The Autism Society Event and Education Recordings Archive

Healthy sexual attitudes and habits pave the way for healthy relationships. Individuals with ASD struggle due to difficulty picking up social cues, which can have dire consequences when it comes to sexuality. Yet parents often hesitate discussing these issues, due to embarrassment, or uncertainty what and how to teach this information This presentation teaches the “unstated rules” regarding sexuality with a strong emphasis on health and safety issues in a frank way to help families overcome their discomfort. As parents we worry about our children’s well being, including issues related to sexuality. Will girls like him? Will she be safe? Will someone hurt my child? These fears often increase in adolescence when both the social challenges and expectations are higher, which also usually coincide with their greater need for privacy, autonomy and independence. They may seek to separate more from parents and connect with same age peers. Meanwhile the gap between our children on the spectrum and “neurotypical” peers often seems to grow during adolescence, leaving our kids left without the protective peer factor and out of the loop of what is socially appropriate behavior. Yet in spite of our parental concerns relatively few parents take the initiative to discuss issues related to sexuality often due to our uncertainty or embarrassment. Sex is a private matter, and it’s extremely uncomfortable to discuss it in a frank way with anyone, much less our own offspring! Add in the additional need to provide direct instruction to kids on the spectrum, parents may be completely at a loss how to approach their child or know how to convey the information in a way that they understand.

In addition to embarrassment parents may not address issues related to sexuality perhaps it is the fear that bringing it up will cause the adolescent to be more sexual. For example, although the Victorian days of believing masturbation is harmful are past, the vestiges of taboo remain and it makes most of us extremely uncomfortable to discuss it. Parents would prefer not to think of their children as sexual beings and may believe that bringing it up will cause them to begin engaging in behaviors they previously hadn’t. Fear of it becoming an obsessive behavior out of balance with studies and social situations is a real concern. However, avoiding discussing it is not a deterrent. Rest assured, our adolescents will hear about or learn these things on their own, but how accurate is the information they are receiving from the kid on the bus? And how well managed will these behaviors be if the child is left to his or her own devices? The reality is that 67% to 97% of individuals on the spectrum engaging in masturbation and it is the most common INAPPROPRIATE sexual behavior (namely public masturbation). There are strict social guidelines regarding things such as who it is okay to be sexual with, as well as when and where. Failure to address these can lead to socially inappropriate behavior such as public masturbation, being sexually victimized or even being charges with sexual misconduct or assault simply because no one was willing to step in and address these issues directly until there was a serious breach of conduct.

What they don’t know will hurt them

According to the Department of Health and Human Services, teens aged 16-19 are 3/12 more likely to be victims of rape, attempted rape and sexual assault. By the age of eighteen 1 in 3 young women in the general population will be sexually assaulted, 1 in 5 young men. These statistics alone are frightening for parents and the community charged with protecting our youth, however, the figures are even more grim for our population in the autism community. A study by Valenti, Hein and Schwartz states that 90% of adults with developmental disabilities will be sexually abused or assaulted over the course of their lifetime. 49% of these individuals will suffer 10 or more incidences. Furthermore, the damage caused by sexual abuse, sexual assault and rape on pervasive and long-lasting. Women who have been victimized are more likely to be promiscuous, enter abusive relationships and experience domestic violence or re-victimization through further sexual abuse and assault. Men who have been abused are also more likely to be exploited and abused repeatedly, and sadly several studies confirm they may unfortunately be more likely to act out violently and inappropriately and may become abusive or sexual predators themselves. What are we do to in light of these overwhelmingly painful statistics? We must take a proactive approach creating awareness and direct instruction that includes social-related safety skills can reduce the incidence of sexual assault and abuse. We also much our youth socially appropriate behavior and convey healthy positive messages about sexuality to our adolescents and young adults on the spectrum.

It’s a community issue: so the community needs to address it

Parents and professionals need to come together to address sexual issues in our ASD population. First and foremost we must acknowledge and accept that individuals with Autism Spectrum Disorder have a right, just as we all human beings to experience healthy sexual relationships and to meet their sexual needs alone or with a partner. Organizations and school must develop policy for dealing with sexual issues, and programs for addressing the need to teach related social skills. As much as possible this must include parent and guardians, and an individualized plan should be created to address the specific need for education and intervention for each client. Consideration for the values of the family and the individual must be addressed when approaching sexuality education. Parents may choose to do some value assessment as part of this process to determine where they stand on various issues. Great care must be taken to be respectful of all involved, but foremost with the greatest sensitivity expressed toward the individual on the spectrum him or herself. Also, no program is effective in isolation, it is important to have a plan to address the actual need and skills needed to be mastered when in the community.

Teaching the Hidden Curriculum of Sexuality

Discussion and instruction should include rules about sexual behavior such as when, where and with who is that behavior appropriate. It needs to include instruction with specific language used and what it means and clear guidelines of what constitutes “appropriate”, “inappropriate”, “private” and “public” behavior. These strategies can be used for any number of social situations and are not limited to those related to sexuality.

Clear definitions of what constitutes dating, sex, relationships must be provided, along with clarifying expectations with a partner or date. For example, what constitutes a date? The dictionary will only serve to give a confusing definition that means absolutely nothing in the real world. For some a date holds the assumption that sex will be involved, and yet the other party may not be thinking the same thing. Teaching the importance of establishing mutual expectations when dating is paramount. In addition instruction must teach the importance of both obtaining consent for intimate behavior with a partner. It is important to note that in some cases the individual may not have the legal right to give his/her own consent and this should be clearly understood to both the individual and potential partners.

Verbal instruction alone is not an effective teaching strategy for individuals with ASD. It can be supplemented with visual aides including video examples from television or movies demonstrating both appropriate and inappropriate behavior. Small group activities for practicing dating related social skills, or having other neurotypical peers or adults play act and demonstrate are both effective strategies for teaching the Hidden Curriculum. One on one direct instruction with a same sex adult is also an important component to teaching individuals on the spectrum. It is important to provide the opportunity to build a relationship of trust with a same sex adult who can be a role model or mentor, and can also be available to discuss questions regarding such personal issues as sexuality.

And, let’s not forget: sex is supposed to be FUN!

Focusing on “healthy sexuality” as opposed to merely taking a fear-based approach reminds us that sex is an expression of who we are as individuals. Irregardless of your value system, sex is part of our identity and how we see ourselves in the world. For anyone, having a sense of who we are, our value as human beings and what it important to us translate into healthier relationships, including sexual ones.

Learning Objectives: