Puberty and autism in boys

What is puberty?

Everybody experiences puberty as part of growing up, and it can be a difficult time for young people and their families whether they have autism or not.

There is no fixed age for puberty to start, however it usually takes place between the age of 8 and 13 years old.

Puberty is caused by changes in hormone levels. This typically leads to the following changes:

Bodily growth

Your child’s body will increase in height and weight, bones will thicken and muscles will develop. Their penis and testicles will also grow, which is often one of the first signs of puberty.

Pubic and body hair

Hair will grow and thicken around their penis, armpits, face and other parts of the body such as legs.

Body odour

Changes in your child’s hormones will make them sweat more which means that they may smell more and need to wash more often.

Voice changes

Your child’s voice is likely to get deeper, which often takes several months to happen. While this is happening their voice may go up and down and sometimes sound squeaky. This will settle down eventually.

Acne

Changes in your child’s hormones may affect their skin which may lead to acne or an increase in spots.

Erections

Erections become more common during puberty and can happen at any time. This can be embarrassing for boys and the people around them, however this is a normal part of puberty and they happen for a number of reasons which are not always due to arousal.

Masturbation

Masturbation is when people touch their genitals for pleasure. It is a healthy and normal part of development and does not cause emotional or physical harm if they are in the right place.

Sexual development

Your child may become more aware of the differences between men and women, and how they feel about other people.

Social and emotional development

Changes in your child’s hormones may impact on their emotions and their ability to emotionally regulate. Puberty can be a confusing time for young people, and is often a time when young people explore their identity and how they fit into social groups.

The impact of puberty for young people with autism

Puberty is a difficult time for all children. Children with autism may find it especially difficult as they may struggle to understand the changes that are happening, regulate their emotions and communicate with others how they are feeling. They may also find it difficult to understand what is appropriate and inappropriate.

They may need extra support and patience from the people around them to understand the changes that they are going through and to help them to learn new skills. They also may need support to understand what is socially acceptable in different situations and support to stay safe.

Puberty is also often a challenging and emotional time for parents and carers too. Some parents and carers may find it embarrassing or difficult to know how to talk about the changes their child is going through, and may have a lot of questions about how they should support their child through puberty. There may also be difficulties that arise due to an increase in hormones which affect the child’s ability to regulate their emotions and behaviour.

It may be tempting to avoid the topic and ignore the changes your child is going through, however this may lead to more problems later on. As difficult as it might be, it is best to acknowledge the changes your child will go through so that you can plan how you will support them.

Key messages for parents and carers

• Your child will go through puberty. Puberty is inevitable, so assume that your child will show changes relating to their gender and sexuality.
• Start thinking about puberty and how you will manage the changes as early as you can.
• We all have different beliefs and expectation about puberty. Think about what your family’s beliefs and expectations are. Does this fit with your child’s needs and abilities?
• Take a matter of fact approach (be neutral). Your child may not pick up on social cues or learn from peers about appropriate behaviour. Therefore you and other adults will be their source of information.
• Establish rules around hygiene as early as possible.
• Introduce the concept of public and private (spaces, body parts, behaviour).

Strategies

Communication

Use the correct words and phrases. Do not use pet names or slang. Be consistent, brief and use simple language. Repeat the information often and be patient with them. You should make sure other environments such as school are also using the same words, phrases and boundaries.

Be clear and concrete with your communication. Do not expect your child to pick up on euphemisms or indirect language. You could also use visual communication such as signs, symbols, and photographs where appropriate.

The private and public concept

Understanding these concepts helps to support your child to behave in socially appropriate ways. These are abstract concepts so you will need to help your child to understand them. Public and private relates to actions, parts of the body as well as space. You can make these concepts real by using rules, boundaries, and modelling appropriate behaviour and language.

Private

Private can be described as being alone in a place where no one else can see or interrupt your child such as their bedroom, a toilet at home, the shower or bath. You need to help your child to understand parts of the body that are okay to touch in private, and actions that are okay to do in private, such as touching selves, masturbating, going to the toilet, washing and so on.

Public

Public is a place where anyone can go and where other people will be around such as a shop or a classroom. You need to help your child understand parts of the body okay to touch in public, and actions that are okay to do in public such as eating, talking to friends and so on.

Setting rules and boundaries

You should think about what rules you want to have in the home. For example, knocking on bedroom doors before entering, always wearing clothes in front of others, undressing in the bedroom, masturbation in the bedroom only, using the toilet with the door shut, and so on. Be clear and consistent with these rules.

Think about your child’s personal care routine and whether you can develop any daily routines and rules about hygiene and personal care.

It is helpful of you model the rules and boundaries, such as going to the toilet with the door shut, and so on.