Understanding the Mental Health Struggles of Kids & Teens with Autism: How Parents Can Provide Support

Throughout my years working with kids and teens with autism, there are five commonly reported difficulties that stand out the most to me as a clinician.

1. Hyperfocus

Kids and teens with autism tend to have 1 or 2 specific interests or obsessions including hobbies and topics such as: history, sports, geography, music or more commonly - a specific artist. Some might be passionate about a certain activity, animal, or skill; these interests vary.

The way that I see it, these interests are a gift. How magical is it to be able to be an expert in a certain topic? To be able to consume a vast amount of knowledge on the topic and to be able to share this with other people.

The hyperfocus can contribute to some challenges in relating and communicating with others if others don't agree, have interests that are different, or want to shift the topic of conversation.

Insight: This can leave everyone feeling frustrated. You want your kid to be able to connect with peers, and with you - but their disinterest in topics of conversation unrelated to their special interest can be a hinderance to connection. This can also be frustrating for your kid, they might realize that some other people do not feel as strongly as they do about the same topic and they might feel misunderstood or undervalued. Kids who struggle with this may need support with 1) Finding peers with similar interests and 2) Incorporating their specific interests into their life as a coping skills and superpower.

2. Social Difficulties

While the hyperfocus can contribute to some interpersonal challenges, other contributing factors can include dichotomous thinking (all-or-nothing), rigid beliefs, and rule-governed thought patterns.

When friends make mistakes or peers are doing something that the individual believes to be "bad" or "wrong", this can lead the person with ASD to completely write off a person, their brain categorizes them into the fear section. There is no "grey area", which can make social relationships challenging because others cannot be perfect 100% of the time.

Insight: Sometimes kiddos with autism may withdraw from social relationships with peers who have different beliefs or values than they do, even if from a parenting perspective, these other peers are peers with a good influence. Kids who struggle with this may need support with 1) to build the skills necessary for empathy, understanding, and acceptance and 2) Building awareness of what is in their control - their own thoughts, feelings, behaviours, and beliefs.

3. No Filter

This one is a question of nature vs. nurture. Some folks with ASD might have innate difficulties picking up on social cues, while for others, this could be learned in order to ignore certain relationship red flags in order to fit in with peer groups.

While persons with ASD might step away from spending time with people who engage in any type of behaviour or activity that they believe is rule breaking or not within their idea of right, due to their perception of danger or threat or stressor; however, there's also the potential for people with ASD to miss out on cues for real danger because so much of what is communicated socially is unspoken - non verbal cues, tone of voice, facial expression - this creates vulnerability as the person with ASD might be unable to respond appropriately to their environment.

Insight: They might overshare, have difficulty trusting others, spend time with peers who don't respect their boundaries, or mold to what their friend's interests are in order to feel accepted. Kids who struggle with this may need support with 1) Building their self-esteem and 2) Setting healthy boundaries.

4. Depressive Symptoms

Low self-esteem, heightened self-awareness, masking, breakinging their own boundaries, a facade at school, exhaustied and lashing out at home in their safe space. Thesense of just "holding it together" all day.

Some folks with ASD might intellectualize their emotions rather than feeling their emotions. This can lead to expressions of anger as not everything in life can be intellectualized.

Insight: Masking at school and at social events can feel exhausting. Time spent being disconnected from self, ingenuine, and inauthentic can leave kiddos on the spectrum feeling lonelier than ever. Parents may see depressive symptoms at home because it's a safe space where kids and teens with ASD can take a break from the façade of masking to appease neurotypical standards and expectations in their daily lives. Kids who struggle with this may need support with 1) Learning to identifying their feelings, needs, and wants and 2) learning to communicate their needs effective

5. Routine Rigidity

Likely a symptom of autism distinct anxiety (more to come on this topic in later blogs/podcasts).

In addition to the regular symptoms of anxiety such as feelings of overwhelm, panic, worried thoughts, irritability, and difficulty with focus and concentration, ASD distinct anxiety can also include fear and anxiety related to 1) Losing access to a special interest and/or 2) A disruption to their routine. Folks with ASD distinct anxiety may feel fearful or threatened by anything that could contribute to this such a traveling, being stuck in traffic, social interactions, or being "in trouble" or "grounded", or going somewhere new.

Insight: This makes it really challenging when you spend a ton of money and plan a great family vacation, only for your kiddo to not want to leave the hotel room or complain that they are missing their video games at home. It can be tough when healthcare professionals change or cancel regular/on-going appointments. Kids who struggle with this might need support with 1) Problem solving and identifying options/planning and other executive functioning skills, and 2) Building coping skills for anxiety.