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Isabelle Hénault, Ph.D. sexologist & psychologist Montreal, Canada Clinique Autisme et Asperger de Montreal.

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Presentation on theme: "Isabelle Hénault, Ph.D. sexologist & psychologist Montreal, Canada Clinique Autisme et Asperger de Montreal."— Presentation transcript:

1 Isabelle Hénault, Ph.D. sexologist & psychologist Montreal, Canada Clinique Autisme et Asperger de Montreal

2 Definition of sexuality Few research & clinical attention Normal part of development and life Complexity of sexuality: more than behaviours!

3 Intellectual and Developmental Disability Profile Social skills: free of social rules Communication abilities: verbal and non verbal Theory of Mind: different ways of thinking? Emotions: detecting, reading, expressing Sensory issues Impulsive behaviours Co-morbidity (other diagnosis)

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7 Fears related to sexuality Not being able to provide correct answer to a question STDs & AIDS Unwanted pregnancy Unions, couples, marriage Sexual exploitation Judgment of others Higher level of sexual interest

8 Issues of development Sexual behaviours: self-stimulation, exploring sexuality Frustrations and inappropriate behaviours Gender identity & role definition: flexibility, conflict, confusion Social imitation: context, consent

9 Issues of development Interpretation of emotions: black & white! Interpersonal relationships: couples, empathy, intimacy. Confusion & anxiety, disappointment Sexual drive, desire, curiosity

10 Factors influencing social and sexual development (Griffiths, 1999) Information Basic knowledge Experiences Social support Limitations of the environment Gender segregation Social network Rules Sex education

11 Factors influencing social and sexual development Intimacy Interests and limits Private and public setting Exploration Medication Secondary effects Synergic effects Infections Monitored

12 Factors influencing social and sexual development Rights and attitudes Stereotypes Permissive attitude or protective attitude?

13 Inappropriate behaviors Selection of partner Restricted choices Natural choices Expanding social circle Sexual history Sexual abuse: repetition, trauma Lack of knowledge and experiences

14 Inappropriate behaviors Sensory issues: hypersensitivity, hyposensitivity of tactile sense: vulvodynia, irritations, compulsivity Social attention Misunderstanding the environment Deficit in expression (needs, verbal emotional) Lack of stimulation or activities

15 Inappropriate behaviors Overwhelming demands Organic factors (25% serious health problems) no complains… Psychologic/psychiatric condition: dual diagnosis Depression, anxiety ADHD Phobia, OCD, etc.

16 Puberty Physiological changes Hormones levels (testosterone, oestrogen) Body changes: body hair, sexual function, reactions, periods, etc. Psychological changes Emotions (mood changes,stronger, cycle) Independence Curiosity Interests

17 Puberty Friendship & social skills Skills: communication: verbal & non verbal, social interactions, sharing Intensity of relationship Appropriate: finding a balance Inappropriate Love & friendship, intimacy

18 Puberty Recognition of abusive/unfriendly relationship Dangerous relationship Qualities of a healthy relationship Sharing Communication Pleasure, interest Respect, communication and much more… Making Waves Program:

19 Puberty Self esteem: image Self confidence: positive experiences Social network Finding identity (group, norms, person, sexual) Isolation Depression, anxiety, (arrogance 15%) Aggressive behaviors, self-abusing behaviors

20 Puberty Hygiene Positive & appropriate image Peer pressure & reactions Desire to create relationships Transition period, adjustments

21 Hygiene Steps to Good Hygiene Monday AM. P.M. Tuesday A.M. P.M. Wed. A.M. P.M. Thursday A.M. P.M. Friday A.M. P.M. Saturday A.M. P.M. Sunday A.M. P.M. Body Face twice/day Deodoran t Teeth Twice/day Clean clothing Periods ( change sanitary pad every 2-4 hours)

22 Sex education Goals: Better knowledge Develop own limits and judgement Decode situations: interpersonal & intimate contexts Improve social and sexual skills: learn adaptive and positive behaviours

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25 Sociosexual Skills Workshops weeks, 90 minutes 10 themes Small groups (4-12) Adolescents & adults Questionnaires, games, role-playing, software, videos, discussions, social stories, group project

26 Workshop Themes & Activities Introduction 1. Love & friendship 2. Physiological changes 3. Sexual relationships 4. Emotions 5. Contraception and prevention of STD and AIDS

27 Workshop Themes & Activities 6. Sexual orientation 7. Alcohol, drugs and sexuality 8. Sexism and gender roles 9. Sexual abuse and problem behaviours 10. Theory of Mind, communication and intimacy

28 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 parts Age groups Private-public Sexual behaviours

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32 3. Sexual relationships « My first relationship » video « Fears » checklist « Values » game The 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 when someone expects affection. Ability to express the appropriate level 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 gestures Compassion for animas Actions

40 Empathy Affection to repair feelings Frequency of affection Sensory sensitivity and affection

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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 Objectives 1. Help each child-adolescent discover how expressing and experiencing affection can improve friendships and relationships. 2. 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.

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47 4. Emotions and sexuality Explore, identify and recognize a range of emotions Pictures of human faces Imitation Mirror Software-Gaining Face/Mind Reading Emotions related to sexual realities: body language

48 Emotions Thermometer

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50 5. Contraception and prevention Quizz Importance of condom use Demonstration on « penile model »

51 Condom use 10-steps on « penile model » In fact, what ’s the first step?

52 6. Sexual orientation List of myths Quizz: Am I homophobic? Video Discussion

53 7. Alcohol, drugs and sexuality Group project: scenario Positive approach (reinforcement) instead of reprehensive Guide on the effects of alcohol and drugs on sexuality

54 8. Sexism and gender roles Privacy, boundaries, intimacy Video: « machos » Stereotyped relationships and roles Scenarios and role-playing

55 9. Sexual abuse and inadequate behaviours Intimacy Consent Sexual assault Sexuality and the law

56 10. Mind-blindness, communication & intimacy Social Stories integrating sexuality Recognize other ’s emotions: Mind Reading software (Baron-Cohen & coll., 2002) Non verbal skills Role-play: ToM activities

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59 Relationships (What to expect in the couple?) Respect Accepting the partner ’s imperfections Constructive criticism Developing the potential of the couple Blaming AS Balance in the couple Making time Priority Schedule management Spending time together

60 Relationships Insecurity Taking responsibility Making you feel good: comittment and trust Dealing with conflict Compromise Dividing tasks Using qualities of each partner

61 Relationships Expressing emotions Gestures, non verbal communication Decoding the feelings of the partner Intensity of emotions Communication Non verbal (? %) Avoiding misinterpretations Coherence Priority

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64 Video: 5 Safety rules: sexual abuse prevention Basic rules, behaviours, young teenagers, low to middle functioning

65 Videos Relationship series-3 videos 1. Friendship 2. Boyfriend-girlfriend 3. Sexuality

66 Videos Flirting or Stalking? Making New Friends Love or Abuse? www. socialsignalsed.com

67 Results 1.Improvement of social and sexual skills Presentation Conversation/reciprocity Helping/empathy Non verbal skills General knowledge/judgement

68 Results 2. Reduction of problem behaviours Isolation (contact, activities, conversation) Impulsivity Inapp. sexual behaviours (masturbation, touching) 3. Generalization (3 months measure) Better knowledge Interpersonal relationships, friendship Positive attitude about sexuality

69 Discussion Interest and needs from individuals Demand from parents and professionals Interesting results Service curriculum


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