Milestones

Teens and Sensory Issues: Autism, ADHD, Anxiety

What changes between 13 and 17, how autism, ADHD, sensory differences, anxiety and depression show up in the teen years, and how to plan for school, driving and adulthood.

  • Patient Focused
A teenager in headphones looking out of a bus window

Curated by the DrSensory editorial team · Last updated October 22, 2026

Quick answer. The teen years bring puberty, a brain that keeps maturing into the mid-20s and a body clock that runs later, so teens need 8 to 10 hours of sleep.⁠1,2 Autism, ADHD, anxiety, depression and sensory differences can look different now or surface for the first time, sometimes after years of masking.⁠1,3,4

Key takeaways

  • Puberty continues through the mid-teens, and the brain keeps maturing into the mid-20s, with the prefrontal cortex among the last parts to develop.⁠1,5
  • Teens need 8 to 10 hours of sleep; their body clock runs up to two hours later, and the AAP backs school start times of 8:30 a.m. or later.⁠2,6,7
  • Sensory over-responsivity in teens tracks with anxiety and depression symptoms.⁠8,9
  • Autism can be first diagnosed in the teen years, especially in girls and in teens who mask.⁠3,4,10
  • ADHD usually persists into adolescence; treatment combines medication with the teen’s agreement and behavioral support.⁠11,12
  • Teen drivers with ADHD have a 36% higher crash risk, so plan extra practice and talk with the doctor first.⁠13
  • About 1 in 5 adolescents had a major depressive episode in 2021, and screening is recommended from 12.⁠14,15
  • IEP transition planning must start by 16; only Section 504 protections continue into college.⁠16,17

What changes during the teen years?

Between 13 and 17, most teens move from early into middle adolescence: puberty continues, arguments with parents over independence become more common, and teens spend less time with family and more with friends.⁠5 The brain keeps developing into the mid-to-late 20s, and the prefrontal cortex, which handles planning, prioritizing and decisions, is one of the last parts to mature.⁠1

When does puberty start and end?

Girls usually begin puberty between 8 and 13, and the average first period in the United States comes at about 12, two to three years after breast development starts.⁠5,18 By middle adolescence most boys have started their growth spurt; the voice deepens just after its peak, and boys keep adding muscle long after girls do.⁠5,19

How does the teenage brain develop?

Different parts of the brain mature at different rates: the amygdala, which drives fear, anger and reflex-like reactions, matures sooner than the prefrontal cortex, which may not be fully mature until about 24.⁠20 That mismatch may be one reason teens are more moody and impulsive, and the pull toward peers can make social rewards outweigh risks.⁠1,20

All these changes happening at once may also explain why many mental health conditions, such as anxiety, depression, bipolar disorder and eating disorders, emerge in adolescence, even though most teens go on to become healthy adults.⁠1

Why do teens want more privacy and independence?

A growing need for privacy and independence is a normal part of adolescence, and part of it is learning to take charge of their own health care: at checkups, the pediatrician spends some time alone with the teen.⁠5,21 For a teen with a neurodevelopmental difference, that step may look different, and the pediatrician can help plan it.⁠21

Read next on DrSensory

How much sleep and exercise do teenagers need?

Teenagers need 8 to 10 hours of sleep a night and at least 60 minutes of physical activity a day.⁠2,22

How much sleep do teenagers need?

Teenagers need 8 to 10 hours of sleep every 24 hours, and regularly getting less is linked with self-harm, suicidal thoughts and suicide attempts.⁠2 Their sleep-wake cycle shifts up to two hours later at the start of puberty, because the body’s sleep hormone stays high later at night and drops later in the morning.⁠1,6

That is why the AAP urges middle and high schools to start no earlier than 8:30 a.m., so students can get 8.5 to 9.5 hours of sleep.⁠6,7 At home, keep phones and screens out of the bedroom at night, and stop using them at least an hour before bed.⁠6,23

Sleep is a particular problem for autistic teens: sleep disturbances affect up to 83% of autistic children and adolescents and go with more aggression, hyperactivity and emotional dysregulation.⁠24

How much exercise do teenagers need?

At least 60 minutes of moderate-to-vigorous activity a day, with vigorous, muscle-strengthening and bone-strengthening activity each on at least 3 days a week; teens may start structured weightlifting programs.⁠22

Read next on DrSensory

What do sensory issues look like in teens?

Sensory issues in teens look like over- or under-reactions to sounds, textures, smells or the taste and texture of food, and they are common in autism, ADHD, coordination disorders and anxiety.⁠25,26 Sensory processing disorder is not a diagnosis with a universally accepted framework, so the AAP advises looking for the conditions it often comes with.⁠25

Sensory over-responsivity tracks with mental health in this age group. In a study of 1,012 adolescent twins it went with internalizing symptoms such as anxiety and depression, and in more than 11,000 children aged 9 to 12, the 18% with it made up more than half of those with clinical-range emotional or behavior problems and had more anxiety and ADHD symptoms a year later.⁠8,9

Puberty adds new sensations to manage, from deodorant and shaving to periods and period products, and a teen who has coped quietly for years may now say it is too much. Noise-reducing headphones, clothing choices, a quiet place at school and planned breaks are reasonable supports to ask for.

