Social Skills for Kids

Sex Education for Kids and Teens with Autism and Asperger's: A Conversation with Sarah Attwood

Puberty and sex can be tough for any parents to discuss with their children, but it's important. And for kids, preteens, and teenagers with autism and Asperger's, sex education is vital. Kids on the autism spectrum may be less socially sophisticated than peers, but their physical development will progress regardless if they, or their parents, are ready to handle the changes. For your child's safety and happiness, parents need to put aside any reservations and start discussing sex!

Today, I'm talking with Sarah Attwood, the author of Making Sense of Sex: A Forthright Guide to Puberty, Sex and Relationships for People with Asperger's Syndrome. (Jessica Kingsley Publishers, 2008) Ms Attwood has been a sexuality educator in Australia for fifteen years, and has worked extensively with parents and their preteen and teenage children.

Patricia Robinson: Sarah, your book is different than other sex education books because it's specifically written to adolescents with Asperger's Syndrome. How is the information in your book tailored specifically to those on the autistic spectrum? What do you think are the special concerns and issues of teens with autism and Asperger's?

Sarah Attwood:You're quite right, Patricia, that young people on the autism spectrum are going to go through the changes of puberty in exactly the same way as all other people, and for this reason they need exactly the same information as everyone else. However, the nature of autism and Asperger's syndrome means that there are some specific issues which usually aren't addressed in regular puberty books, and that's why Jessica Kingsley asked me to write Making Sense of Sex.

Lots of regular puberty books use contemporary language - 'teen talk', if you like - and while this can be fun and amusing, it isn't always to everybody's taste, so I decided that it was more important to treat the subject with respect, and use a straightforward, factual tone (hopefully not too deadly serious, however!). I took into consideration that most people with ASD enjoy facts and appreciate being able to apply logic, so I have always explained 'why' as well as 'what'. An example of this is when I discuss hygiene (an issue for a lot of adolescents, whether or not they have ASD!). I explain EXACTLY what causes body odour, which bits of the body are affected most specifically, the reasons why it is important to wash regularly (health as well as social reasons), and exactly HOW to wash. I don't assume knowledge or make generalisations that can be misinterpreted. Because of the love of knowledge that most people with ASD have, I have provided plenty of facts. For example, the usual rule in sexuality education is to avoid giving young people any sort of hang-ups by giving facts and figures regarding penis size; it's standard practice to say something like 'Whatever size your penis is, is exactly right for you.' This isn't clear enough or reassuring enough for young people on the autism spectrum, however. So I have given specific measurements of both flaccid and erect penises (of fully grown men), and plenty of other reassuring facts about penises, so that there is no room for confusion or doubt.

I have also been careful throughout the book to use correct terminology, with a view to modelling this so that adolescents know how to talk about sex in a respectful way, and can make themselves understood. There is a whole chapter dedicated to the subject of sexual language (including slang), as young people with ASD so often miss out on what is current because they aren't included in teenage groups.

There are some social issues surrounding puberty that can be veritable minefields for young people with ASD, and which are often not included in any detail in regular puberty books - namely, the rules that surround sexual behaviour (especially public vs. private behaviour, body parts, places and language); friendships; coping with teasing, bullying and peer pressure; and handling strong emotions (a particularly important issue for people on the autism spectrum). So I have included whole chapters on these subjects, with some specific guidelines, laid out in dot point format for easy reference.  All young people need someone they can turn to when they have questions or anxieties, and research shows that most youngsters would love to be able to talk to their parents about sexual issues. Many don't, however, often due to their parents' discomfort with the topic, instead turning to their friends for information (or misinformation). Adolescents on the autism spectrum may not be able to turn to a group of friends, so it is absolutely vital that parents and carers fulfil the role of mentor. There is no place for squeamishness or embarrassment - parents and carers MUST educate themselves and be there for their child. Throughout the book I make reference to the young person's social mentor, and give many pointers as to the role this person may take in terms of providing reassurance and guidance, giving accurate information, and helping with friendship skills and emotion management.

At the end of the book, I provide quite an extensive list of resources, both for parents and for the young people themselves. Some of these are specific to people on the autism spectrum and some are mainstream but still very relevant.

The book is illustrated with diagrams and cartoons to provide both detailed information (anatomical drawings etc.) and fun ways of viewing some of the points made in the different chapters. I hope these illustrations make the book more accessible and reader-friendly.

Patricia Robinson: Thanks for your comments!

