Sexuality and relationships: teenagers with autism spectrum disorder

Sexuality and relationships: teenagers with autism spectrum disorder

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Sexuality and sexual development

Sexuality is more than sex. It's also the way your child feels about his developing body. It's how he understands feelings of intimacy, attraction and affection for others, and how he develops and maintains respectful relationships.

Sexuality is essential to healthy overall development.

Teenagers with autism spectrum disorder (ASD) develop sexually in the same way as other teenagers do, but they might need extra help to build the social skills and maturity that go along with developing sexuality.

Sex and sexuality for teenagers with autism spectrum disorder: what to expect

Your child will be more or less interested in sex and sexuality - just like other children her age. She can develop romantic relationships too, which might or might not be sexual.

Exploration and experimentation with sexuality is normal and common. For example, for some young people - with and without autism spectrum disorder (ASD) - sexual development will include same-sex attraction and experiences.

But sexual and romantic experiences and feelings might have extra challenges for your child. Many teenagers with ASD can find it hard to understand feelings of intimacy, attraction and affection - in themselves and others. It might also be harder for them to express their feelings. If your child does find these things difficult, he might be more at risk of doing inappropriate or risky things or getting into unhealthy relationships.

In every situation, the most important things are consent and safety:

  • Consent means that your child needs to be sure that she feels OK about any kind of sexual experimentation and that the other person is OK with it too.
  • Safety means that your child and the other person are protected against pregnancy and sexually transmitted infections, and that the experience is respectful and non-violent.
The complicated interactions between two people and the mixed messages about what other people are thinking or feeling, or what their intentions are… I can see that being a real challenge for him.
- Peter, parent of a 13-year-old with ASD

Romantic relationships: helping your child with autism spectrum disorder

Your child with autism spectrum disorder (ASD) might ask tricky questions, like, 'How do I get a girlfriend/boyfriend?', or 'How do you kiss someone?'. By answering these questions, and speaking to your child about sex and sexuality, you can help him to understand his feelings and behave appropriately.

Recognising feelings
You might need to explain attraction to your child. For example, when she's attracted to another person, she might feel a tingly sensation in her body, or she might think about the other person a lot and want to be with them a lot. A Social Story™ might be helpful.

Teenagers with ASD might also find it hard to understand that people can feel embarrassed about expressing deep romantic feelings for somebody. Teenagers don't always show these feelings on the outside. This can make it hard for a child with ASD to work out how someone feels. You can help your child to work out if the other person feels the same way that he does.

For example, you could use pictures of how people might behave if they're attracted to your child. The pictures might show a person leaning forward to hear what your child says, touching your child's hair, laughing at her jokes, touching her arm or inviting her to do something together.

On the other hand, you might also need to explain that if someone smiles at your child and talks to him, it doesn't always mean that the other person is romantically interested. The person might just be being friendly.

Visual supports are a good idea too. These might include photos or drawings showing how people might behave when they're not interested. The images might be of people looking, moving or turning away, folding arms or not answering when your child talks to them.

You can also talk to your child about how other people might interpret her behaviour. For example, if she smiles and is very friendly towards someone, that person might think she has romantic feelings.

Building up your child's confidence and self-esteem is also a good way to prepare your child for romantic and intimate relationships.

Managing sensory issues
Sensory issues can have an impact on romantic relationships for young people with ASD. For example, if your child isn't comfortable hugging other people, this affects the ways he can express affection and attraction.

Some children don't like being touched, and that's OK. But some children can become comfortable with touch.

You could try 'desensitising' your child. This might involve you sitting near your child, wherever she'll happily tolerate. Then increase your physical contact with her - for example, you could touch her arm for a small amount of time. You could keep this going over months or even years until she can handle a hug from you.

You know your child well, so you'll know how much to realistically expect. For example, your child might never feel comfortable having a hug from you or anyone, or he might be able to hug you, but not anyone else.

Respectful relationships
If you explain good and bad signs in a relationship, it can help your child develop healthy and respectful romantic relationships.

Here are some good signs to talk about with your child:

  • The other person only asks you to do things that you feel safe and comfortable with.
  • The person is honest and doesn't tell made-up stories to you about family members or peers.
  • The person listens to you as much as you listen.
  • The person doesn't expect you to do everything that the person wants. For example, the person is happy if you want to do something different or go out by yourself or with other people.
  • The person supports you. For example, the person says nice words to you and helps you when you're upset.
  • The person doesn't tease or bully you or say things that make you feel bad.

Here are some bad signs:

  • The person doesn't give you much attention or affection in return for your feelings.
  • The person says mean things that make you feel stupid or bad.
  • The person hurts your body, your private parts or your feelings about your body and private parts. For example, the person makes you do something that makes you feel uncomfortable.
  • The person doesn't want you to meet friends and family.
  • The person bullies you.

End of a relationship
Teenage romantic relationships don't always last forever. Your child might need to know that sometimes they go for a long time, and sometimes they end quickly. Sometimes both people in a relationship agree to end it. Other times only one person decides to end the relationship.

If your child didn't want a relationship to end, she might feel confused, sad, lonely or angry. She might also feel like this if she wanted a romantic relationship with someone but the other person didn't want one. These feelings are normal.

