Sex Disabil (2013) 31:189–200

DOI 10.1007/s11195-013-9286-8

ORIGINAL PAPER

Sexual Abuse and Offending in Autism Spectrum

Disorders

Melina Sevlever • Matthew E. Roth • Jennifer M. Gillis

Published online: 23 January 2013

 Springer Science+Business Media New York 2013

Abstract Individuals with autism spectrum disorders (ASD) may be disproportionately at

risk of experiencing sexual abuse and victimization. Moreover, limited research suggests
some individuals with ASD may be more likely to engage in sexual offending behavior.
The present review addresses both sexual abuse and offending within the ASD population.
The literature review was conducted utilizing PsycINFO and the Education Resources
Information Center. Characteristics of the ASD population and how they relate to both
victimization and offending are assessed. Additionally, a brief review of sexual education
for this population is presented.

Keywords Sexual abuse
Victimization
Sexual offending

Autism spectrum disorders
United States

For individuals with autism spectrum disorders (ASD), sexuality development during
adolescence (and into adulthood) may be complicated by the core deficits of the disorder
(i.e., social, communication, and possible cognitive deficits). Thus, at the time individuals
with ASD undergo puberty, they are often lacking the commensurate social behaviors
present in typical adolescents [1]. Indeed, parents of children with ASD have described
adolescence as the ‘‘second crisis’’ and a period of ‘‘re-grieving’’ [2, 3]. Many parents also
indicate concern that others will take advantage of their child or that their child will act in
an inappropriate sexual way towards another [3]. Unfortunately, given the characteristics
of this population, parental fears of sexual abuse and offending are too often realized. The
present review describes sexual abuse and offending across the autism spectrum. Addi-
tionally, although sexual education for individuals with ASD is lacking, a review of
available treatment modalities are discussed. Finally, the social and political implications
of sexual education for individuals with ASD are considered.

M. Sevlever (&)
M. E. Roth
J. M. Gillis

Auburn University, 226 Thach Hall, Auburn, AL 36849, USA
e-mail: melina.sevlever@gmail.com

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Search Strategy

The literature review was conducted using the following search terms: abuse, Autism,
Autism Spectrum Disorders, Asperger’s, disability, education, sexuality, sexual abuse,
sexual offending, and sexual behaviors. PsychINFO and ERIC databases were utilized to
conduct the search. Articles were included in the review if they focused on or related to the
topics of sexual abuse and sexual offending within the autism population. Additional
articles and chapters were selected based on the authors’ knowledge of the topic area.

Sexual Abuse

Few research studies on sexual abuse and ASD have been conducted; thus, little is known
regarding the prevalence and risk factors for this population. Although research on sexual
abuse in the broader category of developmental disabilities (DD) has been conducted
(which provides some insight into the ASD population), these statistics should be exam-
ined with caution given the heterogeneity of DD diagnoses and their associated risk factors
for abuse. For instance, substantial empirical evidence exists to suggest individuals with
intellectual disabilities (ID) are more likely to suffer from acts of sexual violence than non-
intellectually disabled persons [4]. As approximately 50–70 % of the ASD population can
be described as intellectually disabled, it follows that these persons are also vulnerable to
sexual abuse [5, 6]. Moreover, the social deficits inherent in ASD further serve to place
these individuals at an even higher risk of sexual abuse and other types of abuse (e.g.,
physical abuse, neglect, exploitation, etc. [7]).

Prevalence of Sexual Abuse in ASD

To date, there has only been one published study examining the prevalence of sexual abuse in
an exclusively ASD sample [8]. Mandell et al. assessed the rates of sexual abuse in an
American sample of 156 children with a mean age of 11.6 years diagnosed with Autism and
Asperger’s syndrome (AS). According to parental report, approximately 12 % of the sample
experienced at least one instance of sexual abuse and an additional 4 % experienced both
sexual and physical abuse. Given the stigma of sexual abuse and the high possibility that
parents were unaware of all instances of sexual abuse, the authors argue that the true inci-
dence of sexual abuse is higher in this population [8]. Although the prevalence of approx-
imately 16 % is rather staggering, it should be noted that this figure is not significantly
greater than estimates of sexual abuse in the general population (i.e., 6–10 % for men and
16–23 % for women; [9] or in the ID population (i.e., approximately 14 %; [10]). Thus, the
Mandell et al. study does not seem to support the notion that individuals with ASD are at
increased risk. However, given the ASD population has a higher male to female ratio; males
with ASD may be more vulnerable to sexual abuse than males without ASD (i.e., the rate of
abuse for typically developing males is likely less than the rate of abuse for males with ASD).
Additionally, the participants in the study sample were children and attendees of a com-
munity mental health clinic; therefore, it is difficult to generalize these estimates to older
individuals with ASD and/or those in more restricted settings.
Risk Factors for Sexual Abuse in ASD

