Walking The Tightrope: Promoting success in the adolescent with ASD

Originally appeared in Behavioral Health News June 2019

It is tough being an adolescent. Adolescence is a time fraught with changes at many levels. Physically, the body is growing and changing, evolving from the body of a child to an adult, and becoming physiologically capable of bearing children. There is a tremendous surge of hormones that allow for many of the physical and sexual changes that can affect the adolescent’s mood and sense of stability. Socially, there is an evolution of many of the friend groups, with complicated social dynamics that shift from the more straightforward experiences of the latency-age child. In addition, romantic and sexual feelings come to the forefront with a vengeance. As I said, it’s tough.

It’s also a tremendous challenge being on the Autism Spectrum. Two of the prominent characteristics of being on the spectrum are social difficulties and difficulties with being independent. Social difficulties characterize the individual with ASD from early on in life, but the difficulties can become more problematic as the individual enters middle school and later, and social relationships take on a more central role developmentally for all children. Similarly, while all children feel a desire to be autonomous and independent throughout childhood to some extent or another, it becomes much more prominent in the adolescent phase. It is for these reasons that an adolescent on the Spectrum likely will have a more difficult time getting through this time period because of the specific and unique challenges that being on the spectrum poses combined with the typical challenges that all adolescents face.

Despite these challenges, I find it gratifying to work with adolescents and their parents during this time period. The time is fraught with the possibilities of the future, and the sense of accomplishment and success when the adolescent comes to a place of understanding or solidifies an aspect of identity. It is wonderful to hear him on a quest to understand himself while he struggles with questions and crises related to the formation of the self that are specifically unique to that time period. Once the adolescent grows into adulthood, there are fewer crises, but it is also harder to access these life questions and decisions. As such, this time period is filled with hope and certainty, but also frequently stress, and often a sense of drama and despair.

The challenge in woking with adolescents on the spectrum is to support them in this developmental phase and help them work through the typical crisis of adolescence. This includes the quest for personal identification, independence, and the increased focus on social relationships, including romantic interests, while at the same time allowing for the unique challenges encountered. At times, supporting the unique needs of autism may seem contrary to to some of these important goals of adolescence. Because individuals with ASD struggle with social relationships, it does not mean they do not have the same desire and interest in social and romantic relationships of adolescence. Similarly, even though the individual with ASD is more reliant on parents and caregivers than their neurotypical peers, they still crave the desire for autonomy and independence as their counterparts.

As a result, parents and caregivers are in a unique position to try to promote the adolescent with ASD’s developmental process consistent with all adolescents, while simultaneously supporting the unique needs related to Autism. Unfortunately, many well-meaning caregivers err on the side of squelching their desire for autonomy toting the Autism difficulties, or the opposite, in an effort to promote independence, give them too much freedom, not taking into account some of the difficulties their Autism presents. This can lead to much frustration and anger for the adolescent and caregiver. The caregiver can do a lot to help the adolescent get through this possibly rocky time and turn it into one of success.

Some parents may argue that their child is not capable of being independent and exercises poor judgment, citing examples where they “trusted” their child to set up a facebook account or travel somewhere with disastrous results. My response is that everyone is capable of some level of independence, though obviously that depends on each individual’s abilities and weaknesses. Independence is something that can be cultivated through teaching and modeling. A child who is taught how to use the internet properly with a parent’s involvement, at least initially, is being taught how to be independent. A parent who goes through the steps with a child to teach him or her to travel, which may include doing a dry run with them several times, then slowly phasing out, is promoting independence.

Similarly there are parents who believe their child has no interest in socialization. More often than not, when I have met these children, they are very much interested in social relationships but are afraid of getting “burned” like they have in the past. This may be a time when social skills groups are valuable, not just in teaching social skills, but helping the adolescent forge social relationships. Parents can also be in touch with school personnel to help determine if there are particular students in the class that would be a good match with their child and facilitate interactions with that child. Romantic interests come to the forefront as well. Parents can be present to provide an open environment for questions on this topic, providing appropriate books, but also encouraging a sense of privacy as the adolescent’s body grows and changes with signs of puberty. I encourage parents to be proactive in this area and teach their child about puberty and sexuality in an appropriate manner so the child does not unwittingly engage in any socially inappropriate or embarrassing actions without understanding the social ramifications of what they mean. This continues to encourage a sense of personal agency in the adolescent.

There is nothing more exciting than watching a smile of success when an adolescent feels a sense of personal accomplishment, when he or she feels independent, autonomous, and successful. It increases and promotes self-esteem and sets them on a good pathway toward adulthood.