Expert: Dr. Sharon A. Mitchell - 1/7/2010

Question
I work in a (public) middle school special education classroom. One of our students has severe autism: he can read basic sight words and knows some numbers, but he is 99% nonverbal and requests nothing without prompts. His mom does not work and seems to spend all her time looking for new ways to sue people (she currently has lawsuits with two separate school districts) and dad works the minimum number of hours so that they qualify for all financial help.

The PROBLEM is this: the boy, who is 14, tall, over 200lbs, and very strong has an obsession with a couple of us (being his teachers). He tries to kiss us on the mouth, grabs our head, lunges over tables to reach us, or chases us around the room. His mom defends his behavior by saying that she allows him to love on her at home. Obviously, he hasn't learned when it's appropriate.

Even THAT isn't my biggest concern. What really bothers me (and my therapist who told me to look into this further because she thinks it's hot-lineable) is that according to mom, he usually sleeps naked AND because he's had three seizures in the past five years, she sleeps next to him. She says she gets out of bed when he starts to touch himself, and frankly, disability or not, it's very disturbing, especially considering how his obsession with us seems to be sexually motivated.

Any ideas on whether mom sleeping with a naked teen boy with severe autism is still inappropriate? Any ideas on how to teach him what is appropriate behavior at school?  

Answer
I understand your concerns.

To you, he is a 14 year old boy. In his parents' eyes though, they may still see him as a little boy. Having your child mature and grow can be hard for any parent but when in many respects your child still functions as a much younger kid, it can be more difficult to come to terms with adolescence. When a child is nonverbal and not doing many of the things other teens would do, sometimes parents assume that their little boy is at the functional age of say an eight year old. Although your student possesses some skills seen in early elementary students, his body is that of a young man.

Just because a child is delayed in some areas does not mean that his sexual growth is likewise delayed.

Kids with autism spectrum disorders (ASD)often do not pick up on the social signs and conventions other kids gather through osmosis. Instead kids with have to be taught rules and habits and conventions specifically.

Boundaries are especially important for boys who are big and strong and could be intimidating, whether or not that is their intention. It sounds like you are well aware of what is and what is not appropriate at school. This may be harder for the parents if they still see their son as a child.

If you are truly concerned about possible inappropriate actions or potential abuse at home, I would suggest you contact the authorities in your state. Could you make the call anonymously, and without giving any names just describe the situation to get the social worker's impressions?

For this boy's sake, it would be better if his parents can be led to see that he is close to being grown up. It's often hard for parents of a child with a disability to see past the moment. The day-to-day care can weigh so heavily that there seems little time to ponder the future. But in less that ten years this lad will be out of school.

Also, he will not always necessarily be around his parents. Without learning the impulse control that goes along with sexual urges, he could find himself in serious legal trouble.

It may be that you do not have control over what happens at home. But you do have control over what happens at school.

Chase games are not good. I'm sure you do not enjoy being chased around the room, but apart from your discomfort, this does not give your student the right idea. It implies that he has some power over you and at some point he could realize that his greater size could give him control. As a school could you work out a plan for when he attempts to chase anyone?

What he is feeling is normal. How many 14 year old boys have crushes on their teachers. What is not normal is that this student is acting on his urges.

At home he's allowed to show affection to his family. When he was younger, school personnel likely accepted and even reciprocated physical affection with him. It's not uncommon for grade one teachers to give their students a hug. But as kids get older, the physical affection in school usually stops to be replaced by high fives, pats on the shoulder, verbal praise, etc. Sometimes with special needs kids we forget this, so they continue to treat staff they like in the same physical ways they did when they were younger.

Before adolescence approaches I like to transition kids away from hugging school staff. Kids with ASDs get stuck in their ways and it often takes time to establish new patterns.

I would be very blunt with your student. Say "No" firmly. Don't run but stand your ground with a stern expression and a firm voice. Model for him other ways of showing friendship and approval and praise. Create a visual representation of ways he interact with you, such as:

- shaking hands
- giving high fives
- making an OK sign with thumb and fingers
- work on a catch phrase such as, "Good job", "Nice to see you", etc.

When he tries something appropriate, show him the picture of what he can do instead.

Draw a large circle on chart paper. In the middle of the circle draw a small circle. within this inner circle write the names of the people he is allowed to hug (or use their pictures). You may be able to ask the parents to help you with this because despite what happens at home they may not want him kissing school staff on the mouth). They may provide you with photos of themselves, grandparents, etc. with whom he is physically affectionate at home. Explain to him that these are the people he can kiss and hug.

Next draw a larger circle outside this inner one. In this next circle are the people he knows well with whom he might have some physical contact such as high fives, someone might put a hand on his shoulder to guide him, etc. You and other school personnel might come in this circle, along with kids he may play with or have physical contact with in the gym.

You can make as many layers of circles as you feel appropriate to the situation. In an outer circle should come professionals like physicians, nurses and police who may have occasion to touch him.

You will need to go over this circle chart often, reinforcing that the inner circle contains the people he can hug. He may not hug the others. This is also for his protection. We don't want him in legal difficulties, nor do we want him taken advantage of. The incidence of disabled people subjected to sexual abuse is appaling.

There is another side to this. It is possible that the sexual implications are in the minds of the staff (and well-based, considering his age and size). Possibly the boy is doing these actions because he gets a sizable response when he does. Do you think his intent is not sexual stimulation but for attention? Doing these things will certainly get a rise out of an adult woman.

There is a good book on sexuality for youth like your student. You can take a look at it here: http://www.amazon.com/Sexuality-Your-Daughters-Intellectual-Disabilities/dp/1557...

Jerry and Mary Newport (both diagnosed with ASDs) have a book useful for higher functioning youth with ASDs http://www.amazon.com/Autism-Aspergers-Sexuality-Puberty-Beyond/dp/1885477880/re...

You might find some of the Autism & PDD Adolescent Social Skills Lessons books from LinguiSystems helpful http://www.linguisystems.com/itemdetail.php?id=287

This social skills picture book for high school might also have something useful to your situation: http://www.amazon.com/Social-Skills-Picture-School-Beyond/dp/1932565353/ref=sr_1...

The next two books may also provide some ideas: http://www.amazon.com/Attainments-Looking-Curriculum-Skills-Development/dp/B000O... and http://www.amazon.com/Skills-Activities-Secondary-Students-Special/dp/0470259396...

Your student is lucky to have such a concerned educator in his camp. Your actions may teach him valuable lessons and help prevent him from getting himself into serious difficulties.

Best wishes,

Sharon A. Mitchell, B.A., B.Ed., M.A., PhD candidate
www.autismsite.ca