Although the limited data indicate it may be inaccurate to suggest the rate of sexual abuse
in ASD is greater than the rate of abuse in the general population, several risk factors may

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serve to explain why individuals with ASD may be susceptible to victimization. Recently,
Edelson [11] reviewed several characteristics of ASD that may contribute to risk of sexual
abuse. Edelson highlights the impact of social-emotional deficits, which place individuals
with ASD at a greater risk of experiencing sexual abuse. For example, due to difficulty
interpreting social cues, individuals with ASD may have difficulty discriminating ‘‘safe’’
from ‘‘unsafe’’ individuals and may not have the knowledge of what behavior constitutes as
abuse. Additionally, as individuals with ASD have difficulty detecting emotions [12, 13]
and impaired theory of mind [14], they may be unable to process deception by others who
approach them. Thus, predicting sexual abuse (or any type of abuse), which may lead to
calling for help and attempting to escape, is less likely. Preliminary research findings also
suggest individuals with ASD have more deviant sexual interests than individuals with
intellectual disabilities alone [15], which may also serve to increase the risk of sexual
offending for this population.
In addition to the risk imposed by social-emotional deficits characteristic of ASD, these
individuals are often in contact with a multitude of environments and settings that may be
easily accessible to sexual predators. For example, due to their wide-ranging deficits,
individuals with ASD are in contact with and are many times dependent on several dif-
ferent service providers, which may increase their contact with sexual offenders [11].
These service providers often assist individuals with ASD in completing a variety of
adaptive skills, such as toileting and showering, which may serve to both increase the
individual’s risk of victimization and further impair the individual’s ability to discriminate
between appropriate and inappropriate touching or other behaviors. Moreover, individuals
with ASD are often taught to comply with requests from others; thus, they may be less
likely to deny inappropriate requests from perpetrators. Conversely, it could be argued that
having many service providers could also be a protective factor given that individuals with
ASD are more closely monitored than their typically developing peers. Ideally, background
checks required of service providers in contact with individuals with ASD also serve to
limit the potential of victimization for individuals with ASD.
Two final risk factors relate to poor communication skills and the difficulty inherent in
identifying sexual abuse within this population [11, 16]. Individuals with ASD range in
their communicative abilities; however, communicative impairments make it less likely for
an individual with ASD to report abuse to a caregiver. In turn, parents of a child with ASD
may be less able to interpret changes in their child’s behavior indicative of sexual abuse.
Parents of children with ASD who have experienced an instance of trauma (i.e., sexual and
physical) often report the following symptoms for their child: regression in social skills
(e.g., imitation skills), decreases in social initiations and responses, deterioration of
communication skills, increases in activity level, increases in self-injurious behavior, sleep
and appetite disturbances, regression in adaptive skills, and increases in restricted interests
and stereotypy [17]. Similarly, Mandell et al., suggests individuals with ASD who are
sexually and/or physical abused may be more likely to sexually act out or engage in
aggression and self-injury. Yet, because rates of aggression and self-injury often fluctuate
over the course of an individual’s lifetime, changes in this rate may fail to lead providers
and parents to suspect abuse. Thus, the overlap across general symptomatology in ASD
(e.g., loss of communication skills) and symptoms associated with sexual abuse illustrates
the difficulty facing parents and providers in identifying signs of sexual abuse.
Furthermore, as symptoms in individuals with ASD tend to fluctuate, caregivers and
service providers often explain changes in behavior as a function of the disorder, rather
than behaviors of interest in their own right (i.e., behaviors that may indicate the occur-
rence of sexual abuse). Thus, when disruptions in behavior do occur, the focus is often on

