Practical Strategies for Managing Sexually Inappropriate Behavior in Teens With Autism
Effective approaches for managing hypersexual behaviors in autistic teenagers underscore the necessity of educating parents and caregivers. These strategies stress the importance of professional intervention, the formulation of safety plans, and the instruction of appropriate social skills and sex education. This podcast also delves into the hurdles parents encounter when broaching the topic of sex education with their children, the effects of exposure to sexually explicit content, and the crucial role of empowering children to make informed decisions about physical affection.
Raising a teenager is tough, and when autism enters the mix, the challenges can feel even more daunting. Imagine navigating the intricate world of teenage behavior, only to face the unexpected twists of hypersexuality. You're not alone, and there's a path forward—one filled with understanding, empathy, and practical strategies. Join Tiffany Herlin, LCSW, and Matt Call, LMFT of Oxbow Academy as they discuss:
- Education and resources for parents and caregivers to better manage sexually inappropriate behavior.
- The crucial step of seeking professional help and creating safety plans, especially if there's a victim involved.
- The importance of proactive parenting and using teachable moments to discuss sexual content.
- Sensory strategies and healthy coping mechanisms that are essential to help teens regulate their emotions and behaviors.
Concerned about your teen's escalating sexual behaviors? Don't wait. Get the support you need now. Oxbow Academy can help. We offer personalized support for families facing these challenges. Call 855-676-4272 to learn how we can guide your family toward healing.
Introduction
Tiffany: All right, welcome back. My name is Tiffany and we have Matt again with us today from Oxbow Academy. And today, in this episode, we're going to be talking about practical strategies for managing hypersexual behaviors and tips for caregivers and parents for monitoring technology. Now we've talked about some of these things already. So a few of these might be a little bit of a repeat, so we won't dive in as deeply.
Practical Strategies for Parents and Caregivers
Tiffany: What are some practical strategies for parents and caregivers to manage hypersexual behaviors in teenagers with autism? So where can we start with, with parents?
Matt: Well, and I think once again, the place I would say is start by educating yourself. Learn what you can about this particular issue. There's a lot of great resources out there, particularly if it involves sibling sexual abuse. There’s a great book out there called “Sibling Sexual Abuse: A Guide for Confronting America's Silent Epidemic.” It’s by a researcher named Brad Watts, who has done a lot of work great work on understand sibling sexual abuse.
There's resources like ATSA, that's the association for treatment of sexual abusers. Like I said, we mentioned the NOJOS in the last episode. There’s a variety of resources, but get educated about this particular issue and I guess that's the place I would start.
Tiffany: Yeah, which leads to seeking professional help, finding a therapist who is not only skilled to help your child, who is struggling with this issue, but also finding a therapist for yourself and if needed also a therapist if there is a victim involved as well.
Creating safety if there's a victim. And also I'd like to develop a safety plan that they can work with their team to outline what to do in the event of a sexual crisis or emergency. And that doesn't necessarily mean like if they are acting out with someone else, but also if they are exposing themselves online. you know, Maybe even looking up deviant and dark web pornography, how to help them navigate that and help them through that.
Matt: Well, and a lot of times one of the big challenges is that it's not uncommon for many of the students I've worked with who go online looking for companionship, they go online looking for friendship, and they go online looking for willing sexual partners because they don't think they can find them in their regular school.
And the problem is that's a seedbed for all sorts of bad actors. A lot of times I think parents will express concern because it's like, I've got a kid and he's like giving our personal contact information out to somebody who ostensibly is 14 years old, but who may very well be a 40 year old man in some basement somewhere, you know?
And so I think there's a lot of fear about, you know, what if my child is also going online and doing these things that are putting us and the family and everybody else at risk.
Tiffany: Yeah. Or in putting them at risk. That can lead to them being victimized a lot of times, which is what unfortunately we have seen.
Matt: Yeah, absolutely.
