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Sexuality, the “Double Vulnerability,” and Youth with ASDs

The social deficits of youth with Autism Spectrum Disorders (ASDs) place them at an increased risk of experiencing physical or sexual abuse, neglect or exploitation (Gabriels, 2007). However, these same social impairments can also increase their vulnerability to engaging in inappropriate behavior which can be interpreted by others as sexual or intentionally harmful (e.g., stalking, molestation). Engaging in such behaviors can lead to contact with the legal system as concerns are raised regarding the safety of others. Often, the behaviors have occurred not as a result of deviance, but rather because of the individual not knowing better. These youth commit what Dave Hingsburger and colleagues first called “counterfeit deviance,” or behaviors that are a result of a lack of sexual knowledge, social skills, or social naiveté (Hingsburger, Griffiths, & Quinsey, 1991). The unwritten social rules of sexual and relationship behaviors are highly complex and are often not explicitly taught, particularly to youth with ASDs. Social learning theory highlights the informal and incidental processes by which many concepts related to sexual interactions and behaviors are learned (Gagnon, 1991). These are mechanisms of learning that are not very accessible to youth with ASDs. Therefore, as more individuals with ASDs are becoming fully integrated into community life it is essential for socio-sexual rules to be taught explicitly as part of a comprehensive curriculum in order to prevent misinterpretation of behavior, negative interactions with the legal system, and the serious repercussions of such interactions (e.g., being labeled a youth sexual offender, jail time).

Little research has been conducted on the sexual behavior of youth with ASDs, however there are several recent studies which highlight the need for increased education. Stokes and Kaur (2005) examined the sexual behaviors of adolescents with high functioning autism and Asperger syndrome and found that these adolescents engaged in fewer privacy behaviors (e.g., seeking out privacy to undress and masturbate), had less knowledge regarding privacy issues and displayed more inappropriate sexual behaviors (e.g., touching others inappropriately, touching themselves inappropriately, masturbating in public, disrobing in public and speaking about sexual activities in an inappropriate manner) than did their typically developing peers. In an earlier study, Ruble and Dalrymple (1991) examined parent reports of the rates of sexual behavior in their children, including school-aged children, adolescents, and adults. Sixty-five percent of individuals touched their private parts in public, 28% removed clothing in public, 23% masturbated in public and 18% touched the opposite-sex inappropriately.

These alarmingly high rates of inappropriate behavior are consistent with what we have observed in our clinical practice. We have worked with youth who engage in the following two kinds of behaviors: (1) behaviors which are not sexualized yet are interpreted as such. For example, youth whose sensory interests lead them to smell or stroke someone’s hair, to touch women’s legs and feel the texture of stockings, or to want to play with skin that wrinkles (e.g., elbows, knees). When these behaviors occur in young children, they are frequently tolerated or dismissed as cute; however, when an adolescent or young adult engages in sensory seeking of a socially inappropriate nature, their actions are often interpreted as sexual, which unfortunately can result in significant legal repercussions. The second kind of behavior youth can engage in is (2) socially inappropriate sexual behavior that is misinterpreted as intentional or deviant. For example, we have worked with many youth who do not know how to appropriately express romantic interest; their advances are at times inappropriate in nature. Additionally, rigidity and limited social understanding can prevent some youth with ASDs from accepting rejection by a desired partner, or a fixation can develop related to having someone as their romantic partner. These behaviors are often identified as stalking and the ramifications are often severe. We have seen teens expelled from school, banned from community social groups, and tried as juvenile sex offenders. The legal system, including police officers, lawyers, judges, and parole officers, is not equipped to understand the behaviors of youth with ASDs and therefore any behaviors perceived to be sexual and inappropriate in nature are not taken lightly. The most suitable intervention for neurotypical youth (e.g., a standard juvenile sex offender course), is likely not appropriate for youth with ASDs. Though we have communicated these concerns to the courts on a number of occasions, flexibility in fulfilling treatment requirements has not been an option, resulting in a very difficult experience for our clients with ASDs.