Read next on DrSensory

All sensory processing →

What does autism look like in teens?

In teens, autism often shows as one-sided conversations, few close friendships, taking things literally, very specific interests, strong distress at changes in routine, and over- or under-reactions to sounds, textures or smells.⁠26 Some autistic teens are identified only now, because coping strategies or a supportive environment masked the signs earlier.⁠3

What are the signs of autism in a teenager?

  • Conversation

    Talking at others rather than with them, a flat or unusual tone, or long monologues on a favorite topic.⁠26

  • Friendships

    Few close friends, wanting friends without knowing how to keep them, or easier ties with adults or younger children.⁠26

  • Literal understanding

    Taking things literally and missing sarcasm, metaphor or unwritten social rules.⁠26

  • Interests and routines

    Highly specific interests, strict rules or rituals, and distress at changes that seem small to others.⁠26

  • Sensory reactions

    Over- or under-reacting to textures, sounds and smells, or strong reactions to the taste or texture of food.⁠26

  • Demand avoidance

    An unusually negative response to other people’s requests, which NICE lists among the signs at this age.⁠26

Does autism look different in teen boys and girls?

Boys are diagnosed far more often, 3.4 times as often at age 8 in the 2022 US data, but a meta-analysis of 54 studies put the true ratio closer to 3 to 1 and found that girls who meet the criteria are disproportionately likely to go undiagnosed.⁠10,27 In a Dutch survey of 2,275 people, girls with what was then called Asperger’s syndrome were identified later than boys, and NICE warns that autism may be under-recognized in girls.⁠3,28

An autistic teen boy is more likely to have been identified in childhood; an autistic teen girl, or any teen who camouflages well, may reach adolescence without a diagnosis.⁠4,10,27,28

Can a teenager be diagnosed with autism?

Yes. NICE advises clinicians that when an older child or young person is first assessed for autism, the signs may have been masked until then.⁠3 Camouflaging is not harmless: in 733 autistic young people aged 4 to 17 it predicted anxiety, depression and physical complaints, and the gap between what parents and clinicians saw was largest in adolescents.⁠4

How does autism affect teen mental health?

Anxiety and depression are common in autistic youth; in a population sample of autistic 10- to 14-year-olds, 70% had at least one other psychiatric condition, most often social anxiety disorder (29%).⁠29,30 Changes in behavior are often the first clue, such as more repetitive behavior, rigid routines, withdrawal, or eating and sleeping more or less than usual.⁠29 Cognitive behavioral therapy works well for many autistic teens, ideally with a counselor experienced in autism.⁠29

Read next on DrSensory

All autism →

How does ADHD change in the teen years?

For most teens with ADHD, symptoms persist and keep interfering with daily life as school and social demands grow, and the AAP notes that about 80% of those who needed medication as children still need it as teenagers.⁠11 About 11.7% of US children aged 3 to 17 have a current ADHD diagnosis.⁠31

For ages 12 to 17, the AAP guideline recommends FDA-approved ADHD medication with the teen’s agreement, together with evidence-based training or behavioral interventions where available, and screening for substance use, anxiety, depression and learning disabilities.⁠12 Daily planners, routines, a set homework place and enough sleep help teens manage on their own.⁠11

Is driving riskier for teens with ADHD?

Yes. Teen drivers with ADHD have a 36% higher crash risk than their peers, whatever their sex, age or experience; a study of nearly 18,000 young people found the same 1.36-fold risk, and that those with ADHD were 35% less likely to be licensed 6 months after becoming eligible.⁠13,32 All drivers aged 16 to 19 already have a fatal crash rate almost three times that of drivers 20 and older.⁠33

In a national study of 2.3 million people with ADHD of all ages, the risk of a crash serious enough for an emergency visit was 38% to 42% lower in months when they took ADHD medication, and the AAP guideline asks clinicians to make sure medication covers driving times; the AAP also notes the benefit for teen drivers is not certain.⁠12,13,34 Extra supervised driving and a talk with the pediatrician before the license are the practical steps.⁠13

Read next on DrSensory

All ADHD →

What are the signs of anxiety and depression in teens?

The most common signs of depression in teens are a sad or irritable mood most of the day and losing interest in things they used to enjoy; teens may also stop caring about the future or their appearance, or start using substances.⁠35 In 2021, 20.1% of US adolescents aged 12 to 17 had a major depressive episode, girls (29.2%) far more often than boys (11.5%).⁠14

Anxiety is common too: 31.9% of adolescents have had an anxiety disorder at some point, and in 2021–2023, 20% of 12- to 17-year-olds reported anxiety symptoms in the past two weeks.⁠36,37 In 2023, 40% of high school students reported persistent sadness or hopelessness and 20% had seriously considered suicide.⁠37

The USPSTF recommends screening teens for depression from 12 and for anxiety from 8, so the yearly checkup is a natural place to start.⁠15,38 Cognitive behavioral therapy and dialectical behavior therapy are common treatments, and a mental health evaluation makes sense when symptoms keep a teen from coping with daily life.⁠39

Substance use often travels with low mood: in 2023, 22% of high school students had drunk alcohol and 17% had used marijuana in the past month, and starting to use substances is one of the signs of depression in teens.⁠35,37 Teens with ADHD are more likely to smoke, drink or use drugs and start younger, and treating ADHD and co-occurring anxiety or depression may lower that risk.⁠40

What should you do if your teen talks about suicide?