Teaching Sex Education and Social Skills
Tiffany: And that leads us to really making sure that we teach them appropriate social skills and communication and then specifically about sex education as well.
Matt: Which we recognize is kind of a touchy subject because obviously there's a lot of opinions about that and I've worked with a lot of parents that come from a lot of different backgrounds, a lot of different perspectives on what should and should not be taught to kids and at what age, and those are all very valid concerns. And part of the challenge I think for a lot of parents is I don't know what my kid has already been exposed to.
Tiffany: Yeah.
Matt: And I don't want to give them too much information, right? Especially if giving them too much information is going to trigger something in the more deviant category. But you also want to really know what they have been exposed to and it's hard because a lot of times kids are not going to talk about that.
I don't have an easy answer for that as far as like, what is too much. But I think part of it is how you present it. I think you can teach almost anything as long as you know how to teach it in a way that shows these are the consequences for some of these kinds of things. This is why this is wrong. Some people think that this is an okay behavior. Here's why our personal value system is against that. Or this is why this is something we're not okay with.
Tiffany: Or even what's socially acceptable. Parents who are neurotypical are not going to process things the same way as a kid who has Autism Spectrum Disorder, so they may not think that they have to spell out a specific, I'm trying to think of an example.
Matt: Well, masturbation is really, really a simple one.
Tiffany: Needs to be in private and the door shut and not in a room with someone else. But a lot but of times kids who are on the spectrum don't even think about that. And they need someone to sit down and have that open conversation that's not shame based to help them answer questions and help guide them of like, this is appropriate and this is not appropriate.
And it can even be something as simple that's not sexual as well.
Proactive Parenting and Communication
Matt: I will say this. One of the things that I think goes a long way when it comes to this kind of stuff is an ounce of prevention is equal to a pound of repair.
Half the challenge is, a lot of times as parents, we tend to be reactive. You know, we only speak up and talk about something when it's become clear that it's become a problem. And the problem is that if you use reactive parenting, a lot of times you're already too late.
Tiffany: Well, you're just on the defense.
Matt: Yeah, exactly. And so I think a good place to start is anytime you perceive something that could be even slightly construed as possibly arousing or triggering for these kids, call it out. You know, I remember this happened several years ago. I was working with a kid who was really big into the Transformers movies and, You know, we'll get into it, this is not a cinematic podcast. It won't get into the cinematic value of those movies, but I can tell you one of the things that the first couple of films did, it very, very clearly intentionally was the camera work was done in such a way that it was meant to draw specific attention to one particular female character. And she later criticized the director for this and a variety of reasons. You have become very sexualized. And I remember, it's not uncommon for kids to go see movies like that, you know, and if, as a parent, I'm sitting here and I'm watching a what should be just a kid show, a fun kid show like Transformers with my kids and I'm watching this camera slowly pan up a girl's backside while she he's leaning over a car, right, that's a teaching moment. That's an opportunity to say, why is the director focusing on that? What is he wanting you to focus on? Right. How does that make you feel? Right. You know, those teaching moments come a lot of times when we're not expecting them. And if you do that when kids are pretty young, before they start getting into those awkward teenage years and they don't want to talk about those things with you, they're going to be a lot more likely to talk about those things with you if you've set that this is a family where we talk openly about this stuff.
Tiffany: I think that's the bottom line for me is a lot of parents that come to Oxbow, not all, but I wish they would talk about things more openly whether it's social skills or sex education, I wish they would talk about it more, right. Not saying that they haven't, not saying that they haven't tried. Yet, I wish they were more courageous and more open to have that dialogue with their kid.
Matt: Well, and that's especially challenging if parents themselves have sexual trauma, which a lot of our parents do.
Tiffany: That's a good point.
