News and Knowledge

Watching teenagers flirt can be cringe-inducing for any adult. But when the youth in question are on the spectrum, sometimes it can be all the more challenging to figure out whether—or how—to run interference.

Take the case of Nina,* a 15 year-old girl who joined a recreational program for youth with autism spectrum disorder (ASD). At her very first event, she felt attracted to a boy she met. She wanted Jason* to notice her, so she started cracking jokes about sex, playfully threatening to throw things at him, yelling loudly, overreacting to things he said, and trying to tickle him. Any teen might have tried these tactics, but the fact that Nina tried them all at once, right upon meeting Jason, and in the group activity setting was unusual.

What’s more, 20 minutes later, Nina and Jason were paired off, sitting alone at a table, rubbing each other’s legs, and touching. They stopped participating in the group activity and acted like they were in their own private world. None of the other kids noticed and the facilitators didn’t want Nina and Jason to feel like the recreational program wasn’t a safe space, so they didn’t interrupt or talk to them about it afterwards.

Two weeks later, at the next recreational event, Nina wrote a suggestive note to Jason that included specific instructions to “text me but do not call me.” The adult facilitators intercepted the note before it got to Jason, but they were left wondering: is there something more that we could offer the youth in our program to help them become more skilled at flirting, respecting boundaries, and dating successfully?

Working in residential and clinical settings with youth with ASD, we have observed that teenagers often have the desire to date but not necessarily the skills to make it work. We have heard older teenagers and young adults who have a limited number of peer relationships express an interest in dating, marrying, and having kids, but they cannot see a clear pathway to making those things happen for themselves. We have seen some youth try online dating but not be able to get past the first date because they did not know how much or what to share about themselves and at what point in the relationship.

Some end up feeling depressed when it does not work out, and blame themselves. In other cases, when relationships do get past the first date, we have seen youth start calling their partner multiple times a day, expecting immediate return calls, and not understanding how to give the other person space. There are also times when adolescents with ASD enjoy being on the receiving end of romantic attention—but quickly become confused when the person pursuing them touches them inappropriately, harasses them, or stalks them—and the adolescent with ASD is left unsure if they should tell someone else about it, get help, or continue the relationship. 

There is a dearth of information about when, how, and who should teach healthy relationship skills to youth with ASD. Schools, parents, therapists, youth program facilitators, and medical providers could all play a role and they could all work together. There is sometimes an assumption that youth with ASD may be less interested in dating or sex, or more likely to be asexual, than neurotypical youth. But a substantial percentage of youth with ASD do have romantic interests, want to date, and want to be successful in intimate partnerships.

Talking with adolescents about romance and relationships, from the pleasures of love to the potential dangers and safety concerns, can be hard in any situation. That is why psychologists and research experts have worked to create evidence-based programs on healthy dating including Safe Dates, Safe Dates for Families, the Fourth R, Shifting Boundaries, and others.

While these school-based, didactic programs appear to have a positive effective for general populations of youth, there are too few options for adults who want to educate youth with ASD about healthy dating—including some of the unique stressors that they might face. Issues including whether and when to disclose one’s ASD status, liking or not liking certain types of tactile sensations (i.e., touch), interpreting signals of mutual attraction, and perspective-taking during conflicts all may need to be talked about explicitly.

While any adolescent is capable of becoming too intensely focused on a crush, youth with ASD may be particularly susceptible to learning romantic or sexual behaviors from television, movies, or pornography; taking what they see literally; and using the language as a script for actual encounters. What works on a television show or even in most romantic-comedy movies may be misconstrued as harassment or stalking when used in real life.

Nobody is born knowing how to have a healthy dating relationship. Flirting, dating, and even the social skills involved in hooking up for casual sexual encounters are all learned behaviors. Youth with autism often need help with relationships across the continuum from being an acquaintance to being a long-term partner. Thanks to a grant from OAR, our research team is now developing and pilot-testing a new healthy dating curriculum for teenagers with ASD ages 15-19 years old. We are excited to hear from youth, parents, and professionals with an interest in this topic and are eager to share what we learn during the development and testing process. 

*Names have been changed to protect privacy.

Emily Rothman, Sc.D., is professor of community health science at the Boston University School of Public Health, and co-director of the Violence Prevention Research Unit.

Megan Bair-Merritt, M.D., MSCE, is an associate professor of pediatrics at Boston University School of Medicine and associate division chief of general pediatrics.

Sarabeth Broder-Fingert, M.D., M.P.H., is an assistant professor at Boston University School of Medicine with more 10 years of experience working with and studying the health and wellbeing of individuals with ASD.

Shari Krauss, M.A., M.P.H., is the Program Director for Boston Medical Center’s Autism Program and has an extensive background supporting individuals with ASD and their families in home, school, community and health care settings.