Sexual activity is a basic Activity of Daily Living (ADL) according to the American Occupational Therapy Association (AOTA) and involves “engaging in the broad possibilities for sexual expression and experiences with self or others (e.g., hugging, kissing, foreplay, masturbation, oral sex, intercourse)”.

Sexual Education received during childhood affects to some extent the healthy development of sexuality, which is directly linked to a good quality of life.

Given that engaging in sexual activity with others is a social transaction that requires communication and understanding of oneself and the other party, as well as it is a multi-sensory experience, it can increase the challenges for people in the Autism Spectrum who typically face difficulties:

• in communication
• in understanding rules and concepts related to human interaction, including the expression of “social cues”
• in knowledge generalization in unstructured contexts
• due to frequent concerns/obsessions
• in understanding that relations are based on and influenced by the cause-effect relationship
• with sensory stimuli
• in social interactions 

Due to some of the aforementioned difficulties of people in the Autism Spectrum, even engaging in sexual activity with themselves can be a challenge.

Sexual Education for people in the Autism Spectrum is an extremely important, complex and ongoing process that covers issues such as:

• for pre-school and school-age children:
  • gender differences
  • recognition of private & public spaces
  • understanding the private parts of the body
  • security (Social Circles – Social Proximity)
  • introduction to puberty and body changes
  • recognition of appropriate & inappropriate touch
• for high school children and teenagers:
  • puberty and menstruation
  • ejaculation and ovulation
  • expression of refusal to participate in something dangerous
  • masturbation
  • use of public toilets
  • attraction and sexual feelings
  • relationships and dating
  • personal responsibility and family values
  • love by gender

References

Βοσκόπουλος, Ι., & Ιωάννου, Λ. (2019). Σεξουαλική Εκπαίδευση. Σύλλογος Γονέων Κηδεμόνων και Φίλων Ατόμων με Αυτισμό Ν. Λάρισας. Retrieved October 22, 2022, from https://www.autismthessaly.gr/index.php/autism/autismos/fylo-sexoualikotita/
American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process(4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010. https://doi.org/10.5014/ajot.2020.74S2001
Ellis, K. (2020). Mission. Institute for Sex, Intimacy & Occupational Therapy. Retrieved October 22, 2022, from https://www.sexintimacyot.com/pages/mission
Episode 1: Sex is an ADL by OT after dark. Anchor. (2019, February 10). Retrieved October 22, 2022, from https://anchor.fm/ot-after-dark/episodes/Episode-1-Sex-is-an-ADL-e35vcg
MacRae, N. (2013). Sexuality and the role of occupational therapy. American Occupational Therapy Association. Retrieved October 22, 2022, from https://www.aota.org/~/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/RDP/Facts/Sexuality.pdf