Matt: A lot of our parents are victims of abuse themselves. And so it's that double edged sword of like, I'm raising a child who's a perpetrator, right. Or who has perpetrated it. And I am myself, I'm a victim. And so, it's hard to disentangle that issue of like, how do I develop comfort to talk openly about sexuality when doing so triggers my own trauma or my own shame or my own stigma about it.
Importance of Open Conversations and Destigmatizing Topics
Tiffany: Which in that case, seeking out a professional therapist to help you navigate those waters is going to be highly important, you know, and if you aren't in that situation as a parent. Please have these conversations with your kids. Don't be shy away. Don't stick your head in the sand hoping that they'll figure it out because unfortunately we're living in a world that is constantly bombarding our kids who are either on the autism spectrum or not. It doesn't matter. Our kids are being bombarded with things that are of a sexual nature. And if we aren't talking to them about what is morally acceptable in our family or even, socially appropriate and healthy, then our kids are going to be confused and not understand where the line and the boundary is.
So a big thing is please talk to your kids and that's going to help with destigmatizing this topic. And it's surprising what kids may perceive as appropriate and not appropriate and just not even understanding to have with your kids.
And one other thing I think that is important to point out is using positive reinforcement. If you have a child who comes to you, who especially is on the spectrum, who has a question about even a sexual topic, rather than avoiding it, like praise them. That's a time to be like, I am so glad that you came to me and trusted me with this really difficult conversation or difficult question. Let's talk about that. What does that look like? And not be afraid to more than anything, just focus on rewarding that behavior.
Matt: Right.
Tiffany: Because if you can do that versus shaming it and avoiding it, that's just going to tell them that this is not a safe place to talk about it and I can't get answers from this person. And therefore I'm going to go on the internet and seek things elsewhere.
Matt: Yeah. What you're trying to create is a situation where I am the safe person. And the relationship is really what heals. But that's what's going to guide your kids through these difficult things because you're in for a long, I mean, depending on how big of an issue this is, you might be in for a really big process and it might be going on for a while and what your kids need to know is regardless of whatever boundaries you have to set for safety and stuff like that, because there might be some legitimate issues with that. You might have to say to them, we're going to have to send you to a residential program. You're not going to be able to see your sister again until you've gone through this clarification process. But they need to be able to know through that process that that relationship is still going to be solid.
And if you build these issues by starting with keeping that relationship solid and establishing I'm a safe person, which is, I know what you just said, then that's going to be what's going to help you get through those, those really difficult times.
Trauma from Exposure to Sexual Content
Matt: Part of the challenge is that a lot of times exposure to this sexually explicit material online is always inherently traumatic. And here's the reason why it's inherently traumatic is, when someone is sexually abused, like a child is sexually abused, molested, what essentially is happening is they're being exposed to an adult world of sexual content they are not cognitively, emotionally, or socially mature enough to know how to deal with that. They're just not. And if you're in a situation where an uncle, right, shows a 10 year old kid, an eight, nine year old kid, pornography, rightly so, we go arrest that uncle and we charge him. That's exactly what should happen in those kinds of situations. If someone is exposing a child to those kinds of things, we rightly go and we arrest that person.
The problem is what do we do, what's actually the difference between the eight and nine year old who gets exposed to it because the uncle shows it to them and the eight, nine year old who stumbles upon it on the internet. The answer is no difference whatsoever. They're still not cognitively ready for it. They still don't understand it. It still shakes up their world. It still changes, in some ways permanently, the way they view the world. But the difference is who do you hold accountable in that situation? But it's still traumatic, right? And so treat early exposure to sexually explicit material with these kids as if it was a trauma on par, almost with being abused, because for a lot of these kids, it is.
Tiffany: Well, it's creating neural pathways in their brain that they're not ready to create and maybe aren't even healthy, right? And it's sending off dopamine and oxytocin that is confusing to them, right? Like I'm watching this. It feels good. I feel close and attached to whatever I'm watching. Yet, I also know this isn't necessarily appropriate at times, or they may have some awareness, like, This also isn't probably right. Or they may not. They may think, Oh, this is great. You know, what a great outlet.
