Living With an Autism Spectrum Disorder (ASD): The High School Years

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Occupational therapy practitioners help individuals to participate in daily activities in school, at home, and in the community. Teens with an ASD face unique daily challenges due to difficulties with social communication and sensory processing. The following tips are from occupational therapy practitioners working with teenage students with an ASD.

If you want to:

Consider these activity tips:

An occupational therapy practitioner offers expertise to:

Help the teenager participate in more social activities with peers.

  • Anticipate sensory experiences that are typical of teen years and that might cause discomfort, such as jostling, loud music, bright clothing, etc., and practice ways to respond.
  • Invite a small group of teens of both genders from a social club or activity to a familiar location for a low-stress social gathering.
  • Keep new social experiences short and predictable, and pre-arrange when and how the teenager can leave the situation, to reduce anxiety.
  • Develop strategies to address challenges. For example, if the teen requires greater personal space on a bus, the practitioner will coach the teen to develop the skills to state his or her preference, choose a different seat, stand instead of sit, etc.
  • Help identify activities that match the teen's skills while promoting participation (e.g., keep statistics for the basketball team, create computer graphics for an event flyer).
  • Collaborate and plan with business leaders, community partners, etc. before the teenager joins an activity so that strategies, schedules, and partnerships can be created. Provide the teen with ways to succeed with the group, such as understanding social expectations, meeting responsibilities, etc.
  • Help the family to participate in social activities by reviewing the social rules, discussing examples of what might happen at these events, and helping the student practice how members of a community group are expected to behave in different situations.

Help the teenager become more independent and responsible by learning to solve problems, cope with daily events, and interpret social information effectively.

  • Ask the teen about his or her priorities each day and focus on those things to encourage more independence.
  • Explain how decisions are made, and offer several appropriate choices to the teen, who can then discuss the pros and cons of each before selecting one.
  • Work with the family and teen to create an effective checklist or schedule of the daily tasks (including pictures and/or smart phone apps if necessary).
  • Help the teen understand social cues during community activities, such as getting jokes, interpreting e-mail messages, etc.
  • Address challenges with time management and follow through.
  • Conduct an activity analysis to break tasks into small, simple steps; help the teen stay calm and organized; and determine individualized reminders and cues based on the teen's learning style.
  • Identify age-appropriate calming or stimulating sensory experiences that the teen can independently use throughout the day. For example, remove irritating tags from clothing, communicate through texting if phone calls are challenging, and use ear buds with or without the device turned on to either block noise or listen to calming music.

Help the teenager get and keep a job.

  • Identify possible employers based on the teen's interests and skills.
  • Support the teen's employment by reducing other stressors, and share the teen's needs and issues with the team.
  • Complete a job analysis, identify work skills, determine which skills need to be developed, and visit work sites to discuss potential modifications and supports with potential employers.
  • Practice social skills needed at work (e.g., interacting with coworkers, reacting to stress).
  • Help the teen appropriately let others know what he or she needs to succeed (e.g., sit in a quiet location rather than near reception).

Help the teenager prepare for the future.

  • Discuss self-advocacy and self-disclosure with the teenager to determine when this approach is helpful, and what to expect from others.
  • Focus on the steps necessary to achieve larger goals. For example, if the goal is for the teen to get an apartment, start by adding more household responsibilities to emphasize dependability, provide opportunities to learn to handle money, etc.
  • Identify what services and accommodations the teen is legally entitled to, and provide resources to obtain these services.
  • Help determine necessary modifications if the teen is learning to drive, or provide training in how to use public transportation and how to cope if something goes wrong.
  • Assist the teenager in using community resources, such as locating bulletin boards announcing community events, accessing the library for discussion groups, and going to the local YMCA for swimming or other classes.

Need More Information?
Children of teenage years (up to age 21) may be eligible to receive occupational therapy in the school environment through the Individuals with Disabilities Education Act (IDEA) or Section 504 of the Rehabilitation Act. It is important to become familiar with the laws, particularly the sections about the school's responsibility in transition planning, so you and your teenager can take an active role in identifying areas of need and developing goals. Services are also covered by health insurance and can be found in private clinics, local health centers, or local children's hospitals. Pediatricians can help parents identify local occupational therapy programs whose staff have experience working with children with an ASD. You can find additional information throughout our website.

Occupational therapy is a skilled health, rehabilitation, and educational service that helps people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations).

Copyright © 2012by the American Occupational Therapy Association. This material may be copied and distributed for personal or educational uses without written consent. For all other uses, contact