Many parents struggle with how to explain puberty to their children and how much information is necessary to include, preferring to use the metaphor of the Birds and the Bees than to talk openly about sexual development. For preteens with high-functioning autism going through puberty, they are less likely to understand that the Birds and the Bees are symbolic for their own journey and may have more questions about what is happening to their bodies.
Problems Dealing with Physical Changes
Everyone’s body changes during puberty as they transition to adult bodies, but it is hard for children that are less emotionally and socially mature. In addition to changing bodies, puberty is associated with the development of sexual feelings and social challenges. For many autistic children, puberty can be very overwhelming and confusing. Children with autism struggle with transitions and changes in their routine and understanding that some of their experiences are shared with others. Hormonal changes may trigger sensory overstimulation and social changes may lead to increased difficulty with social cues and social interactions. This instability in the routines they’ve gotten used to can contribute to lower self-esteem and higher anxiety.
When is it Appropriate to Start the Conversation?
Although middle school is assumed to be when puberty takes place, the start of puberty can range from 8-13 years old in girls and 9-14 years old in boys. It usually starts 1-2 years before a girl’s first period or a boy’s first ejaculation with the production of sex hormones, a growth spurt, and the development of body hair. When approaching the topic of puberty with autistic pre-teens, these guidelines may be helpful in helping them make sense of the process.
Don’t wait for them to ask you about it. It is important that kids are given some advance warning that puberty is an inevitable transition that they will go through. Even if you worry that they might not be mature enough to fully understand what it means, it is better that it is introduced to them before they start to panic about the physical changes they are experiencing. They may feel ashamed about the experience and may be unwilling to talk about it if they think there is something wrong with them.
Reassure them that puberty is normal, but that so is insecurity. While teenagers with autism may be more likely to struggle with accepting their new body and feeling out of touch with their identity, most teenagers feel insecure about their changing bodies and growing awareness of sexuality. Puberty is a universal process, but it happens at different times and varies in lengths for everyone. It is common for teenagers to compare their changing bodies to their peers; however, there is no standard “final outcome” for puberty based on body shape and size.
Keep the discussion open. As puberty can be a lengthy and gradual process, conversations about it should grow along with your child. Instead of dropping some fact bombs and not bringing it up again, remind them that you are always there to answer any questions they might have or to talk about their experiences. The questions they might ask may become more specific over time and will require more in-depth or honest answers than they were prepared to handle at a younger age. Children with Autism may need more time to process and understand these changes.
Adjust the stories you tell to accommodate their level of understanding. This does not mean withholding information, minimizing the impact, or lying about what the process may look like. Give them the correct information, but consider how what might help them process it more easily. This could include being careful about how you describe certain changes that may sound intimidating, using simpler language, offering visual representations, incorporating social stories, and offering to look up resources together.
Emphasize social and emotional changes as well as physical changes. Social expectations become intensified in adolescence due to increase in romantic interest and formation of cliques. Teens with autism may struggle more with understanding these changes and connecting to peers. Their interests may come across as more child-like and they may feel more socially isolated. Hormonal changes in puberty can lead to mood swings and difficulty regulating emotions. Feelings of depression and anxiety may increase during this period, although signs may be expressed differently in teens with autism as increased irritability, changes in eating and sleeping patterns, and disconnect from their emotions.
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