Issue 15 – Q&A Section
I have a daughter that is ten with autism and I don’t know how to explain or talk to her about when girls get their monthly period. I am worried how my daughter will react when she gets her first period.
Answer: Many parents with children on the spectrum, as well as most parents with typical children, have problems with talking to their children about puberty and the beginning of menstruation. So many parents see their children as innocent and these parents have fears of destroying that innocence by revealing what society considers adult issues to the child. Unfortunately, this leads to seriously dangerous consequences. Every girl needs to know and has a right to know everything about her body and how it works. This does not take away her innocence, it protects her from disease, predators, and other societal dangers while at the same time empowers her to know what it truly means to be a woman, what her body can do, and when it is appropriate to talk about certain topics and allow others into her personal space.
The first thing any parent must do is to educate himself/herself on puberty, sexual maturation, and the pre-teen and teen social environments. You cannot give your child accurate information if you do not know enough yourself. Did you know that most adult women (all women, not just those on the spectrum) do not know the correct terms for their sexual organs? For example, many women do not know that the vulva is the external area of the female genitals, whereas the vagina is the internal tubular tract of the female genitals. They are two separate sex organs. Likewise, slang terminology and vague references such as “down there” should never be used when talking about female sex organs or sex in general unless used as examples of other things people may say so that the child is familiar with and aware of what others may be discussing around her or with her at any given time.
Next, after the parent educates herself and makes sure she has all the answers (or knows where to find the answers) to possible questions her daughter may have for her during a discussion, she can then go on and casually ask her daughter what she knows about puberty and if she knows what a girl’s period or menstrual cycle is. The parent may be surprised with what her daughter already knows, and surprised at the possible misconceptions her daughter may have. Initially, parents should talk about the mechanics; every month a girl goes through a menstrual cycle where the uterine lining is shed, (pictures and examples should be shown to illustrate.) This information can be readily obtained via the internet, of course monitored first by the parent before showing the information to the child.
During any discussion about puberty, menstruation, or sex the parent should be calm, cheerful, and show no signs of anxiety or stress. All children, even those on the spectrum, pick up on this. Menstruation is not scary, it is not horrible and it should not be treated as such. It should be treated as normal, natural, and something every woman shares. After describing the mechanics the daughter needs to be shown and given options for cleanliness. The proper use of pads, tampons, and how to properly wash herself throughout her period should be demonstrated and shown to her long before her menstrual cycle begins. She needs to be well prepared ahead of time. You want her to learn these behaviors from you the parent, not a teacher, school nurse, or stranger. For those on the spectrum surprises are not usually welcome, if she is well prepared and knows exactly what to do when her period occurs, she will most likely be perfectly fine.
Additionally, another important thing to discuss is when it is appropriate for the daughter to talk about her period and body changes. For instance, she needs to be explicitly told that she should not raise her hand in class to “change a tampon” but to simple raise her hand and ask to use the restroom. Many on the spectrum do not know what needs to be kept private and what is open knowledge. She needs to be told this directly. Bodily functions in our society must be handled discreetly. This needs to be taught explicitly, clearly, and thoroughly. Furthermore, since the parent will be having a discussion about the child’s body it is also the perfect time to talk about appropriate and inappropriate touch, and what to do if she isn’t sure. The child is to be told directly using the correct words where she can and can’t be touched. A safe bet is telling her that no one is allowed to touch anything her clothing covers with the exceptions being few and listed.
To summarize, the key points are to give the child as much accurate knowledge as possible so that her classmates and other people she comes in contact with do not give her inaccurate information, to explain exactly what menstruation is and its purpose in blunt and proper terms, to show her how to remain clean and hygienic during her menstrual cycle and be assured that she can handle this on her own without her parent’s presence, appropriate times to discuss sexuality, and finally what is and isn’t appropriate physical contact. All of this must be accomplished, and as soon as possible. Remember, this discussion does not have to take place all at once. Spread it out over a week or two because no child (autistic or not) can hold attention and process all of that information in one conversation. Also, don’t feel that your job is done after the talk is over. The lines of communication must always remain open. The parent should always ask questions and provide additional age appropriate information about sexuality as her daughter gets older. If the parent is unsure about certain things she herself must educate herself before speaking with her daughter, or better yet research the topic together!
Question: Should I discuss puberty with my son?
