Sexual Development

Even parents with normal children often find sexuality a difficult subject to discuss, yet it's far too important a topic to avoid. Most adolescents between 13 and 18 report frequently thinking about sex, and 50% say they engaged in sexual intercourse before age 18. Adolescents with AS-HFA may lag in emotional or social development, but for many their biological drives develop on time. Given the reticence about personal matters so typical of those with AS-HFA, it is even more important for you than for a parent of a normal child to approach your child about this topic. Sometimes parents of children with AS-HFA wrongly assume that delays in social development and interests give them permission to delay conveying information about sexuality and puberty. We recommend, however, that you deliver this information on the same timetable, or even earlier, as you would for children without AS-HFA. In fact when it comes to discussing sexuality, it's not a question of ifbut of when. The answer, we firmly believe, is early. Don't put off this essential discussion until a crisis occurs. Important issues to address include sexual intercourse, birth control, nocturnal emissions, breast and tes-ticular self-examination, masturbation, and menstruation.

Be specific and concrete in your discussions of sexuality with your child. Provide factually accurate information in a comprehensible and straightforward manner, perhaps referring to a book with illustrations. For example, set up a concrete system and schedule for hygiene related to menstruation. In addition to showing your daughter the materials she will need to use and how to use them, you might also want to furnish her with pictures or photographs showing the order in which each step is carried out. Be specific about how often she will need to change her pad or tampon. Allow her to use a watch with a timer, if necessary, or mark in her day planner when she needs to visit the bathroom. If your daughter's menstrual cycle is regular, mark the days on the calendar each month that she will need to carry supplies with her. Write out a script that she can use in class to ask to use the restroom.

Masturbation is another important topic to discuss with your adolescent. Masturbation is a natural means of exploring developing sexuality. Teach your child very specific rules in terms of when and where masturbation or the discussion of it is appropriate. One adolescent we know was so excited when he discovered masturbation that he began telling all of his friends about his wonderful discovery. His parents certainly wished they had thought to discuss the topic with him before he brought it up.

Since, particularly in adolescent boys, sexual arousal can be unpredictable but conspicuous, it is also helpful to work out a plan of action to help your child manage such circumstances. For example, you might tell your son that when he has an erection, he should remain seated or go to the restroom. One precaution to take when the teenage years of spontaneous erections approach is to make sure your child does not wear certain types of pants to school. Sweat pants, for example, can make sexual arousal extremely noticeable.

It's important not just to broach the subject of sexuality with your child but also to revisit it periodically to ensure that your child thoroughly comprehends the social rules surrounding sexuality. The best way to do so is to make sure that your child knows it is okay to talk with you about these matters. For a child who is not forthcoming, it may be necessary to approach him or her for an official update every few months. In a worst-case scenario, misunderstandings in this area could lead to individuals with AS-HFA becoming either unwitting sexual offenders or vulnerable to sexual victimization. If you find these topics too uncomfortable to broach, enlist the aid of a pediatrician, psychologist, or other health professional.

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