Navigating puberty autistic teenagers

Puberty marks a significant milestone in every child’s life, in both physical and emotional development.

This period can be particularly challenging for teenagers with autism and their families. Rapid bodily changes, increasing social pressures, and emerging personal identities can be challenging to navigate. Navigating the teenage years with an autistic child involves a delicate balance of preparation, education, and emotional support. Understanding the unique challenges faced by autistic teens helps in developing an approach that respects their individuality while guiding them through the complexities of puberty. By creating open communication, educating on key topics, and using appropriate resources, parents can provide the necessary support to help autistic teens develop into adults with a healthy understanding of themselves and their bodies.

Puberty is often a time of high emotions and changes that can overwhelm all teenagers. For autistic teens, these changes can be even more profound. The emotional turbulence may increase anger or heightened sensitivity, making some days challenging. However, it's also a period where many autistic teens can express more complex thoughts and exhibit a sharp, quirky sense of humour. This mix of experiences can make the teenage years a rollercoaster of good and challenging days.‍

Physical and emotional changes

As autistic children enter puberty, they face the same physical developments as their peers, such as growth spurts and sexual maturation. These changes often need to be in sync with their social and emotional development, creating a confusing experience for the teen. For instance, they may develop an adult's body while navigating social interactions with the skills of a much younger development age.‍

Social challenges

The teenage years are also filled with important social interactions, which can be tricky for some autistic teens. Understanding social cues and managing peer relationships can become more demanding as expectations age. Friendships and peer relationships take on new meanings, and the desire for acceptance can heighten feelings of anxiety.

Preparing for puberty: advice for parents

Early preparation can ease the transition into puberty for both the child and the family. It's beneficial to start discussions about bodily changes when the child shows awareness of physical differences between children and adults.

When to start the conversation

Parents can begin by pointing out observable differences, such as facial hair or changes in body shape, linking these to growing up. For younger children, simple explanations paired with visual aids like line drawings or photos from different life stages can be helpful. For example, explaining the development of breasts in a straightforward, factual manner helps set a foundation for more detailed discussions as the child matures.

Educating on privacy and consent

It's essential to educate autistic teens about privacy and consent as they mature. Discussions should include understanding that certain body parts, like breasts and genitalia, are private and should not be touched without consent. The process of education plays a crucial role in instilling a sense of respect towards oneself and others.

Handling sensitive topics

For topics like menstruation and masturbation, which may come with specific challenges, focus on practical guidance like maintaining hygiene and respecting privacy. These discussions should be tailored to the teen's level of understanding and can be supported by educational books tailored to autistic learners.

Managing emotional wellbeing

The emotional volatility often seen during puberty in autistic teens requires a measured response. Recognising that outbursts may be part of navigating new emotional feelings can help maintain a supportive environment. Parents ' patience and calm approach during tough moments can make a significant difference.

Encouraging open communication

Creating an atmosphere where the teen feels safe expressing positive and negative feelings is essential. On days when the teen is more communicative, engaging in deep conversations can strengthen your relationship and provide valuable insights into their thoughts and feelings.‍

Explaining puberty to autistic teens

Visual aids and social stories

Many autistic individuals possess strong visual processing skills, and visual aids such as social stories are particularly effective. Social stories can be customised to the individual, allowing for a personal touch in addressing each aspect of puberty. These stories can be crafted with various titles and contents, each focusing on specific changes, thus providing clear and direct information.‍

Social stories for girls

For adolescent girls, the following topics are crucial and can be covered in separate social stories:

• Breast development and widening of the hips: A story titled "The Shape of My Body Will Change" can describe the expected physical changes straightforwardly, ensuring the adolescent understands what to expect.
• Pubic and underarm hair development: With a title like "Extra Hair Will Grow", this story can detail where new hair will appear and the normalcy of this development.
• The starts of menstruation/periods: "I Will Begin to Have My Period" can prepare them for this significant bodily change by explaining what menstruation is and how they might feel physically and emotionally. Girls on the spectrum may find menstruation particularly difficult to manage due to the sensory experiences associated with it, such as the feeling of sanitary products and the sight and smell of blood.
• Growth acceleration: "I Will Get Taller" can be used to explain the sudden increase in height that is typical during puberty.

