Sexuality is a central component of socialization for all people and can play a major role in an individual’s overall self-identity and quality of life. Unfortunately, the discussion and promotion of this area of adaptive and social functioning in individuals with autism spectrum disorder (ASD) is often avoided. A number of myths regarding sexuality and people with ASD persist, such as:
However, individuals with autism are sexual beings, have the same hormones and urges as their typically developing peers, and are faced with the same choices regarding sexuality as their peers. For those reasons, individuals with ASD must receive education and training pertaining to sexuality issues, beginning in infancy and extending throughout their life span (Ailey et al., 2003).
The failure to develop healthy sexuality through appropriate sexuality education can put individuals with ASD at risk for sexual abuse and exploitation, AIDS and other sexually transmitted diseases (STDs), unplanned and unwanted pregnancies, and misinformation (Ailey et al., 2003; McDaniels & Fleming, 2016). Further, individuals may suffer from mental disorders, such as anxiety, depression, and adjustment disorder, as well as impaired self-esteem (Evans & Conine, 1985). Additionally, researchers have found that individuals with ASD were more likely than their neurotypical peers to engage in inappropriate courting behaviors; focus their attention on celebrities, strangers, colleagues, and former romantic partners; and stalk their target (Stokes, Newton, & Kaur, 2007).
There is a significant need for individualized, effective instruction for persons with ASD commensurate with each individual’s receptive and expressive abilities. Effective sexuality education is complicated for individuals with ASD by language and communication problems, as well as by social deficits associated with the disorder. Additionally, whereas other teens serve as a primary information source available to neurotypical teens, this is not typically the case for individuals with ASD. As a result, this population is not often taught information related to sexuality in school or by family and friends.
Three basic goals for sexuality instruction are providing accurate information, developing individual values, and teaching appropriate social relationship skills. General topics should include:
It is also important to discuss different types of relationships, such as friendships, romantic relationships, and family relationships, and how one acts in those various relationships.
Although the topics included in sexuality education for individuals with ASD may be very similar to those taught to their neurotypical peers, how this information is taught is likely to be quite different. Information should be delivered in a concrete, serious, calm, and supportive manner and repeated to ensure mastery of the material.
Parents and educators must think ahead and be proactive when teaching sexuality education. In order to ensure that sexuality education is most effective, adults should never wait until something inappropriate happens before teaching a specific skill. Communication and consistency are also important for successful sexuality education. An individual’s team (e.g., teachers, doctors, parents, therapists) should discuss strategies and progress to ensure consistency with language throughout the individual’s life, which can greatly impact the generalization of skills.
When taught proactively and effectively, sexuality education allows individuals with ASD to be safer, more independent, and more integrated into their own communities. Together, this results in a more positive quality of life for this population.
You are also welcome to contact Dr. Schulman at rschulman@behaviortherapyassociates.com or Dr. Gerhardt at PGerhardt@epicschool.org.
About the Authors
Peter F. Gerhardt, Ed.D., is the executive director of the EPIC School and the founding chairman of OAR’s Scientific Council. He has more than 30 years experience utilizing the principles of applied behavior analysis in support of individuals with ASD in educational, employment, residential, and community-based settings. Dr. Gerhardt is the author or the coauthor of many articles and book chapters on the needs of adolescents and adults with ASD and has presented nationally and internationally on this topic.
Rebecca Schulman, Psy.D., BCBA-D, is a postdoctoral fellow and board-certified behavior analyst at Behavior Therapy Associates. She has extensive experience providing individual, family, and group therapy. Dr. Schulman specializes in evidence-based treatments for children through adults presenting with developmental disabilities, disruptive behaviors, sleep problems, social skills deficits, anxiety disorders, past and present childhood sexual abuse, and sexual problem behaviors. Dr. Schulman also conducts diagnostic evaluations, psychological and psychoeducational evaluations, and functional behavior assessments.
A longer and more detailed version of this article was originally published in the Winter 2017 issue of “Autism Spectrum News” and is reprinted with permission. For more information, please visit www.mhnews-autism.org or contact dminot@mhnews.org.
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