Autism first signs and checklist for teenagers

Navigating life can be difficult for a teen. Being autistic can make things even more complicated.

If you haven’t been diagnosed yet, you may not understand that the way you process the world around you could be part of being on the autism spectrum. This may make you feel isolated and confused.

As a teenager, you may find that you are withdrawing, quick to temper, easily distressed, anxious or confused.

But much of this could just be ‘typical’ teenage behaviour. Knowing some of the characteristics of autism in teenagers can be the first step in working out if behaviour is related to stage of life, or if characteristics might be an indicator that an individual is autistic.

Characteristics

There are a number of characteristics that may make you question if you are autistic.

These characteristics cover a range of human behaviours, from social communication and social interaction, to behaviour and sensory processing.

Please note that the information below is just some of the common characteristics of autism. It is unlikely that any teenager will display all these characteristics. It is important to remember that only a qualified professional can carry out an assessment for autism.

Checklist

Social communication signs

As you grow into your teenage years, social communication takes on a new importance. There are many nuances in developing social networks and communication, both verbal and non-verbal, that teenagers on the autism spectrum may find challenging.

As a teenager on the spectrum, you may:

• Tend to lead conversations in which you are taking part, or not take turns regularly in conversations. Alternatively, you may find it difficult when the focus is on you and find it challenging to answer questions about yourself.
• Have intense conversational focus on subjects that interest you, combined with a minimal interest to engage in conversation on other topics.
• Find it hard to ‘read’ non-verbal social cues, such as body language or tone of voice in others. For example, you may not realise if one of your peers is ‘paying you out’ or using sarcasm. You may also have difficultly ‘reading’ people’s faces to know if they are feeling angry, sad or other emotions.
• May have trouble negotiating the unwritten rules of friendship.
• Tend to try to lead engagement and activities with others and find it challenging to let others have a go.
• Prefer spending time with peers that are younger or older than yourself, including adults.
• Have a strong desire to set and follow rules, whether in the classroom, work or social situations.
• Have differences in natural communication styles, preferring more literal language use rather than the use of non-literal language like sarcasm or metaphor, which may be more challenging to understand in context.
• Prefer to make little or no eye contact with others.
• May speak in a monotone, with an accent, in a very proper and formal way or not at all.
• Find it hard to follow instructions that contain more than one or two steps.
• Display a select range of facial expressions or use facial expressions that are different in the context of what you are communicating.
• Prefer hanging around on your own, rather than joining in with others.
• Have differences in recognising other people’s personal space.

Behavioural signs

Teenagers on the spectrum may also display some other behaviours or preferences. These may include:

• The ability to focus intensely on hobbies or activities of interest. For example, you may be able to memorise all the facts about a popular band but have no interest in listening to the music itself.
• Repetitive behaviour, such as lining up your books or computer games on the shelf.
• Loving routine and getting upset when your plans change suddenly, and routines are not followed.
• Extreme sensitivity to a range of sensory experiences which can result in you feeling extremely overwhelmed (an experience called sensory overload). For example, you may like to wear clothes made from certain fabrics, hate loud noises, or only eat certain foods based on their texture.
• Being under-responsive to sensory experiences. For example, keeping a jumper on when it is very hot, or not reacting to pain when hurt.
• Making repetitive body movements, such as hand clapping, hand flapping or rocking, making noises such as grunts or squeals, or frequently clearing the throat, also knowing as stimming.

Other characteristics that are often associated with, or can be common co-occurring among teenagers on the spectrum include:

• Unique sleeping patterns. For example, waking up repeatedly at a certain time each night, or staying awake long after you have gone to bed.
• Regularly resisting or refusing to go to school because you feel overwhelmed, upset or confused.
• Feeling anxious or upset if you experience a new social situation or have to go somewhere new.
• Feelings of depression, which may emerge when you feel that others don’t understand some of your behaviours or preferences. This can lead you to feeling ‘on the outer’.
• A sensory ‘overload’ or build-up can lead to you to become frustrated, upset or angry causing you to lash out or display behaviours that others perceive as concerning.
• The development of an eating disorder, which can emerge during times of peak stress or anxiety, such as when a teenager starts high school.
• Challenges in being organised. You may find it difficult to manage  school life, juggling study with extracurricular activity.

Why should you seek an autism assessment as a teenager?

It is a personal decision to seek an autism assessment as a teenager.

Some individuals can find it daunting thinking about getting an autism assessment as there are many steps involved.

As a teenager, it is important to remember that you know you best, and if you think that you may be autistic, it is best to share these thoughts with your parents, family or a trusted person. Parents and trusted ones may be able to provide information and advice on the diagnostic process and offer support as someone that knows you well. Together, you may seek advice from a qualified professional to gather information to shape your decision.

Some of the benefits of seeking an autism assessment sooner rather than later, can include:

• You may get the help and support you desire.
• If you choose to share your diagnosis, your school and teaching staff may have a better understanding of your strengths, skills, learning preferences and needs – allowing for more effective support and a better educational experience.
• You may have a greater sense of self-identity if you understand yourself better.
• You may have increased confidence knowing you are part of a larger group of teens on the spectrum!

Seeking a diagnosis

Getting started

Assessments for teenagers involve appropriately qualified health professionals gathering and considering a range of developmental, historical and current information against the criteria for autism.

To seek an assessment for autism, you have a couple of options:

• Contact your state or territory autism association for information about assessments.
• Talk to a qualified health professional with experience in the assessment and diagnosis of autism.
• Make an appointment with your GP to discuss and, if necessary, to refer you to a qualified health professional with experience in the assessment and diagnosis of autism.
• You can also refer yourself or your teenager for an assessment.

There are a number of government-funded services that specialise in the assessment and diagnosis of autism. You can contact these teams directly, but you may need a referral from your GP or paediatrician.

There are also private practitioners and organisations that conduct assessments on a fee-paying basis.

You can learn more about the tools used for diagnosis at getting a diagnosis for children (under 18); or getting a diagnosis for adults (over 18), or visit to our Resources page to find an autism support service provider in your local area.

Who will be involved in the assessment?

It will depend on where you go to get an assessment done as to who, and how many professionals will be involved in doing to autism assessment.

If you go to a private professional, the assessment will generally be completed by one professional, such as a Speech Pathologist or Psychologist. In some states, you will be required to see two different types of professionals to complete an autism assessment, before a diagnosis of autism can be made. It is best to contact your local autism support service provider to find out what is required in your state or territory. However, if you go for an assessment by a government funded organisation, a range of professionals will generally be involved in any diagnostic assessment.

The following professionals may be involved in an autism assessment in a multi-disciplinary team according to the National Guideline for the Assessment and Diagnosis of Autism Spectrum Disorders in Australia.

• Medical practitioner
• Nurse practitioner
• Occupational therapist
• Psychologist
• Social worker
• Speech pathologist
• Paediatrician
• Child psychiatrist
• Neurologist

Important: Only professionals that receive additional autism assessment training can make an autism diagnosis.

Where to get an assessment

There are both government funded and private services available. Sometimes, there will be a longer wait time for government-funded services.

You can find a list of local autism support service providers on our Resources page.