Abstract
Physical and emotional changes occurring during adolescence can present serious challenges to individuals with autism spectrum disorder (ASD). Social skills deficits may become more pronounced and the awakening of sexual urges and behaviors may not be understood by youth with ASD and their families. Mental health providers can help to address these changes, primarily in the area of sexuality education. However the extant literature on ASD and sexuality is limited. This article highlights issues inherent in the sexuality education of adolescents with ASD, and presents three methods for intervention: Applied Behavior Analysis, Social Stories, and Social Behavior Mapping. Examples of each intervention are provided to promote collaboration among clinicians, families and adolescents with ASD to address sexuality and to ensure adequate preparation for transition to adulthood.
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Notes
The term “mental health providers/professionals” will be used in this article to refer to psychologists, social workers, behavior specialists, and related professionals concerned with the mental health of adolescents with ASD.
References
Ballan, M.S.: Parental perspectives of communication about sexuality in families of children with Autism Spectrum Disorders. J. Autism Dev. Disord. 42(5), 676–684 (2012)
Travers, J., Tincani, M.: Sexuality education for individuals with autism spectrum disorders: critical issues and decision making guidelines. Educ. Train. Dev. Disabil. 45(2), 284–293 (2010)
Dewinter, J., Vermeiren, R., Vanwesenbeeck, I., Nieuwenhuizen, C.: Autism and normative sexual development: a narrative review. J. Clin. Nurs. 22(23–24), 3467–3483 (2013)
Sullivan, A., Caterino, L.C.: Addressing the sexuality and sex education of individuals with autism spectrum disorders. Educ. Treat. Child. 31(3), 381–394 (2008)
Hellemans, H., Roeyers, H., Leplae, W., Dewaele, T., Deboutte, D.: Sexual behavior in male adolescents and young adults with autism spectrum disorder and borderline/mild mental retardation. Sex. Disabil. 28(2), 93–104 (2010)
Gougeon, N.A.: Sexuality and autism: a critical review of selected literature using a social-relational model of disability. Am. J. Sex. Educ. 5(4), 328–361 (2010)
Stokes, M.A., Newton, N., Kaur, A.: Stalking, and social and romantic functioning among adolescents and adults with autism spectrum disorder. J. Aut. Dev. Disord. 37(10), 1969–1986 (2007)
Gougeon, N.: Sexuality education for students with intellectual disabilities, a critical pedagogical approach: outing the ignored curriculum. J. Sex. Educ. 9(3), 277–291 (2009)
Mehzabin, P., Stokes, M.A.: Self-assessed sexuality in young adults with high-functioning autism. Res. Aut. Spectr. Disord. 5, 614–621 (2011)
McDaniels, M., Fleming, A.: Sexuality education and intellectual disability: time to address the challenge. Sex. Disabil. 34(2), 215–225 (2016)
Blakely-Smith, A., Nichols, S.: “I’m not sure we’re ready for this…”: working with families toward facilitating healthy sexuality for individuals with autism spectrum disorders. Soc. Work Ment. Health 8(1), 72–91 (2010)
Tarnai, B.: Review of effective interventions for socially inappropriate masturbation in persons with cognitive disabilities. Sex. Disabil. 24(3), 151–168 (2006)
Lee, H.J.: Cultural factors related to the hidden curriculum for students with autism and related disabilities. Interv. Sch. Clin. 46(3), 141–149 (2011)
Dekker, L.P., van der Vegt, E.J., Visser, K., Tick, N., Boudesteijn, F., Verhulst, F.C., Maras, A., Greaves-Lord, K.: Improving psychosexual knowledge in adolescents with autism spectrum disorder: pilot of the tackling teenage training program. J. Aut. Dev. Disord. 45(6), 1532–1540 (2015)
Committee on Children with Disabilities: Sexuality education of children and adolescents with developmental disabilities. Pediatrics 97(2), 275–278 (1996)
Ginevra, M.C., Nota, L., Stokes, M.A.: The differential effects of Autism and Down’s syndrome on sexual behavior. Aut. Res. 9(1), 131–140 (2016)
Hartman, D.: Sexuality and Relationship Education for Children and Adolescents with Autism Spectrum Disorders: a Professional’s Guide to Understanding, Preventing Issues, Supporting Sexuality and Responding to Inappropriate Behaviors. Jessica Kingsley Publishers, London (2013)
