Transcript Slide 1

‘Issues within Puberty &
Sexuality in people with
Autism Spectrum Disorders’
Lynne Moxon
ESPA, Northumbria University
Building social relationships by making
friends and establishing intimate partners
is a key developmental life stage for
young adults
“ Before I turned sixteen years old I became sexually
active. Had anyone asked me if I were, I probably would
have said no, only because I did not comprehend what
“sexually active” meant. I can now comprehend the
term, but not always the degree of “activity” that
accurately defines “sexually active””.
(Snyder 2006 p.121)
• Young people are increasingly bombarded by sexual images
and there is an increase in casual sex
• 60% of children,12 to 15 have seen porn online
• Boys may be pressurised into having sex
• Girls as young as 12 feel they should be shaving their pubic hair
• There is a dangerous lack of knowledge about STIs
• However, individual interest in sex or in developing an
intimate sexual relationship with another person varies
widely across individuals at all ability levels
• As such, there is a significant need for group and
individualised effective instruction for people with ASD
across the ability spectrum
(Henault and Attwood Hellemans et al 2007)
Sexuality is a part of life and is as developmentally appropriate
for people with autism as anyone else Hellemans 2001
Heterosexuality
Homosexuality
50%
4%
Bisexuality
Asexuality or undetermined
13%
25%
8% heterosexual paedophile
Sexuality education should be proactive
• Griffiths, (1999) notes that most learners with a
developmental disability receive sexuality education only
after having engaged in sexual behavior that is considered
inappropriate, offensive or potentially dangerous..
Social competence
• Levels of perception, cognition and connected
communication are fundamental in determining whether a
relationship progresses into friendship, along with shared
interests, fantasy, humour and self-disclosure
(Dodge, Pettit & McClaskey, 1986, Dunn, 1993)
• Mere exposure to appropriate, social situations does not
help a child with ASD improve their social skills, or there
would not be a problem in the first place (Jordan & Jones,
1999) rather specific interventions which aim to remediate
the core deficit in social functioning are necessary
(White, 2002; Jordan & Jones, 1999; Aarons & Gittens, 1998;
Donnellan & Kilman, 1986)
• People with ASD desire intimate relationships, yet they lack
the appropriate skills and knowledge to initiate such
relationships successfully
(Henault & Attwood, 2002; Stokes & Kaur, 2005)
• Due to their social ineptness, some people with ASD may
naively engage in inappropriate or intrusive courtship
behaviours, including stalking, in their attempts to initiate a
relationship
(Stokes, Newton & Kaur 2007)
Sexual expression in individuals with autism may
easily be mistaken as deviant…
Difficulty in learning adaptive social behaviours in an
unstructured fashion, recognising subtle affective cues,
communicating accurately and competently with others, taking
the perspectives of other individuals and considering their own
and others’ viewpoints may confound sexual development and
contribute to inappropriate sexual behaviours
Realmuto and Ruble 1999
• “Chatting someone up is not that different to an interview.
Don’t forget to look at their face more than two thirds of the
time whilst listening or speaking and smile a bit. If they are
doing the same, it means they like you.”
(Segar 1996)
• “I don’t like to masturbate because I think of all of those
thousands of children who will never be born.”
(Harocopus 1996)
• “An autistic teenager, 18, who groped two care workers has
been sent to a mental health hospital indefinitely.” (2005)
• Solicitor with AS aged 35, given a three-year sentence for the
attempted rape of a woman solicitor after a ball. He told police:
“I spent £200 on her. Why can’t I do what I did to her?”
Goals of a comprehensive
sex education programme
• Provide accurate information
• Develop personal values
• Develop the necessary social competence
• Use ‘scripts’ to give an approximate idea of rules and
expectations, what to do in different situations
What should be included in
a sex education programme?
• BODIES - women’s and men’s bodies, naming of
private parts, the
• Differences and similarities
• Growing up and puberty
• Menstruation and menopause
• Hygiene
• Body parts and functions
What do you see?
Sex - physical and practical aspects
• Masturbation
• Same sex activity - including consequences. Sexual health
information
• Heterosexual activity - including consequences. Information
on pregnancy
• Contraception, - sexual health information
• Different kinds of sex
Relationships
• Family relationships
• Friendships
• Boyfriends/girlfriends
• Relationships with staff
• Internet sex
• The needs of individuals will vary according to ability
and experience
How to get a second date
Sex - social aspects
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What does sex mean?
Why do people do it?
How do we learn about sex?
Who can/can’t we have sex with and why?
Consent
Right times and places – public and private
Keeping safe, socio-sexual rules, norms and values,
Discrimination skills (which behaviour is appropriate in which
situation, place, and time?)
Will I get into trouble?
Sex - keeping safe
• Good and bad touching
• Pressures to have sex
• Who makes decisions about sex
• Reasons for saying no, role-play saying no
• What to do to try to prevent abuse
• What to do if it happens
Personal space
ASD Specific Areas
• Emotional guidance and support (explaining autism,
acceptance of the sexual and relational limitations related to
ASD, searching for alternative ways of satisfying sexual
expression); counselling in dating skills and development of
an intimate relationship (emotional reciprocity, perspectivetaking, setting and accepting limits, responsibility, norms
and values)
The Private Parts Rules
• If it has to do with PRIVATE PARTS, then
• It is to be done at a PRIVATE TIME, and
• In a PRIVATE PLACE and
• If it involves someone else I need his/her
PERMISSION OR CONSENT
Use visuals and explicit pictures
Social Story
It is OK to have an erection or hard-on while at school.
When this happens I will ask the teacher to be excused
to go to the bathroom.
I will not talk to others about my erection.
I know that this is a private thing and it is natural.
Erections happen to all boys at some time.
Social Stories for Sexuality Education for Persons with Autism/Pervasive
Developmental Disorders - Balazs Tarnai & Pamela S. Wolfe Sexuality &
Disability (2008) 26:29-36
• Koller (2000) gave a short overview of teaching
methods and sexuality curricula for people with
autism. She concluded that the question is not if
sexuality education can or should be provided for
individuals with autism, but how it will be offered
• Aston, M. (2003) Aspergers In Love. Jessica Kingsley Press
• Attwood S. and Powell J. (2008) Making sense of Sex, Jessica Kingsley
• Henault, I (2003) in Asperger Syndrome and Adolescence Ed. Liane Holliday Willey. Jessica Kingsley
• Henault I (2006) Aspergers Syndrome and Sexuality, Jessica Kingsley
• Kerr Edwards, l. and Scott, L. (2003) Talking together about sex and relationships, fpa
• Kerr Edwards, l. and Scott, L. (2005) Talking together about contraception. Fpa and Teenage
Pregnancy Unit
• Newport, J. and Newport, M. (2002) Autism-Asperger’s and Sexuality: Puberty and Beyond. Future
Horizons Inc.
• Schwier, K.M. and Hingsburger, D. (2000) Sexuality: Your sons and daughters with intellectual
disabilities. Paul H. Brookes
• Slater-Walker, G. and Slater-Walker, C. (2002) An Asperger Marriage. Jessica Kingsley Publishers.
• Wrobel, M. (2003) Taking Care of Myself. Future Horizons inc.