Take it seriously and act now: call or text 988, the Suicide & Crisis Lifeline, which is open around the clock, and if you think your teen is at immediate risk, go to the emergency department or call 911.⁠41,42

Read next on DrSensory

All behavior and emotions →

Does social media affect teen mental health?

It can, but the evidence is mixed. Up to 95% of 13- to 17-year-olds use social media and more than a third say they use it almost constantly; in one study of 6,595 US adolescents, those on social media more than 3 hours a day had double the risk of depression and anxiety symptoms.⁠23 The AAP notes that the cause-and-effect relationship remains unclear and that how teens use it matters: passive scrolling goes with more depression symptoms than active use.⁠43

A teen social media plan, from the Surgeon General and the AAP

  • Make a family media plan together.⁠23
  • Keep tech-free zones and protect in-person friendships.⁠23
  • Keep phones and gaming devices out of the bedroom at night, and off for at least an hour before bed.⁠23,44
  • Wait until 13 for social media accounts, and do not lie about age to open one.⁠44

What learning and school problems show up in the teen years?

A teen with a subtle learning disability may compensate for years and start to struggle only as schoolwork becomes more complex, and the effects rarely stay in the classroom.⁠45 Trouble concentrating is a sign of ADHD but also of autism, intellectual disability and depression, which is why a full evaluation matters.⁠45

An IEP or a 504 plan continues through high school, and only a 504 plan’s protections carry on to college, where students with ADHD and other differences can ask for accommodations such as priority scheduling, reduced course loads, tutoring and separate, untimed testing.⁠17,46

Read next on DrSensory

All learning differences →

What is IEP transition planning, and when does it start?

Transition planning is the part of an IEP that prepares a teen for life after high school, and it must start no later than the IEP in effect when the student turns 16, earlier if the team decides.⁠16 From then on, the IEP must include measurable goals for training, education, employment and, where appropriate, independent living, updated every year.⁠16

Transition services cover the move to college, vocational training, work, adult services, independent living and community life.⁠47 At least a year before the age of majority under state law, the IEP must say the student has been told which rights will transfer to them, and states may provide that parents’ IDEA rights pass to the student at that age.⁠16,48

The AAP suggests starting to think about the move to adulthood around 12, since legal changes come at 18, and helping teens build health care skills such as making appointments and filling prescriptions.⁠49

Which therapies help teenagers?

Talking therapies lead for anxiety and mood: cognitive behavioral therapy helps teens notice and change thought patterns, and dialectical behavior therapy helps those with intense emotional reactions learn to regulate them.⁠39 DrSensory’s therapy guides for teens explain what occupational, speech and physical therapists work on at this age.

Need more than an article?

If something about how your teen copes, moves, or communicates has been on your mind, a pediatric therapist is the person who assesses it. Every state lets families go to a physical therapist without a referral, though some limit treatment without one;⁠50 the rules for occupational and speech therapy vary by state, and some insurance plans ask for a referral before they pay, so check with yours when you call.

Find a therapist near you →
Occupational therapySensory, self-care, fine motor, feedingPhysical therapyMovement, coordination, body awarenessSpeech therapyLanguage, naming feelings, being understood

When should you get help for your teen?

Moodiness is part of adolescence; what calls for help is a change that lasts, such as signs of depression for more than two weeks, or symptoms that keep a teen from coping with school, friends or daily life.⁠35,39 The pediatrician is the first partner, and nearly 1 in 5 young people aged 12 to 17 has a mental health diagnosis.⁠39

Talk to your teen’s doctor if

  • low or irritable mood or lost interest lasts more than two weeks.⁠35
  • worries keep your teen from school, friends or activities.⁠39
  • you see signs of substance use, or severe problems alongside ADHD.⁠11,35
  • an autistic teen eats or sleeps much more or less, withdraws, or shows more repetitive behavior.⁠29
  • your teen regularly gets less than 8 hours of sleep, snores or struggles to wake for school.⁠2,6
  • your teen with ADHD is about to start driving.⁠13

For any talk of suicide, call or text 988 at once, and go to the emergency department or call 911 if your teen may be in immediate danger.⁠41,42

Frequently Asked Questions

What ages count as adolescence?

The AAP describes early adolescence as 10 to 13, middle adolescence as 14 to 17 and late adolescence as 18 to 21, and brain development continues into the 20s.⁠5

Can a teenager be diagnosed with autism for the first time?

Yes. NICE notes that in older children and young people assessed for the first time, the signs may have been masked by coping strategies or a supportive environment, and that autism may be under-recognized in girls.⁠3

Is it normal for teenagers to stay up late and sleep in?

Yes. At puberty the sleep-wake cycle shifts up to two hours later, but teens still need 8 to 10 hours, which early school start times make hard to get.⁠2,6

Do teens with ADHD still need medication?

