Autism and sexuality

The importance of sexuality and sexual behavior in the life of people with autism spectrum disorders has been a subject of debate for many years. This has been focused mainly on the way the characteristic social and communication deficits as well as behavior difficulties of individuals with autism affect their interest in sexuality and intimate relationships and what type of sex education is needed in order to promote development, functioning and quality of life in this domain. Literature regarding the nature and the frequency and the manifestation of sexual behaviors in this population is very limited and centered on those people with disabilities other than autism. The limited available research data suggest that sexuality and appropriate sexual behaviors may be a more important issue for individuals with autism spectrum disorders than has been previously thought.

Parents of people with autism have indicated that the sexual behavior of their child is a major concern to them, while professionals try to determine the importance of sex education to the entire population with autism spectrum disorders. A growing concern for those professionals who work with children and adults with autism spectrum disorders has been focused on how to address issues of sexuality in a sensitive manner which takes into account the quality of the triad of impairments, the unique learning style of this population as well as their unique special needs. Professionals who serve children, adolescents and adults with autism and their families are facing today a number of challenges concerning attitudes of parents, educators and society in general, policies specifically designed to protect the rights of individuals regarding sexuality, the level of education offered and who should address these issues, informed consent and the point at which individualized behavioral interventions should be put into place.

The most extensive survey of the sexual behavior of adolescents and adults with autism completed by Haracopos and Pedersen (1992), strongly suggested some years ago that people with autism are interested in and are engaging in sexual behavior. This research has also shown that systematic approaches to educating this population regarding the appropriate expression of these feelings are needed. The sexual experiences of the majority of people with autism spectrum disorders could be improved by devising fairly simple education plans which should be individualized and based on the autistic person's particular skills, learning style and cognitive level. The content of the individualized educational program should then be adapted to the person's level of functioning and special interests. However, different opinions could arise mainly on the details regarding professionals who are allowed to take part in sex education of this population and intrude on the intimate matters of the person with autism and how. Moreover, whose ideas of what is ethical and aesthetic can be imposed on the autistic person who cannot choose for him/herself. For these reasons persons with autism spectrum disorders should internalize and demonstrate understanding of different levels of awareness about sexual matters before a personal sex education plan is devised. The first level of awareness is understanding about appropriate places and times for touching and nudity. The second level is handling personal hygiene, and the third level is identifying body parts. The plan that has been developed, as and when these have been passed, should then show opportunities, ways and means of possibly obtaining 'normal relationships'.

Strategies developed by autistic adults and experience should be collected and presented to the parents of younger children and adolescents with autism spectrum disorders in order to help them organize early sex education programs for their child and give them better chances of finding ways of sexual behavior and forms of sexuality which are more suitable to them.

Key words: Autism, sexuality, sex education.