Autism and mental health across the lifespan

People with autism tend to struggle with mental health challenges throughout their lives, more so than their neurotypical counterparts. Many studies have found that autistic people are more likely to suffer from common mental health conditions, including anxiety, depression, and attention-deficit/hyperactivity disorder (ADHD). These can significantly impact their overall well-being, affect their day-to-day lives, and possibly exacerbate existing symptoms as well.

Recently, it has been found that some mental health issues could be linked to changes in autistic traits over time. Understanding the different challenges autistic children may face as they grow older can be helpful for caregivers to better identify and provide the support they need.

How autistic traits change as children grow up

Autism is a lifelong condition and can develop differently in different people. Unlike previously thought, autism does not always remain stable. The severity of core autism traits, social-communication issues (SC) and restricted, repetitive behaviours (RRB), can change as individuals age, improving in some children and worsening in others. This can depend on a variety of factors, including gender, socioeconomic status, and cognitive ability. Children with less severe autism tend to show more improvement than those with more severe symptoms overall. In children with less severe autism, their core autism traits also seem to show different trajectories.

Changes in Social Communication (SC) symptoms and mental health challenges

As children grow older, many of them show improvement in social-communication abilities; in other words, they get better at expressing themselves and interacting with others. However, some autistic children start to struggle more with social interaction over time, possibly due to changing social stressors and expectations. These children are more likely to experience heightened levels of anxiety, more disruptive behaviours, and ADHD symptoms.

Changes in Restricted, Repetitive Behaviours (RRB) and mental health challenges

When it comes to RRB, some children experience changes in severity, while others do not experience any changes at all. In children whose RRB symptoms improve (i.e., they exhibited less RRBs with age), they tend to show higher levels of anxiety that also increased over time. This could be because some RRBs may help autistic people regulate their emotions and calm themselves. As they learn what is socially acceptable, they may change their behaviours accordingly and reduce RRBs. This could leave them with fewer ways to manage their feelings and lead to increased anxiety, especially if they do not have other coping mechanisms.

Understanding the evolving challenges autistic children may face as they go through different life stages can inform how we can support them more effectively. For instance, acknowledging the potential benefits of RRBs might redirect therapeutic interventions away from targeting these behaviours, instead focus on teaching alternative strategies for emotion regulation. Having the right support and treatment can significantly improve outcomes and provide children with the best chance to lead fulfilling lives.