How to Best Handle Puberty in an Autistic Child

Article cover

Few people have fond memories of puberty. But for people with autism, puberty is more than an annoyance. Physical changes, emotional disturbances, and routine alterations can add up to significant distress, especially when they're unexpected.

Discussing autism and puberty is critical. Talk with your child openly, and explain what to expect. Don't wait for your child's body to change.

These discussions may seem uncomfortable, but they can help your child move through the transition with grace.

Why Should You Talk About Puberty?

Your child's body has grown and changed since birth, and chances are, those alterations pass by unremarked. You don't discuss why your child needs new shoes or bigger pants or why her forehead widens. These things happen, and you respond. Puberty is different.

Puberty causes deep alterations in:

  • Mood. Hormone fluctuations spark a similar swing in the way your child feels. Strong emotions like anger or sorrow can well up, and without an explanation, a child could be intensely confused about how they're feeling and why it's happening.
  • Body shape. Hair grows, and acne develops. Boys experience voice changes, and girls experience breast growth and menstruation. Any child can feel bewildered by these adjustments, but for children with autism, they can be alarming.
  • Sexual feelings. New hormones can mean new feelings about others. Some children with autism feel ashamed or worried about their fantasies, and others may grow angry when their outreach efforts aren't reciprocated.
  • Routine changes. For many people with autism, adjustments to everyday activities are deeply distressing. But new hygiene requirements will change a child's life. They may need to learn how to shave, use maxi pads, and more. Many children need coaching on these new steps.

Parents guide their children from birth to adulthood, and puberty comes with plenty of lessons. No child expects a parent to be perfect, but all children deserve help as they navigate challenging moments.

Parents who talk to their children about puberty can head off panic and confusion. Their talks can help children understand what to do to stay healthy as their bodies change.

How to Talk With Your Child

Autism is a spectrum disorder, and some children have strong verbal skills others lack. You're accustomed to how your child communicates and what's required to keep the conversation flowing. Following a few tips could help you handle a talk about autism and puberty, no matter where your child falls on the spectrum.

During your talk, it’s wise to:

  • Speak clearly. Call body parts by their anatomical names, and avoid euphemisms. Remember that people with autism often prefer direct, literal speech. Slang and jokes can make the conversation confusing.
  • Use visuals, if needed. Some verbal children appreciate diagrams, and some children with autism don't speak at all. Charts, photos, and graphics can also give you something to look at during uncomfortable moments.
  • Prepare for questions. Your child may follow up your talk with immediate queries. Or you may get questions later during inopportune moments. Use a rehearsed phrase, such as, "That is a good question. Let's talk about it at home when we're alone."
  • Keep the talk short. You can't cover all items about autism and puberty in one massive conversation. Know you'll revisit this issue, and don't overwhelm your child on the first try.

If you're uncomfortable and need a break, explain that to your child. Be open and honest to gain trust.

Special Topics to Mention

Most puberty talks center around body changes. Parents explain how their children will look different due to hormones and growth. Children with autism may need to spend more time on a few important topics.

Girls with autism may need to discuss menstruation. They need to know:

  • How to care for their bodies. Instructions about sanitary products and cleansing are critical.
  • Why this happens. Bleeding is distressing, and some girls with autism worry that their bodies are somehow defective or broken. Explaining the biology behind menstruation can help.
  • How to prepare. A calendar or visual can help girls understand when this issue will come back.

Boys with autism may have questions about nighttime emissions and erections. They may also need reassurance that impure thoughts or broken bodies don't cause these issues. They may appreciate instructions about how to clean up.

Both boys and girls need instruction about privacy. Cover:

  • Definitions. What spaces does your family consider private? Are both bedrooms and bathrooms included?
  • Anatomy. What parts of the body are private? Who should see them? What should a child do if someone touches them in a private area?
  • Acceptability. What can children do in private? What can they do in public?

Every child is different, and your child may wish to discuss things others do not. Be as open and honest as you can.

Support Your Child Through Puberty

With difficult discussions handled, your child is prepared to enter puberty. Your work isn't done. You remain your child's most important ally, and your guidance and support are critical.

To help your child through puberty:

  • Stay open. Don't dismiss questions or concerns. Be a guide for your child.
  • Encourage self-regulation. Entice your child to meditate, do yoga, or exercise. These activities can calm the mind and ease some of the discomfort raging hormones can cause.
  • Offer more freedom. Adolescence comes with demands for independence. Refuse those outlets, and your child may not comply with your requests as a form of defiance. Give choices about meals, activities, and outings. Let your child feel some of the benefits of their increasing age.
  • Step in when needed. Your child may need help putting on a bra, changing a sanitary pad, or swapping out soiled sheets. Help as much as you can with a positive attitude.

Extra Help Is Available

Some children with autism grow so distressed and upset with puberty changes that they lash out with violence. Others pepper their parents with around-the-clock questions that seem impossible to answer. Remember that you don't have to do this alone.

Reach out to counselors to guide your family through this challenging time. A therapist might help to:

  • Facilitate awareness.
  • Develop self-care plans.
  • Teach new social rules.
  • Create visual supports.
  • Teach your child how to use hygiene products.
  • Enhance independence.

If your child is verbal and interested in learning more, lean on published guides from the Organization for Autism Research or La Trobe University. They can't replace your loving, one-on-one conversations, but they could give your child the added information required.

If, despite your best efforts, autism and puberty combine into violence and tantrums, get help. Explain your difficulties to your therapy team, and ask for advice on how to handle the conversations. Don't be afraid to reach out when you're overwhelmed.

References

Families Struggle to Cope With Autism and Puberty. (April 2016). Spectrum.

Autism in Teens: Helping Your Child Through Puberty. (September 2018). Autism Speaks.

Helping Tweens and Teens With Autism Master Puberty Health and Hygiene. (July 2017). Autism Speaks.

Preparing for Puberty: Children With Autism Spectrum Disorder. (January 2017). Raising Children Network.

Sex Education and Puberty. (April 2018). National Autistic Society.

Your Changing Body: Answers for Boys With Autism. (December 2017). The Nemours Foundation.

Puberty. The Autism Community in Action.

Is Their Autism Getting Worse When They Reach Puberty? (April 2011). Psychology Today.

Puberty and Adolescence Resource. (October 2014). Autism Speaks.

Sex Ed for Self-Advocates. Organization for Autism Research.

Puberty: A Guide for Teenagers With an Autism Spectrum Disorder and Their Parents. La Trobe University.