Sexuality

The "M" word is masturbation. For everyone involved, it can be an uncomfortable topic when discussed at case conferences, parent meetings, or within oneís own family. The fact is that when each of us were infants, we spent time discovering our bodies, including our toes, feet, fingers, and yes even our vagina or penis. As boys and girls reach puberty, their sex hormones become more active. Many adolescents begin to have even more pleasurable and excited feelings about their own bodies and may be more attracted to and interested in other peopleís bodies (Harris, 1994). Even though the feelings are hard to describe, they are normal feelings. They happen at different times and in different ways for both boys and girls. Actually, if individuals have not begun masturbating before adolescence, they likely will begin their hormonal and physical changes when puberty starts. Many males begin masturbating between ages 13 and 15, whereas the onset among females occurs more gradually (Strong, et al., 2005). While these statistics are for neuro-typical adolescents, they also apply to individuals on the autism spectrum. The sexual feelings and needs of individuals on the autism spectrum are no different than the rest of the population. People of all ages masturbate including children, teenagers, married and unmarried adults, and the elderly because it ìfeels goodî (Gravelle, 1998).

Adolescents with Autism

With neuro-typical adolescents, parents usually don't need to address the issue of masturbation because their son or daughter is able to understand the social cues associated with it from friends and parents. They understand that it is to be done in a private place, and to not discuss or do it in a public area. However, individuals on the autism spectrum may not be embarrassed about talking about their bodies. They may be unaware of the reactions of others or may continue to discuss the topic despite the negative attention of others. These individuals may have naturally started to fondle themselves. When they realize how good it feels, they may do it more. Their families may not be sure how to address the masturbation because their other children just ìfigured it outî for themselves. Other times, adults mistakenly believe that masturbation is a behavior a child will soon tire of and stop on his or her own (Wrobel, 2003). This is usually not the case. When a child is masturbating even occasionally in public, it needs to be addressed by his or her teachers and parents immediately.

How to React

Is masturbation morally wrong? Parents must talk among themselves about their beliefs, how they will react, and how they will teach their child about masturbation. Within the discussion, parents must consider their adolescents ability to understand this concept (e.g., cognitive abilities, ability to process information). One must also be careful about how your adolescent thinks you perceive him or her touching their genitals. For example, if you view it as ìnasty or dirtyî and touching oneself is strictly forbidden, then your adolescent may refuse to have a medical physician touch their penis or vagina during an exam because they interpret the rule literally. Or your child may conceal their masturbatory play from you, and start masturbating in inappropriate places (e.g., playground, school bus, locker room, hallway, community park). This could lead to more serious problems. Knowing your child, and demonstrating maturity and calm understanding is essential. For example, remain calm and do not scream when catching your son or daughter masturbating. Rather than simply telling your son or daughter to stop the behavior, teachers and parents should discuss why it is inappropriate to do so in public. It is important to teach oneís adolescent with autism strategies when, where, and how to be safe in regards to masturbation.

Questions and Answers

Parents, teachers, and individuals on the autism spectrum have called the Indiana Resource Center for Autism asking many questions related to masturbation. There isnít one prescribed answer to all of the specific scenarios, but rather resources and ideas to explore. Here are a few of the scenarios:

My son is masturbating in the living room when he watches his favorite television show, how do I handle this situation?

* Teach rules and the boundaries about privacy with the use of social stories, pictures, and videos. Compare masturbating to another experience that he does by himself like taking a shower or using the restroom. Teach him that one should only touch oneself in a ìprivateî area. It is imperative to teach private and public behaviors when children are young. Calgary Health Program has a useful lesson plan on their website (www.teachingsexuality.ca) to teach the terms public and private.

* Private should be described as oneís bedroom only. Hopefully, the child has private time alone in his/her room. It is highly recommended that an individual not be taught that the bathroom is an appropriate place, unless a door can be closed (no stalls). For students that canít generalize, one may start to masturbate in a bathroom with stalls at school. This can open a child up to ridicule from other students in the school if one is discovered masturbating in the boys or girls bathroom. Parents and teachers must teach the child the appropriate times and places to masturbate.

Should a student be allowed to masturbate at school or on the bus?

* No. At school and on the bus are public places. This rule needs to be strict. A student on the autism spectrum could get into trouble for sexual harassment charges from his peers or be accused of indecent exposure. Both of these situations could lead to being arrested. Each school has a policy regarding sexual harassment. Contact your local school district for a copy of this policy.

A girl in my class is rubbing her genitals against the legs of her desk, what do I do about this?

* One has to analyze the situation to understand the antecedents of the behavior and the function of her masturbation (e.g., what reward is she getting out it). A functional behavior assessment needs to be completed in order to know how to change this behavior. The student could be rubbing their genitals against the desk because there is too much wait time in a transition, the work could be too easy, or she may find this behavior calming in a stimulating environment. There are many reasons for this behavior. Once the team discovers why she is masturbating, a replacement behavior can be taught to change the situation.

* Frequently it seems that the group working with the individual who is masturbating is uncomfortable with the situation. One must take a step back from the situation, so that it is not so personal. How one works with a student does not reflect on oneís own sexuality issues, but it does reflect on how the lessons of life are being taught. Letís be sure to be positive and supportive of this tender subject.

How do I teach my son who has been identified with a moderate disability about having erections?

* Use the same strategies that have been working to teach other concepts like when to brush your hair or take off your clothes. Below are reference ideas or strategies to use:

o Mary Wrobelís book listed in the reference is an excellent resource that includes facts about masturbation, short stories, and visual strategies as well. Other books available on this reference list can also be used, but should be adapted to meet the childís cognitive abilities.

o Create a visual system of explaining the process. Use photographs of a person or access pictures from Mayer Johnson (http://www.mayer-johnson.com/).

o Show factual slides or videos from materials written by James Stanfield. These are highlighted below in the reference list.

o Develop a routine and schedule at home when he or she can masturbate in their own room.

I'm an adult with autism, I am having troubles understanding how I can reach an orgasm, please help.

* There are several videos in our library at CeDIR (Center for Disability Information & Referral) that show how to masturbate in the privacy of oneís room alone. See the video list by Dave Hingsburger in the references below.

* Go to your local bookstore to quietly ask the person at the help desk about where the section on adult sexuality is located so that you can look at the numerous books to decide which one(s) will address your own questions.

In closing, the topic of masturbation must be discussed in private with individuals on the spectrum in order to help him or her develop an awareness of their own bodies, an understanding of when and where to do this, and to develop positive loving relationships with oneself or others in their adult lives.

IRCA - Melissa Dubie