Many do: the AAP notes that about 80% of those who needed ADHD medication as children still need it as teenagers. Decisions about medication belong with your teen and their doctor.⁠11,12

Is it safe for a teen with ADHD to learn to drive?

It can be, with preparation. Their crash risk is 36% higher, so the AAP suggests extra supervised driving and a talk with the pediatrician about medication timing before the license.⁠13

How much social media is too much for a teen?

There is no agreed limit. In one study, adolescents using social media more than 3 hours a day had double the risk of depression and anxiety symptoms, while the AAP notes cause and effect are unclear and how a teen uses it matters.⁠23,43

What is masking in autistic teens?

Masking, or camouflaging, is hiding autistic traits in social situations. In autistic young people it predicted more anxiety and depression symptoms, and it can delay diagnosis.⁠3,4

Does a 504 plan carry over to college?

Section 504 accommodations can continue at the post-secondary level; an IEP does not follow a student to college.⁠17

What happens to IEP rights when a teen turns 18?

In states that provide for it, the rights IDEA gives parents transfer to the student at the age of majority, and the IEP must tell the student about this at least a year beforehand.⁠16,48

Why is my teenager so moody?

The brain’s emotional centers mature before the prefrontal cortex, which may make teens more moody and impulsive; a low mood that lasts more than two weeks is a reason to see the doctor.⁠20,35

