ASD Girls and puberty

Most adults with ASD wish they had understood themselves better when they were younger; they wish they had known about their ASD and learnt about its impact and how people without ASD are different.

They particularly would like to have been taught something about relationships and how they worked.

Initial advice is that any communication regarding puberty needs to be open, frank and unambiguous - be direct. Make contextualised rules of conduct and reinforce these visually. You can use a 5-point scale to indicate things that are ‘ok' and things that are ‘not', or ‘things that are uncomfortable' and things that are ‘ok', etc. 

ASD students are most likely to not have other peers to bounce information from to make sense of this period of transition. Talk through any new situations that may occur, using scenarios to discuss what should happen next, or what should be said, etc.

Some students with ASD find the changes that are happening to their bodies very difficult to cope with and menstruation adds to this dilemma. Using a calendar and visual reminders about changing pads can help with this - plan and prepare is the key. 

The author Kate Reynolds has a series of books, including one about puberty, which might be useful for them to read.

Make the implicit explicit when it comes to sex and relationships - students with ASD find non verbal cues/communication difficult to read or to even be aware of. There is also a lot of misunderstanding and misinterpretation of teenage social rules and these may need to be spelt out, with the help of scenarios or even stick figures with speech balloons. 

Consent is also an issue - we find that girls with ASD will give their consent (even when they do not want to do something) because they believe that this is what neurotypical teenagers do: 

‘I thought to get a boyfriend you had to agree to have sex with them and so I told the first boyfriend I had that I knew about this and would have sex.'

‘ I wish I had learnt to keep myself safe and what is meant if someone asks you to go for a walk and then they want to touch you - I did not understand.' 

Open communication may be facilitated by reading a selection of books together and discussing them. 

Here is a link to a review of the book (M is for Autism) which staff and students from Limpsfield Grange School wrote, available from amazon. This article talks about the book and might be a good place to start:

I would also recommend reading ‘The Growing Up Guide for Girls: What Girls on the Autism Spectrum Need to Know!' 

There are many issues for girls with ASD at puberty:

● Feeling totally out of control - mood swings and how to understand these

● Not being prepared for the intensity of emotions

● Help with practicalities - wearing black knickers when menstruating

● Help and advice about personal hygiene - acne, antiperspirants 

● What to do with body hair

● Dealing with any sensory issues or hypersensitivities.

Parents need to try to be one step ahead through the teenage years, so that they can help to plan and prepare their teenager for that ‘next step'. Reading some of the literature that has been written by women with aspergers may also help to avoid pitfalls. Be ready to set the boundaries and social ‘rules' for each context - eg visual reminders, as laminated cards.

Sarah Hendrichx's book, ‘Women and Girls with Autism Spectrum Disorder: Understanding Life Experiences from Early Childhood to Old Age' is a useful read. 

Rudy Simone's book , ‘Aspergirls: Empowering Females with Asperger Syndrome', is also good.

Robyn Steward's website and book both offer detailed advice about life as an adult with aspergers which they may be able to start to relate to: www.robynsteward.com/

Parents also need to monitor the ongoing use of the internet, going in to puberty, as ASD teens are particularily vulnerable and there are many different (sometimes very serious) issues and problems which particularly result from students with ASD having unsupervised access of social media sites, gaming etc. 

The NAS website is a valuable tool, as is the ‘Autism Speaks' website in the US. 

The NAS have a great set of pages about sex education and puberty: