Some girls reach secondary school before anyone considers whether they might be autistic. They may have done well academically, developed friendships and appeared to manage the routines of primary school. When difficulties become more noticeable in adolescence, parents can feel confused: how could something so significant have gone unrecognised?
Autism is a lifelong neurodevelopmental difference, but its signs are not always obvious in early childhood. NICE recognises that autism can be overlooked in girls and that coping strategies or a supportive environment may conceal difficulties until later. Recognition in adolescence does not mean that autism has suddenly developed. (nice.org.uk)
Why secondary school can change the picture
Secondary school brings a different combination of demands. Moving between classrooms, managing several teachers, navigating busy corridors and keeping track of homework all require greater independence. A girl who managed within a familiar primary school may find this environment much harder to navigate.
Friendships also change. Conversations may involve more subtle humour, indirect messages and shifting expectations about belonging. Wanting friends and understanding how to manage these relationships are different things. Small qualitative studies of autistic adolescent girls describe a strong desire for friendship alongside increasing difficulty maintaining relationships as they grow older. (sciencedirect.com)
For example, a girl may have managed well with one familiar friend but feel lost when that friend joins a wider group. She may spend considerable time working out what a message meant or why someone’s behaviour towards her has changed.
Looking beyond whether she appears to cope
Having friends, speaking confidently or achieving good grades tells us only part of a young person’s story. It is also important to understand how she experiences the school day.
Some autistic girls describe carefully monitoring their expressions, rehearsing conversations or copying others to avoid standing out. This is often called masking or camouflaging. Research involving adolescent girls suggests that masking can vary between settings and may be particularly demanding around unfamiliar peers and teachers. These findings describe some girls’ experiences; they do not apply to every autistic girl. (pmc.ncbi.nlm.nih.gov)
A useful conversation therefore goes beyond “Did school go well?” It explores which parts felt confusing, uncomfortable or exhausting, and what helped her manage.
Understanding the earlier pattern
When autism is first considered in adolescence, looking back at childhood can help make sense of the present.
There may have been longstanding sensory sensitivities, difficulty with unexpected changes, unusually absorbing interests or differences in social communication. These experiences may previously have seemed unrelated. No single feature establishes autism, and interests, shyness or a preference for routine are not diagnostic by themselves.
Assessment brings together the young person’s perspective, developmental history, information from school and clinical observation. It also considers other explanations and coexisting conditions. Good eye contact or fluent speech does not exclude autism, and no questionnaire or observational tool should determine the diagnosis alone. (nice.org.uk)
Making room for her own understanding
An adolescent may already have wondered whether she is autistic. Another may feel uncertain or uncomfortable discussing it. Giving her space to describe her experiences helps keep the conversation centred on her needs.
Questions such as “What takes the most effort?” or “When do you feel most comfortable being yourself?” can open a more useful discussion than asking her to match herself to a list of signs.
Any recent deterioration also deserves attention in its own right. Anxiety, depression, bullying and other difficulties need appropriate assessment rather than being assumed to be part of autism.
Support while the picture becomes clearer
Practical support can focus on the difficulties already identified. At school, reasonable adjustments may include clearer written instructions, advance notice of changes, access to a quieter space and a trusted adult who understands her concerns. Adjustments need to reflect her individual sensory and communication needs.
At home, predictable arrangements, clear communication and time to recover from demanding activities can reduce avoidable pressure. Where anxiety requires psychological treatment, therapy can be adapted through a more concrete, structured approach, visual information and appropriate parental involvement. (nice.org.uk)
If longstanding differences are becoming harder to manage, discussing them with the school SENCO, GP or an appropriately qualified clinician can help clarify whether an autism assessment is indicated. The purpose is to understand her development and identify support that fits her, while recognising her strengths, preferences and aspirations.