Book Review: Asperger’s and Girls

Asperger’s and autism are diagnosed much more frequently in boys than girls. But that doesn’t mean there aren’t many girls and women dealing with autism and Asperger's. The book Asperger’s and Girls (2006, Future Horizons) addresses the female part of the spectrum.

The book is compiled of chapters written by different individuals on different topics, such as education, puberty, dating, marriage and relationships. All the authors are either well known experts, such as Tony Attwood or Temple Grandin, lesser known authors, or individuals with their own or family connections to the autism spectrum. Although the quality of the writing varies, the tone of the book is positive and much of the material is useful.

For this review, I want to focus on one chapter, "Girl to Girl: Advice on Friendship, Bullying, and Fitting In", written by Lisa Iland. At the time of publication, Iland was a college student who’d gotten interested in this topic because of her interactions with her brother, who is on the autistic spectrum. In this rapidly changing world, it can be tough for parents to really understand what high school is like, so a younger person’s insights can be especially useful. Although the chapter is aimed at teenage girls, much of it can be useful for boys as well.

Iland covers ideas such as personal style, social hierarchies, and levels of friendships. Although it’s already getting out of date, there’s information on popular social conversation topics, like TV shows and music. (Lots of girls on the spectrum may avoid pop culture, often to their parents relief. Still, it’s hard to join in the conversation if you haven’t read the book or seen the movie that everyone’s talking about. I think it more effective when parents read the book or see the movie also, then have a conversation with their daughter about their concerns.)

The chapter includes lots of examples and step-by-step instructions on starting a conversation, making new friends, and dealing with bullies. Why don’t you check it out and see if it might be helpful for your child?

Helping Autistic Kids Deal With Change

I’m rereading an old favorite, Temple Grandin’s Thinking in Pictures. This book is so rich and deep, and the author is so insightful, that the book offers something new on every reading. For parents of children on the autistic spectrum and for adults who have, or suspect they have, an autism or Asperger’s diagnosis, this book is one of the first I recommend.

Early in the book, Grandin discusses how she uses doorways and windows as an experiential and visual metaphor for dealing with change and emotion. Grandin explains how the image of a doorway helped her manage changes she was going to experience, such as a graduation. She moved beyond visualizing a doorway and repeatedly walked through an actual door. In a similar manner, Grandin used an experience of being stuck between two windows to understand relationships with people, with the window symbolizing disconnected feelings and the fragile glass symbolic of relationships. Grandin goes on the discuss how other autistic individuals use symbols which may not be as logical and understandable for neurotypicals to understand.

I think the important message here is that the symbols individuals choose, whatever they are, can be so useful for them. I’ve worked with clients who make tremendous progress in dealing with difficult experiences and emotions after they physically create a container for their feelings, or build an object that expresses emotion. Many of my clients love to graph out their emotions, sometimes getting quite elaborate mathematically. As a therapist, I try to initiate this symbolic process for my clients, follow their lead and then trust their innate wisdom and ability to heal. It can be a challenge to sit back and support when I don’t know quite what’s going on.

What can parents do? For starters, trust your instincts. Then, provide the richest, most varied environment you can, and give your child a wealth of experiences. If they seem to be using symbols and metaphors, can you encourage that and make the experience fuller? Finally, to some degree, you’re going to have to let go and trust in the wisdom of your child.

Understanding Your Child: Expert Opinions

Are you looking for a deeper understanding of your child with autism or Asperger’s? One of the best sources of information about the world of children on the spectrum can come from adults with the same diagnosis. That’s one of the reasons that I enjoy following blogs written by adults on the autism spectrum. With all the media attention that focuses on children with autism, adults on the spectrum may be overlooked. As parents of autistic children, these individuals can be a wonderful resource.

You can't necessarily expect to find bloggers with a diagnosis that exactly matches your child's. Because the official diagnostic criteria have changed over the years, and because many adults were never officially diagnosed or were misdiagnosed, adult diagnoses may not match those of your children precisely.  Diagnosis in children can offer many benefits. In adults, an official diagnosis may not offer as many advantages, so many adults choose not to undertake official testing. Often you’ll find more general terms like “autistic blogger” rather than a formal diagnosis.

How do you find autistic bloggers? One of my favorite sources is the Autism Hub. There, blogs written by adults with autism or Asperger’s are clearly identified. Alltop lists selected blogs by category, including autism. Various autism and Asperger's related blogs are linked on Asperger Webring as well as listed on The Autistic Place.

What can you expect to find on these blogs? Every viewpoint you can imagine, including some that I’m sure you’ll disagree with. (Those are probably the most important ones for you to read!) After all, your kids will grow up and disagree with you on some things as well!