Growing Up with Autism: Developing A Healthy Sexuality Curriculum for Teens and Young Adults

Sexuality education for individuals with autism spectrum disorders is critical. What is healthy sexuality development for youth and young adults with ASDs, and how do we help them with this important part of who they are? Using case presentations and materials from our clinic program and parent groups, this session will focus on the key components in creating a sexuality and relationship development curriculum for ASD learners and how to effective instructional approaches for individuals with ASDs to sexuality learning. Session Content Plan:                                                                                                                                                                                                                           The need to provide sexuality education to individuals with autism spectrum disorders has been previously deemed critical (NICHYD, 1992). Individuals with autism spectrum disorders develop physically in the same way as their typically developing peers (Adams & Sheslow, 1983; DeMeter, 1979; Schoreder, LeBlanc, & Mayo, 1996). Additionally, individuals with ASD are likely more vulnerable to sexual abuse and exploitation due to difficulties reading warning signs and “red flags” (Sobesy, 1994). Finally, by providing more education about sexuality and sexual behavior, one can decrease an individual’s likelihood to engage in dangerous and inappropriate sexual behavior. By failing to provide individuals with autism spectrum disorders a comprehensive and appropriate sexuality education, we are failing to meet their learning needs and the opportunity to experience healthy development. However, little has been discussed as to how to develop an evidence based, developmentally appropriate, comprehensive sexuality curriculum for individuals with ASD. Therefore, it is of increasing importance to create and disseminate empirically supported, comprehensive sexuality curricula for individuals with ASD. Of particular relevance is the focus on two primary issues in the development of sexuality curricula for individuals with ASD. That is, what should be taught and what is the best practice for teaching?
What is contained in a comprehensive sexuality curriculum?                                                                                                                                                                                                                                A comprehensive sexuality curriculum does cover basics about sex, but also needs to include important topics which address foundational skills (e.g., social and emotional development) and all dimensions of human sexuality (e.g., values, personality, communication, self-image). Given the nature of autism spectrum disorders, these components are essential and cannot be ignored when designing a sexuality education curriculum.
Content areas which are considered in the literature to be core in the development of a sexuality education curriculum include: the body (including parts, functions, body image, and hygiene), privacy, boundaries/ touch/ expressing affection, social skills, and exploitation prevention. Additional topics may also include education on dating, relationships, marriage, and having a family. An important aspect of a comprehensive sexuality curriculum is the inclusion of a plan to handle and prevent difficult sexual behaviors. This may include defining inappropriate sexual behavior, common behavioral concerns, a functional analysis of inappropriate behavior, as well as specific strategies to address inappropriate behavior.
How do we create individualized plans for sexual learning?                                                                                                                                                                                                                            When deciding what to include in an individual’s plan for sexual learning, it is considered best practice to assess individual needs, set specific goals, set roles for the teaching team members. Additionally, it is important to evaluate learning and reassess goals periodically, as individual’s needs may change. This session will highlight individual adaptations to curricular content dependent on the individual’s age, gender, cognitive developmental level, physical development level, and presenting problems. These factors will determine what information needs to be taught, in what detail it needs to be understood, and the order in which material needs to be presented.
 How do we teach sexuality to individuals with autism spectrum disorders?                                                                                                                                                                                                    As with any curriculum development for individuals on the spectrum, modifications to existing teaching strategies must be made. This session will discuss how to adapt effective instructional approaches for individuals with ASDs to sexuality learning. Examples of teaching strategies which will be discussed are:
·         Concrete multi/sensory teaching approaches
·         Picture stories
·         Social stories
·         Role-playing
·         Video modeling
·         Visual supports
·         Environmental/activity/ schedule changes
·         Establishing routines
·         Incidental teaching
·         Modeling
These techniques are relevant for individuals with a range of cognitive and language abilities and interests. Participants in this session will learn that teaching methods used to for other core skills can be applied to teaching a comprehensive sexuality education to individuals with autism spectrum disorders. Additionally, the importance of working with individual’s strengths and interests to individualize teaching strategies will be highlighted. Individual differences must be taken into account when developing an educational plan as the teaching strategies chosen should reflect age, developmental level, language abilities, personality, and interest levels.
To highlight these techniques and strategies, we will share case examples of applications from our sexuality clinic including:
·         Individualized sexuality assessments
·         Parent-developed sexuality education plans
·         Consultation regarding problematic behaviors
·         Findings from our 10-week group parent education and skill building curriculum                                                                                                                            Findings from our 8-week “guys growing up” teen group curriculum

This session expands on our previous presentation at the ASA National meeting in 2005 where we highlighted the importance of sexuality education for individuals with ASDs and what we currently know about sexuality development and behavior in learners with ASDs.

Understanding issues regarding sexuality for youth with ASDs is critical for fostering healthy development. Youth and young adults with ASDs deserve knowledge about sexuality appropriate for their age, developmental level and readiness. They also deserve to play an active role in their own sexual decision making and to have their sexuality appreciated, accepted and understood by others. Together, these goals contribute to fostering personal safety and life satisfaction.