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treatment of these behaviors, rather than an analysis of their development [11]. For
example, increases in self-injurious behavior, which may occur in response to sexual abuse
in individuals with ASD, are often immediately targeted for treatment without regard to the
precipitating condition that may account for their increase (e.g., sexual abuse).
In summary, while the prevalence of sexual abuse in children with ASD may or may not
exceed that of the general population, the rate of abuse in adolescents and adults with ASD
is currently unknown. It appears as though the risk factors of sexual abuse outnumber the
protective factors for children with ASD. Furthermore, sexual abuse is much more difficult
to detect among this population.

Sexual Offending

Higher rates of criminal behavior associated with ASD may be explained by deficits in
social-emotional reciprocity characteristic of the disorder [18, 19]. Specifically, proponents
of this claim hypothesize that a lack of empathy and poor social reciprocity might influence
individuals with ASD to act aggressively towards others and engage in criminal activity
and sexual offending [20, 21] Given that several case studies of sexual offenders with ASD
do exist in the literature, it is likely that some individuals with ASD may be prone to
commit sexual offenses; however, an estimated prevalence is unknown. Further, a limited
number of empirical investigations of sexual offending in ASD are available in the liter-
ature. Thus, although some evidence exists to suggest individuals with ASD are over-
represented in forensic settings, studies often fail to report the type of offense committed
by participants. Additionally, the majority of studies related to violence focus primarily on
AS rather than the entire ASD spectrum. With these caveats in mind, the few studies
examining this topic are presented below.

Qualitative Examination

As noted a large proportion of the literature related to ASD and violence is comprised of
detailed case studies. Case studies relevant to this topic (e.g., descriptions of assault and
sexual molestation by individuals with ASD) have existed in the literature for several
decades [22–24]. Murrie, Warren, Kistiansson, and Dietz [20] more recently outlined six
cases exemplifying the co-occurrence of violence and ASD (specifically AS). The indi-
viduals described came into contact with the forensic system after committing a wide
variety of offenses including: burglary, arson, physical assault, sexual assault, sexual
abuse, and attempted murder. In all cases, the authors surmised characteristics of AS
contributed to criminal behavior. For example, the authors found that all four individuals
convicted of sexual crimes failed to appreciate the harm they caused to their victims.
Murrie et al. [20] attributed this lack of victim empathy as symptomatic of the core
characteristics of ASD. However, it is noteworthy that typically developing individuals
who sexually offend against others also demonstrate a lack of empathy for their victims,
and as such empathy is often included as a treatment goal for typical sexual offenders [25].
Thus, Murrie et al.’s assumption that deficient empathy in these sexual offenders is a result
of their ASD diagnosis may be inaccurate. An evaluation of empathy among ASD sexual
offenders and ASD non-sexual offenders may serve to reconcile this issue, and may have
wide ranging implications for therapy for these two groups (e.g., in determining the amount
of focus placed on empathy training).

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Murrie et al. also identify ‘‘interpersonal naiveté’’ as a factor that contributed to contact
with the criminal justice system in their case studies. As an example, one of the partici-
pants who engaged in repeated instances of sexual behavior with a minor disclosed the
relationship to the police when the victim stole his stereo, thereby incriminating himself.
Clearly this individual failed to grasp the inappropriateness of the sexual relationship with
the minor. In addition to this lack of sexual awareness, Murrie et al. notes a variety of
others factors including, sexual frustration, immediate confession (likely related to diffi-
culty with deception and poor theory of mind skills), and sexual preoccupations appear to
contribute to sexual offending behavior in individuals with ASD. Although the authors
present a cogent argument related to interpersonal naı̈veté, more empirical evidence is
clearly needed. Both comparisons of sexual offenders with and without ASD, and between
sexual offenders with ASD and non-offenders with ASD, across these variables of interest
(empathy, social naiveté, circumscribed interests, and sexual frustration) should be
conducted.

