ASD Learners and Sexuality


By: Randy Horowitz, M.S. Ed., S.A.S. and Joanne Capuano Sgambati, Ph.D., BCBA-D, LBA

Sexuality is part of normal human development for every man, woman and child. It is a basic need and an integral part of life. Sexuality is not just physical maturity and sexual intercourse; it is diverse and personal. It’s about relationships, intimacy, and thoughts and feelings about other people. Individuals with ASD follow the same physiological sexual development and interests as their typically developing peers; About 75% of individuals on the spectrum desire and engage in some form of sexual behavior. (A comparable percentage to the neuro-typical population). Behaviors range from masturbation to intercourse and many steps along the way. Individuals with ASD have the same sexual interests, needs, and rights as anyone else, they just may not have the same ways to express themselves and share their feelings.

So what else is unique about individuals with ASD in relation to sex education?

  • Poor social competence and limited peer relationships lead to few opportunities to obtain sexual information, have sexual relationships, and fulfill their desire to have a healthy romantic and sexual life.
  • Cognitive differences (difficulty with inferencing, perspective taking, and theory of mind) can impact their understanding, generalization, and application of sexual information.
  • Language and communication challenges as well as social skills deficits can get in the way of initiating and maintaining relationships.
  • Societal barriers which interfere with learning necessary sexual information that can prevent intimate relationships from taking place. 

It is a natural instinct for parents and teachers to want to protect their children; however, by avoiding speaking about sexuality and sex education, they may be suggesting that sexuality is unimportant or shameful and they may be leaving their children even more vulnerable to frustration, problematic behaviors, social isolation, anxiety, depression, low self-esteem and even victimization.

So, how can we best educate learners with ASD about sexuality?

Start early: Children with ASD may have a hard time with change and take longer to learn concepts. Start very early; and present positively in a calm and clear manner:

  • Body part ID
  • Using appropriate words and language to identify genitals.
  • Private vs. public (e.g., places, behaviors, hygiene, and eventually conversations and on-line activities etc.)

Remember what is cute as a child (like hugging teachers), may be inappropriate in middle school. So, teach appropriate social boundaries early on. Do not wait until puberty to discuss body changes as it can be alarming to teens with ASD who resist change (pubic hair, private time for masturbation, shaving, bras, maxi pads, etc.).

Use appropriate teaching strategies: You can teach sexuality skills the same way you teach other skills to those with ASD. Some ideas are use of visuals, schedules, task analysis, functional communication training, and video modeling. Remember that sexual behavior is still behavior and adheres to the laws of applied behavior analysis. If there is a behavior to increase, decrease, or maintain it is important to know the function of that behavior in order to modify it.

Remember while teaching make sure you are aware of issues regarding consent, legalities in your state, wishes of the parents, policies of your agencies and how your intervention will look to others.

Teach independence: It is natural for parents to want to protect their child with ASD but to avoid sex education and relationship development may actually make the individual vulnerable to dependency. Teach independence on skills that are transferable to sex education:

  • personal hygiene
  • dressing
  • toileting
  • use of a cell phone
  • who and how to call in an emergency

Don’t do anything for them that they can do for themselves. This will help the child be less dependent on others for “help” and able to make their own decisions.

Teach safety skills: . Children with ASD are typically taught compliance, They may not know how to self-advocate and say “No” because they have been rewarded for compliance and listening to people who are “in charge”.

  • Teach them to say “NO” when asked to do something they do not want to do (i.e. “No thank you, I do not want a hug”).
  • Teach them that “Your body belongs to you” and rules for touching (appropriate vs inappropriate touches). They need to know they have rights over their bodies and how to “report” any inappropriate sexual behaviors or abuse.

Teach the obvious: Most children learn from a variety of sources: family, peers, TV, movies, internet etc. Those on the spectrum may not pick up on all this information. They may need things spelled out for them in a concrete literal fashion. “You cannot date women younger than 18”. Avoid or explain confusing language. “A “hook-up” is slang for meeting someone for sex and not a relationship.”

