Puberty in Autism Teens (Girls)

Most individuals with autism have a difficult time with changes and are very comfortable with familiarity and sameness. So one can imagine the stressfulness and uncertainty that occurs when their physical appearance start to change drastically and rapidly. It is not enough that they have a terrible time with changes, but that the changes are happening to themselves personally and that they have no control over the changes.

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. They also might need a longer time understanding how puberty implicates their lives. If your child is not prepared for these bodily changes, puberty may cause confusion, frightened feelings and stress due to the rapid changes that they have no control over. It may be a good thing to get your child accustomed to the idea of puberty by starting preparations early (Raising Children Network, 2015).

Every child is different and there is no way to know exactly when puberty hits your child. The onset of puberty depends relatively significantly on genetics, puberty, social factors and more. However, as a guideline, puberty often ranges around 8 to 13 years old for girls and 9 to 14 years for the boys (Davis, 2013).

Contrary to what some may believe, autism does not affect the onset of puberty.

Talking to your daughter 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 vagina, breast for body parts and period, menstruation for bodily functions. This prevents confusion (Vanderbilt Kennedy Centre, 2013). Attached below are several resources that you can use to help teach your daughter the body parts and changes.

Encourage good hygiene

Good hygiene habits are important especially after the onset of puberty. As girls enter puberty, they many need to wash their hair and themselves more often and 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.

Appropriate and inappropriate public behaviour

As a growing adult, your daughter’s body becomes even more precious and it is important that she knows that too. 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 daughter needs to learn what is appropriate to do in public and what can only be done in private. An example of private behaviour may include passing gas, touching private parts for whatever reason, or changing clothes (Vanderbilt Kennedy Centre, 2013).

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

Introducing appropriate undergarments

As your daughter’s body begins to change, she will begin to develop certain body parts and bodily changes such as menstruation. You will need to help your daughter by introducing bras to her and preparing her for her period. Again, starting early, talking to her about it, and helping her step-by-step would mean a lot to your daughter and provide a secure-haven for her who is unsure and overwhelmed with changes.

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 can sometimes be normal during menstruation and it would be best to teach your daughter to label such emotions, so that she 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 daughter:

- Emotions

- Behaviours: Pacing, rocking, etc.

- Agressions

- Appetite

Wellness and health: Stomach cramps, 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 daughter – for instance, a boy does not develop breasts (Autism Victoria, 2006). An “all about me” and “all about boys” book may help your daughter understand the changes that will happen to both genders and also help her track her 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 she was young to present for her to track her changes. If your daughter 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 the opposite gender’s 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 girls with disabilities

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

Puberty health education curriculum for girls on the spectrum

Puberty and children on the autism spectrum

Puberty information sheet

Hygiene checklist

What’s happening to Ellie?: A book about puberty for girls and young women 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