Case report: 16-Year-old male with autistic disorder with preoccupation with female feet.

A therapist worked with a 16-year-old boy with autism who kept making sexual comments about women’s feet. The team called the problem “relationship-skills training” so the teen would buy in.

They used exposure therapy. He looked at pictures of feet while practicing calm, polite talk. Sessions ran once a week for a few months.

The comments dropped from one or two every month to one every six months. The teen also started asking age-appropriate dating questions instead.

Parents and teachers saw the change at home and at school. No new problem behaviors popped up.

Hodges et al. (2020) later treated the same foot-fetish behavior with a short rule plus fun alternative tasks. Both studies got near-zero comments, showing two roads to the same goal.

Prigge et al. (2013) used graduated exposure plus prizes to help an autistic teen enter feared school rooms. The step-by-step plan mirrors the foot-picture steps, proving exposure works for very different fears.

Guertin et al. (2019) cut preschool obsessive behaviors with exposure plus response prevention. The core idea—face the trigger and don’t do the old act—holds from age 4 to 16.

You can re-label sexual behavior as “social skills” and use simple exposure to cut it. Try short, visual sessions and track comments per week. If the teen stalls, add Hodges-style rules or fun tasks as a backup.