Autism & Developmental

Aspects of Sexuality in Adolescents and Adults Diagnosed with Autism Spectrum Disorders in Childhood.

Fernandes et al. (2016) · Journal of autism and developmental disorders 2016
★ The Verdict

Most autistic teens and adults show sexual interest, but lower adaptive skills and higher autism severity raise the risk of inappropriate or paraphilic behaviors.

✓ Read this if BCBAs serving adolescents or adults with moderate-to-severe ASD in day, residential, or transition programs.
✗ Skip if Clinicians who only work with preschoolers or with verbally fluent adults without behavior concerns.

01Research in Context

01

What this study did

Fernandes et al. (2016) tracked 184 teens and adults who got an autism diagnosis as kids.

The team asked about sexual feelings, dating history, and any sexual behaviors others might see as wrong.

They also rated each person's autism severity and daily-living skills.

02

What they found

Most participants showed sexual interest, but about one in four had acted in sexually inappropriate ways.

People with more severe autism traits and lower adaptive skills were more likely to have paraphilias or problem behaviors.

The authors urge clinicians to screen for these issues, not to assume asexuality.

03

How this fits with other research

Postorino et al. (2017) looked for autism in teen girls hospitalized for anorexia and found almost none. That seems opposite to Cabral's high rate of sexual issues in ASD, but the samples differ: acute anorexia patients versus a childhood-ASD cohort.

Lehnhardt et al. (2016) studied late-diagnosed adults and showed that women camouflage better and score higher on planning tasks. Together with Cabral, this tells us sex and functioning level both shape adult outcomes—cognitive, social, and sexual.

Roberts et al. (2008) followed similar adults and found one in six develop new psychiatric disorders. Cabral extends that picture by adding sexual behavior problems to the list of later-life risks.

04

Why it matters

If you work with teens or adults who have classic autism, ask direct questions about sexual interest, knowledge, and behavior. Use visuals or social stories if language is limited. Watch for red flags when adaptive scores are low or when repetitive behaviors spill into sexual themes. A quick screen can prevent police calls, shame, or victimization.

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Add two questions to your intake: 'Has anyone ever worried about your sexual behavior?' and 'Do you understand private versus public body parts?' Use a simple visual checklist if needed.

02At a glance

Intervention
not applicable
Design
case series
Sample size
184
Population
autism spectrum disorder
Finding
not reported

03Original abstract

The literature concerning sexuality in autism spectrum disorders (ASDs) is limited regarding inappropriate sexual behaviours and paraphilias and its relation to age, verbal ability, symptom severity, intellectual ability, or adaptive functioning. A cohort of 184 adolescents and young adults (ages 15-39 years) with ASD diagnosed in childhood, including both low and high functioning individuals, was examined. The large majority were found to have a sexual interest and showed interest towards the opposite sex. Inappropriate sexual behaviours and paraphilias were reported for about a fourth of the individuals. No relationships were found between inappropriate sexual behaviours and any of the background variables listed above. However, associations were found between paraphilias and ASD symptom severity, intellectual ability, and adaptive functioning.

Journal of autism and developmental disorders, 2016 · doi:10.1007/s10803-016-2855-9