Teach about relationships: Explain the variety of relationships that people have (friendship vs love vs intimacy) and (close family and friends vs professionals, acquaintances, and strangers). Help them be social, learn social communication skills, and make friendships. Best friendships form from common interests (e.g., video games, “Anime”, trains etc.). The internet can help you find special interest groups and meet ups. There are also speed dating and singles groups for those with ASD.

Teach them about themselves: They need to develop self-esteem and a healthy self-concept. Understanding their diagnosis, strengths and weaknesses will help them be better advocates for themselves. Being a better self-advocate will also help protect their sexual well-being.


Randy Horowitz, M.S. Ed., S.A.S.

Randy has a Master of Science in Education from Queens College and a Certificate of School Administration and Supervision from the College of New Rochelle. Randy is currently a doctoral candidate in the educational leadership program at Concordia University. Randy started her career as a special education teacher in public school in Nassau County and then spent close to 30 years in senior leadership positions at nonprofit organizations serving children and adults with autism in NYC and Long Island. Randy has presented at local, national and international conferences on topics relating to educating individuals with autism. Her particular areas of interest include preparing and supporting individuals with autism for integration into community activities.

In addition to her many work responsibilities, Randy is also a seasoned runner and has participated in countless road races and marathons, including our Blazing Trails Run/Walk, raising well over $65,000 in the past 15 years to benefit the autism community.

Joanne Capuano Sgambati, Ph.D., BCBA-D, LBA

Dr. Sgambati serves as the Director of Psychological Services for Eden II’s Genesis Programs on LI.  She specializes in consulting, counseling, evaluations, and behavior management of individuals with autism spectrum disorder (ASD).  For the past 30 years, she has been dedicated to using positive behavior approaches, applied behavior analysis (ABA), for enhancing the lives of students in special education and adults on the autism spectrum.  Dr. Sgambati is an active participant in Eden II’s Genesis Outreach Department conducting live presentations and webinars on a variety of topics at organizations, conferences, schools, and universities. She also conducts training seminars for local schools and various parent organizations.  Dr. Sgambati specializes in ABA interventions for families of children and adults with special needs who demonstrate challenging behaviors. She is also the proud parent of two young adults on the Autism Spectrum.


Resources:

https://researchautism.org/sex-ed-guide/

https://www.autismspeaks.org/sites/default/files/2018-08/Puberty%20and%20Adolescence%20Resource.pdf

https://www.autismspeaks.org/recognizing-and-preventing-sexual-abuse

Ames, H. & Samowitz, P. (1995). Inclusionary standards for determining sexual consent for individuals with developmental disabilities. Mental Retardation, 4, 264-268.

Davies, C., Dubie, M. (2012). Intimate Relationships  & and Sexual Health: A Curriculum for Teaching Adolescents/Adults with High Functioning Autism Spectrum Disorders and Other Social Challenges.

Griffiths, D. (1999) Sexuality and developmental disabilities: Mythconceptions and facts. In I. Brown and M. Percy, (Eds.). Developmental Disabilities in Ontario (pp. 443-451). Toronto: Front Porch Publishing.

Griffiths, D.M., Richards, D. , Fedoroff, P., & Watson, S.L. (Eds.) 2002. Ethical dilemmas: Sexuality and developmental disabilities.  NADD Press: Kingston, NY

Hanault, I. (2006). Asperger’s Syndrome and Sexuality: from Adolescence through Adulthood. (information and lessons for students on the less cognitively impaired end of the spectrum)

McLaughlin, K., Topper, K., & Lindert, J. (2010). Sexuality Education for Adults with Developmental Disabilities, Second Edition. (structured group model) Schwier, K.M., & Hingsberger, D. (2000). Sexuality: Your sons and daughters with intellectual disabilities. Baltimore: Paul H. Brookes Publishing

Focus on Generalization and Maintenance

On more than one occasion, I’ve been in the situation that a student will only demonstrate a skill in my presence. And I’ve heard from other colleagues that they have had similar experiences. This is highly problematic. When it happens with one of my students, there is only one person I can blame: myself.  A skill that a student can only demonstrate in my presence is a pretty useless skill and does nothing to promote independence.

