Presentation on theme: "Clinique Autisme et Asperger de Montreal"— Presentation transcript:
1 Clinique Autisme et Asperger de Montreal Healthy Sexuality for Individuals with Intellectual, Developmental Disability and other conditionsIsabelle Hénault, Ph.D.sexologist & psychologistMontreal, CanadaClinique Autisme et Asperger de Montreal
2 Definition of sexuality Few research & clinical attentionNormal part of development and lifeComplexity of sexuality: more than behaviours!
3 Intellectual and Developmental Disability Profile Social skills: free of social rulesCommunication abilities: verbal and non verbalTheory of Mind: different ways of thinking?Emotions: detecting, reading, expressingSensory issuesImpulsive behavioursCo-morbidity (other diagnosis)
7 Fears related to sexuality Not being able to provide correct answer to a questionSTDs & AIDSUnwanted pregnancyUnions, couples, marriageSexual exploitationJudgment of othersHigher level of sexual interest
8 Issues of developmentSexual behaviours: self-stimulation, exploring sexualityFrustrations and inappropriate behavioursGender identity & role definition:flexibility, conflict, confusionSocial imitation: context, consent
9 Issues of development Interpretation of emotions: black & white! Interpersonal relationships: couples, empathy, intimacy. Confusion & anxiety, disappointmentSexual drive, desire, curiosity
10 Factors influencing social and sexual development (Griffiths, 1999) InformationBasic knowledgeExperiencesSocial supportLimitations of the environmentGender segregationSocial networkRulesSex education
11 Factors influencing social and sexual development IntimacyInterests and limitsPrivate and public settingExplorationMedicationSecondary effectsSynergic effectsInfectionsMonitored
12 Factors influencing social and sexual development Rights and attitudesStereotypesPermissive attitude or protective attitude?
13 Inappropriate behaviors Selection of partnerRestricted choicesNatural choicesExpanding social circleSexual historySexual abuse: repetition, traumaLack of knowledge and experiences
14 Inappropriate behaviors Sensory issues: hypersensitivity, hyposensitivity of tactile sense: vulvodynia, irritations, compulsivitySocial attentionMisunderstanding the environmentDeficit in expression (needs, verbal emotional)Lack of stimulation or activities
15 Inappropriate behaviors Overwhelming demandsOrganic factors (25% serious health problems) no complains…Psychologic/psychiatric condition: dual diagnosisDepression, anxietyADHDPhobia, OCD, etc.
17 Puberty Friendship & social skills Skills: communication: verbal & non verbal, social interactions, sharingIntensity of relationshipAppropriate: finding a balanceInappropriateLove & friendship, intimacy
18 Puberty Recognition of abusive/unfriendly relationship Dangerous relationshipQualities of a healthy relationshipSharingCommunicationPleasure, interestRespect, communication and much more…Making Waves Program:
21 Hygiene Body Face twice/day Deodorant Teeth Twice/day Clean clothing Steps to Good HygieneMondayAM. P.M.TuesdayA.M. P.M.Wed.A.M. P.M.ThursdayFridaySaturdayA.M. P.M.SundayA.M P.M.BodyFacetwice/dayDeodorantTeethTwice/dayClean clothingPeriods(change sanitary pad every 2-4 hours)
22 Sex education Goals: Better knowledge Develop own limits and judgement Decode situations: interpersonal & intimate contextsImprove social and sexual skills: learn adaptive and positive behaviours
25 Sociosexual Skills Workshops 10-12 weeks, 90 minutes10 themesSmall groups (4-12)Adolescents & adultsQuestionnaires, games, role-playing, software, videos, discussions, social stories, group project
26 Workshop Themes & Activities Introduction1. Love & friendship2. Physiological changes3. Sexual relationships4. Emotions5. Contraception and prevention of STD and AIDS
27 Workshop Themes & Activities 6. Sexual orientation7. Alcohol, drugs and sexuality8. Sexism and gender roles9. Sexual abuse and problem behaviours10. Theory of Mind, communication and intimacy
28 www.msss.gouv.qc.ca Free Program Preventing AIDS and other STDS through sexuality education for students with intellectual impairments - Compendium of teaching and learning activities geared to adapted curricula
29 Government program-free Gender differences, body partsAge groupsPrivate-publicSexual behaviours
32 3. Sexual relationships « My first relationship » video « Fears » checklist« Values » gameThe Five Senses Activity:A) Experience the senses?B) Consequences in relationships?C) Behaviours concerned?
33 Emotional sensitivity “We don’t have emotional skin or protection. We are exposed, and that is why we hide”. Liliana
34 The Understanding and Expression of Affection Ability to read the signals whensomeone expects affection.Ability to express the appropriatelevel of affection.
35 The Understanding and Expression of Affection Affection to repair someone’s feelings.An immature expression of affection.A limited vocabulary of expression that may not include subtle or age appropriate expressions.Sometimes needing frequent expressions of affection for reassurance.
36 “We feel and show affection but not often enough, and at the wrong intensity”
37 Affection?Why are typical people so obsessed with expressing reciprocal love and affection?A hug can be an uncomfortable, constricting squeeze.Don’t cry because someone will squeeze you.Not comforted by affection to the degree that neurotypicals expect.
38 Different Perspective Intense dislike of public praise that includes words and gestures of affection.The capacity for affection, a cup versus a bucket.
39 Empathy Different type of empathy Practical-functional Not in words or gesturesCompassion for animasActions
40 Empathy Affection to repair feelings Frequency of affection Sensory sensitivity and affection
43 Aims of the Program Affection education to ‘de-mystify’ affection. To understand why people need and enjoy affection.Explain and encourage appropriate expressions of affection.Explain to parents the perspective of the person with Asperger’s syndrome.
44 ObjectivesHelp each child-adolescent discover how expressing and experiencing affection can improve friendships and relationships.Help each child-adolescent to identify not only his or her own comfort and enjoyment range for gestures, actions and words of affection, but also those of friends and family members.
45 3. Improve for each child-adolescent the range of expressions for liking and loving someone, appropriate to each relationship and situation. 4. Explain to parents, friends and professionals the challenges faced by a person with an ASD in reading the signals that indicate when expressions of affection are needed and appreciated.
47 4. Emotions and sexuality Explore, identify and recognize a range of emotionsPictures of human facesImitationMirrorSoftware-Gaining Face/Mind ReadingEmotions related to sexual realities: body language
59 Relationships (What to expect in the couple?) RespectAccepting the partner ’s imperfectionsConstructive criticismDeveloping the potential of the coupleBlaming ASBalance in the coupleMaking timePrioritySchedule managementSpending time together
60 Relationships Insecurity Dealing with conflict Taking responsibility Making you feel good: comittment and trustDealing with conflictCompromiseDividing tasksUsing qualities of each partner
61 Relationships Expressing emotions Communication Gestures, non verbal communicationDecoding the feelings of the partnerIntensity of emotionsCommunicationNon verbal (? %)Avoiding misinterpretationsCoherencePriority