Puberty in Autism Teens (Boys)

As we discussed last week, puberty is one of the most challenging developmental states both for the child and also the parents. Many parents fear approaching the subject and are worried on how to relate the information to a child with autism. Individuals on the spectrum often need longer to adjust and understand the process of puberty.

The same goes for boys. Boys also undergo various physical changes that may be unnerving to some of them. Generally, boys’ puberty lag behind girls and usually occur between the ages of 11 to 13 years old for boys. They develop growth spurts, bigger hands and feets, muscle mass, deepened voice, facial and underarm hair, development of the pubic area and also nocturnal emission.

Nocturnal emission (e.g.: wet dreams) and the first appearance of semen can be a very difficult process to explain for many parents. Therefore, many parents tend to avoid the subject altogether. It is important calmly explain what is happening and how they’re body is changing and developing.

Talking to your son about puberty

When?

Start early. It is best to touch the topic of puberty before obvious signs of puberty and physical changes begin. You know your child best, so you’re the best person to decide how much preparation time is needed for your child to understand (Raising Children Network, 2015).

What?

Teach body parts

Introduce formal and appropriate words for body parts. Give them words that they can use later to express the changes and prevents confusion such as penis, erection, mustache for body parts and urinate, ejaculate for bodily functions. This prevents confusion (Vanderbilt Kennedy Centre, 2013). Attached below are several resources that you can use to help teach your son the body parts and changes.

Teaching bodily changes

When your son reaches puberty, many changes will happen and it is important that you talk to your child about these changes before they happen so that he does not think he has done something wrong. Many teen boys’ voice will start to change and deepened. Use visuals, videos and make connections other changes in your son’s puberty such as growth spurts and facial hair. Many teen boys also ejaculate or have nocturnal emissions while sleeping during the onset of puberty. This process is normal and a natural part of puberty and is also beyond your son’s control. Keep calm, explain to him what has happened. It cannot be prevented, so teach him what he can do afterwards such as changing the sheets, cleaning his genitals and putting his underwear into the laundry.

It is understandable that this topic is particularly a taboo or difficult subject for many parents. Parents tend to shy away from approaching the subject, but remember, your son is still a child. He knows little about the subject and these rapid bodily changes are new to him. Be the safe haven he can learn appropriately from.

Encourage good hygiene

Good hygiene habits are important especially after the onset of puberty. As boys enter puberty, common trouble spots for boys with autism include keeping clean hair, making sure they stay fresh from body odour, and shaving. This is often a struggle for individuals with autism due to the sensory and motor aspects of the task (Vanderbilt Kennedy Centre, 2013). There are several ways to help with this including social stories, creating a hygiene kit, making a picture book, etc. Good hygiene can improve your child’s self-esteem and independence as well.

Keeping it private

Lots of bodily changes that a boy goes through are private matters. Nocturnal emissions are a private matter. Teach your son that he should not discuss it with friends, teachers, or strangers. Teach him to understand that he can only talk about such private matters with his parents or the doctor.

Appropriate and inappropriate public behaviour

As a growing adult, your son needs to learn what is appropriate and inappropriate behaviour in public. As individuals with autism struggle with social cues, they are often unaware that there are social cues of what can and cannot be said/ done in public. Your son needs to learn that private behaviours such as going to the bathroom, passing gas, touching private parts for any reason, and changing clothes are inappropriate in public areas and must be done behind close doors (Vanderbilt Kennedy Centre, 2013).

Parents tend to note that it can be a struggle to prevent their child from touching their “private parts” completely. All kids at some points discover their “private parts” and such behaviour is often impossible to prevent. However, there are ways to teach your child which parts of the body are “private” by describing them as parts of the body covered by an underwear or swimming trunk. Use social stories, or visuals to remind them of rules such as “No hands in pants” or bringing activities that will keep their hands active such as handheld games.

Performing socially appropriate behaviours will help your son adjust better with peers and reduce the changes of being bullied. Helping your son understand appropriate and inappropriate public behaviours also decreases run-ins with the school or police as they grow older.

