High-functioning teens with autism may be difficult to spot because they don't display typical behaviors, such as rocking and hand waving, and their language skills may be adequate. Because the features of autism are less obvious among these youth, a disproportionate number land in juvenile detention for behaviors such as obsessive following or touching others, says school psychologist Tammy L. Hughes, PhD, who chairs Duquesne University's department of counseling, psychology and special education.

But the nature of their developmental disorder makes it imperative that they be treated in a way that recognizes their unique issues, preferably through well-designed diversion programs, she says.

"Not many young people with autism commit crimes, but of that small group, their needs are distinct," she says.

The issue came to Hughes's attention when her colleague Lawrence Sutton, PhD, a clinical psychologist who works for the state of Pennsylvania, observed that 43 percent of the young people in a juvenile sex-offense unit met criteria for autism. After taking a closer look, the psychologists also found that these young people weren't improving under traditional treatment approaches for sexual offenses. For example, the standard treatment for juvenile sex offenders places a strong emphasis on learning to empathize with the victim's point of view, as well as on putting young people into group formats that aid their socialization.

"But kids with autism have a lot of difficulty understanding another's perspective," Hughes says. Many also find traditional group therapy confusing and therefore ineffective.

Their motives are also different from those of typical sex-offending youth, says Hughes. For instance, they may come up to someone and smell and touch their shiny hair because of sensory-stimulation needs combined with poor social skills, "not because they're lying in wait to commit an assault," she says.

Several efforts are under way to address the courts' and public's lack of knowledge on this issue. Hughes and Sutton are working to set up screening and treatment mechanisms for youth who are already in detention. They have also developed a diagnostic protocol to help courts determine the treatment needs of high-functioning children with autism, as well as prevention and intervention programs to help these young people understand sexual development, peer relationships and dating. In addition, Hughes and others are training juvenile justice workers to appropriately assess and intervene with autistic youth.

"We'd like to have a system in place where we can catch problems in these young people early on and solve them," Hughes says, "and if we have to go before a judge, the judge is already informed about their needs."

—T. DeAngelis