Autism and Trauma in Teens: How Trauma Can Affect Autistic Teens Differently

Published: 02/06/2026 | Updated: 02/06/2026

Authored by: Daniel Hoadley, B.S. Psychology

Edited by: Jemma Strain, B.S. Psychology

Many parents reach a point where their teen’s struggles just don’t make sense. When the explanations from healthcare professionals no longer seem to fit the behaviors and emotions you’re seeing, it can feel like you’re looking at pieces of a puzzle that don’t quite match.

Understanding why certain behaviors appear is just as important as recognizing the signs. This article explores the common, but under-recognized, overlap between autism and trauma. While these are distinct conditions, they share more symptoms than many parents realize.

To fully understand the link between autism and trauma, we will cover:

Why autistic teens are more likely to experience trauma
The similarities in brain structure of trauma survivors and autistic teens
The similar symptoms that autistic teens and trauma survivors present
Misdiagnosis of autistic teens and trauma survivors
How Mission Prep can provide trauma-informed care for autistic teens

Why Are Autistic Teens More Likely To Experience Trauma?

Trauma rates among neurodivergent adolescents are significantly higher than among neurotypical peers. This is especially true for those with autism, with studies suggesting that autistic people are up to 45% more likely to develop PTSD, compared to around 4% of the general population.¹

This may be because autistic individuals are exposed to a higher number of experiences that can feel traumatic, particularly those involving other people.1 Issues like bullying and rejection are reported at higher rates, and these experiences are known to increase the risk of PTSD when social support is limited.¹

It is important to understand that trauma for autistic people does not always stem from events that look extreme from the outside. Many autistic individuals describe distress linked to loss, sudden separation, or the removal of a trusted support figure.¹ Others report that intense sensory experiences, such as fire alarms or crowded environments, felt overwhelming enough to leave a lasting emotional impact.¹ This kind of sensory trauma in autistic teens is often overlooked.

Periods of transition can also be sources of chronic stress. For neurodivergent teens, changes in routine or unpredictability in daily life can create a persistent sense of threat rather than simple discomfort.¹

In some cases, a young person’s own mental health experiences, including severe anxiety or psychotic symptoms, may themselves be experienced as traumatic.¹

These events can feel even more intense because of common autistic traits. Heightened sensory sensitivity, differences in communication, distress around disrupted routines, or being prevented from using self-regulating behaviors such as stimming can all amplify how threatening an experience feels.¹

While autistic teens are at higher risk of experiencing trauma, one of the biggest challenges is how similar the outward signs can appear. A teenager with autism and no trauma history, and a trauma-affected teen without autism, may both show many of the same struggles in daily life. This can make it difficult for parents and even professionals to know what is really going on.

Similarities in the Brain Structure of Trauma Survivors and Those with Autism

Neuroscience research and theories show us that autism and traumatic stress can influence the same key areas of a child’s brain.

For example, the amygdala, which is the ‘alarm system’ for emotion, is affected in both conditions. Studies have found that autistic people can have differences in how their amygdala develops and functions.² Similarly, children who experience trauma can end up with an amygdala that keeps them on constant high alert.³ This means that both groups of children may experience hypervigilance and sensory sensitivity more intensely because the brain region that processes threat works differently than in neurotypical children.

Another important part of the brain is the hippocampus, which helps form memories and regulate stress responses. Research has found that chronic stress from traumatic events can disrupt and, in some cases, even shrink the hippocampus.² Likewise, autism is linked to distinct hippocampus development that can affect how individuals process memories and emotions.² This may explain why those with autism struggle with emotional dysregulation.

The prefrontal cortex, the front of the brain that helps with self-control and decision making, also shows similar changes in both autistic and traumatized children. When this region is affected, teens may struggle to regulate emotional responses. This can result in a meltdown, a shutdown, or a trauma freeze response.

How Do Autism and Trauma Symptoms Overlap?

Given the brain similarities and overlapping symptoms, it is easy to see why autism and trauma are often confused. Below, we compare trauma responses vs autistic traits to show how they often present in similar ways.

Difficulty Coping with Change

Trauma

Teens with a history of developmental trauma disorder sometimes show difficulty adapting to new environments or tasks. One review explains that developmental trauma survivors display traits like rigid adherence to routines, meaning they may struggle with transitions like moving into adulthood.⁴

Autism

Resistance to change is a well-known trait in autism. Autistic teens may show repetitive, ritualistic behaviors and aggression when these routines are disrupted.⁵

Sensory Sensitivities

Trauma

Studies show that PTSD alters sensory processing and has been linked to difficulties with sensory stimuli such as sound or touch.6 This can create states of hyper-arousal, causing trauma-exposed teens to react strongly to ordinary noises or textures.⁶

Autism

Sensory difficulties are also very common in those with autism. One review found that around 90% of those with ASD experience difficulties with sensory processing, including both hyper- and hypo-reactivity to sensory stimuli.⁷

Sleep-Related Problems

Trauma

Trauma seriously impacts sleep. One large study found that teens who had experienced trauma often suffered from sleep disturbances such as nightmares and difficulty falling asleep.⁸

Autism

Sleep problems are just as common in autistic teens, with more than 80% experiencing issues with either maintaining sleep or initiating it.⁹ In some cases, these difficulties are enough to meet the criteria for insomnia.⁹

Emotional Dysregulation

Trauma

Studies have found that those with chronic childhood trauma often have difficulties understanding and regulating emotions.¹⁰ They may have intense and rapidly changing emotions coupled with difficulty calming down.

