The following is an excerpt from the author’s writings and is printed with permission

By:  Susan Johnston Copyright © 2004. All Rights Reserved.

Part I – Birth to Age Three

A child is born and the journey begins. Parents await the birth of their new son or daughter with joy and excited anticipation, dreaming of their child’s future. Sexuality is often the last thing a parent thinks about as they gaze into their newborns eyes, however as is so eloquently stated in the following quote, sexuality encompasses all aspects of being human.

"Sexuality is an integral part of the personality of everyone: man, woman and child. It is a basic need and an aspect of being human that cannot be separated from other aspects of human life. Sexuality is not synonymous with sexual intercourse, it is not about whether we have orgasms or not, and it is not the sum total of our erotic lives. These may be part of our sexuality, but equally they may not. Sexuality is so much more: it is in the energy that motivates us to find love, contact, feel warmth, and intimacy. It is expressed in the way we feel, move, touch and are touched; it is about being sensual as well as sexual. Sexuality influences thoughts, feelings, actions and interactions and thereby our mental and physical health." (Langfeldt & Porter, 1986, p5)

When a family receives a diagnosis of Autism for their child they may deal with this information in a variety of ways; many experience grief, anger, disappointment, and confusion. The last thing that they are thinking about is sexuality, much less how or where to begin introducing this topic.

Individuals with an Autism Spectrum Disorder have very specific learning styles and needs related to processing and integrating relevant information. It is important to understand their learning styles in order to successfully teach positive proactive strategies for social interactions. For the most part individuals with ASD are literal, visual, concrete learners who experience difficulties related to transitions and the generalization of skills.

The first step as a parent is to think of your child, in your mind’s eye, as an adult (no matter what age they are at this time).  What does that look like? What skills will they need to have in order to live a fulfilled life? How will these skills be taught?  This process is referred to as “Forward Thinking”. The next step is to plan a systematic course of action to achieve these goals; which is referred to as “Backward Planning” These are important concepts to keep in mind when addressing the social/sexual needs of your child. Plan to introduce social understanding skills at least 2-4 years prior to your child requiring them. 

This article provides social/sexually relevant information for developing appropriate routines from birth to approximately age three (about the age a child might attend preschool and be introduced to a variety of people outside of their family). Discussing information related to sexuality may be uncomfortable in the beginning but, the more you engage in a concrete and systematic approach related to this topic, the more relaxed you will become.

Many individuals with an ASD experience challenges related to sensory processing, it is recommended that you consult with an Occupational Therapist to assist with any sensory related strategies.

Safety first, individuals with an ASD often have difficulty with the generalization of skills, they thrive on predictability and routines. Establishing very clear guidelines of what is socially and morally acceptable will assist the child in their understanding of a very complex life journey.

1. Use visual cues to assist your child in their understanding of their body and the social concepts being       discussed, even if they are very young.
2. Use correct terminology when discussing body parts; such as eyes, arms, legs, penis or vagina etc.
3. Keep statements short and to the point, allowing at least 10 seconds for your child to process and integrate information before repeating the statement.
4. Read and look at body books, discussing the different body parts in context. It is difficult to know what your child may be focusing on. One strategy might be to create an “All About Me” book using photos of your child incorporating simple concrete descriptive sentences.
5. Because of the difficulties related to the generalization of the specific privacy skills that they will be required to know and understand, it is important to decide when and where you are going to talk about private body information. These discussions should take place in a location that is natural and appropriate to the context, such as during bath time when it is acceptable for your child to be naked, or in the bedroom when changing your child for bed. Another location to discuss private body issues is in a doctor’s examining room. This strategy will be important as the child grows and more explicit social/sexual issues will need to be addressed.
6. Teach your child what parts of their bodies are private (i.e. anything that would be covered by a t-shirt and shorts – this applies to males or females).
   
7. Whenever possible ensure that your child is wearing clothing during the day even while in the privacy of their own home. Remember “Forward Thinking”; is it acceptable to walk around naked when they are an adult?
8. Establish a specific uniform that you would wear when toileting your child at home (e.g. a white lab coat like a doctor would wear). This sets up a “Forward Thinking” code of conduct that can then be used by school staff and ensures that your child understands personal boundary expectations and safety issues. (e.g. only the person that is wearing the specific uniform will be toileting them). Even a non-verbal child will react if this toileting pattern is broken, thus alerting an adult to a possible unsafe situation. Remember, safety first, who will be allowed to touch or toilet this individual when they are an adult?
9. Ensure that anyone interacting with your child does so in a safe and professional respectful manner. For example, your child should not be encouraged to hug or sit on the lap of anyone other than a close personal family member such as Mom or Dad. It is often difficult for a child to know who they may or may not hug. Remember “Forward Thinking” who can they hug or who will be allowed to hug them when they are an adult?
10. Encourage proper hygiene such as bathing, brushing hair and teeth when your child is very young. This will create positive social interactions with your child’s peers in the future.
11. Develop a visual calendar which clearly indicates when to bathe, shower, brush teeth etc. Reinforce your child for following through with these expectations.
12. Provide positive socially appropriate peer interactions for your child whenever possible (e.g. outings at the park, family gatherings, community events, etc.).

Enjoy your child, have fun and think of the social/sexual outcomes required in their future with every interaction. As they begin to experience consistency in social situations, they will begin to better understand the expectations required of them. 

Part II, will address strategies for addressing Sexuality and ASD within the school setting, will be addressed.