Most children with autism are diagnosed somewhere between 3 and 5 years old, however, those who are higher functioning and did not have speech delays when younger, may not be diagnosed until much older, sometimes in their teen years when social interactions become more difficult and harder to navigate.

These children often show signs of what was previously considered Asperger’s syndrome (this was previously a separate diagnosis but was integrated with autism spectrum disorders in the 2013 edition of the Diagnostic and Statistical Manual). Because symptoms were mild, parents may accept their child as "quirky" but not necessarily autistic.

During the teen years, when social skills and friendships become so important, the symptoms are more noticeable. As other teens are spending free time with friends and involved in many different activities, teens with ASD often spend time alone and are much more selective on what activities they join. During the teen years, especially if not diagnosed, they can develop depression or anxiety. They can seem distant or unable to express their emotions.

Symptoms of ASD in Teens

Social Skills

• Few friends
• Seems detached or withdrawn
• Inability to read social cues such as facial expressions, body language or changes in tone of voice
• May prefer individual activities and sports over team activities and sports
• May dislike changes in routine

Communication

• Difficulty expressing themselves
• Don’t understand humor, sarcasm or idioms
• Are frequently misunderstood
• Difficulty initiating conversations
• Difficulty making "small talk"
• May appear to be insensitive or rude (although it is not how they intend to be)
• Appears to lack empathy
• Avoids eye contact
• Extremely logical or linear in thinking

Academics

• Average or above average intelligence
• May have other learning disabilities
• May need educational interventions based on individual difficulties
• May have a hard time expressing their thoughts
• May have poor or illegible handwriting

Other Symptoms

• May have preoccupation in one or two interests
• May talk a lot about their specialized interest
• May have had delayed motor development, such as riding a bike or catching a ball
• Sensory sensitivities

Teens with ASD may learn to compensate for some of their difficulties or differences, however, their difficulty with social situations and communication usually continue into the teen years. He or she may want to have friends but not know how to make friends or have problems initiating conversations or approaching other teens. Many are not concerned with outward appearance and don’t worry about trendy clothing. They can find it exhausting trying to fit in with other teens. They usually are rule-oriented and feel uncomfortable when there are no rules to help them understand expectations.

If you recognize some of the symptoms of autism in your teen, talk with your doctor. A diagnosis isn’t going to change your child or how you feel about your child but can help in accessing educational services, even as your teen goes to college. It can also help you better understand your teen and accept some of the differences you have noticed. Your teen may be relieved with a diagnosis, he may have wondered why he was different or why he had such a hard time making friends. A diagnosis may help him better accept who he is.