The physical and emotional changes that occur in adolescence, known as puberty, are part of the process of growing into an adult. Although young people with autism follow the same physical development trajectory as their peers at puberty, the emotional changes and increasing sexual urges that accompany adolescence maybe delayed or prolonged (Sullivan and Caterino, 2008). This means that sometimes a young person with autism’s psychological and social maturity does not keep pace with their physical maturity irrespective of ability.
Teenagers with autism might need longer to understand that their bodies and feelings may change during puberty.
‘The sexual health experiences and needs of young people with learning disabilities are varied and complex and issues will vary from individual to individual. However, their sexuality is often ignored, stereotyped or distorted, which may lead to the development of low expectations about sexual relationships and impact on their self-esteem.’ (Douglas Scott, 2004)
Douglas-Scott, S (2004), ‘Sexuality and Learning Disability’. In Burtney, E and Duffy, M (eds), Young People and Sexual Health: individual, social and policy contexts, Basingstoke: Palgrave Macmillan
It may be best to start preparing teenagers with autism for puberty well in advance.
As a guide, teenagers usually start puberty between the ages of 8 and 14 years – although every child is different!
Strategies that may help prepare teenagers for puberty include:
- Prepare the teenager for all the changes ahead:
- Mood swings and hormones
- Body changes, physical growth and maturity (Lynne Moxon Preparing for Powerpoint)
- Improved physical skills and strength
- Need for more sleep
- Special Issues for Young People with Autism
- Emotions, friendships and strong sexual feelings
- It may be helpful to discuss puberty along with using visual strategies such as books, pictures, videos etc. e.g. see Puberty and menstruation for girls: https://www.youtube.com/watch?v=MF2Yn2KV4Og
- Remember that sometimes individuals with autism can interpret language literally, e.g. if you describe a boys voice as ‘breaking’, the teenager with autism might find this worrying. Instead you could say something like, ‘Your voice is changing and will get deeper’
- Use both the formal terms and the everyday words for body parts.
- An ‘All about me’ book can help teenagers see how they change over time. It could include pictures of the teenager now and when they were younger
- It is important to explain that boys and girls develop differently http://kc.vanderbilt.edu/healthybodies/files/HealthyBodies-Girls-web.pdf http://kc.vanderbilt.edu/healthybodies/files/HealthyBodiesAppendix-Girls.pdf http://kc.vanderbilt.edu/healthybodies/files/HealthyBodies-Boys-web.pdf http://kc.vanderbilt.edu/healthybodies/files/HealthyBodiesAppendix-Boys.pdf
- Reassure the teenager that all these changes are a natural part of growing up and they happen to everyone
- Social Stories™ regarding puberty may be helpful
- Mark Segar’s Coping, A Survival Guide for People with Asperger syndrome
- 10 Tips to Support Children with Autism through Puberty, Adolescence and Beyond By Davida Hartman
- Some books can be helpful, such as:
- What’s Happening to Tom: A book about puberty for boys and young men with autism and related conditions (Sexuality and Safety with Tom and Ellie) by Kate E Reynolds (2014) Jessica Kingsley Publishers, London, UK
- What’s Happening to Ellie: A book about puberty for girls and young women with autism and related conditions (Sexuality and Safety with Tom and Ellie) by Kate E Reynolds (2014) Jessica Kingsley Publishers, London, UK
- Things Tom Likes: A book about sexuality and masturbation for boys and young men with autism and related conditions ) by Kate E Reynolds (2015) Jessica Kingsley Publishers, London, UK
- Things Ellie Likes: A book about sexuality and masturbation for girls and young women with autism and related conditions ) by Kate E Reynolds (2015) Jessica Kingsley Publishers, London, UK
- Busy Bodies: A book about puberty for you and your parents, by The Health Promotion Department, HSE South (2008), HSE South
- Sexuality and Severe Autism: A practical guide for parents, caregivers and health educators, by Kate E Reynolds (2013) Jessica Kingsley Publishers, London, UK