Quantitative Examination

Although case studies provide preliminary evidence for the co-occurrence of ASD and
sexual offending, they fail to provide any information related to prevalence. Research
related to prevalence has primarily attempted to assess the rate of non-sexual violence and
to a lesser degree sexual offending in individuals with ASD. Scragg and Shah [26] assessed
a forensic sample of 392 inmates for the prevalence of AS. The authors first reviewed case
notes for all inmates to identify the presence of AS characteristics. Inmates meeting
specified criteria were then interviewed using a semi-structured format (or if inmates
refused to be interviewed, staff familiar with the participant were interviewed) to obtain a
diagnosis of AS. Using these methods the authors found a prevalence rate of 1.5 %, which
is fairly larger than the estimated prevalence rate of AS in the general population at the
time the study was conducted (estimated to be approximately 3.6/1,000 or 0.36 %; [27]).
Unfortunately, the authors did not obtain information pertaining to the type of crime
committed; thus, the rate of sexual offending in this sample is unknown. Furthermore, the
validity and reliability of the semi-structured interview format to confirm an ASD diag-
nosis is unclear. Despite these limitations, these results suggest individuals with AS may be
overrepresented in forensic settings.
In a similar study, researchers reviewed Sweden’s crime registry from 1988–2000 to
identify the prevalence of violence in ASD [28]. The authors obtained a sample of 422
individuals (317 diagnosed with autism and 105 diagnosed with AS). Of 422 participants,
the authors found only two participants diagnosed with an ASD were convicted of sexual
offenses. Yet, the authors found a large proportion of individuals diagnosed with AS
committed a violent crime (20 %), whereas only 3 % of individuals with autism were
convicted for violent crimes. Although this study suggests a potential association between
AS and violence, sexual offending was not found to be representative of this group of
individuals with ASD. As these data were collected retrospectively, it is certainly possible
that forensic cases of ASD within the criminal registry were undiagnosed or diagnosed
inappropriately. It is also not clear what type of diagnostic tools were used to determine the
presence of an ASD. Thus, these data may fail to capture the true prevalence of violent and
sexual offending and ASD.
In another study of juvenile offenders (ages 15–22 years old), 15 % of offenders were
found to meet diagnostic criteria for ASD (with 3 % meeting criteria for AS; [29]. This rate
is fairly higher than rate of ASD reported by Scragg and Shah [26] for an adult forensic

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population and may suggest a true developmental difference, with younger individuals
with ASD being more likely to commit criminal offenses, or may be reflective of the
difficulty in diagnosing ASD in adults. Unfortunately, again, information related to the
type of offense was not provided by the authors. Nevertheless, it is possible that of
the 15 % of offenders with ASD, some had committed sexually related crimes.
In summary, some preliminary evidence exists to suggest individuals with ASD may be
overrepresented in forensic settings. Future studies would benefit from a closer examina-
tion of the types of criminal offenses committed in order to obtain a more accurate
prevalence of the rate of sexual offending among individuals with ASD.

Additional Hypothesized Factors Contributing to Offending in ASD

A longer history of studying sexual offending in individuals with ID exists compared to

individuals with ASD, with some researchers suggesting a higher prevalence of sexual
offending among individuals with ID relative to the rate in the general population [30].
Although this claim has not yet been validated, some findings related to offending in the ID
population may be important to consider. For example, intellectually disabled sexual
offenders are more likely to offend against younger children than non-intellectually dis-
abled offenders [31], perhaps because younger children serve as easier targets as compared
to older children or adults. This same relationship may hold true for individuals with ASD
for two reasons. First, as noted earlier a large proportion of the ASD population can be
described as intellectually disabled. Additionally, it is possible that individuals with ASD
may be more likely to offend against younger children because, given poor social skills,
younger children may be easier to interact with than older children or adults. Research
aimed at replicating findings from the general ID population with the ASD population
should attempt to determine the degree of similarity between the sexual profiles of these
groups of individuals. By doing so, researchers could assist practitioners in tailoring
sexuality education and sexual offending treatment for both of these populations.
Another often-cited behavior hypothesized to contribute to offending in ASD is the
tendency to engage in private sexual behaviors in public settings (e.g., masturbation or
exposing one’s genital area in a park or school bathroom) [31–33]. Although these types of
behaviors may occur due to the difficulty individuals with ASD face in discriminating
between private and public behavior, these actions may still lead to sexually related charges
and contact with the forensic system. The lack of social understanding may also lead indi-
viduals with ASD to be exploited by others, which may lead to sexually acting out (e.g.,
others may convince an individual with ASD to expose themselves in public as a joke).
Importantly, these types of sexual offenses occur, not due to lack of empathy, but rather to a
lack of social understanding. The authors hypothesize that these types of sexual offenses
comprise the majority of ASD related sexual offenses. There is no research to suggest
individuals with ASD are likely to commit violent sexual acts (e.g., rape, sexual assault).
Limited intimate relationships may also inhibit individuals with ASD from expressing
their sexuality within the context of an appropriate relationship, potentially leading to
offending as a result of sexual frustration [20]. In fact, some empirical evidence does exist
to support the notion that individuals with ASD experience high levels of sexual frustration
[34]. Furthermore, several survey studies have shown individuals with ASD are interested
in sexual activities [1, 35, 36] however; individuals with ASD may be more likely to be
dissatisfied with their sex life than individuals without ASD [37]. Nevertheless, the level of
sexual frustration in sexual offenders with ASD needs to be assessed before the claim that
sexual frustration leads to sexual offending can be validated.

