Adolescence: A Special Challenge in Autism Spectrum Disorder

Adolescence is a most difficult time for all young people, but for the individual with autism/Asperger's syndrome, it is particularly difficult. During adolescence, social demands become more complex and subtle social cues are important. For autistic and Asperger's kids, they can be especially vulnerable to manipulation and peer pressure. They are usually socially naive, do not understand the subtle clues, and may experience rejection more frequently than their 'typical' peers.

With individuals who have autism/Asperger's syndrome, interaction with peers usually creates more anxiety than interaction with younger or older people. Younger children are safer as they are less likely to be critical. Older adolescents and adults are safe because they are more likely to understand and tolerate. Some adolescents with autism/Asperger's do not avoid interaction with their peers and are anxious to communicate with them but often do so in a clumsy, in-your-face way.The Social Disability of Autism

The level of their insight into their social disability will become the determining factor of their social success. If they are unaware of these shortcomings in gauging the social settings and reading the social cues, they will come across as rude, insulting or boring. They often miss subtle criticism, sarcasm or teasing.

Dealing with a Loss

Most children with autism/Asperger's begin realizing they are not quite like others at some point during their adolescence. Once he realizes his difficulties in dealing with social relationships compared to his peers, he needs to deal with the loss he feels. Understanding the thoughts, behavior and feelings of an adolescent with autism/Asperger's is the necessary first step in helping him deal with this loss and being there for him. He will go through the same stages as any one does when being faced with a loss: Anger; denial; depression; acceptance; adaptation.

An adolescent will most likely NOT go through these stages one after an other, but rather display a larger or smaller aspect of each stage at any given time. This is a very painful process for the child as well as the parents. It is tempting for parents to want to act as if nothing is happening to avoid the pain, but courage and strength is needed.

When the child sees his parents dealing with the situation calmly and matter-of-factly, it encourages him to talk about his anger and frustration and this will help him get closer to the acceptance and adaptation stages. Here are some suggestions:

You don't have to bring it up, but when he does, listen attentively and be patient.

Don't try to change the subject, unless your child does.

Don't try to minimize his difficulties, but also don't let him exaggerate. Provide gentle reality testing.

Offer the option of counseling, since sometimes it is easier to talk to a stranger. However, try not to push the idea directly even if you feel that your child clearly needs professional help. Sometimes it is easier if the idea comes from a family friend, teacher or someone he trusts. Give him time to think about it. He may come back to the suggestion when he feels he is ready.Depression/Antidepressant Medication

If your child doesn't seem able to move on and has any of the following symptoms of clinical depression, consult his physician to discuss the possibility of antidepressant medication to help him through this difficult period.

SIGNS OF DEPRESSION:

Appearing sad most of the time

Becoming irritable and angry with the drop of a hat so that family members start walking on egg shells

Not being able to fall asleep, waking up in the middle of the night and having difficulty falling back to sleep

Complaining that he is tired all the time and wanting to take naps during the day

Eating less or more than usual

Putting himself down, saying he is stupid

Making remarks like he hates life, he hates you, nobody loves him, or wishing he was dead;

Losing interest in activities he usually enjoys

Withdrawing himself from the rest of the family, refusing to participate in group activities

Blaming himself unfairly for anything that goes wrong

If five or more of these symptoms are present, seek help. Clinical depression is a serious condition and carries a significant risk for self-harming behavior. If you suspect that your child may have clinical depression, make an appointment with a child and adolescent psychiatrist as soon as possible and do not make this an option. He must go. The child does not have a veto power of this decision!