adolescence, a complex and difficult period
Autism in adolescents: specific challenges and how to cope with them
👦🏽 Adolescence is characterized by biological, cognitive, social and psychological changes. It is a transition from childhood to adulthood and is a time of preparation for future adult roles and responsibilities. The beginning of adolescence is marked by the onset of puberty, where physical changes in height, weight and maturation of primary and secondary sexual characteristics are important factors in this transitional period. The biological development of puberty occurs in tandem with cognitive and psychosocial transitions in adolescence.
🧠 Autism is a neurodevelopmental condition characterized by limitations in communication skills, social interaction, and repetitive behaviors.
👦🏽 Adolescence + 🧠 Autism = 💫
Autism Spectrum Disorder (ASD) presents unique challenges when it passes into the teenage years. Although early diagnosis in childhood is ideal, many patients are not diagnosed until adolescence. Often because of missed signs or symptoms that overlap with other conditions, early diagnosis of autism can be a real challenge. Understanding these nuances is essential for effective support and intervention.
Symptoms of autism during adolescence
🔒 Symptoms of autism during adolescence often include significant challenges in social communication. These can manifest as difficulties forming friendships and misunderstanding social cues. Adolescents with autism may engage in inflexible thinking.
Sensory processing problems can also worsen during this period, causing sensory overload in environments such as school. Emotional difficulties are also common, with many experiencing anxiety, low self-esteem or mood disorders. In addition, poor social skills can hinder their ability to navigate complex social dynamics, leading to isolation or bullying.
When discussing the challenges faced by adolescents diagnosed with autism it is important to remember about the role of the family in managing them in in collaboration with the psychiatrist and therapist the patient. A relevant aspect is psychoeducation, which involves informing and preparing both the adolescent and the family about the possible difficulties that may arise, how to manage them, when to call in specialists and what the potential solutions are.
🔑 Remember how important it is to understand that every patient is different, that we do not just approach a diagnosis, but that we try to identify the needs and difficulties of each patient we are dealing with and that we always correlate the data obtained from the patient, the patient’s family and a complex medical examination, sometimes also calling on specialists in endocrinology or neurology, depending on the particularities we are dealing with.
💓 We want to have a more complex approach to cases, to identify the precipitating factors of some symptoms, so that we can make more effective and personalized recommendations.
A major challenge is the occurrence of significant behavioral disturbances that accompany the onset of puberty and sexual changes. Aggression, irritability and irritability can occur and are associated with psychosocial and physiological challenges. Behavioral disorders could be related to limited psychological and social resources that patients have to manage feelings and changes related to puberty.
😠 An important symptom in adolescent autism: AGGRESSIVITY
According to the American Psychological Association’s (APA) dictionary, aggression is “behavior that aims to hurt others physically or psychologically”.
Aggressiveness is one of the symptoms faced by adolescents with autism. Whether we are talking about aggression towards others or self-aggression, this symptom can play a key role in the imbalance of the whole family. Aggression is often the main reason for referral to mental health professionals. In such cases it is important to eliminate a somatic distress such as the occurrence of pain syndrome or hormonal imbalanceA complete clinical examination, a thorough anamnesis and a set of laboratory tests are necessary. 👉👉The onset of aggression may be a form of pain manifestation especially in non-verbal patients.
It is also relevant to consider when and under what circumstances aggression occurs, how long it lasts and how it improves. For children who are non-verbal or have communication difficulties, 👉👉aggression is a way for them to communicate their needs or dislike of something. We also identify possible changes in the patient’s routine, whether he/she has been informed and prepared for the changes he/she has undergone, for example if the school environment has changed it is important to discuss with the teacher how the adolescent is adjusting to the new environment, how he/she is working with other colleagues.
👉👉 Adolescents may show aggression if they are angry and lose control of their emotions, if they are experiencing high anxiety in a situation, or if frustration arises about a problem they cannot solve.
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Another important aspect is to assess whether other symptoms have developed, such as sleep disturbances, eating disorders or sexual disorders. A patient who is not resting properly may be more irritable or aggressive.
The changes that have occurred in the patient’s treatment or even the administration of supplements are aspects that we can analyze.
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We also recommend that you physical exercise, for example walk has both a relaxing and connecting role with the person accompanying them. Many studies have highlighted the positive impact of sport on people with autism. Discussing their needs and goals with coaches or instructors in advance and establishing clear channels of communication can help address these challenges.
