Sex?
Lawrence Sutton, Ph.D. and Claire Maher Choutka, M.Ed., BCBA
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Objectives
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Typical development
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Specifics for ASD
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Issues when sexual development is not addressed
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Case studies
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Psychosexual development
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Teaching resources/programs
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Questions?
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Friends are nice You have to do what
I say!
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Typical children learn good touch/bad touch in
Kindergarten.
They are taught no one but mom, dad, doctor, or nurse touches you where your swimsuit covers.
You don’t touch others in those places.
If a touch feels funny, strange, or uncomfortable, tell someone in charge.
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Often praise statements are accompanied by tickles, hugs, big squeezes, etc.
By school age these are inappropriate in a school setting.
Typical peers are not being tickled by staff-- it sets the child up for a problem—allows more people to put hands on him/her, and potentially starts “feelings”.
How will they know who is allowed to tickle them and who not? They should not be asking adults for hugs, squeezes, tickles; it’s a slippery slope.
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We are thrilled when they spontaneously show affection.
We rejoice that they understand others exist in their world.
We need to teach our children how to read the signs others give, that a hug to staff would be better as a hand shake or smile.
That you ask a girl, “May I kiss you?, touch you?”, etc.
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Starts with “playing doctor” with little sister.
On vacation in the south friends set Jimmy up with a date. They tell him what girls “expect.”
Girl and parents freak out and do not press charges. His parents seek a “sex therapist” to help.
At home local girl who once had crush on him becomes object of his fascination—includes stalking, following, staring, and she cries rape.
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She later recants & both families agreed Jimmy disregarded conventional social boundaries,
But never involved in anything overtly sexual with Jen; no intercourse, exposure, or touches.
Jimmy was then home schooled full time.
Next summer in the South- met a 17 yr old who shows him lots of video porn and porn mags.
Jimmy told me, “Now I know what sex is”, now
“I know what to expect” from a girl.
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Sadly, this story is not that unusual.
Every week we get calls about young men masturbating in school, in the boys room with female aides trying to straighten out the situation.
When the exposure occurs in front of other students, now it’s really problematic and police are often called.
This gets a young man a ticket to the YDC.
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Reality is even with a developmental delay the biology moves onward. As the child grows…
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Bodies change.
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Adolescence begins at 8 for girls 10 for boys.
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Medications may increase or decrease sexual urges.
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Regardless, the children need to be taught what to do.
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Bodies react; biology marches on in spite of cognitive delays or social skills issues.
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They need to know who to hug, kiss, approach about dating
They need to know when to do this.
They need to know how to ask for a date, a kiss, more…
What rules does the family have for their neuro-typical children?
Who will do the coaching?
How do you address problems? Think Cyrano de
Bergerac
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From friendship to dating, to relationship, to sex?
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What are the boundaries? How do you teach that?
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How do you keep your child safe from predators and from him/herself?
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Remember, with frustration comes increased possibility of aggression.
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Is SEX a Four letter Word? Does it need to be?
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Supposed to be an expression of love and deep regard between two people?
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Even adolescents and young adults with ASD that can discuss their feelings have discussions of sex accompanied by fear and anxiety, surprises, and sometimes ugliness?
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Adolescents with ASD are sometimes convinced or coerced/duped by peers to commit criminal offenses and then are left to face the consequences of the
“criminal act” by themselves.
Teach this young. Use sample worksheets, role plays.
“Teach Me Language” by
Freeman, has a format.
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In data from treatment facilities for sexually related crimes, children and adolescents with
ASD may have been the victim of a sexual assault and may be re-enacting a sexual act on someone else the way they were
“taught”.
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To learn need to see appropriate models of behavior
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Typical situations and peers to practice skills in vivo in order to change what may be really, downright challenging behavior.
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Often individuals now in “difficulty” learned about sex by being sexually assaulted as children.
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Often by loved ones or by important authority figures in their lives.
Despite the fact that the sex may have hurt they perceive the acts in a concrete and matter-of-fact way—as in this is what a person does to someone else—very matter of factly, to meet sexual needs.
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Learning a treatment program “inside” does not mean that the skills will generalize and transfer.
“Tom” has said “I don’t know that I will not go out and sexually offend.” if placed in a situation where he is attracted to someone and denied access.
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Children with autism are now entering the criminal justice system in surprising and yet unknown numbers. In an unpublished account at the New Castle Youth Development Center in
May, 2005 it was estimated that 40% of the adolescents in the sexual offenders unit had an autism spectrum disorder.
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Child with ASD will meet “new friends” who explain that it is ok to do something to a girl or another boy.
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Or meet a peer who may site a popular television program as an authority –Rick meets
Courtney at the start of a 30 minute sitcom and by the end of the program, they are lovers in bed together.
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Black and white thinking –also concrete thinking in the way they interpret things. If for example one is told that if they have a problem it is important to go to a person in authority to get help with the problem.
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What happens if the authority does not help?
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What might happen to that child/adolescent?
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Combine significant deficits in social skills
Rage over bullying, inability to understand or control many things
Inappropriate information about sex/boy-girl relationships
No peer group to use to find out information
They go on incorrect/ half-correct info
No sleepovers a friends home to gain info, no sleepover camp, sometimes no bus ride which is where many learn about sex.
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Bobby was being bullied by peers.
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Brought a knife to school to “show he was not to be messed with” that day.
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Rethought it and went immediately to the guidance counselor to tell her of his troubles.
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Counselor then called the principal and the police—zero tolerance rules—or does it?
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An additional problem exists with scripted and canned programs when attempting to rehabilitate adolescent sexual offenders is that many of these individuals are concrete thinkers.
