
• Trouble sleeping normally
• Gastrointestinal issues

That said, there are some general indicators that may suggest a diagnosis of autism. These include:

• Avoiding or general discomfort making eye contact with people
• Failing to use common gestures (e.g. pointing) to increase meaning
• Repeating words and phrases
• Repeating motions, such as spinning or flapping hands
• Playing or operating ritualistically
• Showing a strong preference for routines (and distress when they’re broken)
• Not getting jokes or sarcasm
• Being “obsessed” with certain activities or interests

Symptoms of Autism by Age

As discussed, signs of autism often transcend age. However, teenage autism signs do differ from those in children, toddlers, and babies.

What Are the Signs of Autism in Teens?

The signs of autism in teens can differ from those in children and may include:

• Difficulty with both verbal and nonverbal communication
• Different ways of speaking than peers
• Executive functioning difficulties such as planning and organizing
• Restrictive eating preferences
• Focusing heavily on specific interests

Note that during transitions, such as moving to a new house or going to a new school, symptoms in teens with autism may become more pronounced.

What Are the Signs of Autism in Children?

Many parents wonder if sticking their tongue out, known as tongue thrusting, is a sign of autism in children around 5 years old. This behavior may indeed be an indicator of autism, as many children engage in “stimming,” a pattern of self-sensory stimulation, to help them cope with situations they find challenging or exciting.

Other signs that may be noticeable at this age include:

• Getting upset when arrangements of toys are displaced
• Spending more time lining up toys than playing with them
• Unexpected fearfulness or fearlessness

What Are the Signs of Autism in a 2-Year-Old?

The ages of 2 and 3 are common times at which diagnosis occurs. It is, therefore, useful to know exactly what to look for at this developmental milestone. Specifically, signs of autism in a 2-year-old may include:

• A lot of repetitive movement
• Showing no interest in playing with others
• Exhibiting limited or no pretend play
• Failing to laugh or cry frequently

What Are the Signs of Autism in Babies?

Most children receive an autism diagnosis later in life. However, signs crop up in children as young as a few months old. Age-related signs include:

• Avoiding eye contact (which most babies seek out constantly)
• Showing little interest in interactive games
• Not responding to their name by 9 months
• Not showing emotions by 9 months
• Not using hand gestures by 12 months
• Not noticing hurt in others by 24 months

Rest assured that crawling or scooting backward is not a sign of autism. Rocking may also be a normal developmental activity, but it may also be a sign.

What Is the Earliest Sign of Autism?

According to the Child Mind Institute, some of the earliest signs of autism include:

• Showing a preference for interacting with objects over people
• Using objects in nontraditional ways, such as holding rather than playing with toys
• Exhibiting strong responses to sensory stimuli

If you have noticed any of the above symptoms, then you’re likely curious about getting an autism diagnosis for your child or loved one.

Getting an Autism Diagnosis for Your Loved One

If you’ve recognized several signs of autism, then it is time to look into a diagnosis. Diagnostic measures for teens and children can be different.

To determine the accommodations a child with autism will require to be successful in school, they need an appropriate assessment and diagnosis. An accurate diagnosis leads to a better understanding of the child and their needs. It can help you find the right community for your child or loved one and address all aspects of functioning, from speech to social and beyond.

Most importantly, you want to get this diagnosis as early as you can. As soon as you start to notice signs of autism, especially if your child is not meeting or is significantly lagging behind in meeting developmental milestones, schedule an appointment with your pediatrician. Given the impact early intervention services can have, it is far better to test and be wrong than to wait and be right.

Can a Child Go Undiagnosed Until Teen Years?

Yes, children may go undiagnosed with autism until their teen years. In general, most American children are diagnosed at about age 5. Typically, signs of autism appear in the baby or toddler years, but not always.

Studies show that both missed diagnoses and misdiagnoses are common. As reported in the journal European Archives of Psychiatry and Clinical Neuroscience, adult participants diagnosed with ASD for the first time had all been evaluated in their teen years. However, at the time of their previous evaluation, they were given either no diagnosis (about a third) or a different diagnosis (the rest).

Make sure to get a diagnosis if you notice any signs. If the initial diagnosis is negative but you still have concerns, seek a second opinion.

Gender and the Autism Diagnosis

Gender may also blind professionals to the presence of autism. Statistics indicate that autism is diagnosed around four times more often in boys than in girls.

However, new research indicates that this doesn’t mean it is more common in boys. As published in the journal Brain Sciences, autism is most likely to go unrecognized when in its mild form and when the patient is a woman. The research showed that women get referrals later in life than men, and those referrals occur more slowly than in men.

Potential Treatments for Autism in Children and Teens

While autism is considered a lifelong diagnosis that one will not grow out of, that doesn’t mean you can’t help individuals with autism live full, rich lives. The autism community is robust, and the benefits of a neurodiverse society are becoming more and more recognized. Once you know the signs to look out for, it’s important to know what to do when your child is diagnosed with autism.

First, understand that autism is not the same for everyone. Rather, it is broken down into three levels. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) guidelines, it is the amount of needed support that dictates the level: 1, 2, or 3. Your clinician will help you choose the appropriate level of support.

In general, there are some strategies that can help with how to deal with your child’s autism diagnosis. This will help them through the childhood years and into adulthood.

Treatment for children and teens with autism can include, but may not be limited to, medication, counseling, and a variety of therapies, such as speech and language (including social skills), occupational (including life skills), behavioral, physical, play, art, and animal-assisted therapies (e.g., pet therapy, farm therapy, equine therapy, etc.).

Early interventions especially support the development of any lagging skills and take advantage of the brain’s ability to reroute and strengthen its neural pathways, known as neural plasticity. These therapies can support learning and skill-building for kids in their own unique learning styles.

Communication Is Key

One of the biggest challenges with autism in very young children, especially if they are nonverbal, can be understanding what they are trying to communicate. You need to be able to understand what your child is communicating in order to meet their needs. Teaching some basic sign language may help, but always consult with your clinician or speech/language therapist.

In teens, social communication often becomes an issue. At a time when developing some independence from parents is common, peer groups become increasingly important. Teens with autism cannot always connect with their peers in an expected manner.

Social skills training and support can help a great deal. Often called social pragmatics, social skills training can include school-based instruction and support, and can also include therapeutic social groups, small-group social skills training, and 1:1 work with a speech/language therapist.

When supporting teens with social skill development, it is important to remember that they may have difficulty putting themselves in another person’s shoes. For example, it can be helpful to narrate how a comment or action can make another person feel. With guidance and support, teens with autism can learn the meaning behind mysteries such as body language, facial expressions, and sarcasm.