Social stories for boys

Boys will also require tailored stories, such as:

• Growth acceleration: Similarly, a story titled "I Will Get Taller" will help them understand growth spurts.
• Development of pubic, underarm, and facial hair: "Extra Hair Will Grow" can explain these changes.
• Testicular and penile enlargement: "My Body Will Look Different" addresses these changes directly, easing anxiety about body image.
• Spontaneous erections, sperm production, wet dreams: A story like "My Body Will Do New Things" can describe these new experiences simply.
• Voice deepening: "My Voice Will Sound Different" helps prepare them for changes in their voice.‍

Hormonal and emotional changes

Puberty isn't just about physical changes. The hormonal shifts can also cause significant mood fluctuations. Autistic teens need to understand these potential emotional ups and downs. For girls, charting mood changes on a calendar can visually represent emotional cycles, particularly about their menstrual cycle.

Managing low moods

Visual strategies can help teenagers to manage their emotions. Creating a visual chart with options for when they feel low, such as:

• Listen to music
• Have a nap
• Play on the computer
• Spend time alone
• Read a book

These options give teens clear choices when managing their moods independently.

Understanding social and romantic interests

As teenagers' interests extend to romantic relationships, providing clear guidance about social and romantic cues is important. Autistic teens might not intuitively understand flirtatious behaviour or the subtleties of romantic interest.

Explicit instructions on social cues

Provide clear, explicit explanations of social cues related to romantic interest, such as:

• How people might act when they like someone (smiling, seeking proximity, etc).
• How to differentiate between friendly behaviour and romantic interest.
• Understanding and respecting boundaries.

This information should be presented visually through diagrams or role-play scenarios captured in videos or illustrations.

Addressing masturbation and privacy

Masturbation is a natural part of adolescence. However, autistic teens might need explicit instruction about the appropriateness of doing this in private. Use social stories to:

• Define what is a private place.
• Discuss the importance of privacy in various behaviours.
• Clearly explain that masturbation, like other private activities, should not be done in public.

For example, illustrations and clear narratives can help differentiate between public and private behaviours and locations.

Personal hygiene 

Personal hygiene becomes notably more significant as children enter puberty. For autistic teens, the changes associated with puberty, such as increased sweat gland activity and the growth of body hair, can introduce challenges that are not immediately obvious to them. Understanding and maintaining personal hygiene is crucial for health, social interactions, and acceptance.

Challenges in personal hygiene

The start of puberty brings about many physical changes that can affect an autistic adolescent’s hygiene:

• Increased sweat and body odour: Body odour can become noticeable as adolescents sweat more. Due to differences in sensory perception, autistic individuals might ignore or not notice this change.
• Hair care: The growth of pubic, facial, and underarm hair requires new grooming techniques, which may be challenging to manage, particularly for those with sensory sensitivities to textures and sensations associated with washing and brushing hair.
• Dental hygiene: Changes in diet and hormones can affect oral health. Regular brushing becomes even more important; for some autistic individuals, the sensation of brushing can be uncomfortable or distressing.

Implementing a hygiene routine

Establishing a consistent hygiene routine can mitigate some of the challenges faced during puberty. Here are several strategies that can help:

• Visual schedules and checklists: Outlining the steps involved in daily hygiene routines using visual aids can help make the process clear and manageable. For instance, a chart in the bathroom showing the steps for brushing teeth or a checklist for a shower routine can provide structure.
• Social stories for hygiene: Creating social stories that explain why hygiene is important can help connect personal care and social acceptance. These stories can cover topics like 'Why We Brush Our Teeth' or 'Keeping Clean to Stay Healthy'.
• Sensory-friendly products: For sensory-sensitive people, using unscented hygiene products with a neutral pH can reduce discomfort. Similarly, using tools like electric toothbrushes that might be less irritating than traditional brushes can also be beneficial.
• Practical demonstrations and role-playing: Sometimes, direct demonstration of hygiene practices or role-playing can help an adolescent understand and get used to the routines involved in personal care.

Professional support and resources

Seeking professional help is a proactive step that can significantly benefit autistic teenagers. Therapists or counsellors who specialise in autism can provide valuable support tailored to the specific needs of autistic teenagers, helping them to understand and navigate the emotional and social challenges of puberty.

An excellent resource is Planet Puberty, a platform dedicated to providing accessible information and practical tips for discussing puberty with young people. Their resources are designed to help caregivers and autistic teenagers manage the intricacies of puberty with confidence and understanding.