Matt: It feels good. I've worked with so many kids that the word they will often use is comfortable. It feels comfortable to be touched sexually. And it's like, yeah, absolutely. It does. It does feel comfortable. It's a good thing. And it's a good thing for a reason. And if used in the wrong direction, the wrong situation, it becomes a very destructive thing where you can cause a lot of damage and a lot of harm. But for a lot of these kids, it's like, but it feels good.
Tiffany: Which is confusing. Why would I stop?
Understanding Healthy Sexual Behavior
Matt: And I think it's important that parents make that clear with, and going back to the non shaming, non stigmatizing, you want to be really clear with these kids. The fact that you have sexual urges is okay. The fact that you have sexual thoughts and feelings is okay. Those are healthy. Those are normal.
What's not normal, and this is where you get into the line between what is problematic sexual behavior and what is not, what is not normal is to do something that's not consenting, is to do something when you are too young or the other person is too young, is to do something where there is, you know, manipulation or coercion, right?
I have to kind of trick or force this person into it. And just being really clear about this is where we have to draw those lines. And of course we're talking from a public health perspective. If you come from a highly religious family where your standards are even further above that, right.
You know, I've worked with a lot of kids whose parents say, we don't believe in masturbation. We don't believe in pornography. We don't believe in any sex before marriage. That's fine. That's your belief system. Hold to that. Teach your kid that, but also help them understand this is why we have this belief, right?
This is why we have this belief is because we want you to have a really awesome sexual relationship with your future wife.
Tiffany: That's healthy and within these boundaries.
Matt: Yes, healthy, that's within these boundaries. That's why we want you to, because it's so good. We want you to have that. We're not trying to say we don't want you to have this. We want you to have it at the right time, the right place with the right person.
Tiffany: And that's a pretty abstract concept for any kid to understand. Most kids are pretty concrete and black and white. And then you throw in autism spectrum disorder, which makes it even more concrete and black and white.
That's a tough concept and a conversation you should be continuing to have. I know we've been talking a lot about kids who may be sexually acting out with someone else younger than them. Let's also acknowledge that there's a chance that if you're not having these conversations with your child who's on the spectrum about what is healthy sexual boundaries and education, there is an opportunity that they could be abused as well at a very young age, if they don't understand, you know, about their private parts and not sharing them with others. And when appropriate, like the doctor with, you know, your parent in the office is appropriate, but yet the doctor alone, you know, those kinds of things, because that's a very adult abstract world and understanding the social skills and the boundaries and what's healthy and not is complex.
Educating on Consent and Grooming
Matt: Yeah. And that's where, and I think you mentioned this in the last episode, that's where you have to check in with them to make sure they're really getting it, you know, and you know, I think using social stories, using really any resource where you can role playing obviously is a good example of that. "Let's role play this. There's a girl you're interested in. You want to talk to her. What does that look like?
Tiffany: Yeah.
Matt: And there's resources out there that talk about teaching grooming. What does grooming look like? And they'll do that in a story format so it feels less kind of attacking, less intrusive. And, you know, so you can use those kinds of resources as well.
Tiffany: There's one on consent too.
Matt: There's, yeah, great things. There's three resources that I always turn to with consent depending on the kid that I'm working with.
Number one is there's a really great manual out there. It's for working with sexual offending specifically. It's called Pathways. It's one of the ones we use at Oxbow. And they have a consent bridge in there that is these nine pieces of consent. And basically the idea is you've got you on this side, you've got your partner or potential partner on this other side. And if you want to be sexual with this person, all nine pieces of this bridge have to be in place. And if all nine of them are not in place, you fall into the water and get eaten by the sharks, right? Yeah. You know, problems happen, right? You get into trouble and I like that. That's really concrete.
I love the Planned Parenthood FRIES consent model, where it talks about it's freely given, it's reversible, it's informed, it's enthusiastic, it’s specific.