So what do you do when you find yourself in this situation? You reteach, with a focus on generalization. This means that, from the very beginning, you are teaching with a wide variety of materials, varying your instructions, asking other adults to help teach the skill, and demonstrating its use in a variety of environments. Preparing activities takes more time on the front-end for the teacher, but saves a ton of time later because your student is more likely to actually master the skill. (Generalization, after all, does show true mastery.)

Hopefully, you don’t have to do this, though. Hopefully, you’ve focused on generalization from the first time you taught the skill. You may see generalization built into materials you already use.

Another commonly cited issue teachers of children with autism encounter is failure to maintain a skill. In my mind, generalization and maintenance go hand-in-hand, in that they require you to plan ahead and consider how, when, and where you will practice acquired skills. Here are a few tips that may help you with maintenance of skills:

  1. Create notecards of all mastered skills. During the course of a session, go through the notecards and set aside any missed questions or activities. You might need to do booster sessions on these. (This can also be an opportunity for extending generalization by presenting the questions with different materials, phrases, environments, or people.)
  2. Set an alert on your phone to remind you to do a maintenance test two weeks, four weeks, and eight weeks after the student has mastered the skill.
  3. Create a space on your data sheets for maintenance tasks to help you remember not only to build maintenance into your programs, but also to take data on maintenance.

Considering generalization and maintenance from the outset of any teaching procedure is incredibly important. Often, when working with students with special needs, we are working with students who are already one or more grade levels behind their typically developing peers. Failing to teach generalization and maintenance, then having to reteach, is a waste of your students’ time.

Sam Blanco, PhD, LBA, BCBA is an ABA provider for students ages 3-15 in NYC. Working in education for sixteen years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. She is also an assistant professor in the ABA program at The Sage Colleges, and she is the Senior Clinical Strategist at Chorus Software Solutions.

Simplifying the Science: Using SAFMEDS in Applied Behavior Analysis

When I first heard about SAFMEDS, I wondered how they were different from standard use of flashcards. What I learned, in fact, is that the process is quite different, and it’s evidence-based! SAFMEDS is actually an acronym that means “Say All Fast Minute Each Day Shuffled.” (I know, I know…it doesn’t exactly roll off the tongue.) Created by Ogden Lindsley, SAFMEDS are focused specifically on fluency, or, in other words, speed and accuracy.

While there are some things that don’t require fluency, there are many things that do: such as simple multiplication or letter recognition. This means that some tasks I teach my students will require the use of fluency training, which is often completed through the use of SAFMEDS. Lindsley outlined results of his experiments using SAFMEDS with students and demonstrated that this process of instruction resulted in faster acquisition of fluency than other, similar flashcard procedures (Lindsley, 1996) with his work having been replicated many times over.

So, how do you implement SAFMEDS?

First, get your materials together. Create your flashcards. (I typically use index cards where I’ve written the problem on one side and the correct response on the back.) Be sure to get a timer.

From there, the procedure is pretty straight forward:

  • You will have ALL the flashcards available and the student will respond to as many as he/she can in one minute.
  • The student can run the activity on their own, and will likely go much faster if they are the one turning the cards (Lindsley, 1996). The student looks at the card, provides the response, then puts the card in the correct or incorrect pile.
  • The cards should be shuffled between each fluency drill so that the student won’t learn the answers in order.

I’ve used actual flashcards, but also created SAFMEDS sets using different apps and websites. If you’re interested in learning more about implementing this simple strategy for building fluency, you should take a look here for more information.

REFERENCES

Lindsley, O. R. (1996). The four free-operant freedoms. The Behavior Analyst, 19(2), 199.

WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-15 in NYC. Working in education for twelve years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently a PhD candidate in Applied Behavior Analysis at Endicott College. She is also a lecturer in the ABA program at The Sage Colleges.

Pick of the Week: Self Management Planners – 20% OFF!

