Teenage years are fraught with drama under the best of circumstances. For some children with autism, they can be downright harrowing.

The self-consciousness that is the hallmark of adolescence places an exceptional burden on young people with autism, as they become aware that they are different from others their age.

According to a new study published in the September issue of the American Journal of Intellectual and Developmental Disabilities, many respond by withdrawing socially, even as some of their core symptoms, such as repetitive behaviors, and other difficulties, such as irritability and hyperactivity, begin to improve.

The researchers followed 142 children from age 3 through early adulthood. Based on the two gold standard tests for diagnosing the disorder, they identified three groups: 65 children with classic autism, 27 with a broader autism spectrum disorder and 24 who either have a developmental disability or who were referred for autism but did not receive a diagnosis.

Parents of all 142 children filled out the Aberrant Behavior Checklist, a 58-item questionnaire that assesses the children’s puberty, medications, seizure history and maladaptive behaviors, such as anxiety, depression, aggression and hyperactivity, that are often associated with the disorder.

The parents first filled out the checklist when their children were 9 years old, then every four months between 13 and 18 years of age.

The researchers reported that between 9 and 18 years of age, children in all three groups became significantly less hyperactive, although those in the autism group showed the biggest change. They also found significant improvement in irritability among children in the autism group.

Strikingly, however, those with less severe forms of autism became markedly more socially withdrawn compared with children in either of the other two groups.

Individuals with higher intelligence quotients (IQs) in this group reported feelings of loneliness and difficulty forming friendships. Those with lower IQs showed more symptoms of depression. 

In all three groups, those with the highest scores on the Aberrant Behavior Checklist at younger ages, regardless of diagnosis, continued to exhibit more maladaptive behaviors as they aged compared with their peers. Young people with lower nonverbal IQs generally showed more maladaptive behaviors.

The findings are an important reminder, the researchers say, that there is a continuing need for support services and interventions for individuals on the spectrum as they become teenagers and young adults.

Social withdrawal and loneliness are aspects of social functioning that are not typically picked up by diagnostic instruments, they point out. But they may have a considerable impact on an individual’s quality of life in adolescence and adulthood.

Teenagers are famous for retreating to their rooms. But eventually, most come out and rejoin the world. Teens with autism may need a bit more coaxing.