Sexuality Instruction for Tweens, Teens, and Young Adults

Sexuality can be a difficult subject to broach with your kids — whether they are on the autism spectrum or not. It can be especially difficult to discuss if your child is on the autism spectrum. This is in part because children on the spectrum often prefer very clear, specific explanations and tend to see the world in literal terms. Meanwhile, parents are often accustomed to beating around the bush and using euphemisms to explain sexuality — if they even have "the talk" at all

Regardless of your child's intellect, verbal ability, or school placement, it is critical that you put aside the awkwardness and discuss sexuality and related issues with your child. Your child may not have any other reliable way of receiving this information. Most typical adolescents get a great deal of information about sex from their peers. However, because children on the autism spectrum often don't read social cues well enough to get information about sex from their peers, parent involvement in this aspect of the child's life is extremely important.

Experts advise parents of children on the autism spectrum to teach topics of sexuality five years ahead of when the parents think their children need the information. One reason for this is that children on the spectrum learn from repetition. Starting early gives you and your child time to prepare for what lies ahead.

You will need to tailor the information to your child's specific learning needs. Discussing these topics with your child on the autism spectrum will be complicated by language and communication problems and social competence. Just as in other areas of learning, be accurate, concrete, and repetitive when teaching your child on the spectrum about sex, and break larger portions of information into smaller chunks and use visuals and Social Stories™.

Sexuality topics for adolescents and young adults can be broken down into five groups:

1. Anatomy
2. Sexual Acts
3. Relationships
4. Safety and Laws Regarding Sexuality
5. Values

Anatomy

By the time your child is a preteen, he or she should know about his or her own body. But your child may not have much knowledge about the bodies of the opposite gender. Talk one-on-one with your child and assess what he or she already knows. Both genders need to know about the anatomy and sexual functions of the other gender.

When discussing body parts, don't use complex diagrams; instead choose accurate, simple diagrams which are realistic portrayals of the human body, including sex organs. You may want to consider using real pictures, including pictures that show what males and females look like at different points in development (including variations in size and pubic hair). Encourage your child to look at his or her own body, but be respectful of your child's privacy if your child wants to do this on his or her own, rather than with you. When talking with your child, use the real names of each body part instead of just saying "down there." However, it is important to also teach vernacular labels for body parts, so that your child understands what these are if and when he or she hears them.

Sexual Acts

Once your child enters puberty, he or she may experience sexual urges, which are brought on by hormonal changes during puberty. Talking about sexual acts will probably be uncomfortable for both you and your child. Nonetheless, it is something that must be done. Start by checking in with your child about his or her sexual knowledge so that you can add information or correct misinformation as needed. Be honest, accurate, and straight forward. Be willing to answer questions, but make sure you are prepared to answer even the most uncomfortable ones. It is okay to pass on a question, however; this will help your child learn that some topics are private. Be sure to discuss not only intercourse, but oral sex, masturbation, nocturnal emissions, and erotic dreams too. Your child needs to understand that sexual actions can have consequences, like sexually transmitted diseases (STDs) or pregnancy. Discuss pregnancy, STDs, methods of birth control, safe sex, and parenthood.

Relationships

Teaching your child about sexual relationships will be difficult. A critical component of ASD is difficulty understanding social interactions, so you will need to adjust your lessons to your child's developmental level. Tell your child that it is natural to experience attraction and sexual feelings, and candidly discuss how to appropriately handle these feelings and urges. Also teach your child how to respond to attention from someone else, including how to say "no." Discuss dating, intimacy, and sexual preference. Responsible sexual behavior necessitates both good judgement and the ability to anticipate the future. This is difficult for typical teenagers, but it may be especially difficult for autistic teens and young adults. Sexual contact can also have emotional implications that your child on the autism spectrum may be unprepared for, so keeping the lines of communication open is crucial.

There is a curriculum titled Circles, which provides a method for visually delineating relationships. The curriculum uses concentric circles to show levels of relationships, from strangers to those in the inner most circle who are people your child is closest to. Visually show your child who fits into each circle.

