Sexuality in patients with autism: how do educational and paramedical staff deal with it?

Abstract

Background: Confronted by inappropriate intimate behaviours, mental health caregivers tend to approach sexuality only when it becomes embarrassing. The aim of this study was to explore how educational and paramedical staff manage the sexual behaviours of patients with Autism Spectrum Disorder (ASD) and their associated roles, difficulties and requests, in order to provide recommendations to improve interventions in this area. Methods: 60 mental health caregivers (85% women) working with children and adolescents (63%) or adults (37%) diagnosed with ASD in 10 institutions in the Paris area were asked to answer a 1-time multiple-choice questions survey. They reported their levels of self-efficacy and skills to manage sexual behaviours, as well as their perception of institutional orientation and the importance given to this matter. We conducted descriptive analyses to describe the situation professional caregivers face with regard to their patients’ sexuality. Findings: 96.6% of participants reported they already had to deal with patients’ sexual behaviours (72% on a weekly basis; 63% failed to manage it). 80% reported that supporting patients’ sexuality was not an objective for the institution. 44% felt comfortable supporting patients’ sexuality, despite 83% never received specific training. Furthermore, 84% thought they lacked knowledge in the management of patients’ sexuality. Discussion: Our results show that institutions still neglect ASD patients’ sexuality, although mental health caregivers frequently encounter this issue. Explicit institutional objectives and specific trainings could improve support in patients’ sexuality.