Male urges, with autistic son

Hi I am the single mom of a 12 year old autistic boy. Now like most autistic children he stems off different things, but lately he has been laying on the floor on his stomach satisfy his male urges. Now most people can not tell what it is he is doing, just that he is laying on his stomach on the floor. But lately he has been doing this everywhere in the store, the car, etc... He don't talk at all, but I still am trying to explain to him that this is a natural male thing, but that it is not appropriate to do anywhere but in his room. I am not real sure what else to do beyond that. So if there are any other parents out there that has dealt with this , any advice would be great.

Hi kurtsmom, and welcome to IAN.

It is, of course, perfectly natural for 12 year old boys to masturbate or otherwise become interested in sex and sexual feelings. The difficult question is: how to you address sexual education for children on the autism spectrum?

Here is an excerpt from a 2007 interview Lisa Jo Rudy of About.com conducted with Dr. Peter Gerhardt of the Organization for Autism Research (OAR) in which they discussed this issue:

Very few programs exist to teach young people with autism about sex and sexuality, and because people with autism are often unaware of social cues and peer expectations, clear, direct education is often critical. For example, says, Dr. Gerhardt, "they need to know they should lock the bathroom stall, and they need to learn how to do it. Sometimes parents think it's safer if they take their child into the bathroom with them, but the challenge with that is that the person most likely to cause abuse is someone the child knows, not someone the child doesn't know. And if you don't teach your son to close and lock the door in a public bathroom, he's too open to abuse."

Beyond day-to-day hygiene and the issues of bathroom and locker room safety, it's important to address the social aspects of sexuality. Unlike most youngsters, teens on the autism spectrum are unlikely to learn about sexual norms from peers or even from teachers. So it's up to parents to pick up the slack. Some things that almost anyone on the autism spectrum can learn about include:

a. circles of comfort (who may touch you or ask you to undress)
b. good touch/bad touch
c. bathroom and locker room independence
d. reporting of past events such an inappropriate touch

For parents of young people with autism, however, there's a second level of difficulty: teaching even the most basic social aspects of sexuality. Even masturbation has a social component. Teens need to know when and where it's okay to touch themselves, and they need to understand the absolute need for privacy.

Says Dr. Gerhardt, "for kids with autism going to middle school, if we're not pre-teaching, they'll get a very skewed vision of human sexuality. Right now, there's no curriculum that truly addresses the programmatic issues in a functional way, and there's little research on the topic - there's some for mental retardation, but with sexuality you're not just teaching information. You're also teaching values and social competence."

How can parents begin to think about this issue? Dr. Gerhardt recommends that parents:

a. Think ahead - be proactive ("pre-teach")
b. Be concrete (talk about the penis or vagina, not the birds and bees)
c. Be consistent and repetitive about sexual safety
d. Find someone of the same gender to teach the basics of safety and hygiene
e. Be sure to address the social dimension of sexuality
f. Strongly reinforce for all appropriate behavior
g. Redirect inappropriate behaviors. For example, if a child is likely to masturbate in class or in public, give him something to carry or hold, etc.

Sometimes families need help with this issue. For example, a mental health professional with training in behavioral interventions might be able to develop a program for your family to follow that would mold this behavior so that it only happens in the appropriate time and place and not in public. Of course, whatever intervention you would try would be designed to match your son's overall level of ability and means of communication. What has worked to communicate and teach other behaviors might be adapted to communicate and teach this.

In cases where a person with autism is compulsively masturbating to a really detrimental extent, medication is sometimes used. See: http://www.ncbi.nlm.nih.gov/pubmed/19364298?dopt=abstract

I hope this information proves helpful - this is a difficult issue for most parents of children with ASD.