The Optimus blog

The blog that inspires leaders in the UK education sector

The Optimus blog

The blog that inspires leaders in the UK education sector

Gareth D Morewood

Autism and sexual health: need it be a challenge?

Understanding sexuality and relationships can one of the most challenging areas for a young person with ASC. Here are some resources to support a proactive approach.

In my last post, I suggested some ‘go-to’ books for a SENCO’s autism reading list. One book I chose is the Independent Woman's Handbook for Super Safe Living on the Autistic Spectrum by Robyn Steward, an important text for discussing young women’s safety and self-awareness.

This prompted me to think more about relationships and sexuality, an important area that often proves challenging for SENCOs, parents and carers as well as young people themselves. 

As ever, a good strategy developed from specific SEND research is a good strategy for all. Even though the evidence in the post is mostly autism-specific, it should also assist colleagues, parents and carers in responding to wider challenges.

Inappropriate behaviour

This is an area that has garnered much attention. Through inappropriate sexualised behaviour, young people with autism risk becoming caught in the criminal justice system.

A better understanding of the impact autism can have would allow those working within the system to take a more pro-active, preventative approach to reduce unnecessary convictions.

Recent research (Brown, et al, 2016) indicates that social skills deficits, developmental functioning, obsessive behaviours, normative sexual development and victimisation are the most prominent additional challenges that young people with autism face.

While the authors recognise that further work is needed to form a more complete understanding of these specific difficulties, they do suggest that parents, carers and professionals should work to help young people with autism understand their own physical, emotional and sexual development. This should include information on appropriate behaviour between friends and those in closer relationships.

Menstrual care and girls

Experts emphasise the need for all young people, including those with autism, to be taught how to care for their bodies and express their sexual selves appropriately (Klett et al, 2012). In today’s digital world this has become increasingly complex.

Given that puberty and menstruation are critical development milestones for young women, further research must evaluate the effectiveness of interventions we put in place to prepare young women for these changes, and encourage independent self-care.

The aim of the Klett (2012) study was to fill gaps in the existing literature by using social stories to explicitly teach young females with autism the basic concepts of menstruation and puberty. However, the researchers concluded that further work is needed.

In isolation, social stories with visual elements were found to be an effective way of teaching self-care skills. Parents and carers were also satisfied that the stories could be personalised to their child’s needs, and support regular interaction of mother and daughter.

Social stories are used to teach particular social skills, such as:

  • identifying important cues in a social situation
  • understanding another person's point of view
  • understanding rules, routines, situations, upcoming events or abstract concepts
  • understanding expectations.

SRE and sexual health

The World Health Organisation (WHO) states that sex is an important element in quality of life and sexuality is vital to being human. Individuals with ASC present with quite specific sexuality educational needs but these tend not to be adequately addressed in the scope of current educational programmes. As SENCOs will know, other needs can also go unaddressed.

Research by Loftin, R. L. and Hartlage, S. (2015) focused on seven areas identified by the WHO.

  1. Physical wellbeing in relation to sexuality.
  2. Emotional and mental wellbeing in relation to sexuality.
  3. Social wellbeing in relation to sexuality.
  4. Disease, dysfunction or infirmity.
  5. A positive and respectful approach to sexuality and sexual relationships.
  6. Freedom from coercion or violence.
  7. Freedom from discrimination.

The outcomes of their study identified that sexual education for individuals with ASC is valuable and warranted to improve the sexual health of those individuals.

Promoting positive sexual health for young people has economic and societal benefits, such as a reduced risk of unplanned pregnancy or long-term medical difficulties.

The wider public, and especially those members of the community who engage with young people, need more information on the sexual risks our more vulnerable learners face.

Implications for schools

This can be an exceptionally difficult topic for school staff, parents and young people alike. However, there are some fantastic resources out there. I hope that, by highlighting some of these, this post will help you to support young people and their families.

For colleagues, my initial suggestion would be to explore some of the materials highlighted below and consider how you could develop your school’s existing curriculum. Can the curriculum better support young people with sexual health and relationships? Can you raise broader awareness elsewhere?

Talking about this now will allow you to start making a difference. Don't do nothing! 

References

Brown, J., Anderson, G., Cooney-Koss, L., Hastings, B., Pickett, H., Neal, D., Martindale, J., Dodson, K. and Barfknecht, L.,  'Autism Spectrum Disorder and Sexually Inappropriate Behaviors: An Introduction for Caregivers and Professionals', Journal of Special Population 1/1 (2016). 

Klett, L. S. and Turan, Y., 'Generalized Effects of Social Stories with Task Analysis for Teaching Menstrual Care to Three Young Girls with Autism', Sexuality and Disability, 30 (2012), pp. 319-336.

Loftin, R. L. and Hartlage, S, 'Sex Education, Sexual Health, and Autism Spectrum Disorder', Paediatrics & Therapeutics, 5/1 (2015), pp. 230-235.

Further reading

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