As a pediatric endocrinologist, I often encounter early signs of puberty in my daily work. Puberty typically begins between the ages of 9 and 13 in girls, marked by breast development and the appearance of pubic hair.
Menstrual periods usually start between 11 to 14 years. For boys, puberty starts with testicular enlargement and the growth of pubic hair between ages 9 and 14. Other changes, like underarm hair, facial hair, and voice deepening, occur between 13 and 16 years.
If signs of puberty occur earlier than expected, this may indicate precocious puberty, which is more common in children with autism. In such cases, a referral to a specialist pediatric endocrinologist is often recommended.
Preparing for autism and puberty
While some schools may provide puberty and sex education at an age-appropriate level, many children with autism require additional preparation.
Autism and early puberty present unique challenges, as autistic children may need extra time and support to understand and adjust to changes in their bodies.
Hormonal shifts can lead to:
- heightened emotions,
- aggression,
- self-harming behaviors, and
- masturbation.
All of these hormonal changes can affect the day-to-day life of autistic individuals, which can be overwhelming. Even in children who do not have autism, puberty can be a difficult transition due to hormonal changes and requires a lot of support.
Helping your child cope with these changes by talking about puberty and using visual aids is crucial.
Explain and use labeled pictures to explain when puberty happens and how each part of the body will change, including all the fluids that will come out: sweat, tears, semen, menstrual blood, and vaginal discharge.
Addressing precocious puberty and autism
When puberty occurs earlier than expected, known as precocious puberty, it can present additional difficulties for children with autism. The early onset of physical changes may lead to confusion and anxiety, making it essential to monitor your child closely.
Early intervention and support can help mitigate the emotional and behavioral impacts of early puberty in autism.
Hygiene and shaving for autistic adults
As children with autism transition into adulthood, teaching proper hygiene becomes essential. For autistic adults, learning how to shave is often a critical part of maintaining personal hygiene.
Use visual aids to break down hygiene routines, explaining step by step which parts of the body need special attention in the bath or shower and how to shave safely and effectively.
It’s important not to assume your child knows things that may seem normal and natural to you, as these concepts can be unfamiliar.
Dealing with sexual urges during puberty in autism
During puberty, children often experience sexual urges, and masturbation is a natural part of this development. It’s important to explain the difference between public and private behaviors and reassure your child that these feelings are normal.
Make sure your child understands that activities such as undressing and masturbation should only happen in private. Safety is another critical conversation.
Teach your child to say “no” to inappropriate touch and to report if someone touches them without consent. Similarly, explain the importance of not touching others without their permission and talking to you if any of these things happen to them.
Navigating romantic relationships and sexuality
As your child moves through puberty, they may begin to develop romantic interests in others. This is a natural part of growing up. Help your child understand these feelings and sexual and romantic relationships.
To make the concept clearer, consider using social stories, visual aids, or stick figure drawings. Be prepared to discuss topics like sexual consent and the importance of safe, protected sex as they develop more understanding.
Be open to any questions they may have. Provide clear answers in simple language, and make your child feel comfortable and safe sharing these thoughts with you.
Quick tips for supporting autistic children through puberty
Navigating puberty can be challenging for autistic children and their families. As physical, emotional, and behavioral changes occur, it’s essential to provide guidance and support tailored to their unique needs.
Here are some quick tips to help you prepare and assist your child during this important developmental stage:
- Be prepared: Puberty brings many new challenges for children with autism, including emotional and behavioral changes. Preparation is crucial.
- Avoid assuming knowledge: Use pictures and clear language to explain how the body will change during puberty.
- Use visual aids to teach hygiene: Using pictures, explain how to properly wash, shave, and use menstrual products.
- Teach them about public and private behaviors: Also, emphasize the importance of safety, both personal and online.
- Be involved in your child’s curiosity: Answer their questions about relationships and sexuality and encourage open discussions where they feel safe.
Helping your autistic child navigate puberty
Puberty is an important developmental stage, with many changes that occur physically, emotionally, and socially. As parents and carers, puberty can be challenging, and it is advisable to be both prepared and informed about how to approach any related issue as it arises.
By staying informed, using visual supports, and maintaining open communication, you can help your child navigate these changes with confidence.
This article was featured in Issue 98 – Fresh ASD Guidance For A New Year
FAQs
Q: Do children with autism go through puberty early?
A: Some children with autism may experience early puberty, also known as precocious puberty, but it is not common. While research suggests a possible connection between autism and early onset of puberty, it varies from child to child.
Q: How does autism affect puberty?
A: Puberty can be more challenging for individuals with autism due to increased sensitivity to physical and emotional changes, as well as difficulty understanding social cues. Hormonal shifts may also heighten sensory sensitivities, anxiety, and behavioral challenges.
Q: What are the healthy habits for adults with autism?
A: Healthy habits for adults with autism include maintaining a balanced diet, regular physical activity, and structured routines. Additionally, self-care practices such as mindfulness and stress management can support emotional well-being.
References
Geier, D. A., & Geier, M. R. (2021). A longitudinal cohort study of precocious puberty and autism spectrum disorder. Hormone Research in Paediatrics, 94(5-6), 219-228. https://onlinelibrary.wiley.com/doi/abs/10.1002/aur.2406
Tsai, S. J., Lue, Y. W., Yu, C. H., Chen, T. J., & Chen, M. H. (2024). Autism and risk of precocious puberty: A cohort study of 22,208 children. Research in Autism Spectrum Disorders, 114, 102390. https://www.sciencedirect.com/science/article/pii/S1750946724000655
Finkle, A., Zavertnik, S., Myers, S., Cormier, D., Heithaus, J., & Augustyn, M. (2020). Growing up fast: managing autism spectrum disorder and precocious puberty. Journal of Developmental & Behavioral Pediatrics, 41(9), 740-742. https://journals.lww.com/jrnldbp/fulltext/2020/12000/growing_up_fast__managing_autism_spectrum_disorder.10.aspx
Groenman, A. P., Van der Oord, S., & Geurts, H. M. (2024). Navigating adolescence: pubertal development in autism spectrum conditions and its relation to mental health. Archives of Women’s Mental Health, 1-9. https://link.springer.com/article/10.1007/s00737-023-01414-0
Larson, S. K., Nielsen, S., Hemberger, K., & Klug, M. G. (2021). Addressing puberty challenges for adolescents with autism spectrum disorder: A survey of occupational therapy practice trends. The American Journal of Occupational Therapy, 75(3). https://research.aota.org/ajot/article-abstract/75/3/7503180020/12514
