Autism spectrum disorder(ASD) is not a degenerative disorder,it’s a neurodevelopmental condition.Deficits in social communication,social interaction,manifestation of restricted, repetitive patterns of behaviours,interest and activities are the key features of Autism spectrum disorder.These symptoms will be manifested during the early Developmental period.ASD is a life long condition whose cause is unknown .But a positive family history,low birthweight,infections in mother during pregnancy period either bacterial or viral,increased parental age,gender(ASD is diagnosed four times more in males than female),fetal exposure to valproate,having genetic or chromosomal conditions like fragile X syndrome,Rett syndrome etc are some of the risk factors for ASD.
An individual with ASD,like everyone, goes through several Developmental stages including sexual development.But due to the limited understanding about sexual expression of persons with ASD,their sexual behaviours are often considered or misinterpreted as abnormal or dangerous.”Problematic Sexual Behavior” or “Inappropriate Sexual Behaviour” in
ASD is defined as a repetitive and intense preoccupation with sexual fantasies, urges, and
behaviors, leading to adverse consequences and clinically significant distress or impairment in
social, occupational, or other important areas of functioning (DSM-5, American Psychiatric Association, 2013).The causes of problematic sexual behavior in ASD includes;sensory deficit,social skills deficit,Theory of Mind (TOM) difficulties and repetitive ritualistic stereotypic patterns of behaviors.
As reported by Hellemans (2007) Dewinter & Vermeiren (2014) Realmuto & Ruble (1999)Denise 2015, individuals with ASD due to sensory deficit exhibit behaviours such as rubbing their genitals in public,they may rub their genitals on other people or objects,touch others cloths and body etc.
Individuals with ASD have deficits in social skills.These deficits in social skills make them hard to understand healthy versus unhealthy boundaries( how to set boundaries with people,how much closeness he/she could have with other people,how to prevent when someone tries to cross these boundaries,difficulty in understanding what is friendship and what is relationship etc).They can face difficulty to understand healthy versus unhealthy relationships.They also face challenges to understand which are the behaviours that are accepted or appropriate in public settings and those behaviours that are appropriate in private setting. An individual with ASD may appear “quirky” or “odd” to others who may not understand autism and its characteristics (The National Autistic Society, 2008).Repetitive ritualistic stereotypic patterns of behavior(fixation on body parts,obsession with ponography etc),sexual victimization,lack of sex education ,premature sexual development (onset of
signs of puberty prior to the age of 8 years in girls and 9 years of age in boys (Motzin 1993)) etc are some of the other reasons.
Some of the possible remediation for this includes ,provide sex education(about appropriate social sexual skills),eliminate if there is any medical or organic cause,avoid overreacting to these behaviours etc.Sex education is very much import among these.We can use techniques like social stories,social skills training programme,role playing ,providing visual support ,use videos etc.