Find a better way to manage your time and check more things off your to-do list this school year!  Created with ABA principles by Dan Sundberg, PhD, the Self Management Planner is perfect for those who have busy and frequently changing schedules and want something that will do more than schedule time in the day. This week, you can save 20%* on the Self Management Planners and get a head start on organizing your schedule for the school year! (Use promo code MANAGE at check-out!)

Self Management Planners

Not only is this planner perfect for effective time management and organizing your activities, but it also allows to set and track your goals (it even includes graph paper so you can watch your progress!).

The Self Management Planner includes:

  • Full 18.5-hour days and 7-day weeks
  • Tutorial on using the planner, appointment book, and measuring your success
  • Guide to setting long term goals and figuring out ways to accomplish those goals
  • System of selecting and tracking daily activities. (People have used this section to track a huge variety of important things like spending, hours billed, driving mileage, activity goals, and more.)
  • Graphs for visualizing and tracking progress on goal
  • Lined note paper
  • Blank date periods
  • Weekly and daily to-do lists
  • Space to make note of all day events

Available in two sizes: Full (11.5″ x 8.5″) and Compact (8.5″ x 5.5″).

*Promotion is valid for one-time use through September 6, 2016. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at differentroads.com, enter promo code MANAGE at checkout.

Tip of the Week: Measure Group Behavior in the Classroom

Many classroom teachers are required to take data on the behavior of their students. However, this can feel like a daunting task given the many things teachers are trying to do simultaneously throughout the day! PLACHECK is a simple way to measure group behavior in the classroom for engagement or attention.

PLACHECK is short for Planned Activity Check. Let’s say that Ms. Esterman is using a partner activity for a math lesson for the first time in her fourth grade classroom. She wants to see if the kids remain engaged with the content during the partner activity. Here is how she can implement PLACHECK to collect data on engagement.

  1. Measure Group Behavior in the ClassroomSet a MotivAider for a predetermined interval (learn more about the MotivAider). The partner activity Ms. Esterman has organized will take a total of ten minutes. She decides to set the MotivAider for 2 minute intervals.
  2. At the start of the lesson, set the MotivAider to run and clip it to your waistband. For Ms. Esterman, the MotivAider will vibrate every two minutes to signal her to observe her students.
  3. When the MotivAider vibrates, collect tally data. Ms. Esterman feels the MotivAider vibrate, then quickly counts the number of students who are engaged in the partner activity.
  4. Continue to do this for each interval.
  5. Graph your data.

Ms. Esterman’s graph looks like this for her 24 students:

PLACHECK Graph 1

The next day, Ms. Esterman does a similar activity with her students, but uses an independent activity instead of a partner activity. She uses the same 5 steps to use PLACHECK to measure student engagement in the independent activity. Now she can easily compare engagement between the two types of activities. You can see both days graphed below:

PLACHECK Graph 2

When she compares the two days, she finds these results, and it allows her to make better decisions about what types of activities might work best for the individuals in her classroom. Here, it is clear that between these two activities, her students were more likely to be on task during partner work. However, Ms. Esterman would attain better results by taking more data.

PLACHECK is simple to implement. Ms. Esterman is able to collect this data in less than two minutes each day and can learn a lot from just that brief time.

WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-15 in NYC. Working in education for twelve years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently a PhD candidate in Applied Behavior Analysis at Endicott College. She is also a lecturer in the ABA program at The Sage Colleges.

Pick of the Week: The NEW ABA Program Companion — Take 20% Off!

New ABA Program Companion Cover.inddJ. Tyler Fovel, MA, BCBA’s essential manual for creating professional and effective ABA programs blends clear explanations of scientifically-based concepts and methodology, clinical examples and advice, and suggested implementation strategies. This revised edition presents information on:

  • qualities of an effective ABA program
  • transdisciplinary teamwork
  • curriculum selection and development
  • program writing and revision
  • strategies for attention and engagement
  • prompts
  • error- correction
  • reinforcement
  • progress evaluation
  • data-based decision-making

TAKE 20% OFF The NEW ABA Program Companion this week with our promo code NEWABA at check-out, and get a head start on designing an efficient ABA program for your students this year.

