Friday, June 7, 2024

Sex and Autism Spectrum Disorder: Deeper insights into complex relationships (NL-ATSA webinar)

By Minne De Boeck (Stop it Now! Flanders, University Forensic Centre, University Antwerp, Belgium) & Kasia Uzieblo (Helpline 1712, Vrije Universiteit Brussel, Belgium)

An essential goal of the Dutch-speaking affiliation of ATSA, NL-ATSA, is to bring science closer to local professionals, and thus, to strengthen the bridge between theory and practice. Therefore, NL-ATSA, hosts webinars and conferences on various topics relevant to our daily practice. Many professionals indicated that they increasingly encounter people with developmental disabilities, such as autism spectrum disorder, who conduct sexually transgressive behavior. Autistic traits seem to have a substantial impact on the experience of sexuality, sexual identity and sexual behavior. In addition, developing a healthy and safe sexuality can be challenging for people with autism. In times of social media and easy access to online sexual content, things only seem to get more complex for them. These challenges call for an autism-sensitive approach. The question that arises, then, is how to bring about such an approach in our practice? To shape such an approach, we obviously need, first, to understand how these individuals experience sexuality and where the concrete challenges lie.

For these reasons, NL-ATSA aimed to gain -and share- insights about the impact of autism on. NL-ATSA invited several (inter)national experts for an online webinar to discuss autism and (deviant) sexuality.

The first lecture was given by Dr. Wenn Lawson and Maree Crabbe (Australia). Dr. Wenn Lawson is an autism expert and Maree Crabbe is a pornography-education expert. Their presentation focused on the role of pornography on people with autism. Before explaining the role of pornography and technology, the meaning of the term ‘autism’ was briefly touched upon. Different terms are used to describe autism; hence, it is always necessary to check which term is preferred by people with autism. Today, pornography is more readily available than ever before. Also, it increasingly depicts more aggressive forms of sexuality. Since pornography is normalized by many people, pornography is a sexual educator for many. This has serious implications for young people's ability to appreciate and give meaning to concepts such as ‘free consent’ and ‘mutual respect’. The impact of pornography can be even more challenging for young people with autism. Throughout the presentation, the term ‘monotropism’ was strongly emphasized. Monotropic minds tend to have their attention pulled more strongly towards a smaller number of interests at any given time. This characteristic can lead to young people with autism being particularly vulnerable to the effects of pornography. Moreover, there is a risk of forming unrealistic and unhealthy sexual attitudes and expectations. For example, themes such as strangulation, violence, incest, etc. are becoming prevalent in pornography. Even though these themes clearly do not reflect normal and safe sexual behavior, this can be very confusing for young people with autism. These can create doubts about sexual identity, sexuality experience and sexuality (within relationships). This is partly because of their difficulties in interpreting facial expressions and body language, and the fact that the sensory systems of people with autism can be more easily overwhelmed. These characteristics may increase the likelihood of young people with autism becoming victims or even perpetrators of sexual crime, partly because of their distorted perception of what normal sexuality entails. Dr. Wenn Lawson and Maree Crabbe also gave various tips on how to deal with individuals with autism and the impact of pornography. Think about engaging in dialogue, offering adequate sex education, offering healthy alternatives but also posing certain restrictions. 

The second expert was Robert de Hoog (the Netherlands), physical therapist specialized in sensory information processing. His presentation focused on autism and sensory information processing. As humans we are confronted with an almost innumerable number stimuli from the environment and from our own bodies, through our senses. People differ in what kind of stimuli they find pleasant or unpleasant, that certainly applies to persons with autism as well. Furthermore, some people become under- or overstimulated. Understimulation involves barely reacting to a touch and may involve obsessive behavior. Overstimulated people may experience anxiety upon physical arousal and may perceive stimuli (e.g., touch) as painful. Since persons with autism often face under- or over-stimulation in sexual experiences, it is important to understand these processes when working on healthy sexuality with this target audience.

The next speaker of the webinar was Manon Heyndrickx (Belgium), a forensic psychologist at the forensic inpatient treatment centre PC Sint-Jan Baptist. She discussed how sexuality is experienced by people with autistic spectrum disorder and this from a theoretical standpoint as well as from her clinical practice. She portrayed this by showing the video ‘Mind My Mind’. The functioning of the brain of people with autism and how this functioning affects their view on sexuality was explained. Among other things, problems with central coherence in individuals with autism were addressed. Central coherence refers to people’s tendency to process information globally and in context. However, people with autism tend to focus on local rather than on global processing. Consequently, their processing of information is too detailed, too specific, too context-dependent and/or too absolute. In addition, sexual contacts tend to involve unwritten (social) rules, there is a lot of nonverbal communication and limited predictability. This is precisely what makes it so difficult for people with autism, partly as the result of a lack of social insight and skills, limited empathy, and a lack of inhibitions and knowledge. Preoccupations, sensory preferences and persistent, repetitive, behavior are also mechanisms that could explain their (deviant) sexual behavior.

Hence, although autism per se may not be a risk factor for the development of sexually deviant behavior, it is clearly important for clinicians to gain insight into how certain autistic characteristics influence their (deviant) sexual behavior. The numerous attendance during the webinar and the numerous questions NL-ATSA receives about autism in clients who commit sexual offenses, illustrate how important it is not only to discuss scientific insights, but also to give adequate attention to sharing good practices and clinical experiences.

The last speaker was Professor Kieran McCartan (United Kingdom). This presentation provided an opportunity to learn about the Prevent Through Support Project (2PS), a European Commission-funded project that aims to map and understand secondary prevention programs in Europe for (potential) perpetrators of sexual abuse of minors. The session introduced the project, discussed how professionals in our field can get involved and debated some of the challenges and opportunities for secondary prevention right now. Even though this presentation was not about sexuality and autism, this was an excellent opportunity to make our field aware of the necessary prevention initiatives currently underway.