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More insidious explanations for the occurrence of sexual offending suggest that indi-
viduals with ASD lack empathy and impulse control; thus, they fail to recognize the
implications of their behavior and act ‘‘without thinking’’ [19, 21]. Additionally, some
have suggested the ‘‘obsessional’’ interest of ASD can lead to dangerous behavior if the
nature of the individual’s obsession is sexually related or perceived as such [19, 20]. For
example, a former client of the first and second author with an obsessional interest in upper
thighs would often attempt to touch the thigh region of female strangers. Similarly, indi-
viduals with ASD may be more likely to ‘‘stalk’’ romantic interests (e.g., monitoring
others’ activities, making threats toward others and self) than individuals without ASD.
Thus, individuals with ASD engage in more frequent attempts to interact with a romantic
interest in spite of a lack of reciprocity [38]. This type of behavior is likely to lead to
contact with the legal system. Again, social naiveté appears to explain stalking behavior
among individuals with ASD. For example, misunderstanding cues that signal disinterest
from others may lead individuals with ASD to persist in their romantic attempts.
Finally, factors such as sexual abuse, bullying, and family instability may also affect
sexual offending in this population. Thus, it is likely that individuals with ASD who are
sexually abused become more likely to sexually offend against others later in life, as is
often demonstrated in the general population. The extreme levels of bullying these indi-
viduals are exposed to and the family instability that may characterize the home envi-
ronment of this population may also contribute to offending behavior [18]. Additionally,
poor social and institutional support provided to individuals with ASD throughout their
lifetime likely contributes to cases of sexual offending among this population. There is
very limited research that addresses how best to teach sexuality education to individuals
with ASD and these services are often denied.

Hypothesized Protective Factors

Despite the many factors that may increase risk, a variety of factors may serve to decrease
risk of sexual offending in this population. First, due to the social and adaptive impair-
ments, individuals with ASD are more frequently supervised relative to individuals without
ASD. This supervision may lead to fewer opportunities to engage in sexual offending
behavior. Additionally, the limited ability to deceive others may lead to difficulty in
engaging in precursor behaviors that often lead to sexual offending (e.g., establishing a
relationship with a victim, convincing the victim to go somewhere alone). Finally, many
individuals with ASD (especially higher functioning individuals) tend to be rule-governed
and thus ‘‘scrupulously law abiding’’ [20], which may inhibit sexual offending behavior.
Despite the face validity of these hypothesized protective factors, empirical support is
lacking.

Summary

In sum, more systematic research aimed at determining the prevalence and risk factors of
both sexual abuse and offending within the ASD population is needed. Knowledge related
to prevalence is important as it relates to public policy for these individuals. For example,
if a large proportion of individuals with ASD commit sexual offenses, it may be important
to consider the experience of these individuals in forensic settings and to assess their
response to treatment. As noted earlier it may be necessary to focus more on empathy
training for individuals with ASD in rehabilitation programs. Yet, until the true prevalence
of offending in this population is known, and until researchers identify lower empathy as a

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risk factor, mandated treatments tailored for individuals with ASD will remain nonexistent.
The same holds true for sexual abuse within this population. Little is known about the ways
individuals with ASD respond to sexual abuse; thus little is known regarding treatment.
Again, with unknown prevalence rates, it may be difficult to convince policyholders to
direct funds towards the development of sexual abuse treatments for individuals with ASD.