Sources

  1. National Institute of Mental Health. The Teen Brain: 7 Things to Know. Checked October 22, 2026.
    Show the passageHide the passage
    “The brain finishes developing and maturing in the mid-to-late 20s”; the prefrontal cortex, “responsible for skills like planning, prioritizing, and making good decisions”, “is one of the last parts to mature”; teens “focus more on peer relationships and social experiences”; the sleep hormone's levels “stay high later at night and drop later in the morning” in adolescence; “many mental illnesses—such as schizophrenia, anxiety, depression, bipolar disorder, and eating disorders—emerge during adolescence”; “most teens go on to become healthy adults”.
  2. Paruthi S, Brooks LJ, D’Ambrosio C, et al. Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine. Journal of Clinical Sleep Medicine. 2016;12(6):785–786. doi:10.5664/jcsm.5866 (PMID 27250809). Checked October 22, 2026.
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    “Teenagers 13 to 18 years of age should sleep 8 to 10 hours per 24 hours on a regular basis to promote optimal health”; “Insufficient sleep in teenagers is associated with increased risk of self-harm, suicidal thoughts, and suicide attempts”.
  3. National Institute for Health and Care Excellence. Autism spectrum disorder in under 19s: recognition, referral and diagnosis (CG128), Recommendations. Published September 28, 2011, last updated December 20, 2017. Checked October 22, 2026.
    Show the passageHide the passage
    Be aware that “autism may be under-recognised in girls leading to underdiagnosis” and that “when older children or young people present for the first time with possible autism, signs or symptoms may have previously been masked by the child or young person's coping mechanisms and/or a supportive environment”.
  4. Ross A, Grove R, McAloon J. The relationship between camouflaging and mental health in autistic children and adolescents. Autism Research. 2023;16(1):190–199. doi:10.1002/aur.2859 (PMID 36416274). Checked October 22, 2026.
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    In 733 autistic children and adolescents aged 4 to 17, “camouflaging was a significant predictor of internalizing (i.e., anxiety, depression, somatic complaints) symptoms”; “adolescents showing a larger discrepancy between parent and clinician reported autistic traits”.
  5. American Academy of Pediatrics, HealthyChildren.org. Stages of Adolescence. Brittany Allen, MD, FAAP and Helen Waterman, DO. Checked October 22, 2026.
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    Early adolescence is ages 10 to 13, middle adolescence 14 to 17, late adolescence 18 to 21; “Many girls may start their period at around age 12, on average 2-3 years after the onset of breast development”; in middle adolescence “Most males will have started their growth spurt” and “Many middle adolescents have more arguments with their parents as they struggle for more independence”; “They may spend less time with family and more time with friends”; “the frontal lobes are the last areas of the brain to mature―development is not complete until a person is well into their 20s!”; “Pre-teens feel an increased need for privacy”.
  6. American Academy of Pediatrics, HealthyChildren.org. Healthy Sleep Habits: How Many Hours Does Your Child Need?. Checked October 22, 2026.
    Show the passageHide the passage
    “teens require more sleep, not less”; “sleep-wake cycles begin to shift up to two hours later at the start of puberty”; “The AAP has been advocating for middle and high schools delay the start of class to 8:30 a.m. or later”; “The AAP recommends keeping all screens—TVs, computers, laptops, tablets and phones out of children's bedrooms, especially at night”; common sleep problems include “snoring”; “Talk to your child's pediatrician about sleep”.
  7. Adolescent Sleep Working Group; Committee on Adolescence; Council on School Health. School start times for adolescents. Pediatrics. 2014;134(3):642–649. doi:10.1542/peds.2014-1697 (PMID 25156998). Checked October 22, 2026.
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    The AAP “recognizes insufficient sleep in adolescents as an important public health issue” and “urges high schools and middle schools to aim for start times that allow students the opportunity to achieve optimal levels of sleep (8.5-9.5 hours)”; earlier start times are those “before 8:30 am”.
  8. Van Hulle CA, Lemery-Chalfant K, Hill Goldsmith H. Parent-Offspring Transmission of Internalizing and Sensory over-Responsivity Symptoms in Adolescence. Journal of Abnormal Child Psychology. 2018;46(3):557–567. doi:10.1007/s10802-017-0300-y (PMID 28393325). In 1,012 adolescent twins from 506 families, “Adolescent sensory over-responsivity symptoms were correlated with internalizing disorder symptoms”. Checked October 22, 2026.
  9. Schwarzlose RF, Tillman R, Hoyniak CP, Luby JL, Barch DM. Sensory Over-responsivity: A Feature of Childhood Psychiatric Illness Associated With Altered Functional Connectivity of Sensory Networks. Biological Psychiatry. 2023;93(1):92–101. doi:10.1016/j.biopsych.2022.09.004 (PMID 36357217). Checked October 22, 2026.
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    In the ABCD Study (ages 9 to 12, N = 11,210), “Children with SOR constituted 18% of the overall sample but comprised more than half of the children with internalizing or externalizing scores in the clinical range”; SOR “predicted increased anxiety, attention-deficit/hyperactivity disorder, and prodromal psychosis symptoms 1 year later”.
  10. Loomes R, Hull L, Mandy WPL. What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis. Journal of the American Academy of Child and Adolescent Psychiatry. 2017;56(6):466–474. doi:10.1016/j.jaac.2017.03.013 (PMID 28545751). Checked October 22, 2026.
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    54 studies: “the true male-to-female ratio is not 4:1, as is often assumed; rather, it is closer to 3:1”; “girls who meet criteria for ASD are at disproportionate risk of not receiving a clinical diagnosis”.
  11. American Academy of Pediatrics, HealthyChildren.org. Encouraging Independence in Teenagers with ADHD. Checked October 22, 2026.
    Show the passageHide the passage
    “in most cases, ADHD symptoms persist and continue to interfere with the child's ability to function adequately”; “According to the National Institute of Mental Health, about 80% of those who required medication for ADHD as children still need it as teenagers”; strategies include “Using a daily planner for assignments and appointments” and “Getting enough sleep”; “Talk with your pediatrician if your teenager shows signs of severe problems such as depression, drug abuse, or gang-related activities”.