Safety and Laws Regarding Sexuality

Teach your child what sexual abuse is, how to recognize it, and ways to stay safe. While discussing relationships, make sure to discuss appropriate "courting" behaviors. Often individuals on the autism spectrum fail to recognize the line between showing interest and stalking. While perspective taking is difficult for individuals on the spectrum, learning to do so is an important part of being ready for any kind of relationship.

Values

You will need to teach your child about what happens in the world (for example, pornography and prostitution), but you can certainly do this while teaching your child about your family's values. Your child will have sexual urges and desires and will want to act on them. Help to ensure that how your child responds to these feelings as they develop are in line with your beliefs and expectations by encouraging an open dialogue about sexuality.

Additional Resources

• The Circles Concept

Suggested Books

What's Happening to Me? A Guide to Puberty by Peter Mayle and Arthur Robins; Kensington Publishing Ltd, 1975. This straight-forward book on puberty details changes to the bodies of males and females. The use of cartoons and humor sets a light mood for both the parent and child.

What's Happening to My Body: A Book for Girls by Lynda Madaras, Area Madaras, Simon Sullivan; Newmarket Press, 2007. This straightforward book discusses physical body changes, the menstrual cycle, diet and exercise, sexual feelings, and sexually transmitted diseases.

What's Happening to My Body: A Book for Boys by Lynda Madaras, Area Madaras, and Simon Sullivan; Newmarket Press, 2007. This straight-forward book discusses puberty and the male body. A workbook companion piece entitled, My Body, My Self for Boys, can be purchased separately and includes games, checklists, and quizzes to reinforce what boys have learned.

Hygiene and Related Behaviors for Children and Adolescents with Autism Spectrum and Related Disorders by Kelly Mahler, MS, OTR/L; Autism Asperger Publishing Company, 2009. Presented in a lesson plan format, the book is designed to help children on the autism spectrum make the connection between hygiene behaviors and how those behaviors are perceived by others. There is a CD with worksheets that can be downloaded and printed for use.

Making Sense of Sex: A Forthright Guide to Puberty, Sex and Relationships for People with Asperger's Syndrome by Sarah Attwood; Jessica Kingsley Publishers Ltd., 2008. This book is ideal for those who need clear, detailed explanations and direct answers to the many questions raised by puberty and sexual maturity. The book describes developments in both the male and female body, and explains how to maintain hygiene and personal care and how to promote general good health. The book examines emotional changes, including moods and sexual feelings, and provides comprehensive information on sex, sexual health, and reproduction as well as the nature of friendship and how it may change over time.

Personal Hygiene? What's that Got to Do with Me? by Pat Crissey; Jessica Kingsley Publishers Ltd., 2005. This book was developed for individuals on the autism spectrum and other learning and developmental disabilities to help them understand how others perceive their appearance and the social implications of neglecting personal hygiene. There are quizzes and hands-on activities to demonstrate why and how to perform various hygiene tasks.

Taking Care of Myself, A Hygiene, Puberty, and Personal Curriculum for Young People with Autism by Mary Wrobel; Future Horizons, 2003. Written by a teacher/speech-language pathologist, the book uses simple stories to demonstrate what to say and not to say when talking to your child about hygiene and puberty. The book addresses hygiene, modesty, body growth and development, menstruation, touching, personal safety, and more.

The Underground Guide to Teenage Sexuality by Michael J. Basso; Fairview Press, 2003 (2d Ed). Written by a sex educator, this book is for teenagers. It provides accurate and objective information about sexuality to help teens understand their changing bodies and make informed decisions about sexual activity.

My First Human Body Book by Patricia J. Wynne and Donald M. Silver; Dover Publications, 2009. This is a coloring book that teaches all parts of the body and body functions.

Human Body Puzzle by Melissa & Doug. This is a 100-piece, double-sided, cardboard floor puzzle. One side displays the musculoskeletal system and the other shows the internal organs and the circulatory system.