Sexuality Education

Treatment for sexual abuse and offending for individuals with ASD has focused primarily
on prevention. Perhaps because so little is known about sexual abuse and offending within
this population, specific treatments for these issues have yet to be developed. Thus,
treatment providers aim to curb the rates of sexual abuse and offending by providing
individuals with ASD general sexuality education. Aside from this important goal, sexu-
ality education is ideally designed to assist the individual with ASD to develop a fulfilling
sexual life [39]. Thus, sexuality education programs for individuals with ASD may include
information regarding interpersonal skills, gender and sexual identity, masturbation, and
contraceptives.
Despite the calls for sex education programs in the field of ASD, very little research
examining sexuality education in individuals with ASD exists. For example, Tarnai and
Wolfe [40] described how to use an established intervention for children with ASD, Social
StoriesTM, for sexuality education; however, they did not empirically evaluate the inter-
vention. In addition, no assessment of sexuality education has included a control group;
thus, limited conclusions can be made regarding the effectiveness of these programs.
Additionally, methods known to be effective for teaching individuals with ASD may be
inappropriate when applied to sex education. For example, physical prompting, modeling,
rehearsal, and direct feedback cannot be used to teach individuals with ASD how to
masturbate appropriately for obvious reasons. Yet, this requires instructors to teach sex
education using tools that are not optimally designed for the ASD population (e.g., by
providing instructions and a rationale only). Additionally, direct measures of treatment
effectiveness may also be inappropriate. As described in this quote by a teacher during the
review of a sex education program, ‘‘I can’t watch it, can’t demonstrate it or do hand over
hand to teach it. How am I supposed to know if it happens and if he climaxes?’’ [41]. Thus,
the nature of sex education presents researchers and treatment providers with the dilemma
of identifying instructional methods and outcome measures that are both socially appro-
priate and effective.
Moreover, interventions aimed for other populations (e.g., the ID population) do not
address the same social concerns; thus, these programs are limited in their utility [1, 35,
37]. To date, only one comprehensive sexuality education program has been published
specifically for adults (male and female) with AS as part of a book on sexuality and AS
[37]. The comprehensive program, 12 sessions in length, addresses the following topics:
(a) love and friendships; (b) physiological aspects of sexuality; (c) sexual intercourse and
other sexual behaviors; (d) emotions; (e) STD’s and HIV, and prevention of unwanted
pregnancy; (f) sexual orientation; (g) alcohol and drugs; (h) sexual abuse and inappropriate
behaviors; (i) sexism and violence in romantic relationships; (j) and management of
emotions, theory of mind and intimacy. Although the results of the group remain
unpublished in a peer-reviewed journal, Hénault (2006) noted in her book that participants’
(mean age and range unknown) friendship and intimacy skills increased and inappropriate
behavior decreased (per self-report). Despite the limited evidence of its effectiveness, the

