By: Kristin Sohl, MD, FAAP
Being a teenager can be an exciting but challenging time, filled with big physical, emotional and social changes. It's not uncommon for teens to experience
mental health struggles.
Like all kids, teens on the
autism spectrum face mental health challenges, too. If your child is on the autism spectrum, here is information that can help you know when they may be struggling, and ways you can support them.
Anxiety and depression among teens on the autism spectrum
Anxiety and depression are common in autistic youth. In fact, many people on the spectrum experience more issues with anxiety and depression than their non-autistic peers. This may be because the way autistic teens socialize with their peers can be different from typical teen interactions. Autistic teens may also feel lonely or left out of social activities.
Noticing changes: behavior as a clue to emotions
As a parent, caregiver, coach or other important adult in a teen's life, you can play a major role in supporting their mental health. Some of the most important things you can do is take notice of changes in their mood or patterns of behavior.
For example, take note if your teen eating or sleeping more or less than usual, spending more time alone, or is less interested in activities they usually enjoy. Some teens will be more emotional when they are feeling stressed, anxious or depressed. Some will be less engaged or even withdrawn from their friends, family, pets or activities.
The important thing to remember is that noticing changes in behavior is an important clue. All teens navigate emotions in different ways. Autistic teens may have more or less ability to communicate verbally. So, their behavior will be a critical clue to what may be going on for them.
Teens on the autism spectrum may show increased repetitive behaviors (for example, hand flapping), or insist on patterns of behavior. If you notice changes, this is a great time to check in. You can check in verbally by asking questions or non-verbally by being close and offering gentle signs of reassurance.
Therapy for teens on the autism spectrum
We know that teens on the autism spectrum can respond well to common behavioral
therapy just like their non-autistic peers. Counseling (behavioral therapy) options can work well including cognitive behavioral therapy. It's important to find a counselor who has experience working with people on the autism spectrum. There are some helpful adaptations that can increase the effectiveness of counseling for autistic people.
Sometimes it can be hard to know if a teen is struggling, and even harder to know when to step in as a trusted adult. This applies for all teens, autism or not. We know the
mental health crisis is profoundly impacting many teens as they try to navigate their peers and their pressures. It is vital that caring adults pay attention to teens and changes in their behavior and emotions. Those changes can signal the need for support and services that may be lifesaving.
Connecting with your teen & their pediatrician
Families, caregivers, and other adults can listen to and engage with teens on the autism spectrum. You can help them feel they are heard and seen, and to share any mental health concerns with your pediatrician.
This is especially important because there are times when health care clinicians may not recognize serious mental health conditions that co-occur with autism spectrum disorder. Some clinicians don't realize that anxiety and depression are common in autism and important to screen, identify and treat.
This is where your child's pediatrician can be critical. When a child follows closely with a pediatrician through
infancy to adulthood, the clinician is able to support through critical changes and be an additional advocate when increased supports and services are needed. Your pediatrician can play a significant role in helping you and your child access needed intervention and support. If you are concerned, please reach out to them to help you and your teen know the next best step.
Remember
While mental health concerns are common for teens on the autism spectrum, that doesn't mean everyone will have an additional mental health diagnosis. Even if your child is not having any concerns, it's always good to check in with them frequently, engage with them around their interests and enjoy time relaxing together. These are great ways to build
resilience for stressful times and coping skills for the future.
More information
About Dr. Sohl
 Kristin Sohl, MD, FAAP, is a member of the of the AAP Council on Children with Disabilities Autism Subcommittee. Dr. Sohl is a professor of pediatrics at the University of Missouri School of Medicine and is a pediatrician who practices developmental/behavioral pediatrics. She serves as the Medical Director for Missouri Telehealth Network and is the Founder and Executive Director of Extension for Community Healthcare Outcomes (ECHO) Autism. She is the immediate past president of the Missouri Chapter, American Academy of Pediatrics.
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