Choosing appropriate undergarments

As your son grows into becoming a young adult, choosing undergarments become an issue as well. Helping your son choose between boxers and briefs depends on what your child is most comfortable with. Boxers are easier to pull on and off while briefs provide more support. Help your child pick up a few different kinds in the store and let him try them out at home to see which he is best comfortable with (Vanderbilt Kennedy Centre, 2013).

Moods and feelings

Often, along with puberty are hormonic changes and mood swings. These feelings are slightly more difficult to track as they are not physical. Moodiness or agression can sometimes be normal during puberty and it would be best to teach your son to label such emotions, so that he can express them verbally during such times. If your child is less verbal, pictures are good (Dubie, 2014). Teaching them to identify their emotions may help decrease frustration and lower the risk of an outburst due to changes.

Here are certain things you can look out for and track in your son:

- Emotions

- Behaviours: Pacing, rocking, etc.

- Agressions

- Appetite

Wellness and health: Stomach aches, headaches, body aches, etc.

- Sleep

Energy level

Explain that boys and girls develop differently

Again, to avoid confusion, it is also best to touch the subject of the opposite gender with your son – for instance, a boy does not develop breasts or a girl has different body parts  (Autism Victoria, 2006). An “all about me” book may help your son understand the changes that will happen to both genders and also help him track his changes over time.

How?

Use visual supports and stories

Approach and teach the subject of puberty as how you would teach your child any other important topics. If your child works best visually, use social stories to explain the changes. You can also use a diary with pictures of when he was young to present for her to track her changes. If your son learns best through repetition and simple steps, break down more complicated tasks such as shaving into simple and concrete steps and constantly review those steps with her. Use schedules and make each task rewarding or interesting.

Use appropriate language and terminology

One of the many fears that come with the subject of puberty for parents is the terminology attached to it. Many parents are unsure which words are appropriate to be used, especially with the availability of sexually explicit content almost everywhere.

Give your child both formal terms and everyday words that are appropriate to label their body parts and changes. Be careful with the use of your language, especially since individuals with autism have a tendency of being very literal. Instead of describe their voice as ‘breaking’ – which in their case may actually worry them as they’d think their voices are really ‘breaking’ – try to be more concrete and explain it as ‘Their voices will change and will get deeper. Boy’s or men’s voices are usually deeper than women’s’. Also, give them more concrete examples such as relating it to an adult they are familiar with.

Ask a professional

It is often wise to get helpful tips from a professional. Talk to your child’s teachers, doctors, or therapists for ideas and also updates that you may have missed throughout the rest of her day.

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Resources

A parent’s guide to puberty for boys with disabilities

This is a great all-round guide that touches almost every subject from hygiene, appropriate behaviour, hormones and undergarments.

Puberty health education curriculum for boys on the spectrum

Puberty and children on the autism spectrum

Puberty information sheet

Hygiene checklist

What’s happening to Tom?: A book about puberty for boys and young men with autism and related conditions

Reference:

Davis, K. (2013). Relationships, puberty, and sexual health. Retrieved from: http://theautismblog.seattlechildrens.org/relationships-puberty-and-sexual-health-this-months-autism-200-class/

Dubie, M. (2014). Puberty and children on the autism spectrum. Retrieved from: http://www.autism-society.org/wp-content/uploads/2014/04/LWA_Puberty.pdf

Raising Children Network (2015). Children with autism spectrum disorder: Getting ready for puberty. Retrieved from: http://raisingchildren.net.au/articles/autism_spectrum_disorder_puberty_teenagers.html/context/1360

Vanderbilt Kennedy Centre (2013). The healthy bodies toolkit. Retrieved from: http://kc.vanderbilt.edu/healthybodies/

Autism Victoria (2006). Information sheet: Puberty and autism spectrum disorders. Retrieved from: http://www.autismtas.org.au/attachments/article/26/Info%20Sheet%20Puberty.pdf