Parents and Adults with Autism Spectrum Disorder: A Dyadic Study of Parent-Child Sexuality Communication

Background: Sexual relationships are associated with physical and mental health benefits¹ and risks. Despite the recent focus on improving adult outcomes in ASD and the interest most individuals with ASD have in sexuality,^2,3 research on parent-child sexuality communication (PCSC) in ASD remains limited.⁴

While parents are expected to be the primary source of sex education for children, some parents of youth with ASD are unsure of when and how to engage in PCSC and have concerns that PCSC could have unintended negative consequences (e.g., lead to inappropriate sexual behavior or fixation).⁷ In a recent survey of parents of adolescents with ASD, we found that most parents cover basic topics such as sexual abuse prevention, privacy, and hygiene, but are less likely to cover other important topics such as sexual decision-making, contraception, and romantic relationships.⁸ In addition, individuals with ASD may have a delayed relationship trajectory,⁹ causing parents to delay PCSC until they perceive it as being relevant. Thus, many individuals are left to learn from less credible sources, ^10,11 possibly explaining recent findings showing that individuals with ASD have lower sexual knowledge relative to their neurotypical peers, which has been shown to be associated with sexual victimization among adults with ASD.¹¹Therefore, it is crucial to understand factors related to PCSC in families raising a child with ASD.  

Objectives: In order to better understand how parent-child dyads engage in PCSC, we surveyed 56 parents and their adult children with ASD (mean age = 22 years, average or above IQ). 

Methods: Regression models were used to determine the role of adult variables (i.e., sexual behavior, interest) and parent variables (i.e., sexuality-related concerns, self-efficacy) in predicting PCSC. Parents also reported reasons why they had not introduced specific sexuality-related topics to their child. 

Results: Parents discussed a greater number of topics if their child expressed a desire for relationships or if they thought their child had engaged in intercourse (F(3, 51)= 9.065, p= .000, R²= .348). Adult social motivation, cognition, communication, and awareness predicted parental self-efficacy for engaging in PCSC (F(4, 49)= 2.586, p= .048, R² = .174), and self-efficacy predicted number of topics covered (F(1, 52)= 9.086, p= .004, R² = .149). The most common reasons that parents chose not cover topics were that their child had not shown interest in the topic (34%) and parental belief that the topic was irrelevant (27%). Contrary to previous findings, parents rarely endorsed that they did not know how to cover a topic (2%) or were afraid it would lead to negative outcomes (1%), and concerns about negative effects of PCSC did not predict the number of PCSC topics covered (F(2, 49)= .334, p= .718).

Conclusions: Parents rely on cues from their child to decide when and how to engage in PCSC. Support and resources may increase the frequency and depth of PCSC by enhancing parents’ self-efficacy. Encouraging parents to engage in PCSC, especially for those whose children appear disinterested in sex, might reduce the likelihood of negative outcomes such as sexual victimization.