And then one of my absolute favorites, I always show this to the kids at work, is the consent tea video on YouTube, where they just basically go in and they say, "If you're having a hard time understanding consent, just imagine it's you're giving someone tea, right?" So someone walks in and you say, "Hey, do you want tea?" And they say, "Yeah, sure. I'd love tea." You give them tea. If that you walk in and they say, "I don't know." You don't give them tea because they didn't say yes to it. If they're, if they're asleep on the floor, you don't come and pour tea down their throat. And it's a fantastic model.
So those are three of the resources I will often use. And again, there's so much out there that parents can use. Most of what I do, especially in the first phase of treatment at Oxbow, is largely psychoeducational stuff that parents could totally do. In fact, a lot of times I work with kids where they already know some of this stuff.
Tiffany: Yeah.
Matt: I'll walk in and I say, tell me what consent means. And they'll basically give me some version of the consent bridge. And it's like, okay, so you understand some of this already. That's good. You know, that tells me your parents were trying to educate you about some of this stuff.
And then you also teach consent in other areas like, we've been running into this one a lot. It is not uncommon for, say, a grandparent to come and visit and they want to give their grandson or their granddaughter or whatever a hug. And if that granddaughter or that grandson is autistic, they may be real iffy about touch. They may not want to be touched. And a lot of times grandparents say, "Well, come give me a hug, right?" And if parents are not being mindful, they may say, "Give grandma a hug." And the problem is, is what that teaches the child is, even if I'm not comfortable with this, I have to do it because this is a grown up and they're an authority figure and they're telling me what to do.
And so you set that foundation of consent in all areas and it doesn't just have to be sexual. We want to teach these kids that you are the one that gets to decide whether something is something that you're going to do or not. Nobody gets to force upon you any kind of affection. So if you don't want to kiss, you don't have to have a kiss. If you don't want to give grandma a hug, you don't have to give grandma a hug. And that's where you educate the adult. And you say, "Grandma, she doesn't want a hug. Stop trying to give her a hug if she doesn't want one."
Tiffany: Maybe do a high five this time, if they're comfortable with it.
Matt: Exactly.
Tiffany: Yeah, I love that. There's so many resources. There's also one other last thing to touch on is sensory strategies to help kids. Tell a little bit more about that.
Sensory Strategies and Regulation
Matt: Oh, this is one of my favorite things to talk about. So, I don't know how many of you are familiar with Daniel Siegel's work, but he does a lot of work on neuroscience, talking about the brain.
One of his big holdovers that I use a ton with the kids, we talked earlier about hyperarousal and hypoarousal. So, he presented this idea of what he called the window of tolerance. Basically there's this space between when I'm feeling too much of something and when I'm not feeling enough of something, when I'm feeling, you know, angry or stress or rage versus when I'm feeling boredom or sadness or depression or shame.
And there's this space of, "this is what I can tolerate that's in between that." That's the window of tolerance. And you're kind of constantly going up and down and doing these different strategies to try to manage that. And one of the big things that you're going to see, especially with autistic kids, is they use stimming to try to get themselves back in that window of tolerance.
And again, one of the big mistakes that we make, I mean, I ran into this just the other day at Oxbow, we were running a group and there was a student who had these little sticks and he was just kind of drumming them against the, against the armchair and it was obvious he was stimming, right?
Because he was feeling stressed and it was his way of being anxious. Well, because that's kind of an obnoxious behavior and some of the other kids are up here in their window of tolerance and their stress and they're like, "Shut up, you're making too much noise. You're driving me nuts." Right?
And so you've got one kid who is trying to up himself up to trade to regulate, you've got another kid that's trying to bring themselves down to regulate and it creates friction. But the problem is that I think a lot of times we will penalize kids who are using maybe obnoxious, maybe loud, maybe not our preferred way for them to, to cope, but there's nothing inherently wrong with taking sticks and drumming on a couch, right?
