Cross-Cultural Differences in Responses to Sexuality within ASD Across Asian and Australian Cultures

Background: Adolescents with Autistic Spectrum Disorder (ASD) have a nascent sexuality that continues to develop, albeit delayed when compared to their typically developing (TD) counterparts.  However, this then interacts both with parental and societal expectations.  Consequently, it is likely adolescents with ASD may express somewhat different sexual problems depending upon the ambient cultural milieu, in turn revealing something of the importance of culture to the development of sexuality among these persons.  Further, the extent to which stability is found across culture would reveal something of the biological contribution of ASD to the disparate sexual development in this group. 

Objectives: Thus, to explore the effect of culture upon the nascent sexuality of persons with ASD, we hypothesized that persons with ASD would be reported as having greater problems with sexuality than either other group, regardless of country. 

Methods: We examined TD persons (n=153), persons with ASD (n=66), and persons with Down’s syndrome (DS; as a second control; n=111) aged between 10 and 20 years of age from three cultures: Australia (n=129), India (n=120), and Singapore (n=81).  Using the Sexualised Behavior Scale - 2^ndEdition (SBS-II) we examined parental responses concerning their child’s Social Contact, Social Insight, Sexual Behavior and the Parents own future concerns. 

Results: Significant interactions were found across culture and condition for Social Contact (p<0.05, η_p²=.02), and after controlling for social contact, for social insight (p<0.001, η_p²=.10), and Parental Concerns (p<0.05, η_p²=.04).  Problematic sexual behavior was only differentiated by diagnosis (p<0.001, η_p²=.16), and remained significant even when controlling for social contact and social insight (p<0.001, η_p²=.07). 

Conclusions: These findings reveal that the profound issues that arise in sexual development remain difficult for persons with ASD after controlling for their social and cultural milieu. Thus, culture, while important, is not the cause of sexual problems observed among those with ASD.  Therefore, while interventions in this area need to be culturally specific and culturally sensitive, they first need to address basic issues common to all groups examined.