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Taking into account sensory needs and preferences when selecting activities and ensuring a sensory-friendly environmentif necessary, is crucial. Activities should be enjoyable, appropriate and safe for the individual, with the necessary safety equipment and supervision. In conclusion, sport and physical activity are fundamental components of enhancing the quality of life of people with autism and their families.
🔑 Solutions – how do we manage adolescent aggression in autism?
Aggression can also be reactive to conflicts in the family, which is why it is essential to provide patients with as harmonious an environment as possible, without physical or verbal aggression from caregivers. Adolescents with autism need to be surrounded by people to whom they can express themselves, 👨👦 they need validation and encouragement.
Ideally, the best way to manage aggression is to try to avoid triggers. Allow your teen to stick to his or her routines as much as possible. If you need to change them, discuss the reasons why. You can also offer some type of reward if they manage the change well.
▶️ Providing therapy is necessary to help the child improve communication and social skills. It is important for the adolescent to identify and name their emotions. We also recommend the development of coping methods, such as deep breathing and other ways to calm down if they feel they are losing control.
A key role is played by finding a safe place for the patient at home, school and other places to go to calm down if he feels overwhelmed. Giving him a cushion or punching bag to hit if he is upset can help him to mitigate his aggression in a way that does not harm himself or others.
Talk to your child’s psychiatrist if aggression is present to determine if there are treatments that might be beneficial for your child that you haven’t tried or haven’t already considered.
Behavior management is based on conditioning. Good behavior is rewarded and undesirable behavior is eliminated, thus alleviating behavioral problems such as aggression and self-injurious behavior. Parents, teachers and caregivers should encourage desirable behavior rather than prohibit undesirable behavior. Schemes to teach social rules, especially those for adolescents, can help. The aim is to develop a ‘library’ of rules to cover most unexpected situations.
A structured environment is needed that creates a high level of predictability, including acceptable routines for both children and adults. Child education needs structure and consistency in terms of time, room and teacher. Instructions should be given one at a time, with time to complete one task before moving on to the next. There is a fine line between over-stimulation and under-stimulation.
🟣 One of the most profound challenges facing adolescents with autism is SOCIAL INTERACTION.
Social cues, body language and nuances of communication can be challenging. Many teens with autism may struggle to initiate conversations, read social cues or maintain friendships. This can lead to feelings of isolation and loneliness. Adolescents are often very aware of their differences from their peers, which can exacerbate feelings of exclusion. For an adolescent with autism, understanding and navigating these evolving social landscapes can be particularly overwhelming, leading to social anxiety or withdrawal. Support systems, including counseling and therapy, are essential to help these patients cope with their feelings and experiences.
CONCLUSIONS
In short, the challenges faced by adolescents with autism spectrum disorders are numerous and complex, impacting on different aspects of their lives, but also on the whole family. Understanding these challenges, significant measures are needed to support adolescents with autism, ensuring that they move through adolescence with greater confidence, acceptance and opportunities. Community resources, supportive educational environments, family involvement and collaboration with psychiatrist and therapist can make a significant difference in the lives of these adolescents, enabling them to embrace their individuality and potential.
Dr. Ionela Mădălina Gurguță
Specialist Psychiatrist, Psychotherapist
Clinica Med Anima Iași
Bibliography:
- 1. Purba CAP, Febriyana N, Setiawati Y. Managing Aggressive Behavior in AdolescentsWith Autism Spectrum Disorder: Pharmacological and Non-PharmacologicalApproaches. Soa Chongsonyon Chongsin Uihak. 2024 Oct 1;35(4):223-229. doi: 10.5765/jkacap.240026. PMID: 39380568; PMCID: PMC11456650.
- Steenfeldt-Kristensen, C., Jones, C.A., & Richards, C. (2020). The prevalence of self-injurious behavior in autism: A meta-analytic study. Journal of Autism andDevelopmental Disorders, 50(11), 3857-3873. https://doi.org/10.1007/s10803-020-04443-1. https://doi.org/10.1007/s10803-020-04443-1.
- Pamela Gaye Ambler, Ami Eidels, Christopher Gregory, Anxiety and aggression in adolescents with autism spectrum disorders attending mainstream schools, Researchin Autism Spectrum Disorders, https://doi.org/10.1016/j.rasd.2015.07.005.
- Satopoh, F. A. (2024). An Overview of Aggressive Behaviors in Children with Autism Spectrum Disorder. Scientia Psychiatrica, 5(1), 466-471. https://doi.org/10.37275/scipsy.v5i1.69
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