How do we address the often-overlooked sexual health needs of individuals with Autism Spectrum Disorder (ASD)? 

Dr. Zakia Alavi, a seasoned child and adolescent psychiatrist specializing in pediatric mental health and developmental disabilities, joins Dr. Lia Gaggino to unpack this critical yet often neglected aspect of care for individuals on the autism spectrum. Drawing from her extensive experience in child and adolescent psychiatry, Dr. Alavi reveals the patterns she's observed in patient referrals, particularly concerning autism and behavior problems, including inappropriate sexual behavior. This frank discussion covers everything from understanding puberty in children with autism to addressing the complex challenges surrounding sexuality education for neurodivergent individuals. 

Dr. Alavi emphasizes the need for tailored sexual health curricula and the importance of behavioral therapy for youth with autism to manage sexuality-related issues. She also touches on the pressing concern of victimization of youth on the autism spectrum and the role of promoting comprehensive sexual education for these youth.. 

Listen in and discover why Dr. Alavi believes sexuality is not just a basic human need, but a fundamental right for all, regardless of their neurodevelopmental status, including those with neurodevelopmental disorders like ASD.  

[00:33 -10:59] Autistic Traits and Abuse Risk

•   Explores the higher risk of abuse due to social awareness and communication deficits in youth with autism.
•   Non-verbal children or those who misinterpret situations are especially vulnerable.
•   Defines sexual awareness as understanding feelings, desires, and sexual situations.
•   Highlights the struggle of youth on the autism spectrum in independently navigating sexual awareness.

[11:00 - 22:49]  Discussion on Sexual Awareness  

•   Defines sexual monitoring as understanding others' impacts on one's sexuality.
•   Emphasizes the importance of sexual assertiveness and consciousness for protection.
•   Single parents, in particular, may struggle with providing comprehensive sexual education.
•   Suggests the presence of another person during these discussions for better handling.

[22:50 -28:59]  Victimization and the Role of Media

•   Notes the heightened risk of victimization, especially among females with autism spectrum disorders. 
•   Emphasizes the need for protective measures and greater awareness.
•   Role of parents and educators in continual skill-building around privacy and sexual norms.
•   Suggests personalized approaches tailored to each child's level of understanding.

[29:00 - 32:13]  Sexuality as a Human Right:

•   Encourage self-reflection about perspectives on sexuality for oneself and others.
•   Highlight the importance of helping children achieve their fullest potential in all aspects.
•   Reiterates the significance of protecting neurodiverse youth from victimization through education.
•   Encourages proactive approaches to ensure youth understand and navigate normal sexual behaviors

[32:14 - 40:00]  Closing segment Takeaway

You can reach Dr. Zakia Alavi

LinkedIn:  linkedin.com/in/zakia-alavi-7289a9118

Links to resources mentioned on the show

• Socio-sexual functioning in autism spectrum disorder: A systematic review and meta-analyses of existing literature   Grace I P Hancock 1, Mark A Stokes 1, Gary B Mesibov  Socio-sexual functioning in autism spectrum disorder: A systematic review and meta-analyses of existing literature - PubMed (nih.gov)
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• Childhood neurodevelopmental disorders and risk of coercive sexual victimization in childhood and adolescence - a population-based prospective twin study. Ohlsson Gotby V, Lichtenstein P, Långström N, Pettersson E  Childhood neurodevelopmental disorders and risk of coercive sexual victimization in childhood and adolescence - a population-based prospective twin study - PubMed (nih.gov)
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• Sexual knowledge and victimization in adults with autism spectrum disorders. Brown-Lavoie SM, Viecili MA, Weiss JA. Sexual knowledge and victimization in adults with autism spectrum disorders - PubMed (nih.gov)
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• Association of autistic traits in adulthood with childhood abuse, interpersonal victimization, and posttraumatic stress. Roberts AL, Koenen KC, Lyall K, Robinson EB, Weisskopf MG. Child Abuse Negl. 2015 Jul;45:135-42. doi: 10.1016/j.chiabu.2015.04.010. Epub 2015 May 6. PMID: 25957197; PMCID: PMC4784091. Association of autistic traits in adulthood with childhood abuse, interpersonal victimization, and posttraumatic stress - PubMed (nih.gov)
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• Sexuality and Relationship Education for Children and Adolescents with Autism Spectrum Disorders 1st Edition  by Davida Hartman Sexuality and Relationship Education for Children and Adolescents With Autism Spectrum Disorders: Hartman, Davida: 9781849053853: Amazon.com: Books
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• Maggio MG, Calatozzo P, Cerasa A, Pioggia G, Quartarone A, Calabrò RS. Sex and Sexuality in Autism Spectrum Disorders: A Scoping Review on a Neglected but Fundamental Issue. Brain Sci. 2022 Oct 24;12(11):1427. doi: 10.3390/brainsci12111427. PMID: 36358354; PMCID: PMC9688284. Sex and Sexuality in Autism Spectrum Disorders: A Scoping Review on a Neglected but Fundamental Issue - PubMed (nih.gov)
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• What's Happening to Tom?: A Book About Puberty for Boys and Young Men with Autism and Related Conditions (Sexuality and Safety with Tom and Ellie) by Kate E. Reynolds What's Happening to Tom?: A book about puberty for boys and young men with autism and related conditions (Sexuality and Safety with Tom and Ellie): Reynolds, Kate E., Powell, Jonathon: 9781849055239: Amazon.com: Books
• Things Ellie Likes: A Book About Sexuality for Girls and Young Women with Autism and Related Conditions (Sexuality and Safety with Tom and Ellie) by Kate Reynolds Things Ellie Likes: A book about sexuality and masturbation for girls and young women with autism and related conditions (Sexuality and Safety with Tom and Ellie): Reynolds, Kate E., Powell, Jonathon: 9781849055253: Amazon.com: Books

Other episodes you may like:

Episodes - Pediatric Meltdown

201. Sexual Assault Services: Supporting Victims

189. Fetal Alcohol Spectrum Disorders: Recognition Matters

169. Parenting the Neurodivergent Child: What Pediatric Clinicians Need to Know

Key quotes for Twitter:

"We have to keep in mind that kids on the spectrum are not going to be able to navigate this landscape. This is so complex, and that they are going to need help with that."..Dr. Zakia Alavi on understanding sexual sensuality

"So, this sexual consciousness is linked with sexual assertiveness. Right? Because you feel a certain way and then you have to be assertive to express that this is what I feel and this is what I need, and this is where I'm going to go with that”…Dr. Zakia Alavi on sexual consciousness and assertiveness

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