You can support your child by encouraging him to:

  • spend time with other friends and family
  • do things he enjoys
  • talk about what happened and how he's feeling
  • express how he's feeling using writing, Social Stories™, art or sport.

You could also talk about things your child shouldn't do, like shout at the other person, send angry emails or text messages, or post rude things on social media.

Intimate relationships and sexual health for teenagers with autism spectrum disorder

As your child with autism spectrum disorder (ASD) goes through puberty, you might want to talk with her about sexual relationships.

Your child might already have a biological understanding of sexual development from lessons at school or what you've taught him. But he also needs to develop a healthy attitude to intimate relationships.

For example, you could explain that sexual relationships are a normal part of life, and teach your child not to use sex for popularity or to believe everything she hears from peers about their sexual experiences.

Good touch and bad touch
People with ASD can be vulnerable to abuse because they don't always recognise when something isn't right. So you might need to explicitly teach your child the difference between good touch and bad touch.

For example, good touch is something that friends and family might do to show they care for each other. These touches might include a handshake to say hello, a hug or a kiss. A bad touch is something that feels wrong or uncomfortable, like a stranger asking for a kiss.

You might also need to explain that a touch might be a good touch for one person, but the same touch might be a bad touch for someone else. For example, one person might like to be tickled (this is a good touch), whereas someone else might not enjoy being tickled (this is a bad touch). Or it's OK to kiss a close friend or family member hello if you see them in the street, but it's not OK to kiss a stranger hello.

Visual supports showing appropriate and inappropriate touching can help. Social Stories™ might also be useful. Here's an example of a Social Story™.

A Social Story™ about bad touch
Bad touch is something that makes me feel confused and uncomfortable.

Here are some examples of bad touch:

  • Someone who is not my boyfriend or girlfriend touches me in my private areas.
  • Someone hits me.
  • Someone touches me and makes me feel unsafe or uncomfortable.
  • Someone kisses me when I don't want them to.

It makes a difference who is giving me the touch:

  • Hugs, kisses and touches from people I know and love can be good touches.
  • The same touches from people I don't know and love can be bad touches.

Appropriate behaviour for teenagers with autism spectrum disorder

Because teenagers with autism spectrum disorder (ASD) might have trouble understanding social rules or people's words or body language, they can end up responding inappropriately. So they often need clear explanations of what is appropriate and what isn't.

For example, your child might call someone a lot when that person doesn't want to be called, or keep asking someone on a date when the person has already said no a few times. This might be because the other person has made an excuse, rather than saying, 'No I don't want to'. You could explain that if someone makes an excuse or says no three times, you don't ask again. You could turn this into a visual reminder sheet.

Personal boundaries for teenagers with autism spectrum disorder

Teaching your child with autism spectrum disorder (ASD) about personal boundaries will help him avoid embarrassing situations and also help prevent him from getting into risky situations.

A circle of friends activity can help. Your child is in the centre with circles around her. Family are closest and strangers furthest away. For example:

  • Family: these are the people who live at home with me.
  • Extended family: these are the people who are my family but don't live in my home with me. For example, my grandmother, grandfather, aunt, uncle and cousins.
  • Friends: a friend is someone I know very well. My friends care about me and I care about them too. I trust my friends and they trust me.
  • Acquaintances: there's a difference between being an acquaintance and a friend. An acquaintance is someone whose name I know and who I see every now and then. I might have something in common with acquaintances, and I feel comfortable around them. For example, this might be a friend of a family member.
  • Teachers: these are the people who stand in front of the class at school and teach me things.
  • Helpers: these are the people who help with things that I find difficult.
  • Servers: these are the people who work in shops, caf?s, restaurants or clothing stores. It is their job to serve customers like me.
  • Strangers: a stranger is someone I don't know. I don't know a stranger's name.

Talk with your child about who falls into each circle and discuss the behaviour that might be appropriate with each circle. For example, which people would it be OK to kiss or hug?

You could create an 'Is it all right to… ?' table. Use ticks and crosses to show what it's OK to do with different categories of people. Your child could have this in his room to look at whenever he wants to remind himself.

Masturbation and private places for teenagers with autism spectrum disorder

Masturbation is a natural activity for a child going through puberty.

You can let your child with autism spectrum disorder (ASD) know that masturbation is normal - but encourage her to masturbate only in a private place when she's alone. It might help to compare masturbating to other activities that your child does by herself in private, like having a shower or going to the toilet.

You might need to help your child recognise private places. A private place is where other people can't see you. You might also need to make a list of private places with pictures or photos.

Here's an example of a list of private places for your child:

  • the bedroom with the door and the curtains closed.
  • the toilet with the door closed.
  • the shower with the bathroom door closed.

You could also put a 'private' sign on the door of your child's private place in the house - for example, his bedroom. But do make sure that your child understands that if another room - for example, at school - says 'private' on it, it doesn't mean that it's a suitable place to masturbate.

You might also want to make a rule that people should knock on all bedroom doors before going in. Make sure that everyone who visits your home knows the rule.

You'll probably need to go over these messages many times with your child. Try to be patient with your child - and yourself. You might find it helpful to share experiences and get support from other parents. You could try online or face-to-face support groups.