The NEW ABA Program Companion also comes with training packages for implementers, forms, and a 6-month subscription to the online program development and management software, ABA Program Companion 3.0.

Back to School Savings on ALL Flashcards!

Gear up for the school year with our site-wide flashcards sale!

This week, you can take 15% off any set of flashcards from our website or catalog with promo code BTSCARDS at check-out!

Flashcards Collage

Products featured (left to right): Classifying with Seasons Fun DeckLanguage Builder Picture Cards;
Story Prediction Fun DeckBasic Vocabulary Photo Cards.

View our individual categories of flashcards below:

Promotion is valid on all flashcard products with item code ‘DRC’ until August 23, 2016 at 11:59pm ET. Not valid on VBATT (DRC 795), ALL PICS (DRC 110), ABLLS-R Data & Task Organizer Kit (DRC 710), and ABA Language Cards (DRC 790/DRC 791). Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at differentroads.com, enter promo code BTSCARDS at checkout.

Pick of the Week: 15% Off Handwriting Tools

Get a head start on helping your child improve their handwriting skills before the school year begins! This week, take 15% off our handwriting programs and tools with promo code WRITE15 at checkout!

Jumbo triangular pencils are just right for the student who is making the transition from using grips to regular pencils. These pencils are fatter and have a soft dot comfort zone for a non-slip grip. The box comes with 12 pencils, all in black lead.

Get your Jumbo Triangular Pencils here!

 

We’ve compiled the Writing & Art Kit to support students in their writing and arts & crafts skills. This kit contains: a pair of child-safe scissors, lined paper for upper- and lowercase writing, and a jumbo grip triangular pencil that improves a child’s grip directly on the pencil.

For the arts, we’ve included triangular crayons, triangular glue sticks, both for a better grip, and glossy colored paper for bright, shining artwork.

Sensible Pencil, by Linda C. Becht, is a handwriting program that contains 200 sequential worksheets to help new writers achieve success quickly and pain-free. Children start with simple horizontal and vertical lines that are presented as fun, and then go on to the other basic lines needed for handwriting skills. The program also includes a progress chart and a manual for teachers and parents. Notebook format.

 

 

View our entire sale here.

*Code is valid for one-time use through August 16, 2016 at 11:59pm. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at differentroads.com, enter promo code WRITE15 at checkout.

Pick of the Week: Token Boards + 10-Packs, now available!

Token boards are a part of every ABA program. They give teachers a positive way to reinforce good behavior and monitor success. Our lightweight, laminated Token Boards are now available in 10-packs – and even better – you can save 15% on any of our token boards and their 10-packs this week! Just use our promo code TOKENS when you check out online or over the phone with us.

Once the student receives 1 to 5 stars on their token boards, they receive a reward – a favorite activity, a toy, or something good to eat! There is also a 2″ box at the end of the row, so the instructor can place an image of the reward.

Each token board comes with 8 reusable reward stars. The chart measures approximately 5″ x 9″.

View more token boards here.

*Code is valid for one-time use through August 9, 2016 at 11:59pm. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at differentroads.com, enter promo code TOKENS at checkout.

Pick of the Week: Oops Groups Categories — and more!

Can you find the “oops” to help complete the Oops Groups Express Train? Our new Oops Groups Categories is a unique puzzle game where players use concentration and memory to find same-color Oops Groups Express puzzle pieces. To win, players must sequentially build the train and identify the one item on each puzzle piece that does not belong with the other items. Categories include food, animals, tools, season, and colors.

This week, you can save 15% on the Oops Groups Categories game, along with our other favorite educational games and toys for teaching categorization and sorting!

Use our promo code OOPS15 at check-out to redeem your savings!

Promotion is valid until August 2, 2016 at 11:59pm ET. Offer cannot be applied to previous purchases, combined with any other offers, transferred, refunded, or redeemed and/or exchanged for cash or credit. Different Roads to Learning reserves the right to change or cancel this promotion at any time. To redeem offer at differentroads.com, enter promo code OOPS15 at checkout.