Due to the social impairments of ASDs, adolescents may lack insight into comprehending or recognizing whether their behavior is socially inappropriate (Stokes & Kaur, 2005). Adolescents with ASDs have less sexual knowledge compared to their typically developing peers due largely to limited access to available and appropriate educational resources (Koller, 2000); there is little material specifically geared towards teaching sexuality and relationships to individuals with ASDs. Typically developing youth learn a great deal regarding sexual behavior through social observation of peers, family, and media and sharing that information within their peer groups. As discussed earlier, youth with ASDs often lack a peer group and struggle with social observation, thus preventing learning via implicit observation.

A focus on punishment of sexually inappropriate behaviors can prevent teaching opportunities for an individual to learn more responsible behavior (Hénault, 2003). As children with ASDs grow, it becomes increasingly important to help them understand which behaviors are acceptable and which are not (Lang, 2005). Importantly, sexuality education should not focus only on sex and anatomy. A comprehensive sexuality plan additionally incorporates social skills training and social thinking concepts, because healthy sexuality is embedded within the social environment. It is essential that any sexuality education curriculum comprises a strong social skills component and that concepts related to sexuality (e.g., where to be naked) are not taught in isolation from their social context (e.g., why you can be naked in some places and not others). There are a surprisingly large number of social rules that govern our sexual behavior. Many of these rules are unwritten and therefore must be explicitly taught to youth with ASDs who struggle with social understanding. Through comprehensive sexuality education, adolescents with ASDs can learn to recognize what is appropriate and to understand the reasons why, so that they do not endanger themselves, or others, and unfortunately receive the label of “sexually deviant.”

We believe that sexuality education should be viewed as a critical part of a teen’s educational plan. Creating a comprehensive plan that includes goals in the areas of enhancing teen’s knowledge of body parts, differentiating between public and private, identifying clear boundaries, and learning about appropriate expression of affection is crucial to prevent both vulnerability to being sexually exploited and unintentionally exploiting others. By preparing a child and his or her family for their journey through adolescence and into adulthood, healthy and safe sexuality can be achieved.

At the same time, effort is needed to educate law enforcement personnel and individuals working within the legal system, of the unique experiences of individuals with ASDs. Collaborative efforts are necessary in order to determine if a person with ASD has engaged in true deviant sexual behavior, has acted in a socially inappropriate and uneducated manner, or whether their behavior in fact serves a completely different purpose (e.g., sensory). Without this joint effort, youth and adults with ASDs will continue to experience negative and often traumatic interactions with the legal system that are fraught with harmful misunderstandings.

For more information about the “ASPIRE Center” and our sexuality education programs, please contact Samara Tetenbaum, PhD, Psychology Fellow at ASPIRE at 631-923-0923 or sptaspire@gmail.com. You may also visit our website at www.aspirecenterforlearning.com.

3 Responses

  1. Marie says:

    I am looking back to when I was 13 and have been disciplined for harrassing another classmate. It was the only way to get through to me back in 2005 when there was no autistic rights movement. At the time, I did not understand the importance of consensual touch. I did not care that the boy did not like me back, I still pursued him and hugged him when he asked me to stop. I am 28 now and reliving that memory, feeling extremely ashamed for what I did and wish I could go back in time. I have never met any other autistic adults in neurodiversiy activism who have admitted to doing this, so even there I have feared losing respect for admitting my awful past. We should make it clear that autism is NOT an excuse for this, but at the same time, many of us do miss out on learning about healthy relationships. Autistics also are very capable of learning toxic behaviors when they do not have good relationships with family and/or peers.

    • Jen says:

      Thank you so much for your bravery in making this statement! We are working with our 14 year old son to help him avoid these situations.

      • Marie says:

        Thanks for your comment! You are welcome to check out my blog, I post a lot about my experiences as an autistic female. I wish the best for your son, it can be painful dealing with rejection but it is important. I am in a happy relationship of nearly 4 years, it is possible.

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