For Teachers & Professionals

Autistic Spectrum Disorder - Part 2: Practical Tips for Communicaiton

Autism can affect how a person communicates, learns, behaves, and socially interacts with others. Autism is known as a spectrum disorder as it can affect people in different ways. Some autistic people require higher levels of support than others; this can mean that they require assistance with daily tasks or skills such as language and behaviour. Other autistic people may need low levels of support or no support at all. So, it is important to know the person we have in front of us. For example, some have no ability to speak, while others have the extreme ability to talk about their favourite interests in great detail. Those who can talk may have difficulty using language effectively when talking to others. They may also have difficulty processing what they hear, and not understand what was said to them. Of course, having specific training in how to deal with autism conditions is important. When discussing sexual feelings with an autistic person, the following tips may be beneficial.

1. Reduce Unnecessary Sensory Input

The first thing which is often very helpful is to take the ASD patient and their parents/support person to a very quiet, private room where it’s dimly lit with minimal medical equipment in the room. There shouldn’t be other patients or staff in the room. You want to create a relaxed, peaceful environment. That in itself will usually calm the individual down. This will help to decrease the amount of sensory overload that is affecting the patient.

2. Figure out how that patient communicates best

The next thing you need to do is to ask the parent or caregiver how the child/adult typically communicates. They can provide a baseline expectation of how the patient will react to you. Observe the way they communicate with their parent or whoever they are with. You will be able to observe if they use words or any type of gesture.

3. Let them know they are safe

Let them know that they are safe to discuss how they are feeling and that they can ask any questions about sex and sexuality.

4. Discuss sex education with age-appropriate topics

For example, when dealing with an adult it’s important to teach them how to communicate with a sexual partner about things they do and do not enjoy, to speak with them about boundaries and how to discuss these with a sexual partner, to let them know they deserve to be treated with respect by any prospective partner. For children and adolescents, it may be helpful to talk about puberty, to prepare them for changing bodies, to talk about appropriate and inappropriate behaviours and the difference between private and public. A guideline to the topics for what concerns adolescents is the ‘Tackling Teenage Program’, which involves 18 topics divided into 18 sessions, each involving both theoretical and practical education. The topics addressed are: Session 1: Talking about puberty; Session 2: This is me – Appearances; Session 3: A good first impression; Session 4: What do you call that? Naming body parts; Session 5: Changes during puberty in boys – Male physical changes; Session 6: Changes during puberty in girls – Female physical changes; Session 7: Making love to yourself – Masturbation, rules and hygiene; Session 8: Friendship – How to become and maintain friends; Session 9: Being in love and stuff... Falling in love; Session 10: Doubts and confusion during puberty – Sexual orientation; Session 11: Being in love and dating; Session 12: Safe sex, Sexual intercourse, contraception and STD; Session 13: The first time – Sexual intercourse; Session 14: Pregnancy and birth Pregnancy; Session 15: Where do you draw the line? Setting and respecting boundaries; Session 16: Yours and other people’s boundaries; Session 17: Internet and making contact; Session 18: Bad boyfriends (session for girls) - Abusive boyfriends.

5. Adjust the way you talk

Limit the number of words you use to communicate with the ASD patient. Use keywords that are specific to the situation. You may need to repeat and stress them as well as to accompany your words with simple gestures such as pointing. You might need to pause between words or short sentences to allow them time to process what you are saying. Being out of their routine and in an intimidating setting, they might need longer to get their words out. Be patient and allow them time to put their thoughts into words. If possible, use simple gestures and visual support. Avoid the use of figurative language – sarcasm, idiomatic expressions, or read-between-the-lines as ASD people take things very literally.

6. Cooperate with a parent, caregiver or another person close

When dealing with a child, the parents are the best resource to know how the child usually behaves, reacts, listens and communicates, while with adults a partner can be the closest person. When talking to parents give some instructions on how to talk about sexuality outside the facility. For example, if eye contact is difficult it may be helpful to discuss these topics on a walk side-by-side or while preparing a meal together. A parent or caregiver may also try having conversations using “what if” questions to develop solutions, such as “what if a period begins at school?”. They should also be aware of any crushes the child or adolescent has and talk about how to be respectful of boundaries.

REFERENCES

• Autism and sex: Navigating sexuality and relationships. (2022, May 19). Medical News Today. Retrieved September 1, 2022, from https://www.medicalnewstoday.com/articles/autism-and-sex#affect-on-sex

• Dekker, L. (2019). Tackling Teenage Linda Dekker Psychosexual functioning in adolescents with autism spectrum disorder (ASD). Erasmus University Rotterdam

• Sex education - a guide for parents. (2020, August 12). National Autistic Society. Retrieved September 1, 2022, from https://www.autism.org.uk/advice-and-guidance/topics/family-life-and-relationships/sex-edu cation/parents-and-carers

• Visser, K., Greaves-Lord, K., Tick, N.T. et al.(2015). Study protocol: a randomized controlled trial investigating the effects of a psychosexual training program for adolescents with autism spectrum disorder. BMC Psychiatry15, 207. https://doi.org/10.1186/s12888-015-0586-7