Autism and Puberty

Guest post by child psychologist Ariella Silver and adolescent social worker Jordan Wishner, of New York City’s Mount Sinai Adolescent Health Center, which provides free, comprehensive and confidential health and wellness care to young people ages 10 to 24.

During puberty, teens experience changes in their bodies, become more focused on who is and isn’t “cool,” and start to experience sexual and romantic urges. These changes can be tough for anyone. But for kids on the autism spectrum and their families, this time can be particularly challenging.

As specialists in autism and mental health care who work with teens every day at the Mount Sinai Adolescent Health Center, we’re here to help families figure out what to expect when children on the spectrum reach puberty and how to help their adolescents through this period of change.

We hope you find our advice post a useful addition to the Autism Speaks ATN/AIR-P Puberty and Adolescence Resource: A Guide for Parents.

Autism and puberty: What to expect

Changing bodies

Everyone’s body changes during puberty. When boys hit puberty, the voice lowers in pitch and the penis grows larger. When girls reach puberty, breasts grow larger, menstruation starts. In both sexes, puberty brings the growth of pubic and armpit hair and an increased tendency for acne. These changes can be tough for anyone. But many children on the autism spectrum find these body changes deeply alarming.

It’s important to talk to your child before these changes happen. On the topic of periods, for example, you’ll want to teach your daughter about using feminine hygiene products. As a parent, you can use tools such as pictures or cartoons to explain to your child the changes happening in his or her body. (See the visual supports section in the Autism Speaks puberty guide.)

In addition, there’s a growing amount of research associating puberty with a new or increased tendency for seizures among those who have autism. It’s important to discuss this with your child’s doctor and learn how to recognize possible signs and symptoms. If you have further concerns, it’s a good idea to meet with an autism-qualified neurologist to talk through your options.

Sexual feelings

During puberty, most people start to experience sexual urges. It’s likewise normal for children on the spectrum to feel sexually aroused. But for teens with autism-associated sensory issues, these new sensations can cause anxiety.

Your child might also start to masturbate – also a healthy and normal part of development. However, unlike their typically developing peers, some teens on the autism spectrum lack the social awareness to know when and where it’s appropriate, and when it’s not. As awkward as it may feel, it’s important to discuss this issue with your child. If you’re not comfortable bringing it up, or need assistance on how to start the conversation, talk to your child’s therapist—he or she will be happy to help. (Find tips on how to broach this conversation in the Autism Speaks puberty guide.)

School challenges

Most everyone finds middle school and high school more difficult than grade school. For children on the spectrum, though, advancing in grades can pose unique challenges.

For example, if your child is in mainstream classes, his or her teachers will ask for more abstract thinking and expect assignments that can’t be completed through memorization. Many children on the spectrum are fantastic at recall, but struggle with abstract concepts. So be aware that school might get much more difficult and this, in turn, can hurt self-esteem.

During this time, you can work with your child and his therapist to figure out ways to build esteem and a sense of self that aren’t related to grades. His therapist can also help your teen learn to deal with the frustration that comes with having to ask for help.

It can also help to involve the school counselor and teachers in discussing strategies for breaking down information that your child will be better able to understand. Even though classes might become more challenging for your child, his or her school can be an invaluable source of support.

Puberty happens to everyone, and it’s important to make a plan with your child’s teacher, doctor, and therapist for what to do during the critical teen years. With planning and support, you can make this time of changes as smooth as possible.