Adolescence

Adolescence is the period of life between childhood and adulthood when individuals must learn skills to become independent, autonomous, and mature (Geldard et al.,2019). During this time, several cognitive and physiological changes to the body have a significant impact on development, with key areas being cognition, behaviour, and social engagement in several contexts.

Typically, adolescents undertake an individuation process in which they move away from their family unit toward their peers. This can present inconsistency between the various environments adolescents belong to, as expectations and behaviours differ between the home, school, and social settings. Bronfenbrenner’s Ecological Systems Theory (1979) recognises the interactions between individuals and these various systems that may increase stress (risk factors) or decrease stress (protective factors).

Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is categorised by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; APA, 2013b) as a deficit in social communication, and demonstration of restricted, repetitive and/or sensory behaviours or interests. This diagnosis adds a greater level of complexity for adolescents over their neurotypical peers as they navigate cognitive, behavioural, social, and environmental challenges.

While all individuals diagnosed with ASD share core characteristics, these symptoms are manifested in a vast array of severity from low-level high functioning to more acute effects resulting in high dependence on parents and carers. This gamut of attributes is reflected in cognitive functioning, with intellect varying from superior results on conventional IQ tests, to some intellectual impairments requiring highly individualised support and interventions (Phetrasuwan et al., 2009). An ASD diagnosis can be made as early as 18-24 months, with males demonstrating higher prevalence rates. In addition to this, social determinants include demographic, racial and socioeconomic considerations (Zeidan et al., 2022). According to Van ‘t Hof et al. (2020), the mean age of an ASD diagnosis is 60.48 months (approximately five years of age), with a range of 30.9-234.57 months. This indicates that most ASD adolescents have been diagnosed earlier in life, with opportunities to develop skills for socialisation. Despite this, adolescents with ASD have a greater likelihood of mental health condition comorbidity. Zaboski and Storch (2018) state that anxiety appears in 40% of ASD cases, consequently adding strain to family relationships and increasing parental stress.

Evidence of Symptoms 

Common symptoms of adolescents with ASD include rigidity to change in routines, restricted interests, hypo or hyper-reactivity to sensory input, language, and communication difficulties, eating pathology, restricted and repetitive behaviours, including narrow interests (Gal & Yirmiya, 2021).

Adolescents naturally move away from their families and toward their peers during a process of individuation (Geldard et al., 2019). For young people with ASD, this process may be difficult due to a lack of social awareness and ability to communicate with others. Social communication is one of the most pervasive barriers for individuals with ASD, due to their perceptions of difficulties communicating, challenging feelings about their communication experiences, and their perspectives about the support required for developing communication skills (Kelly et al., 2018). Kelly et al. (2018) further report that adolescents with ASD are at increased risk of social isolation, depression, and developing a positive social identity.

Socially, ASD individuals may find it difficult to assimilate with their peers due to unique interests and abilities. Furthermore, interactions may have little meaning to others as conversations are often narrow, with a lack of awareness of how these topics are being received. These experiences contribute to a lack of ability to assimilate, and in some cases attract negative attention from their peers resulting in a higher risk of bullying victimisation (Chou et al., 2020).

Research has demonstrated a link between ASD adolescents and aggression, resulting in increased severity of social anxiety and behavioural consequences, specifically in a school setting. Ambler et al. (2015) reported that adolescents are more likely to be suspended from school than their typically developing peers, due to their reactive anger and lack of self-control and regulation strategies. Bronsard et al. (2010) further researched aggression by ASD adolescents in different environments as reported by parents, caregivers, and mental health professionals. They stated that in stressful situations, ASD individuals were more likely to release their anxiety through a wide range of aggressive behaviours, including slapping, pinching, throwing objects, and pitching into others with their heads. It was noted, however, that the role of the environment impacts the degree to which these behaviours are displayed, as individuals can modulate their behaviour according to the expectations and structure of the environment. This study highlights the impact of supportive environments for individuals with ASD, as well as the relationships built by regular interactions which determine consistent observations, data collection and anecdotal information used for intervention.

Impact on the the Individual and Interactions

Due to difficulties in socialisation, individuals with ASD may struggle with friendships. Bernardin et al. (2021) report the detrimental effects of ASD adolescents who ‘camouflage’ to fit in by hiding their autistic traits. This practice has been found particularly true for ASD females, with mental health links to depression, anxiety, and stress. Adolescents with ASD reportedly spend less time socialising with peers, have smaller peer groups and are less likely to have reciprocal friendships as compared to their neurotypical counterparts (Dean et al., 2020).

Poor communication and socialisation may impact an ASD adolescent’s ability to access individual milestones such as getting a part-time job or learning to drive. Activities such as these are contributors to the individuation process in which young people move toward adulthood. ASD adolescents may demonstrate a similar deficit of adaptive behaviours to those with an Intellectual Disability (ID), resulting in a variance in daily living skills. This is supported by Baker et al. (2021) who report that both ASD and ID individuals have an increased likelihood of demonstrating externalising problem behaviour.

For families, raising ASD adolescents can be challenging, in some cases affecting parents’ mental health and parenting experience. Schiltz et al. (2017) studied the impact on these families, stating that there is a correlation between challenging ASD adolescent behaviours and parental stress. Guidotti et al. (2020) further report that siblings of ASD adolescents may have strong psychological and emotional impacts, with negative emotions evident due to annoyance, shame, and embarrassment.

Suggested Interventions

Supporting ASD adolescents’ social development is integral to their successful integration into school and the wider community. Within a school setting, there are several support staff who work together to ensure that ASD students are given opportunities to succeed, including Special Education Teachers, Classroom Teachers, School Chaplains, and Guidance Officers. Ensuring all support staff are working together to provide adjustments and opportunities for ASD adolescents is integral to their success at school.

Research suggests that the inclusion of individuals with ASD in general education is most beneficial, particularly in social skill interventions. Dean et al. (2020) uncovered that social skill lessons that incorporate typically developing peers are more effective than groups of only ASD individuals due to peer mentoring, with joint engagement decreasing the levels of solitary engagement. Providing a range of extra-curricular interest groups to enhance social engagement is also a support strategy that Guidance Counsellors may use to increase inclusive socialisation.

Meeting the needs of each ASD student can be complicated, due to the complexities and variance of this mental health condition. One way to ensure individualised support is to complete a Functional Behavioural Assessment (FBA), accessible through the Autism Hub (Queensland Government, 2022). This tool is designed to assist educators to understand behaviour and effectively respond to prevent frequent minor behaviours.

There is a range of reasons students with ASD may behave in a particular way, such as attempting to escape or avoid stimulation, sensation, items or activities, as well as obtain stimulation, sensation, items, or activities. When the function of the behaviour is understood, support can be put into place to meet the need of that student in a more desirable and socially acceptable way. FBAs often inform Individual Support Plans (ISPs) for ASD students by highlighting strengths and challenges in a school environment. ISPs are used as a formal reference for all stakeholders, endorsed by parents, of all the supports in place to enable full participation by that student.

It is the role of all educational stakeholders to make reasonable adjustments for students. The Disability Standards for Education (2005) states that all students with disabilities have the right to be treated on the same basis as students without disabilities. Ensuring that ASD students have access to tools and resources to support their learning, including the use of digital technologies, is an example of a reasonable adjustment. Frameworks such as Universal Design for Learning (CAST, 2021) demonstrate pedagogy that supports access to the curriculum in highly individualised ways, without singling out individual students due to academic or social abilities.