Sexual Health & Relationship Skills
The term functional sexual health and relationship skills are very important to adolescents and young adults with disabilities including autism. Just as peers without disabilities experience puberty, adolescents with disabilities experience hormonal and physical body changes during this time. They also have an interest in their bodies and are curious about sex. There are often additional difficulties for these adolescents due to the characteristics of their disabilities including challenges with communication, behavior, and social interactions. Teens with disabilities experiencing puberty may exhibit sexual behaviors which is common and need to be directly taught how to appropriately display their sexual behavior.
Early and Ongoing Education. Educating children early can ease this transitional time and be used as time for teaching appropriate behavior. For example teaching appropriate self-care and displays of affection with peers and adults, using what is typically appropriate for same-age peers that are not disabled as a gauge. To illustrate this, it would not be acceptable for any 4th grade age student to sit on their teacher's lap during class. Sometimes exceptions are made due to the need to calm a child for example. However, these behaviors are learned and as the child grows and ages it becomes more difficult to change them. Behaviors strengthen over time. The sooner behaviors are addressed and more appropriate and socially functional behaviors are taught the less likely the behaviors will interfere daily living and social interactions.
Participation in a sexual education training program can be helpful, but the training should be individualized to meet the needs of the individual(s) attending. Those providing the training should be skilled in working with individuals with disabilities and sexual education. Some adolescents and young adults may need more intensive intervention by a trained psychologist or behavior analyst for creating a behavior modification program. There are some excellent online resources for sexual education for parents including:
Autism Now/Autistic Self Advocacy Network : Relationships and Sexuality: A Guidebook by and for Autistic People. More detailed and explicit content about expectations, moving in together, complex relationships, and more.
Autism Speaks Health: Sexuality is included and there is a downloadable document at this link.
Sexuality Across the Lifespan for Parents: a publication by the Florida Developmental Disabilities Council.
Strategies. Sometimes changes can be made to the environment to reduce the chance of an inappropriate sexual behavior. Examples might include wearing a different type of underwear or wearing a belt. Making environmental changes may stop or reduce a behavior and it does not require a lot of time or effort. Other strategies include giving a child another behavior option to promote appropriate behavior. An example would be if a child is touching himself inappropriately at school, have him help stack chairs (or other activity that requires both hands) which replaces the touching behavior with stacking the chairs. Also, teaching where it is appropriate and inappropriate to engage in sexual behavior, such as what is ok self-touching in public and what is ok self-touching in private. It is important to enforce the rules around public and private sexual behavior so it is clear to the individual. Having sexual behaviors under control is very important to outcomes in community living, educational settings, employment, and overall independence.
Victimization. According to Autism Speaks reporting on a study conducted through the organization, individuals without disabilities tend to get sexual information from social sources such as family, friends, and teachers while people with autism tend to get their sexual information from impersonal sources such as websites. This lack of knowledge can impact individuals with intellectual disabilities and put them at increased risk for sexual victimization. Many with disabilities are also more vulnerable to issues with the legal system due to inappropriate sexual behavior. Often these behaviors are due to lack of understanding what is appropriate which comes through more specific sexuality training.