Will Puberty Exacerbate the Behaviors of a Child With Autism?
by Lisa DiFalco
The transition from childhood to adulthood can be tough on any child. However, how might adolescence and hormonal stresses affect a child with autism? Educators, families and healthcare professionals need to be aware of the potential of changing needs and demands of such an individual and how it may impact those around them. A typically-developing child can become surly and uncommunicative, but what may be in store with a child with autism or ASD? CNN shared the story of Diane and Alexander Brown and how adolescence has impacted the life and family of a severely autistic teen. Understand more about potential changes, challenges and needs of children with autism as they transition into adulthood.
Alexander Brown is a 14 year old boy having difficulty understanding what is happening to him. He finds comfort swaying on a makeshift hammock and Diane Brown, his mother, said:
“I would love to be in Alexander’s head for just a few hours. He’s having a hard time going through puberty right now.”
Alexander has difficulty expressing himself. He now seems sad or angry without understanding why. Currently, he is up at all hours of the night and has begun acting out physically. The parents, other three children and dog all have experienced bite marks, scratches and bruises through interactions with Alexander. Their older child, Connor, also is diagnosed with severe autism and is now cared for at the Tradewinds Residential program.
Aggression is a common behavior seen in some autistic children. It was reported in a study that 68 percent of autistic children had directed aggression toward a caregiver and another 49 percent of autistic children had done so with non-caregivers. Aggression from autistic children can be a factor in:
- Endangerment to the safety of individuals and family members
- Parental exhaustion and isolation
- Increased levels of caregiver stress
- The decision to have a child placed in a facility or residential center
A great deal is not known about how puberty affects children with autism as there is little research on the topic. While the vast children with autism continue to live in their home, a recent study showed that two percent live in supportive facilities. Alexander, on a good day, is often “the sweetest of boys.” However, he is now taller than Diane and will soon outweigh her. She is unable to control him when he does lash out.
It is seen that boys more often have autism than girls and there is a debate as to whether or not continuing to live at home or living in a more structured facility is the best choice for those children with autism who exhibit levels of aggression that exceed the management abilities of a parent or caregiver. A positive aspect of a more structured living arrangement outside the home is presented by Brad Boardman, executive director at the Morgan Autism Center. Boardman said:
“The reality is that for a lot of autistic kids, normal family life is pretty chaotic. A group home might add a little bit of structure to the equation. It can also be beneficial to families who have got into a negative pattern with a child or are seeing aggressive behavior at home. Sometimes a move into a residential group home can be a way to reset the relationship.”
How puberty will affect an individual child and their family is unique to every situation. Some children with autism show aggressive behaviors at a young age. Other children do not express aggressive tendencies. Tensions of raising a child with autism may impact the marital relationship but research results are mixed on the area of marital breakups. Parents need to seek out ways to relieve stress and find outlets to enable them to restore their energy and engage with others. In Diane’s case, she blogs, performs yoga and has a job at a local café, while also taking care of her family.
New Changes, New Questions
As with all children going through adolescence, physical changes, cognitive growth and social relationships may all change. New levels of independence may be thrust upon teens with ASD if they go to middle school and must change classes, interact with more teachers and manage assignments and communications with others. Diane Brown’s children are severely autistic but children with milder expressions of autism and ASD may benefit more from guidance as their bodies, minds and social needs change. Adolescents with such conditions can be happy and continue to develop with additional supports.
Adolescents with autism need guidance as they transition to becoming adults. There are many areas to learn more about to better help them but a major focus is to develop their independence. Judith Miller, PHD, training director and clinical director at the Center for Autism Research, discusses adolescence in autism spectrum disorders, recorded at the Next Steps into Adolescence Workshop. One initial consideration is that puberty and maturation occurs on “the same time scale” for children with autism as it does for a typically developing child. In addition, as a group, Miller states that there is clinical evidence and personal experience showing that those with autism are interested in relationships but that in some cases social development “lags behind.” From physical to sexual to cognitive changes, it becomes important to help autistic teens navigate the common challenges experienced during this period and to develop their individual potential.
From severe to mild and high-functioning levels of autism, it takes a community composed of educators, health professionals and family members to provide the structure and appropriate supports to promote a teen with autism’s development and emotional health as they face the challenges of puberty. Adolescence may bring out new undesirable changes such as aggressive behaviors or positive changes such as a growth in cognitive functioning, awareness of self and of others. More resources and research are necessary to improve understanding and provide tools to case managers, caregivers, families and health professionals.