  12. Wolraich ML, Hagan JF, Allan C, et al.; Subcommittee on Children and Adolescents with Attention-Deficit/Hyperactive Disorder. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics. 2019;144(4):e20192528. doi:10.1542/peds.2019-2528 (PMID 31570648). Checked October 22, 2026.
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    Key action statement 5c: “For adolescents (age 12 years to the 18th birthday) with ADHD, the PCC should prescribe FDA-approved medications for ADHD with the adolescent’s assent”; “The PCC is encouraged to prescribe evidence-based training interventions and/or behavioral interventions as treatment of ADHD, if available”; clinicians should assess adolescents “for symptoms and signs of substance use, anxiety, depression, and learning disabilities”; “special concern should be taken to provide medication coverage for symptom control while driving”.
  13. American Academy of Pediatrics, HealthyChildren.org. ADHD & Driving Risks: The Link Parents Need to Know. Checked October 22, 2026.
    Show the passageHide the passage
    “The risk of a crash is 36% higher for teens drivers with ADHD than their peers, no matter their gender, age or driving experience”; “the benefit of medication on teen driving is uncertain”; “Teens with ADHD might need extra behind-the-wheel training, a longer supervised driving period and medication adjustments”.
  14. National Institute of Mental Health. Major Depression. Checked October 22, 2026.
    Show the passageHide the passage
    “An estimated 5.0 million adolescents aged 12 to 17 in the United States had at least one major depressive episode. This number represented 20.1% of the U.S. population aged 12 to 17” (2021); “The prevalence of major depressive episode was higher among adolescent females (29.2%) compared to males (11.5%)”; “an estimated 40.6% of U.S. adolescents with major depressive episode received treatment in the past year”.
  15. US Preventive Services Task Force. Depression and Suicide Risk in Children and Adolescents: Screening. “The USPSTF recommends screening for major depressive disorder (MDD) in adolescents aged 12 to 18 years” (grade B). Checked October 22, 2026.
  16. U.S. Department of Education, Individuals with Disabilities Education Act regulations. 34 CFR § 300.320 Definition of individualized education program. Checked October 22, 2026.
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    “Beginning not later than the first IEP to be in effect when the child turns 16, or younger if determined appropriate by the IEP Team, and updated annually”, the IEP must include “Appropriate measurable postsecondary goals based upon age appropriate transition assessments related to training, education, employment, and, where appropriate, independent living skills”; “Beginning not later than one year before the child reaches the age of majority under State law”, it must state that the child has been told which rights will transfer.
  17. American Academy of Pediatrics, HealthyChildren.org. IEPs and 504 Plans: A Guide to School Supports for Your Child. Rajapillai Pillai, MD, PhD, FAAP and Jacqueline M. Branch, MD, FAAP. An IEP “Must include post-secondary transition services”; a 504 plan does not; a 504 plan “Provides accommodations beyond kindergarten through 12th-grade education at the post-secondary level”. Checked October 22, 2026.
  18. American Academy of Pediatrics, HealthyChildren.org. Physical Development in Girls: What to Expect During Puberty. “Girls usually begin puberty between the ages of 8 and 13 years old”; “The average age for girls to get their first period in the United States is around age 12”. Checked October 22, 2026.
  19. American Academy of Pediatrics, HealthyChildren.org. Physical Development in Boys: What to Expect. “Just after the peak of the growth spurt, a boy's voice box (larynx) enlarges, as do the vocal cords”; “Boys continue to fill out with muscle mass long after girls do”. Checked October 22, 2026.
  20. American Academy of Pediatrics, HealthyChildren.org. What’s Going On In the Teenage Brain?. Andrew Garner, MD, PhD, FAAP. Checked October 22, 2026.
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    “some parts of the brain, like the prefrontal cortex, do not appear fully mature until 24 years old”; the amygdala “is activated by potential threats and strong emotions like fear and anger, leading to "fight or flight" behaviors, aggression and reflex-like responses” and matures sooner, which “may be one reason that adolescents tend to be more moody and impulsive”; parents can help by staying calm first: “we need to regulate our own emotions”.
  21. American Academy of Pediatrics, HealthyChildren.org. One-on-One Time With the Pediatrician. Suanne Kowal-Connelly, MD, FAAP and Richard J. Chung, MD, FSAHM, FAAP. Checked October 22, 2026.
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    “Before the physical examination, the doctor will ask the parent to allow some time alone with the adolescent”; “teens need to begin to embrace and accept responsibility for their own health care”; for a child with a “neurodevelopmental difference”, “this dynamic may be different”.
  22. Centers for Disease Control and Prevention. Child Activity: An Overview. “Children and adolescents 6 to 17 need to be active for at least 60 minutes every day”, with vigorous, muscle-strengthening and bone-strengthening activity each on at least 3 days a week; “As children grow older and become adolescents, they may start structured weightlifting programs”. Checked October 22, 2026.
  23. Office of the U.S. Surgeon General. Social Media and Youth Mental Health: The U.S. Surgeon General’s Advisory (2023). Checked October 22, 2026.
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    “Up to 95% of youth ages 13–17 report using a social media platform, with more than a third saying they use social media” “almost constantly”. A cohort of US adolescents aged 12 to 15 (n=6,595) “who spent more than 3 hours per day on social media faced double the risk of experiencing poor mental health outcomes including symptoms of depression and anxiety”; “we do not yet have enough evidence to determine if social media is sufficiently safe for children and adolescents”; for families: “Create a family media plan”, “Create tech-free zones and encourage children to foster in-person friendships”, and limit devices “for at least 1 hour before bedtime and through the night”.
  24. Tecar C, Chiperi LE, Iftimie BE, et al. Sleep Disturbances and Behavioral Problems in Children and Adolescents with Autism Spectrum Disorder—A Systematic Review. Clinics and Practice. 2025;15(11):201. doi:10.3390/clinpract15110201 (PMID 41294632). Sleep disturbances affect “up to 83% of this population” (autistic children and adolescents); across 26 studies they were linked with “aggression, hyperactivity, and emotional dysregulation”. Checked October 22, 2026.
