Everything They Wanted to Know about Sex but Were Afraid to Ask: Assessing Knowledge of Sexuality and Relationships with Parents and Children with ASD

Background:   Individuals with ASD have less information about sexuality, rely on their parents more for information, and experience fewer opportunities for social contact and learning than their non-ASD peers. In addition, individuals with ASD have less sexuality education in school and display more inappropriate sexual behaviors. 

Objectives:   To investigate the knowledge that individuals with ASD and their parents have about sexuality and relationships, as well as assess parents’ levels of confidence in teaching their children with ASD about sexuality. 

Methods:  103 individuals with ASD (83 males) aged 9-18 years (M=13.0, SD=2.1) without Intellectual Disability (mean IQ=102.3, SD=17.0, range 80-149) and their parents participated in this study. All individuals possessed a clinical diagnosis of ASD. Parents completed the Parenting Self Efficacy Scale (PSES) as well as a knowledge questionnaire assessing knowledge of sexuality and relationships as well as differences in the social development of their child with ASD. Individuals with ASD completed the Social Self Efficacy Scale (SSES) and two measures created for this study: a knowledge questionnaire, which had similar questions to the parent questionnaire regarding sexuality and relationships, as well as questions pertaining to video vignettes they watched, which also assessed knowledge of sexuality and relationships. 

Results:   Youth with ASD demonstrated gaps in their knowledge about sexuality: their mean percentage correct on the knowledge questionnaire was 70.5 (SD=14.1) with more than half of the participants scoring lower than 70%. Questions about the video vignettes were more difficult for the youth and the mean percentage correct was 57.9 (SD=14.9). There were no significant correlations with age, and teen IQ was weakly correlated with the knowledge questionnaire (r=.25;p>.05), but not performance on the video vignettes (r=.18;p=ns). Parents also demonstrated limited knowledge of sexuality and relationships, their mean percentage correct on the knowledge questionnaire was 68.6% (SD = 8.7).  On the SSES, youth with ASD felt most confident in their ability to wear the kind of clothes they like even if they are different from what others wear (65.1% said that was “Very Easy”) and least confident in their ability to ask someone to go to a school dance or movie (49.0% said that was “Impossible”). On the PSES parents reported they felt most confident in their ability to explain to their child how someone can get AIDS if they don’t use a condom (69.8% said they were “Completely Sure”) but least confident in explaining to their child how to put on a condom (52.8% said they were “Not Sure at All to Moderately Sure”). 

Conclusions:   Both individuals with ASD and their parents had limited knowledge of healthy sexuality and relationships. It was especially difficult for individuals with ASD to interpret and respond to questions about real scenarios they observed in video vignettes. Parents of individuals with ASD were not confident on all their abilities to teach sexuality education to their children. There is a need for a specialized sexuality education program for individuals with ASD and their parents that targets social interactions and relationships.