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Educators: autism can be missed in children who 'mask' or meet milestones, and challenges often intensify in adolescence
Summary
Harford County specialists warn that students who meet developmental milestones may still be autistic—often labeled anxious or hyperactive—and describe masking and the "autism adolescence clash" that can produce later behavioral changes.
Shannon Holly, special education coordinator at Harford County Public Schools, described how some autistic children were not identified until adolescence: “My son, was diagnosed with other health impairment due to ADHD ... I would say, the rigidity with emotional dysregulation is what I saw the most in adolescence.”
Holly said behaviors can evolve: routines that were manageable in early childhood sometimes become more volatile during puberty, producing more vocal outbursts and different presentations of the same underlying pattern. Sarah Sinclair added that some students “hold it together” at school and then “let it all out” at home, a pattern she and other families often report.
Both guests noted that girls and boys may present differently: masking—consciously or unconsciously suppressing autistic traits to fit in—can hide needs at school and lead to exhaustion and withdrawal after school hours. They urged caregivers and educators to observe patterns over time instead of relying strictly on milestone charts when deciding whether to refer for an evaluation.