  25. Zimmer M, Desch L; Section on Complementary and Integrative Medicine; Council on Children with Disabilities; American Academy of Pediatrics. Sensory integration therapies for children with developmental and behavioral disorders. Pediatrics. 2012;129(6):1186–1189. doi:10.1542/peds.2012-0876 (PMID 22641765). Checked October 22, 2026.
    Show the passageHide the passage
    “Because there is no universally accepted framework for diagnosis, sensory processing disorder generally should not be diagnosed”; difficulty with sensory information “may be seen in many developmental behavioral disorders, including autism spectrum disorders, attention-deficit/hyperactivity disorder, developmental coordination disorders, and childhood anxiety disorders”.
  26. National Institute for Health and Care Excellence. Autism spectrum disorder in under 19s (CG128), Appendix: Features suggesting possible autism. Checked October 22, 2026.
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    Box 4, secondary school children (older than 11): “monotonous tone”; “content dominated by excessive information on topics of own interest”; “talking 'at' others rather than sharing a two-way conversation”; “often an unsuccessful desire to have friends (although may find it easier with adults or younger children)”; “A strong adherence to rules or fairness that leads to argument”; “Excessive reaction to taste, smell, texture or appearance of food and/or extreme food fads”; “few close friends or reciprocal relationships”; “may take things literally and misunderstand sarcasm or metaphor”; “Unusually negative response to the requests of others (demand avoidant behaviour)”; “Preference for highly specific interests or hobbies”; “Excessive emotional distress at what seems trivial to others, for example change in routine”; “Over or under reaction to sensory stimuli, for example textures, sounds, smells”; “Social and emotional development more immature than other areas of development”.
  27. Shaw KA, Williams S, Patrick ME, et al. Prevalence and Early Identification of Autism Spectrum Disorder Among Children Aged 4 and 8 Years — Autism and Developmental Disabilities Monitoring Network, 16 Sites, United States, 2022. MMWR Surveillance Summaries. 2025;74(2):1–22. doi:10.15585/mmwr.ss7402a1 (PMID 40232988). Checked October 22, 2026.
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    “Among children aged 8 years in 2022, ASD prevalence was 32.2 per 1,000 children (one in 31)”; “ASD was 3.4 times as prevalent among boys (49.2) than girls (14.3)”.
  28. Begeer S, Mandell D, Wijnker-Holmes B, et al. Sex differences in the timing of identification among children and adults with autism spectrum disorders. Journal of Autism and Developmental Disorders. 2013;43(5):1151–1156. doi:10.1007/s10803-012-1656-z (PMID 23001766). Checked October 22, 2026.
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    Survey of 2,275 people in the Netherlands: “Among participants < 18 years of age, females with Asperger's syndrome were identified later than males”.
  29. American Academy of Pediatrics, HealthyChildren.org. Autism and Mental Health: How to Support Your Teen. Kristin Sohl, MD, FAAP. Checked October 22, 2026.
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    “Anxiety and depression are common in autistic youth”; “Teens on the autism spectrum may show increased repetitive behaviors (for example, hand flapping), or insist on patterns of behavior”; “Counseling (behavioral therapy) options can work well including cognitive behavioral therapy”; “Some clinicians don't realize that anxiety and depression are common in autism and important to screen, identify and treat”.
  30. Simonoff E, Pickles A, Charman T, et al. Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry. 2008;47(8):921–929. doi:10.1097/CHI.0b013e318179964f (PMID 18645422). Checked October 22, 2026.
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    In 112 autistic 10- to 14-year-olds, “Seventy percent of participants had at least one comorbid disorder and 41% had two or more”; the most common was “social anxiety disorder (29.2%”.
  31. Centers for Disease Control and Prevention. Data on ADHD in Children. “An estimated 7 million (11.7%) U.S. children aged 3–17 years have a current ADHD diagnosis, according to data collected in 2024 from a national survey of parents”. Checked October 22, 2026.
  32. Curry AE, Metzger KB, Pfeiffer MR, et al. Motor Vehicle Crash Risk Among Adolescents and Young Adults With Attention-Deficit/Hyperactivity Disorder. JAMA Pediatrics. 2017;171(8):756–763. doi:10.1001/jamapediatrics.2017.0910 (PMID 28604931). Checked October 22, 2026.
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    In 2,479 young people with ADHD and 15,865 without, licensing 6 months after eligibility was “35% lower” and “The adjusted risk for first crash among licensed drivers with ADHD was 1.36 times higher than for those without ADHD”.
  33. Centers for Disease Control and Prevention. Risk Factors for Teen Drivers. “Teen drivers in this age group have a fatal crash rate almost three times as high as drivers ages 20 and older per mile driven”; “Crash risk is particularly high during the first months of licensure”. Checked October 22, 2026.
  34. Chang Z, Quinn PD, Hur K, et al. Association Between Medication Use for Attention-Deficit/Hyperactivity Disorder and Risk of Motor Vehicle Crashes. JAMA Psychiatry. 2017;74(6):597–603. doi:10.1001/jamapsychiatry.2017.0659 (PMID 28492937). Checked October 22, 2026.
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    In 2,319,450 US patients with ADHD, men had “a 38% (odds ratio, 0.62; 95% CI, 0.56-0.67) lower risk of MVCs in months when receiving ADHD medication” and women “a 42% (odds ratio, 0.58; 95% CI, 0.53-0.62) lower risk”.
  35. American Academy of Pediatrics, HealthyChildren.org. Depression in Children and Teens. Checked October 22, 2026.
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    The two most common signs: “Seems more sad and irritable than usual, in a low mood for most of the day” and “No longer enjoys activities that used to make them happy”; among teens also “Not caring or feeling hopeful about the future”, “Lacking interest in personal grooming or appearance” and “Engaging in substance use”; “if you notice signs of depression for more than two weeks, talk with your child's doctor”.
  36. National Institute of Mental Health. Any Anxiety Disorder. From the NCS-A national diagnostic interview survey of adolescents (2001–2004): “An estimated 31.9% of adolescents had any anxiety disorder”; prevalence was “higher for females (38.0%) than for males (26.1%)”. Checked October 22, 2026.