Gabriels, R.L., Van Bourgondien, M.E.: Sexuality and autism: Individual, family, and community perspectives and interventions. In: Gabriels, R.L., Hills, D.E. (eds.) Growing up with autism: working with school-age children and adolescents, pp. 58–72. Guilford, New York (2007)
Travers, J.C., Schaefer Whitby, P.: Sexuality and relationships for individuals with autism spectrum disorders. In: Tincani, M., Bondy, A. (eds.) Autism spectrum disorders in adolescents and adults: evidence-based and promising interventions, pp. 182–207. Guilford, New York (2014)
Tepper, M.S.: Becoming sexually able: education to help youth with disabilities. Siecus Rep. 29(3), 5–13 (2001)
Van Bourgondien, M.E., Reichle, N.C., Palmer, A.: Sexual behavior in adults with autism. J. Aut. Dev. Disord. 27(2), 113–125 (1997)
Billstedt, E., Gillberg, C., Gillberg, C.: Autism after adolescence: population-based 13- to 22-year follow-up study of 120 individuals with autism diagnosed in childhood. J. Aut. Dev. Disord. 35(3), 351–360 (2005)
Lawson, W.J.: Sex, Sexuality, and the Autism Spectrum. Jessica Kingsley Publishers, London (2004)
Stokes, M.A., Kaur, A.: High functioning autism and sexuality. Autism 9(3), 266–289 (2005)
Kalyva, E.: Teachers’ perspectives of the sexuality of children with autism spectrum disorders. Res. Aut. Spect. Disord. 4(3), 433–437 (2010)
Ray, F., Marks, C., Bray-Garretson, H.: Challenges to treating adolescents with Asperger’s syndrome who are sexually abusive. Sex. Addict. Compuls. 11(4), 265–285 (2004)
Mandell, D.S., Walrath, C.M., Manteuffel, B., Sgro, G., Pinto-Martin, J.A.: The prevalence and correlates of abuse among children with autism in comprehensive community-based mental health settings. Child Abuse Negl. 29(12), 1359–1372 (2005)
Edelson, M.G.: Sexual abuse of children with autism: factors that increase risk and interfere with recognition of abuse. Disabil. Stud. Q. 30(1) (2010). doi:10.18061/dsq.v30i1.1058
Adams, W.V., Sheslow, D.V.: A developmental perspective of adolescence. In: Schopler, E., Mesibov, G. (eds.) High-functioning individuals with autism, pp. 11–36. Plenum Press, New York (1992)
Tullis, C.A., Zangrillo, A.N.: Sexuality education for adolescents and adults with autism spectrum disorders. Psychol. Sch. 50(9), 866–875 (2013)
Henault, I.: The sexuality of adolescents with Asperger syndrome. In: Willey, L.H. (ed.) Asperger syndrome in adolescents: living with the ups, the downs and things in between, pp. 69–97. Jessica Kingsley, London (2003)
Wallis, P.J.: Issues in social sexuality for people with disabilities, their families, and professionals. In: Fine, M.J., Simpson, R.L. (eds.) Collaboration with parents and families of children and youth with exceptionalities, pp. 391–407. Pro-Ed, Austin (2000)
Tissot, C.: Establishing a sexual identity: case studies of learners with autism and learning difficulties. Autism 13(6), 551–566 (2009)
Ballan, M.S., Hoban, K.S.: Effective interventions for students with autism and Asperger’s Syndrome. In: Franklin, C., Harris, M.B., Allen-Meares, P. (eds.) The school services sourcebook: a guide for school-based professionals, pp. 147–163. Oxford University Press, New York (2006)
Choutka, C.M., Doloughtry, P.T., Zirkel, P.A.: The “discrete trials” of applied behavior analysis for children with autism: outcome-related factors in the case law. J. Spec. Educ. 38(2), 95–103 (2004)
Roane, H.S., Fisher, W.W., Carr, J.E.: Applied behavior analysis as treatment for autism spectrum disorder. J. Pediatr. 175, 27–32 (2016)
Fyffe, C.E., Kahng, S.W., Fittro, E., Russell, D.: Functional analysis and treatment of inappropriate sexual behavior. J. Appl. Behav. Anal. 37(3), 401–404 (2004)
Gerhardt, P.: Sexuality and sexuality instruction with learners with autism spectrum disorders and other developmental disabilities. https://www.gvsu.edu/cms4/asset/64CB422A-ED08-43F0-F795CA9DE364B6BE/gerhardt_sexuality_ppt.pdf. Accessed 13 July 2016
Wolfe, P.S., Condo, B., Hardaway, E.: Sociosexuality education for persons with Autism Spectrum Disorders using applied behavior analysis. Except. Child. 42(1), 50–61 (2009)
National Autism Center: Findings and conclusions: national standards project, phase 2. Author, Randolph (2015)
U.S. Department of Health and Human Services: Mental Health: A Report of the Surgeon General. Author, Rockville (1999)
