Why do we need to teach children with autism about puberty?

Most children and young people pick up a lot of information about puberty incidentally through talking to their friends or seeing things in the media. People with autism often do not have the same ability to learn in this way and will need to be taught about this important stage of their development in a way that is factual and unambiguous.

Schools play a role in teaching sex and relationship education to pupils.

Additionally, educators and parents need to not ignore the situation and hope it goes away, the different areas of puberty need to be faced head on.

Also we need to be gender specific with our teaching of social cues, especially around the use of toilets and what we should be doing and not doing in public toilets, for example the social etiquette of the men’s toilets and how this differs to the ladies toilets.

Changes that happen during puberty can cause intense anxiety and moods. It is important to be prepared to teach what happens and why it happens and this can be taught using a Social Story™, Comic Strip Conversation ™or even a comparison tool / list:

Comparison sheets are good tools for mapping changes, but they will need to be used in conjunction with other tools, such as social stories™ to explain why changes happen.

Schools will address puberty, sex, sexuality and relationships at an age-appropriate level, as a parent make sure you speak to the school and find out what they are teaching to ensure a consistent approach.

When speaking about changes in the body, be sure to steer clear of inappropriate use of language for example “your voice will break” or “you Adam’s apple will appear in your throat”, use of slang terms will generally lead to confusion and raised levels of anxiety. Children with autism may take longer to understand the changes that happen during puberty and it is important to encourage questions, however this may lead to questions at inappropriate times and if this happens then use good autism practice, for example a timer for when they can ask a question or setting aside some time when the questions can be asked. Never dismiss a question, but agree with your school a script that can be used and follow it through.

Public and private

This section is vital, use a visual to reinforce and explain where it is ok to be naked. For example, emphasis this with use of colours, green for correct use and red for incorrect use, Green = naked in the shower – Red = naked in the supermarket. Be explicit and explain what rooms and areas are private (green) and public (red), make the child aware of social cues around this and also the law. Make sure the child knows who they can speak to about changes or worries and if you are not sure of the answer then do not risk giving an incorrect one and set some rules around private spaces, for example, everyone must knock on the door and wait for 5 seconds before they open it.

Menstruation (period)

Your daughter will need the menstruation cycle explained and that it is a normal biological process, it happens to every female when they get to a certain age and when it starts make it clear that she is not going to bleed to death, which is a common misconception for girls with autism. It is important to explain the process of menstruation but also just as important to explain what to do when it arrives – make sure that there is a visual system in place to teach the process, this will encourage independence and speak to her school about it, have a conversation around who can your daughter talk to and agree a discreet break script with the staff.

Explain sanitary products and the features of each product, leave them in an agreed place so that your daughter is reassured that they will always be there. Utilising smart phones and tablets, download a period tracking app this will develop independence and give that visual reminder about when it might be coming. For example Period Tracker is a simple and user friendly app that gives access to a calendar and also a countdown.


Masturbation can be seen as a taboo subject, but it should be dealt with head on, it is really important to teach children with autism the why and where, link it to private and public and reinforce it with the colours green and red. Additionally it is important to teach “cleaning up after” – tissues should be left in the bedroom for this situation. This may seem a difficult situation to approach, but it is very important to teach where it is appropriate and that it is a total natural biological process.


Use Social Stories™ or Comic strip conversations™ to explain the social aspects of these situations as well as expected behaviour, additionally you can use the circle or relationship and adapt it to teach what is appropriate and what isn’t. Make sure that the subjects are visually supported.


To learn more about autism and puberty, information can be found on the autism website.