What it is:
According to the Diagnostic and Statistical Manual, 5th ed. (APA, 2013), Autism Spectrum Disorder (ASD) is a neurological condition that affects approximately 2% of the U.S. population (Maenner, 2020) and is characterized by (1) difficulties in social communication, and (2) stereotypic, restrictive, or repetitive patterns of behavior. However, many people (including all of us at TAP) view this as a narrow, pejorative description of autism that contributes to the many misconceptions about autism people hold.
The term autism has come to describe an incredibly diverse and wide-ranging group of individuals. At TAP, we work with many autistic teen clients who were frequently misdiagnosed (e.g., as having borderline personality disorder, oppositional defiant disorder, etc.), or their autism was missed entirely (e.g., they are correctly diagnosed as depressed or anxious, but their neurotype is not accounted for). These folks may also experience difficulties navigating a world that is not built for their neurotype (e.g., social difficulties, preferences for routine or predictability) and may have struggled to access empirically supported treatments that were not properly modified for their neurotype.
Does This Sound Familiar?
Although autism is a neurodevelopmental disorder, meaning it is present from early in development, many people find that they do not recognize or see their child’s autism until they reach their teen years. This might be because your teen’s social or academic environmental demands changed, making nuanced friendships harder, social settings more challenging, greater responsibility in one’s day-to-day life overwhelming, and the rising rigor of academics becoming too much.
You may describe your teen as:
- Having a great vocabulary, but often using formal language or repeating catch phrases or pop culture terms
- Someone who finds it hard to follow multi-step directions
- Having a hard time taking turns in conversations, and preferring to talk about their interests
- Someone who has difficulty noticing or understanding subtle or nonverbal communication directed towards them, such as someone using sarcasm or indicating they would rather be done in this conversation
- Not using their hands much to communicate
- Being excellent interactive partners with adults, but not as much with their same-aged peers
- Having difficulty making or keeping friends, perhaps being okay with not having as many friends, or being very interested in making friends but struggling in this domain
- Someone who prefers routines and has a difficult time with changes in schedule or unexpected events
- A smart, gifted child who struggled with emotion regulation and outbursts
Associated Concerns:
Many autistic teens have co-occurring concerns that may be targets for treatment. Autistic teens are more likely to also struggle with anxiety and depression, sleep difficulties, ADHD, trauma, and social difficulties.
- Up to 84% of autistic teens also experience impairing anxiety, including OCD, which can exacerbate insistence on sameness, repetitive behaviors, emotional distress, and self-harm behaviors.
- Autistic adolescents and teenagers are more likely to experience potentially traumatic events and are also more likely to have greater distress in the face of traumatic events.
- ADHD is estimated to co-occur with autism in as much as 75% of autistic teens and adolescents.
- ADHD can exacerbate difficulties with time management, hyper-focus, school-related concerns such as testing and study habits, and generally managing day-to-day functions.
- We offer comprehensive assessments for ADHD, which can be used to provide school accommodations such as extra time, preferential seating, individual settings for testing, and other 504/IEP plan accommodations.
Empirically Supported Treatments at TAP:
If you are reading this and think this sounds a lot like you or your teen, they may benefit from an autism assessment. We offer comprehensive autism assessments at the TAP clinic, including for adolescents and teenagers who think they may have been mis- or un-diagnosed. Autism assessments for adolescents include self-report measures, parent- or other-report measures to obtain a developmental history, and semi-structured interviews. We use evidence-based measures, including the ADOS-2, as well as novel measures that may better account for high camouflaging individuals, such as teens assigned female at birth or teens who may identify as non-binary or gender fluid. More information is available on our Assessment page.
We also offer re-evaluations for teens who already hold an autism diagnosis. These may be to re-assess their current level of functioning, address new school accommodations, or provide an updated cognitive or adaptive functioning estimate for access to waivers or scholarship services provided at the state or federal level. Regardless of your teen’s level on the autism spectrum, we are able to work with them on an assessment of this nature!
We can also adapt any of our empirically supported treatments for adolescents (e.g., CBT or DBT) to be neurodivergent friendly and affirming for Level 1 autism.
In fact, we specialize in offering a neurodivergent-friendly DBT skills group for teenagers. This group focuses on improving distress tolerance, reducing black and white thinking, and improving skills to manage and regulate emotions. This can be a great group for many autistic teenagers and adolescents, and can also be a place to develop social skills and group interactions.
At this time, we do not have therapists that work with teens with Level 2 or 3 autism. We are happy to provide assessments and will then refer you to wonderful providers in the community better suited to support your teen.