Once taught that what they did was something they should not have done (not necessarily wrong), then in some cases it is “all or none”.
Robbie is a young man who “learned that sexual thoughts, interest or even attraction to someone in a sexual way is wrong.
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David – Lacks the Social Sense to LIE
Rocky – Institutional Stress and Biting (self and others)
Robbie - concrete understanding leads to concrete thinking and self-mutilation
Bobby – The Thought Police – Coping with
Bullying and Sexual fantasies
Jimmy – you can see the problem coming, but can’t stop it ( sexual urges leading to sexual abuse )
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Asperger’s Syndrome – senior project
Understand his touching, exposing and attack of mother
Concrete thinking which requires real-life modeling to develop new methods to courtship
ACT 21
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Eventual Arrest
Treatment
Now
Fear of not “testing” prior to potential
Discharge
Lack of the “Social
Sense” to Lie
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History of institutionalization
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ASD issues with rigidity, black and white thinking, social skills problems
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Experienced stress and perception of attack
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Lacks the language to communicate issues
self & others leading to more charges and more time, and more biting and the
Chewing Gum Solution used at YDS
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Staring
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Touching others
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Smelling someone
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Looking different (stimming)
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Missing social cues
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Misinterpreting social cues
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Becoming seduced by the dark side (designing other’s)
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Psycho-sexual skill development and problematic Sexual Behaviors
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Courtship
Touching
Staring
Obsessing- blind infatuations
Wishful thinking
Understanding wants and needs
Love and Friendship
Sexual emotions and adolescence
Communication and
Sexuality
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Psycho-sexual skill development and problematic Sexual Behaviors
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Love and Friendship
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What is a friend? Not just someone in your class.
What is a close friend? To whom do you tell your secrets?
How does friendship turn into love?
Are the rules different for being a friend than for being in love?
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These are taught in Circles Curriculum
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Psycho-sexual skill development and problematic Sexual Behaviors
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Sexual Emotions and
Adolescence
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Sexual Emotions and
Hormones
Sexual needs and desires
Labiality of sexual emotions
Sexual Response Cycle--
Henault book
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Healthy sexual encounters; what do they look like?
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Psycho-sexual skill development and problematic Sexual Behaviors
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Communication and
Sexuality?
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Communication and Honesty between partners
What does “no” really mean?
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Between friends
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When in courtship
When married
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Saying what it is you want to say
Saying what you really mean without offending
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Models for intervention, education and treatment
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It’s Perfectly Normal
Taking Care of Myself
Circles Curriculum
Asperger’s Syndrome and
Sexuality
Positive Approaches
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ASD and Sexual
Education
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Educational-based
Parental-based
Video-based
Should be:
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Peer referenced
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Systematic
Need comprehension checks
Practiced skills
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It’s Perfectly Normal, Robbie Harris
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Sexual Education
A. Sex – defined
B. Our Bodies
C. Puberty- puberty problems --masturbation
D. Relationships
E.- SEX
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How babies are made
Feelings and Love
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Taking Care of Myself, Mary Wrobel
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Self Care – Taking care of myself
A. Hygiene
B. Living Healthy
C. Modesty
D. Touching
E. Masturbation
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Taking Care of Myself, Mary Wrobel
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Basics of self-care
Erections- how to deal with these (before and after puberty)?
Masturbation- where? Only in person’s own bedroom or bathroom
Touching myself- only in private
Male and female masturbation- in private
Appliances
Human rights issues- cannot deny a person sexual expression or tell them “first work; then sex”
Clean-up
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Hand Made Love: A Guide For
Teaching About Male Masturbation
By Dave Hingsburger
Book and video set discusses privacy, pleasure and the realities of sharing living spaces with others.
The narrator of the video talks about myths and suggests that masturbation can be a way of learning about sex, while the book discusses masturbation from the point of view of both health and pleasure.
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Finger Tips: A guide for teaching about female masturbation
By Dave Hingsburger and Sandra
Haar
Book and video set is aimed at teaching women with developmental disabilities about masturbation.
Confronts typical myths about female sexuality. A gentle, positive film that is clear, graphic and dignified.
The book includes a step by step photographic essay about masturbation, and the joy of private time.
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http://www.stanfield.com/sexed.html#B
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Not autism specific but very visual.
Videos show dating situations and work through teaching skills
Part I: Social Distance- 11 video programs students "see" social and sexual distance. It explains the levels of intimacy & TOUCH, TALK to and
TRUST. Teaches "relationship boundaries" and relationship specific behaviors, i.e., it's okay to hug your mother, it's not okay to hug the mailman, or a stranger at the mall.
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Part 2: Relationship Building, six video programs demonstrate how intimacy levels change as relationships change. The role of mutual choice among individuals is emphasized, a critical concept for protecting students from exploitation.
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Authors- Leslie Walker-Hirsch, MED
Marklyn P. Champagne, RN MSW
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We need to break down the steps to appropriate sexual behavior and think about it from the moment the child enters Kindergarten.
If you would not allow the behavior in a typical child do not allow it in a child with ASD.
Be careful of “inappropriate” touching/behaviors. Teach another way to get the need met, high five, praise, teach the sexual bits early.
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Erections – be prepared to respond to children who have discovered/experienced erections for the first time at home, in school, in public places and have a plan on how to respond before and after puberty.
Masturbation in school will get you arrested. Make it more difficult for the person- use pants with a belt; teach where it’s allowed- not the bathroom—the bathroom in their home.
Inappropriate comments to another will get you a harassment charge- teach what to say and what to keep in your head.
Teach and prepare for relationships. As with everything else with our children it won’t happen quickly.
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