And in this particular situation, it was clear that this kid was trying to regulate and his peers got after him and staff got after him and they said, "Stop it. That's being annoying," or whatever. And what was interesting was we finished up the group and within 10 minutes, he's out there running the halls and causing all sorts of mischief and chaos and stuff like that.
And I just sat there and thought, you know if we'd have just given him that little space to kind of stim in a healthy way, maybe we wouldn't have run into these bigger problems down the road. Now granted there are some forms of stimming that are obviously problematic. You know, I've worked with a student that had a tendency to shove things up his rectum, which is obviously not okay because that creates scarring and it's not sanitary and there's a lot of problems with that. So knowing what stimming behaviors are okay and what sensory aids and supports are going to help the kid regulate and just kind of recognize the difference between when it might be obnoxious, but it's not really a problem.
Replacing Unhealthy Coping Skills
Tiffany: Well, I think interesting to point out to parents is helping them understand how you can use healthy sensory strategies to help their kids navigate, like you were saying to regulate themselves or even also regulate themselves sexually, right? Oftentimes, at Oxbow, we say what kids are doing is to help them navigate difficult emotions. And some of the coping skills that they've learned are not healthy. So our job isn't to just take away all their coping skills because that's what they have. We then have to replace them with healthy coping skills. And that's the same as a parent who may be working with a therapist is understanding like, okay, this behavior, yes, is unhealthy and, and is causing issues. What can we do to help replace that? And what is the need met versus this, sensory strategy while maybe annoying, isn't causing any harm or issue and I'm recognizing that's helping my child regulate.
Matt: Right. And it might get wrongly interpreted, like we said last time, as defiance or indifference, you know, he's reading a clarification letter and he's doing it with a flat tone of voice and he's spinning around in his chair and he's spinning a fidget spinner while he's doing it. That does not mean this kid doesn't care about what he's saying. What it means is he's trying to keep himself in his window of tolerance so that he doesn't bounce out of it and get to the point where he's dysregulated.
And the problem is when they're dysregulated, you can't teach them. It's not a matter of they're being stubborn or defiant. If a kid is legitimately dysregulated, their brain is in a state where they cannot learn, they will not learn. It just cannot happen. And so you want to keep them in that space. And we can teach our kids, here's healthy ways to keep you in a space. I have a tote that's full of a variety of different fidgets.
I've got fidget spinners, silly putty, you know, I've got this little clicker thing that a lot of times the kids use. I keep toys in my office, you know, stuff like that, that they can fidget with and they sometimes need that, or sometimes they need to get up and move around. So I'll do walk and talk therapy and say, you know, hey, the basketball court's out there. Grab that basketball. Let's go out and talk about that that way, because there's something about that movement that helps them regulate. But if you want to help your child stay in that space, know what your boundaries are and hold to them. But also try to give them as much latitude as you can, because if they're doing it consistently, there's a reason they're doing it. And they're probably doing it because it's helping in some way. It might not seem like it, it's helping them in some way.
Tiffany: One of my favorite things to do is we had a swing at Oxbow and I had a student who just struggled to stay on task and focus and really struggled to process whatever assignment we were working on. And I took him to swing and he zeroed in and focused when he was moving. It was just remarkable. And I had another one that we would go for runs during our sessions and the same thing. So that's important.
Seeking Support and Practical Strategies
Tiffany: Lastly, I think, you know, we've already touched on this, but ultimately one of the practical strategies is seeking support, whether it be through a therapist or support group. These are just a few practical strategies that parents can use. There's obviously a lot of resources. Please educate yourself.
The next episode, I know we talked about including it in this one, but we ran out of time and there's just so much to talk about it. So we're going to actually do it for the next episode, which is going to be tips for parents and caregivers for monitoring technology, which is a big one. So stay tuned.
Matt: Okay. Thanks.
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