Haracopos, D., Pedersen, L.: Sexuality and autism: a nationwide survey in Denmark. http://www.autismuk.com/autism/sexuality-and-autism/sexuality-and-autism-danish-report/. Accessed 13 July 2016
Ousley, O.Y., Mesibov, G.B.: Sexual attitudes and knowledge of high-functioning adolescents and adults with autism. J. Aut. Dev. Disord. 21(4), 471–481 (1991)
Hellemans, H., Colson, K., Verbraeken, C., Vermeiren, R., Deboutte, D.: Sexual behavior in high-functioning male adolescents and young adults with autism spectrum disorder. J. Aut. Dev. Disord. 37(2), 260–269 (2007)
Gray, C.A., Garand, J.D.: Social stories: improving responses of students with autism spectrum disorders using social stories. Focus Aut. Behav. 8(1), 1–10 (1993)
Spencer, V.G., Simpson, C.G., Lynch, S.A.: Using social stories to increase positive behaviors for children with autism spectrum disorders. Interv. Sch. Clin. 44(1), 58–61 (2008)
Schneider, N., Goldstein, H.: Using social stories and visual schedules to improve socially appropriate behaviors in children with autism. J. Posit. Behav. Interv. 12(3), 149–160 (2010)
Tarnai, B., Wolfe, P.S.: Social stories for sexuality education for persons with autism/pervasive developmental disorder. Sex. Disabil. 26(1), 29–36 (2008)
Ali, S., Frederickson, N.: Investigating the evidence base of social stories. Educ. Psychol. Pract. 22(4), 355–377 (2006)
Henault, I.: Asperger’s syndrome and sexuality: from adolescence through adulthood. Jessica Kingsley, London (2006)
Rodgers, J., Lipscombe, J., Santer, M.: Menstrual problems experienced by women with learning disabilities. J. Appl. Res. Intellect. 19, 364–373 (2006)
Burke, L.M., Kalpakijian, C.Z., Smith, Y.R., Quint, E.H.: Gynecologic issues of adolescents with down syndrome, autism, and cerebral palsy. J. Pediatr. Adolsc. Gynecol. 23, 11–15 (2010)
Koegel, L.K., LaZebnik, C.: Growing up on the spectrum: a guide to life, love, and learning for teens and young adults with autism and Asperger’s. Penguin, New York (2009)
Winner, M.G. (ed.): Social Behavior Mapping: Connecting Behavior, Emotions and Consequences Across the Day. Think Social, San Jose (2007)
Kincade, S.R., McBride, D.L.: CBT and autism spectrum disorders: a comprehensive literature review. http://eric.ed.gov/?id=ED506298. Accessed 13 July 2016
Crooke, P.J., Hendrix, R.E., Rachman, J.Y.: Brief report: measuring the effectiveness of teaching social thinking to children with Asperger syndrome and high functioning autism. J. Aut. Dev. Disord. 38(3), 581–591 (2008)
Winner, M.G.: A politically incorrect look at evidence-based practices and teaching social skills: a literature review and discussion. Think Social, San Jose (2008)
Kohn, Y., Fahum, T., Ratzoni, G., Apter, A.: Aggression and sexual offense in Asperger’s syndrome. Isr. J. Psychiatr. 35(4), 293–299 (1998)
The Gray Center (Producer): Social behavior mapping [DVD]. www.TheGrayCenter.org (2007)
Prelock, P.A., Vargas, C.M.: The role of partnerships in program development for adolescents with autism spectrum disorders. In: Vargas, C.M., Prelock, P.A. (eds.) Caring for children with neurodevelopmental disabilities and their families, pp. 275–300. Lawrence Erlbaum Associates, Mahwah (2004)
Travers, J., Tincani, M., Whitby, P.S., Boutot, E.A.: Alignment of sexuality education with self determination for people with significant disabilities: a review of research and future directions. Educ. Train. Dev. Disabil. 49(2), 232–247 (2014)
Hatton, S., Tector, A.: Sexuality and relationship education for young people with autism spectrum disorder: curriculum change and staff support. Brit. J. Spec. Educ. 37(2), 69–76 (2010)
Cridland, E.K., Jones, S.C., Caputi, P., Magee, C.A.: Being a girl in a boys’ world: investigating the experiences of girls with autism spectrum disorders during adolescence. J. Aut. Dev. Disord. 44(6), 1261–1274 (2014)
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This research was supported by a Grant from the Organization for Autism Research awarded to Michelle S. Ballan.
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Ballan, M.S., Freyer, M.B. Autism Spectrum Disorder, Adolescence, and Sexuality Education: Suggested Interventions for Mental Health Professionals. Sex Disabil 35, 261–273 (2017). https://doi.org/10.1007/s11195-017-9477-9
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DOI: https://doi.org/10.1007/s11195-017-9477-9