Socio-sexual functioning in autism spectrum disorder: A systematic review and meta-analyses of existing literature.
People with autism get less sex education and show more inappropriate sexual behavior, so BCBAs should bake sex-ed targets into regular social-skills programs.
01Research in Context
What this study did
Costa et al. (2017) pooled every paper they could find on dating, flirting, and sex education in people with autism. They compared these folks to typically developing peers.
The team looked at who got formal lessons, who could read social cues, and who showed risky or awkward sexual behavior.
What they found
Across studies, people with autism knew less about consent, birth control, and how to start a date. They also showed more public or unusual sexual behavior.
Schools and parents gave them far fewer lessons than their typical peers.
How this fits with other research
Lee et al. (2022) asked autistic adults where they learned about sex. Most said they taught themselves online because friends and partners rarely helped. This extends the 2017 finding into adulthood, showing the gap does not close on its own.
Gilmore et al. (2022) show group social-skills classes help teens with autism talk and play better with peers. Menezes et al. (2021) find the same in regular classrooms. These reviews overlap with some of the same teens, hinting that good social coaching might also boost dating skills if we add sex-ed goals.
Keenan et al. (2021) plan to pool video-modeling studies for young children. If those clips teach sharing and greetings, future clips could teach private vs. public body parts and safe touch.
Why it matters
Many BCBAs write social-skills goals but skip flirting, consent, and sexual safety. This review says we should not wait. Add simple, behavior-specific targets like 'labels private body parts' or 'asks for permission before hug' to existing social groups. Use the same prompting, modeling, and reinforcement you already know. Start early, track data, and update the plan before transition age so clients enter adulthood with both social ease and safety know-how.
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02At a glance
03Original abstract
UNLABELLED: Socio-sexual functioning encompasses an individual's interests, behaviors, and knowledge with respect to sexual, romantic, and social aspects of life. An individual's understanding of these domains is developed through a range of informal and formal avenues of sexual health education. The current model demonstrated this and proposed that, compared to typically developing individuals, those with ASD develop socio-sexual functioning differently due to having less peer engagement, less relationship experience, more parental guidance, greater use of online materials, receive less school-based sexual health education, and more support from wellbeing services. Systematic review and meta-analysis of existing literature revealed that individuals with ASD have greater difficultly adhering to privacy norms, engage in less social behavior, are described as engaging in less appropriate sexual behavior, have greater concerns about themselves, and receive less sexual health education. Having fewer opportunities for appropriate informal and formal sexual health education leaves them at a double disadvantage from others who are receiving this information from both of these avenues. Some of the current meta-analytic results are cautioned by large l-square statistics which suggest that a degree of variance is being caused by extraneous factors. Further empirical research in this area is needed to overcome current design and sample limitations. Finally, the Sexual Behavior Scale was the most commonly utilized tool in the meta-analyzed studies, thus comprehensive evaluation of its functioning is warranted. The importance of work in this area is highlighted by the central role of social and sexual wellbeing on one's quality of life. Autism Res 2017, 10: 1823-1833. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Review of existing literature revealed that individuals with ASD have greater difficultly adhering to privacy norms, engage in less social behavior, are described as engaging in less appropriate sexual behavior, have greater concerns about themselves, and receive less sexual health education. Having fewer opportunities for appropriate informal and formal sexual health education leaves them at a double disadvantage from others who are receiving this information from both of these avenues.
Autism research : official journal of the International Society for Autism Research, 2017 · doi:10.1002/aur.1831