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Hénault (2006) program nonetheless provides an initial framework for group-based sex-
uality education for the high functioning ASD population.
The lack of research in the area of sexuality education and ASD also raises the question
of who are the most effective sexuality educators for this population. For instance, although
the program described by Hénault (2006) was designed to be delivered directly to adults
with ASD by clinicians, other programs suggest parents should provide sexuality education
for their children [38]. Parents who are weary of what clinicians will expose their children
to may find this approach more useful. However, parents may also be uncomfortable
discussing such a sensitive topic with their child. Recently, Nichols and Blakeley-Smith
(2010) conducted a focus group and subsequent parent psychoeducation group designed to
increase parent confidence and competency to teach their children about sexuality. Fol-
lowing the group, the authors found parents were significantly more comfortable discussing
sexuality in the group, with family members, and the child’s school. A third possible
source for sexuality education may be teachers [31, 41]. However, Kalyva (2010) noted
only 12.5 % of teachers who work with individuals with ASD feel confident in providing
sex education to their students. Although the competency of service providers in providing
sexuality education is currently unknown, the limited evidence suggests that parents and
teachers may not feel comfortable providing sexuality education. Additional work similar
to Nichols and Blakeley-Smith (2010) is needed to evaluate approaches to increase
competencies in providing sexuality education.
Aside from the practical difficulties involved in implementing sex education for indi-
viduals with ASD, a variety of social and political barriers exist that inhibit these types of
programs from developing. For one, the current state of research in ASD lacks much data on
effective instructional methods during adolescence and adulthood, a time when sexuality is a
more relevant topic [42]. Additionally, sexuality education may simply be the least important
priority on a long list of treatment targets for an individual with ASD. For example, a variety
of deficits (e.g., poor communication skills, social skills, aggression, etc.) serve to greatly
impair the lives of individual with ASD. Thus, parents and service providers may appro-
priately prioritize these goals above the need for sexuality education. Furthermore, many
parents, service providers, and policy officials are uncomfortable with the notion of sexuality
as it relates to individuals with ID and ASD [3, 41, 42]. Appropriate sexuality education is
often opposed despite the Sexuality Information and Education Council of the United States
position statement on sexuality and developmental disabilities [44]:
The policies and procedures of social agencies and health care delivery systems
should ensure that services and benefits are provided to all persons without dis-
crimination because of disability. Individuals with disabilities and their caregivers
should have information and education about how to minimize the risk of sexual
abuse and exploitation.
In addition to opposition regarding appropriate education, myths surrounding sexuality
and ASD thwart progress in this area. For one, individuals with ID and ASD are often
perceived as ‘‘child-like’’ and ‘‘asexual’’ [43]. However, the literature has demonstrated
that this population has interest in sexuality and engages in sexual behavior [1, 15, 33, 34,
43, 45, 46].
Furthermore, it is erroneously believed by some that by teaching sexuality education,
individuals will become overly sexualized and more likely to engage in sexual behavior
(e.g., by teaching adolescents about condom use, they will be more likely to have sex). No
evidence exists to suggest individuals with ASD who receive sexual education engage in
more sexual behavior than those who do not. Rather, sexuality education, conducted by

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trained individuals who provide accurate information, reduces sexually inappropriate

behavior in people with developmental disabilities by teaching responsibility and control
[47].
Sexuality education for individuals with ASD should also be viewed in light of the
inclusion movement. As Koller (2000) points out, the need for sexuality education for
individuals with ASD has become ever more pertinent as more students with ASD are
placed in inclusion classrooms. The increased interaction inherent in inclusion settings
between individuals with and without ASD leads to the possibility of negative interactions
and subsequent social isolation from peers. Thus, sexual education aimed at teaching
individuals with ASD appropriate social behaviors, appropriate sexual behaviors, safety
skills, and promoting positive peer interaction are imperative.
Sexuality education for individuals with ASD should not only focus on ‘‘fixing the
problem,’’ which in many cases is reducing problematic sexual behavior (e.g., public
masturbation). Instead, education should be individualized to the developmental level of
the participant (e.g., teaching public and private may be emphasized more for lower
functioning individuals), preventative (e.g., teaching how to accept ‘‘no’’ when courting
others and masturbation training), focused on the entire lifespan, and built upon sexuality
strengths in the ASD population (e.g., high interest in sexuality). Additionally, sexuality
education for the ASD population must be comprehensive and focused on self-determi-
nation. For instance, gender identity and homosexuality should be addressed given the
hypothesized higher prevalence of homosexuality and gender identity dysphoria in indi-
viduals with ASD [48].
This review reveals some of the concerns regarding sexual abuse and offending in the
ASD population. It is clear that more data is needed to be able to draw conclusions about
the risk inherent in the disorder. However, the current literature indicates the core char-
acteristics of ASD PUTS individuals at risk for both sexual abuse and offending; thus,
sexuality education is a critical tool for protecting this population. Individuals with ASD
have the right to a healthy sexual life and, ideally, sexuality education will serve to assist
individuals with ASD in developing healthy and satisfying sexual lives, while minimizing
risk of exploitation of and by others.

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