  37. Centers for Disease Control and Prevention. Data and Statistics on Children’s Mental Health. Checked October 22, 2026.
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    Among US adolescents ages 12-17 in 2021-2023, “20% reported symptoms of anxiety in the past two weeks” and “18% reported symptoms of depression in the past two weeks”; among high school students in 2023, “40% reported persistent feelings of sadness or hopelessness in the past year” and “20% reported seriously considering attempting suicide in the past year”, “22% report drinking alcohol in the past 30 days” and “17% report using marijuana in the past 30 days”.
  38. US Preventive Services Task Force. Anxiety in Children and Adolescents: Screening (Final Recommendation Statement, 2022). “The USPSTF recommends screening for anxiety in children and adolescents aged 8 to 18 years” (grade B). Checked October 22, 2026.
  39. American Academy of Pediatrics, HealthyChildren.org. Teen Mental Health Support 101: Types of Treatment & How to Get Help. Maria H. Rahmandar, MD, FAAP and Michael D. Colburn, MD, MEd, FAAP. Checked October 22, 2026.
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    “Nearly 1 in 5 young people aged 12 to 17 have a mental health diagnosis”; “When symptoms consistently keep them from meeting the challenges of daily life, a mental health evaluation is a wise idea”; “Cognitive behavioral therapy (CBT) helps teens hear their own thoughts”; “Dialectical behavioral therapy (DBT) helps kids who have strong emotional (and sometimes physical) reactions”.
  40. American Academy of Pediatrics, HealthyChildren.org. ADHD and Substance Abuse: The Link Parents Need to Know. Checked October 22, 2026.
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    Children and teens with ADHD “are more likely than other kids to smoke, drink, or use drugs. They experiment with all three at younger ages than those children without ADHD”; “Children treated at a younger age for ADHD may be less likely to develop substance use disorders”; “Treating mental health disorders that often co-exist with ADHD, such as anxiety and depression, is also important and may decrease the risk for substance use”; “No study has ever found that stimulant treatment increases rates of substance use disorders”.
  41. American Academy of Pediatrics, HealthyChildren.org. Suicide Prevention: 12 Things Parents Can Do. Checked October 22, 2026.
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    “If you have any concern that your teen is at more immediate risk for attempting suicide, take them to the emergency department of your local hospital or call 911”; “If your child is considering suicide, call or text 988 or chat on 988lifeline.org right away”.
  42. Substance Abuse and Mental Health Services Administration. 988 Suicide & Crisis Lifeline. “988 offers 24/7 judgment-free support for mental health, substance use, and more”. Checked October 22, 2026.
  43. American Academy of Pediatrics, HealthyChildren.org. Social Media & Your Child’s Mental Health: What the Research Says. Checked October 22, 2026.
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    Megan A Moreno, MD, FAAP and Jenny Radesky, MD, FAAP. “The cause-and-effect relationship for social media and depression remains unclear”; a 2020 review found “most recent and rigorous studies report small associations that do not distinguish between cause and effect”; teens who scroll passively “had a higher likelihood of feeling depression symptoms”, while more active use “did not have negative impact on mental health”.
  44. American Academy of Pediatrics, HealthyChildren.org. Kids & Screen Time: The 5 C’s Questions for Young Teens. Checked October 22, 2026.
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    AAP Center of Excellence on Social Media and Youth Mental Health. “Social media accounts technically can't be created until kids are 13, so encourage kids not to lie about their age”; “AVOID having phones and gaming devices in the bedroom at night, which are linked with poor sleep”.
  45. American Academy of Pediatrics, HealthyChildren.org. Learning Problems in Teens. Checked October 22, 2026.
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    “If the problems are subtle, a child may compensate sufficiently for quite a while”; struggles show “after the work in school becomes more complex”; “Rarely are the effects of a learning problem confined solely to the classroom”; “Difficulty concentrating in school characterizes ADHD, but is also a hallmark of Asperger’s syndrome, intellectual disabilities or depression”.
  46. American Academy of Pediatrics, HealthyChildren.org. College Support Services and Accommodations for Adolescents with ADHD. College accommodations may include “Priority scheduling”, “Reduced course loads”, “Specialized tutoring for students with ADHD” and “Special testing arrangements, such as untimed examinations or testing in a separate, quiet room”. Checked October 22, 2026.
  47. U.S. Department of Education, Individuals with Disabilities Education Act regulations. 34 CFR § 300.43 Transition services. Transition services are “a coordinated set of activities” to ease “the child’s movement from school to post-school activities, including postsecondary education, vocational education, integrated employment (including supported employment), continuing and adult education, adult services, independent living, or community participation”. Checked October 22, 2026.
  48. U.S. Department of Education, Individuals with Disabilities Education Act regulations. 34 CFR § 300.520 Transfer of parental rights at age of majority. A State may provide that at the age of majority “All rights accorded to parents under Part B of the Act transfer to the child”. Checked October 22, 2026.
  49. American Academy of Pediatrics, HealthyChildren.org. Helping Autistic Teens Transition to Adulthood: Tips for Parents & Caregivers. Kristin Sohl, MD, FAAP. “It's a good idea to start thinking about transition to adulthood at age 12”; “Legally things change at 18, too”; work with the pediatrician to build skills “like making appointments, filling prescriptions and medical decision making”. Checked October 22, 2026.
  50. American Physical Therapy Association. Direct Access Advocacy. “As of July 1, 2025, all 50 states, the District of Columbia, and the U.S. Virgin Islands have either provisional or unrestricted direct access to physical therapist services for evaluation and treatment”; some states still attach provisions to treatment without a referral. Checked October 22, 2026.

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your child. If you are worried about immediate safety, call or text 988 (US). Never start, stop, or change a dose without medical guidance.