Autism spectrum disorders, sexuality and relationships

Autism spectrum disorders (ASD) are social communication difficulties which affect a person’s ability to understand socially appropriate behaviour. Therefore individuals with the condition are not necessarily aware, of or constrained by, the social rules which are observed by those who do not have an ASD. This presents difficulties for their development of sexual identity, sexual orientation and generally accepted sexual behaviours. These difficulties in turn influence the individual’s opportunity and availability for romantic and intimate relationships. Individuals with autism spectrum disorder typically have few or no friends and find it difficult to understand or follow the unwritten rules of sexual and relationship behaviour. They may engage in unacceptable behaviours in attempting to initiate romantic relationships and persist in pursuing a relationship even when it is very clear that the other person is not interested. This may lead to allegations of pestering, inappropriate physical contact or stalking.

People who have an ASD also have difficulties seeing situations from another person’s point of view. This can mean that they are unable to consider another person’s feelings, or they may think this person feels the same way as they do. For example, an individual with an ASD may have seen people kissing in the street; later they might approach someone they like, either someone known to them or a stranger, and kiss them. This might cause embarrassment or offence to the intended person, and their reaction may cause confusion and disappointment for the individual with autism. Perhaps they expected a more positive response: to be kissed or hugged back, as they saw happen with the couple on the street. Such examples demonstrate the complexities of socially appropriate behaviour. Individuals on the autism spectrum may need to be steered and supported by those around them to remember not to act on their impulses.

Several other characteristics of people with ASD interfere with the capacity to develop adult social relationships, which are necessary for developing sexual, intimate relationships.
Most significant is difficulty with social judgment, for example, missing nonverbal communication, poor eye contact, theory of mind (one’s ability to perceive how others think and feel, and how that relates to oneself) problems, and flexibility in responding to another person or situation. Lack of experience in peer relationships prevents the development of the usual ways through which adolescents learn about sexuality – from each other and from experimentation. Poor decision-making skills make it difficult to maintain the everyday details of a relationship, such as initiating dates, or remembering plans. Lack of flexibility and self-absorption, create significant areas of conflict in a potential relationship. Unregulated emotions, resulting in feelings that are too intense, or possibly misplaced, together, with a lack of awareness of the other’s response can prevent a relationship developing or quickly bring one to an end.

Many people with ASD have little self-awareness and do not understand their impact on others. People with ASD may have little knowledge about themselves. Part of what helps us create a sense of self is the ability to create an internal autobiography. People with ASD have difficulty in this area, as they frequently cannot describe their own emotions or are unaware of what they are feeling
or have difficulty controlling their emotional responses. As a result, many people with ASD lack the ability to understand themselves or respond to the social context around them. Self-advocacy, a crucial skill for maintaining one’s function in daily life, is something that can be very difficult for a person with ASD to learn. The ability to maintain personal safety without awareness of the environment or the behaviours of others can pose a significant danger.

People with ASD, either as a result of these difficulties or due to a true lack of social interest, can turn away from others into their own world. Self-absorption fosters another type of social disability. The need for aloneness or “down time” may be greater than the need to be with others, which may seriously jeopardize an attempt to relate to others in a more than superficial
manner. People with ASD frequently have little to no desire in sharing an all-consuming interest with others or attending to the interests of others, since there can be a lack of ability to detach from the area of interest without anxiety or distress.

The need for sameness and rigidity in daily routines may supersede one’s ability to flexibly respond to another person, for example, being unable to eat at another restaurant when only two specific restaurants are in that person’s repertoire.

Sensory sensitivities, such as the inability to tolerate touch or other physical sensations, sound sensitivities, or food texture issues can cause dating to be fraught with problems Such sensitivities can create intolerance of what may be considered part of the normal world. For example, sensitivity to sound may prevent someone with ASD from engaging in activities where airplanes may be heard overhead or babies may be heard crying. Sensitivity to touch can be especially difficult in relation to others, as those with ASD may not tolerate someone touching their skin or attempting to hug them. Heightened sensitivity may also affect the choice of clothes for someone with ASD, who may be un‐
able to wear clothes with sleeves or stripes made of particular materials,

Executive function impairments (impairments in decision-making skills, cognitive flexibility, impulse control, organizational skills, and planning) create another layer of social difficulty. Awareness of the passage of time may be compromised for someone with ASD and is an essential component of everyday function. Everyday memory problems or the ability to remember to plan and organize daily life activities can create social havoc. The ability to problem solve, make informed choices, or plan for the future becomes problematic.

All of these challenges are magnified when a person with ASD attempts to have an intimate emotional and perhaps sexual relationship. Intimacy is the sharing of emotional, cognitive, and physical aspects of oneself with those of another. A prerequisite for intimacy is the establishment of a firm sense of self-identity. Intimacy requires the flexibility to loosen one’s identity in order to feel the pleasure of merging with one’s partner in an emotional and physical connection. For all of the reasons above, a person with ASD may be unable to share with another or may be limited in his or her ability to do so.

There are various books which explain about forming relationships, for example the FPA book Talking together…about sex and relationships which describes how people make friends, become closer, become boyfriend and girlfriend, and eventually decide they would like to have sex with each other.

Fitzgerald, Harpur and Lawlor describe making friends at university, dating and how to be considerate towards other people’s relationships in their book Succeeding in college with Asperger syndrome. Luke Jackson provides some dating tips in his book, Freaks, geeks and Asperger syndrome, which have been suggested by his teenage sisters. There are also social skills or social groups in some countries which individuals with an ASD might like to attend.

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Disability and pregnancy

Women with some disabilities sometimes risk their health or even their life to have a baby.  What issues does the story below raise for you about disability, sexuality, risk and parenthood? Will  this child be disadvantaged or lucky to have such a determined mother?

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Dankinja Melek was born with no legs and one arm. Though the doctors told her that pregnancy could be dangerous for her, Melek will soon give birth to a child.

The doctors have told me that they are worried about me but I was not nervous, and I believe that it will be all right. I’m eight months pregnant and everything is fine – says Melek who is about to give birth to a boy. The boy currently  weighs three pounds, and Melek and her husband have decided to name him Semih Akin.

Melek says she got pregnant naturally. She added that at first she could not believe she was pregnant, and she made five or six tests to be sure. She admitted that the last two months have been very difficult. During pregnancy I obviously gained a few pounds and therefore generally lie down – Melek said. She is helped a lot to her husband Mehmet who is originally from Turkey. They met a few years ago. At first they were friends, and then they fell in love. They were married six years ago.

Originally prepared by: Bojana Minic

Translated and edited by: Matthew Griffiths

Source: magazine.invalidnost.net