Autism

Emotional dysregulation is also common in autism. Teens with ASD show two to four times more emotional dysregulation than neurotypical teens.¹¹ Meltdowns, shutdowns, and difficulty recovering from distress are all common presentations.

Avoidant Behaviors

Trauma

Avoidance is a core symptom in PTSD, with researchers describing it as a way to avoid reminders of the traumatic event. Researchers note that avoidance increases over time, meaning that for a teen, it could start as occasional and become more regular as they get older.¹²

Autism

Social avoidance also appears in autism, but in a slightly different way. Researchers studying eye-gaze patterns in autistic individuals found that they avoid eye contact where possible. According to some theories, this is because direct eye contact produces unpleasant arousal.¹³ Autistic teens may therefore avoid eye contact and even social situations and interactions to avoid the arousal.

Changes in Attention or Focus

Trauma

Difficulty concentrating is a hallmark sign of PTSD, with the DSM-5 listing it as a persistent symptom of increased arousal.¹⁴

Autism

Attention difficulties are also common in autism. One review stated that autistic individuals may struggle to direct their attention toward non-social information and to disengage from what they are focusing on.¹⁵However, they can maintain a strong focus for long periods and perform well on visual search tasks.

Difficulty Interpreting Others’ Emotions

Trauma

A study of trauma-affected adolescents found that physical neglect was linked to difficulties recognizing neutral and negative emotions.¹⁶ Emotional neglect or abuse, on the other hand, was linked to difficulties recognizing both positive and negative emotions. False recognition of “anger” was the most common finding.¹⁶

Autism

A 2025 meta-analysis reports that individuals with autism may have difficulty understanding social cues such as facial expressions, tone of voice, and body language.¹⁷ They particularly struggle with complex emotions like sadness or fear.¹⁷

Anxiety and Depression

Trauma

A study found that adolescents who have experienced childhood trauma are more likely to develop depression and anxiety compared with peers who have not experienced trauma.¹⁸

Autism

Anxiety and depression are very common in autism. Studies have found that more than 60% of children with ASD had at least subclinical anxiety, with 40% meeting the criteria for an anxiety disorder.¹⁹Other research on depression in ASD found that autistic individuals are four times more likely to experience depression than the general population.²⁰

In the next section, we will explore how these overlapping symptoms can increase the risk of misdiagnosis.

Why Are Autism and Trauma So Often Misdiagnosed?

The symptom overlap between autism and trauma means misdiagnosis happens in both directions.

Children who have experienced ongoing or early trauma may show emotional numbing, social withdrawal, rigid or repetitive behaviors, and difficulty understanding other people’s thoughts and feelings.⁴However, these features are also commonly associated with autism. If a young person’s history of trauma is not fully explored, trauma-driven responses can be mistaken for autistic traits, leading to a wrong diagnosis.

The reverse also happens: traits a teen shows might be due to autism rather than a trauma response. Researchers found that trauma symptoms can be “masked” by a known autism diagnosis and, as a result, PTSD symptoms in autistic teens can be missed altogether.²¹

Other reviews have found that this is a form of “diagnostic shadowing”, where autism becomes the only lens through which all distress is viewed.²² Without autism-adapted trauma assessments, many autistic teens may never receive appropriate trauma support.²²

Mission Prep: Expert Support for Teens with Autism and Trauma

If you’re unsure whether your autistic teen is dealing with trauma or whether signs of autism have gone unrecognized, reaching out for support is an important step. Autism and trauma are both complex on their own, but when they overlap, it can feel overwhelming just trying to make sense of what your teen needs.

At Mission Prep, we have extensive experience supporting teens with autism, trauma, and the interaction between the two. Our team understands how these experiences can shape behavior and emotional responses in ways that are easy to misread.

Our treatment includes CBT adaptations for autistic adolescents, alongside trauma-informed care for autistic teens, ensuring support reflects how your child processes their emotions.

We understand that these challenges rarely affect only your teen, which is why families are involved throughout the treatment process. Parents are supported in understanding what their teen is experiencing and how to communicate with them during difficult moments.

Mission Prep offers both outpatient and residential options, so care can match what your teen actually needs. This is crucial because some teens do better staying connected to daily routines, and others need time in a structured environment to reset.

If you’re concerned, please reach out to us today. We can help you understand what’s happening and what to do next.

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