Answer: Yes, discuss puberty with boys on the Autism Spectrum
While boys do not go through a reproductive cycle like menstruation when puberty arrives, they still experience changes that can be significant and difficult for the child and parent to handle. Just like girls, the best course of action is to make sure boys are properly prepared for puberty ahead of time. Boys are not immune from disease, predators, and societal dangers. In fact, sometimes they can inadvertently be labeled as predators themselves if they are not properly educated in what is and is not appropriate contact and behavior with others. Puberty brings on instincts and desires that the child may naturally seek out (because it feels good), and to have information prior to these feelings and hormones coming into play will greatly reduce any problems for the future.
Typically, boys start puberty a little later than girls and one of the first changes is an increase in testicle size, penis size, and pubic hair growth. Those on the spectrum need to know it is safe to talk about these changes with a parent, but not with a stranger. These rules need to be learned before puberty, so that the child knows exactly what to do and who to talk to when he begins noticing changes with his body. Additionally, the increase of body hair and sweat glands calls for a discussion on hygiene and the importance of cleanliness. This issue is a common one for those on the spectrum, but where a child may be able to get away without bathing for a few days, a teenager will quickly develop odors that others may notice and find offensive. If there is an odor there is bacteria present and boys are not immune to bacterial skin infections, yeast infections, or other potentially serious consequences of not keeping clean. Teaching cleanliness before puberty begins is ideal so that hormones and defiant behaviors are not getting in the way of forming good hygiene habits.
The second change a boy notices is the ability to masturbate to ejaculation. Sometimes boys go through what is called “spontaneous erections” where there is no stimulus present to cause the erection. This can be scary or confusing to a child who has never experienced it before, and on the other end of the spectrum a child may not feel any embarrassment and begin to masturbate or display his erections in public. Before puberty begins parents must make sure their son understands that he must keep the action of masturbating private. A good way to help this process along before puberty is to teach the child to be clothed at all times except when bathing and alone in their room. Many parents with children on the spectrum have a hard time keeping clothes on their children due to sensory issues. Unfortunately, they then become teenagers running around naked. It is extremely difficult (but not impossible) to teach a teenager with a surge in hormones and defiant behaviors to put on clothes after spending years getting accustomed to the opposite. This must be taught before puberty and the concept that the penis must be covered and kept private a priority. This is important to discuss about others as well. It is not appropriate for a person to touch another person in their genital area. Children do not know this unless they are taught, and an autistic child may need to be taught this rule much more explicitly and completely in order for the rule to be learned and followed appropriately.
Furthermore, ejaculate must also be explained, similar to explaining the purpose of menstruation in girls. The biology and purpose of ejaculate needs to be described and understood so that the child knows the great power, responsibility, and reason for his erections. It is very important for a man to understand his role in reproduction, and again no slang terms should be used unless as an example of what others may say. The child must learn the correct terminology for all of his sexual organs and their functions. Additionally, banning masturbation is not going to keep your child from masturbating. In fact, it may simply increase the allure of the act. They must know how to do so in a cleanly way and dispose of the ejaculate properly. You would not let your child urinate on the floor, and they should not ejaculate on the floor either. The child must be taught that it is okay to masturbate privately but not when others are present, and if he chooses to do so privately he must clean himself properly just as he would after using the bathroom.
Lastly, most boys experience what is called a “wet dream.” This is when the penis becomes erect and ejaculates during sleep. It is completely normal but surprising to a child who never experienced one before. They need to be warned that this could happen and what to do when it does. It is not something to be afraid of or embarrassed about. It simply means that the child’s body is growing into a new stage of development. No child should ever be shamed for masturbating or having a wet dream. This can cause serious psychological distress. Everything relating to sexual development should be dealt with calmly, completely, and without judgment. You would not yell at your child while potty training, and you do not yell at your child while they are essentially training to become an adult.
Remember, it can take a long time for puberty to reach its conclusion. For those on the spectrum who are resistant to change, puberty can be a very long and distressing time full of various bodily changes. The best way to ease the child’s transition into an adult body is preparation, communication, and patience. Give your child as much detailed knowledge about puberty as possible before he enters puberty, provide him with the purpose of puberty and why all children go through it, give him the opportunity to discuss and ask questions about his body without any feelings of discomfort or shame, and be patient with the frustrating behaviors that may come about during this time including: aggression, defiance, and emotional outbursts. For those on the spectrum these feelings are difficult to recognize and describe, so you the parent must help them interpret what they are going through and give them the tools they need to make it through as smoothly as possible.
Books on Puberty and Autism
Puberty in boys
Autism Parenting Tip: Make a Photobook
Jaclyn Hunt is a Certified Autism Specialist (CAS) and Life Coach who specializes in the Autism and Special Needs Population. She works with adults on the spectrum, parents of autistic children and adults, spouses of adults on the spectrum, and anyone affected by autism or other related special needs. Visit her website to learn more: