Autism: Understanding How Autism May Change with Age

Most of the time, when people think of autism, they picture a very young child with noticeable differences. However, autism is a lifelong neurodevelopmental difference that can present differently across various stages of life. Importantly, autistic traits do not simply disappear over time; instead, the way they are expressed, experienced, and supported changes with age. 

Early Childhood (Birth to about age 5)

As developmental milestones emerge, autism-related characteristics become more noticeable. However, keep in mind that every child develops differently, and the way autism presents itself is also unique to each individual.  

Some autistic children may demonstrate (Rogers, 2009)

  • Differences in social communication (e.g. reduced eye contact or difficulty engaging in back-and-forth interactions)

  • Delayed speech or language development

  • Delays in motor development (e.g. differences in fine and gross motor development)

  • Repetitive movements (e.g., spinning, rocking, hand flapping, and/or other stimming behaviors)

  • Differences in joint attention

  • Strong preferences for routines and predictability 

  • Intense interests in specific objects or routines 

  • Sensory sensitivities to certain textures, lights, tastes, sounds, or movement

At the same time, many autistic children demonstrate remarkable strengths, including strong memory skills, attention to detail, honesty, creativity, and deep curiosity about their interests (Woods et al., 2023). 

School Age Years (about ages 6 through 12)

When children enter school, they are faced with social and academic expectations. This is often when autism becomes much more noticeable for some children, particularly in a structured classroom environment.

School-age autistic children may

  • Struggle with understanding social rules, friendships, or group dynamics

  • Experience sensory overwhelm in busy classrooms, assemblies, or cafeterias

  • Have difficulty transitioning between activities

  • Become more exhausted from navigating social expectations throughout the day

  • Show intense interests that become a source of enjoyment and learning

  • Prefer solitary activities 

  • Difficulty understanding conversational cues or reciprocity 

  • Rigid in their behaviors and interests

  • Delays in language processing (e.g., able to read but not understand the content)

Some autistic children may perform exceptionally well academically but still experience significant challenges with executive functioning skills (e.g. organization, time management, flexibility, and planning). 

Adolescence (about ages 13-18)

During this developmental stage, it often brings significant emotional, developmental, and social change in which autistic teens become increasingly aware of social expectations and differences. 

Some common experiences may include 

  • Increase anxiety around social activities 

  • Difficulty navigating complex peer relationships and developing relationships

  • Greater awareness of feeling “different”

  • Emotional exhaustion from trying to “fit in”

  • Difficulty with verbal and nonverbal communication 

  • Sensory sensitivities 

At the same time, autistic adolescents begin developing coping strategies to navigate the social environment. Some may engage in masking or camouflaging behaviors, whether it is done consciously or unconsciously, to suppress autistic traits or mimic social behaviors. Over time, chronic masking may contribute to autistic burnout or fatigue, anxiety, and stress. 

Early Adulthood 

Although little is known about challenging behaviors in the transition from adolescence to young adulthood in autistic individuals, studies suggest that autistic adults may experience ongoing difficulties with emotional regulation, adaptive functioning, and behaviors that emerge (Rattaz et al., 2018). As autistic individuals transition into adulthood, they are often faced with new responsibilities related to higher education, employment, independent living, relationships, and financial management. However, some strengths experienced are 

  • Deep focus and dedication 

  • Strong problem-solving abilities

  • Creativity and innovation 

  • Expertise with areas of interest 

While also having challenges in areas of 

  • Executive functioning 

  • Managing daily responsibilities 

  • Workplace and school environment communication 

  • Navigating different relationships 

  • Balancing energy levels 

Middle Adulthood (Klein & Klinger, 2024). 

During middle adulthood, many autistic individuals continue developing a deeper understanding of themselves, their strengths, and their support needs. While balancing work responsibilities, relationships, parenting, caregiving, and other life demands can increase the risk of chronic stress and autistic burnout, this stage of life often brings greater self-awareness and confidence.

Autistic individuals become better at 

  • Recognizing their personal limits, energy capacity, and sensory needs

  • Making intentional choices about daily routines, relationships, and work environments that support their well-being

  • Advocating for accommodations and supports that help them thrive

  • Developing greater self-acceptance and embrace their autistic identity

Older Adulthood 

For some autistic individuals, they are not diagnosed until later adulthood. Many of them report looking back and recognizing experiences throughout childhood, adolescence, and adulthood that may have been related to autism but were not identified at the time.  Older autistic adults encounter

  • challenges accessing autism-informed healthcare, support services, and providers who understand how autism presents across the lifespan 

  • experience age-related changes (e.g. physical health, cognition, sensory functioning, etc.) alongside autism-related differences

While these factors can create significant barriers, many autistic individuals benefit from established routines, familiar environments, and pursuing lifelong interests and passions that provide a sense of identity and enjoyment. 

It’s important to not only focus on the challenges but also recognize the strengths and support needs throughout life! 

Because autism does not look the same at every age or every person, understanding how autism may look across the lifespan can help provide earlier identification, appropriate supports, and greater acceptance of the diverse ways autistic individuals experience the world. 

*Clinical Note: The information presented in this blog is intended for educational purposes only and should not be used as a substitute for professional medical or mental health advice. If you or your child is experiencing symptoms consistent with a mental illness/disorder, consider consulting with a qualified healthcare professional.

References

Klein, C. B., & Klinger, L. G. (2024). Aging Well and Autism: A Narrative Review and Recommendations for Future Research. Healthcare12(12), 1207. https://doi.org/10.3390/healthcare12121207

Rattaz, C., Michelon, C., Munir, K., & Baghdadli, A. (2018). Challenging behaviours at early adulthood in autism spectrum disorders: topography, risk factors and evolution. Journal of intellectual disability research : JIDR62(7), 637–649. https://doi.org/10.1111/jir.12503

Rogers, S. J. (2009). What are infant siblings teaching us about autism in infancy?. Autism research2(3), 125-137.

Woods, S. E. O., & Estes, A. (2023). Toward a more comprehensive autism assessment: the survey of autistic strengths, skills, and interests. Frontiers in psychiatry14, 1264516. https://doi.org/10.3389/fpsyt.2023.1264516

https://raisingchildren.net.au/autism/learning-about-autism/assessment-diagnosis/signs-of-asd-in-teens

https://thereachinstitute.org/how-autism-may-present-at-different-ages/

Written by: Gabriela Anguiano M.A.Ed., P.A.