Sexuality and Individuals with Autism and Developmental Disabilities

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Sexuality and Individuals with Autism and
Developmental Disabilities

• Dr. Vicki L. Isler, BCBA
• From Autism Spectrum Quarterly
• Holmes, Isler, Bott, Markowitz, 2005

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Overview of things to consider

• Degree of impaired judgment
• Relation to social interaction
• Limited research
• Making free decisions vs. External control
• Trend toward inclusion
• Leading a normal life?
• Sexuality as a quality of life indicator

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Definition

• Sexuality is a composite term referring to the
  totality of a persons being. It is considered
  with the biological, psychological, sociological
  and spiritual variables of life, which affect
  personality development and interpersonal
  relations. It encompasses bodily changes,
  feelings, gender identification and an array of
  behavioral manifestations (Littner, Littner and
  Shah, 2001, p.31).

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Issues to be addressed

• Prevailing attitudes of parents, educators,
  direct care workers and society regarding
  sexuality of individuals with autism and
  developmental disabilities.
• What policies are in place to protect the rights
  of individuals regarding sexuality.
• What level of education should be offered? Who
  should provide it?

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Cont

• What constitutes informed consent and who decides
  if individuals are competent to make their own
  decisions?
• At what point must behavioral interventions be
  put into place for the protection of the
  individual and/or others?

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Attitudes of Parents Professionals and
Society-at-Large

• Conservative views by parents
• Boys vs. girls
• Applying ones own moral standards and values
• Training on how to teach
• Little or no literature/curriculum
• Society does not view individuals with
  disabilities as sexual beings

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Policies Related to Sexual Activity

• Needed for schools and agencies
• Examples
• Public school
• Eden Family of Services

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Education and Training

• Who should teach the information?
• To whom should they teach it?
• At what age should it begin?
• What should be covered?
• How to asses comprehension?
• How much information is appropriate?

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Informed Consent The Search for Consistency

• Informed consent
• Proper educational programming
• Knowledge of potential risks
• Capacity to understand the concept of choice
• No consistent definition by all states
• Biological age vs. mental age
• Guardianship

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Establishing criteria for informed consent

• Absolutely necessary!
• Individual can demonstrate no
• Individual knows that having intercourse can
  result in pregnancy
• When given options the individual can make and
  informed choice
• Individual knows that intercourse/sexual activity
  can result in an STD

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Cont

• Individual can differentiate between appropriate
  and inappropriate times and places to engage in
  intimate relations
• Individual can differentiate between males and
  females
• Individual can recognize persons or situations
  that might be a threat
• Individual will stop a behavior if another
  individual tells him or her no

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Somewhat importance

• Individual can differentiate between legal and
  illegal sexual practices
• Individual knows how to prevent the spread of
  sexually transmitted diseases
• Individual asks staff or family members for help
  when needed

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Little importance

• Nine criteria were listed as of little
  importance. Interestingly, many of these
  concerned issues that are typically discussed in
  sex-education programs. Examples include
  ovulation, homo-sexuality, and proper names for
  genitalia.
• Lack of sexual interest

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Behavioral Intervention

• Harmful to self or others
• Restricts access to the community
• Impedes the learning process
• The Eden Decision Model (EDM)
• Behavior Risk Management (BRM)

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Dr. Vicki L. Isler, BCBAvicki.isler_at_edenservices.
org

• Eden Florida
• 13631 Learning Ct.
• Ft, Myers FL, 33919
• 239.437.5335