Category Archives: Puberty

Taking It in Stride

I tend to notice a lot of things in early spring. By the middle of spring, I am usually plagued by spring fever and am unable to focus on much of anything. But in early spring, I’m alert, I’m happy that winter has come to an end, and I’m much more observant. I notice, of course, that the grass and weeds in my yard grew while my back was turned and that the tree in the front has lost all of its pre-leaf blossoms overnight. I notice that my cats are shedding like we’re in the middle of a heat wave. And I notice that my sons seem much taller than when I dropped them off at the airport nine days ago.

This time, at least, driving to the terminal to pick them up, I don’t cry. I take it in stride now, their new ability to take a direct flight on their own. I will never take it for granted, but it is the new norm, the status quo. Of course, it is still a novelty, and I wait with excitement on the receiving side of the revolving security doors, watching. I see Aidan first, notice the sun across his nose, his hair, the color of milk chocolate, casually falling across his eyes. He wears cargo pants and flip-flops and sports a new shirt. Nigel towers behind him, also in a new shirt, and jeans, carrying a tote bag. I smile and wave as I approach them. I embrace Aidan, inhaling the scent at the top of his head, realizing that I won’t be able to do that much longer. Nigel stiffly accepts a hug. Usually I don’t think about it; this is how he hugs. But sometimes I wonder if it will always be this way. No matter. It is what is, and I love him for it.

I notice a wide ring of chapped, irritated skin surrounding Nigel’s mouth, and then I notice that he has shaved. Shaved! The last time he had gone to L.A. to visit his father (at Christmas), I had mentioned to him that Nigel might need to start shaving soon, but we hadn’t discussed it since, and now, it’s done. My little boy! Shaving!

“Wow! You shaved!” I exclaim.

“Yeah,” he replies in his deep, steady voice.

We step out of the way of the other passengers filing through the security doors and start making our way to the luggage carousel. “It looks like the shaving caused some irritation to your skin,” I say, which he denies. He claims that it had been windy and dry on a day that they were outside all day long, and that had caused it. But Nigel has always had extremely sensitive skin, so I am not convinced. He seems to believe that I might tell him not to shave any more if he admits that it irritated his skin, and no way would he give up a rite of passage that he’d long awaited.

“Well, I think your skin just needs a little time to heal before you shave again,” I suggest. “It needs to get used to the sensation of shaving, and then it won’t get irritated when you do it. We’ll put some lotion on it, and it should be fine in a few days.”

“Okay,” he says.

Later, at home, I bring him some facial lotion. The lower half of his face is red and dry, the skin tight. He has been opening his mouth in an exaggerated manner, trying to “stretch the skin so that it won’t crack.” I suggest that doing so might make it worse, but he is adamant, even though he complains that it hurts. I cut to the chase.

“So how do you feel about shaving? Do you feel like you’re growing up?”

“I’m fine with it,” he states. “It’s just another step to adulthood.”

Apparently the rite of passage wasn’t as big of a deal as I had thought. He takes it in stride, my not-so-little boy. I think I’d do well to follow his lead. But for the moment, I can’t get over the fact that my firstborn is shaving! Even though I knew it was coming, it snuck up on me faster than the grass and the weeds, faster than any sign of spring. Yes, spring is here, and my boys are growing up. All at once.

Scratch Where It Itches

“But it itches!”

This is often Nigel’s refrain (spoken between clenched teeth) when I discreetly remind him to stop scratching his head. And no, he doesn’t have dandruff. Nor does he have lice, scabies, or any other type of external cause of itching.

The head itching started about a year and a half ago, before he began taking either of his two daily medications. Interestingly, it also started right around the same time that the “adjustments” started. By that I mean the “situating” of certain appendages that seem to become jostled throughout the day. Not having the same certain appendages myself, I’m unable to identify with the need for their frequent “adjustments.” Fortunately, my son’s hand remains outside of his clothing when he makes these “adjustments,” but I often have to remind him to go to a bathroom to do it, especially when we’re out in public. Same with the head-scratching.

“People don’t like to see other people scratching their heads for long periods of time,” I tell my son. “It’s not socially acceptable. When people see someone scratching endlessly, they think they have lice or some type of skin disease. A quick, occasional scratch is okay,” – and here, I demonstrate a discreet scratch –  ”but not a lengthy, ‘Bare-Necessities’-type of scratch-fest.”

“But it won’t stop itching!”

Initially I thought that he might have been allergic to the shampoo he had been using, so we switched to a chemical-free, organic shampoo. Then a different one. Then T-Gel. Then we tried various ointments and creams. Heck, we even tried saturating his scalp with organic olive oil for 20 minutes prior to washing his hair, since I had read somewhere that it was a good remedy for itchy scalps. Nothing has worked. Nothing.

I considered the possibility of a food allergy causing his scalp to itch, but his diet hasn’t changed that much in the past year and a half since the itching started. We already tried the GF/CF diet, but Nigel has never exhibited the gut and digestive issues present with GF/CF allergies, nor did he show any signs of improvement when we tried the diet. It could be something not GF/CF-related, but since his daily diet has not changed much, I have no idea what it could be.

One thing’s certain – the itching started right about the time I realized that he was into puberty. So it could be a result of the hormonal changes he’s experiencing. If that’s the case, how long before his body adjusts? How long before his scalp normalizes and the itching goes away? I had learned last year at the Autism and Puberty seminar that I attended that people with autism are prone to Candida, a type of fungus, which can cause itching. However, that is usually accompanied by gastrointestinal issues and other symptoms. Yet again, I am at a loss for the cause of the itching of Nigel’s scalp.

So I’ll just blame puberty. It’s responsible for many other problems we experience around here. And since the average time span of puberty for boys is six years, we’ve got a few more years of rampant scalp-itching to contend with. Any ideas out there other than Baloo’s tree method? Please?

Adventures in Puberty, Part 5

When I left the Autism and Puberty seminar I recently attended, my head was swimming with all the information I had obtained. I had learned about the difference between puberty and adolescence, that there is nothing delayed about the former and that the latter usually is. I learned how to teach about difficult topics like sexual abuse. I learned how the concept of emotional age affects how a child responds to puberty and adolescence. I learned what to teach older ASD teens when they do reach adolescence. There was quite a bit of information to absorb, and I knew that a good deal of it would require some follow-up.

The seminar presenters thought of everything. They provided a list of resources with a wealth of information and tips.

Books:

Websites:

Adventures in Puberty, Part 4

Continuing the series on information from the Autism and Puberty seminar I attended . . .

How does emotional age affect adolescence? It’s what makes adolescence come later for ASD teens. And if their social-emotional gap is large, they don’t reach adolescence until well into adulthood; in some cases, not at all. For ASD parents, puberty and adolescence is a long ride that can last into their child’s twenties or later; it’s not over after twelfth grade! Parents are constantly teaching, and ASD teens are constantly learning. It’s a time for reaching out to peers and being more aware of the media. They get information from many sources, and it needs to be filtered. Even though at the onset of adolescence ASD teens tend to want more peer interaction, they are still not connected to what their behaviors look like to others. They will need constant communication about what’s appropriate and inappropriate, and it’s up to parents to provide it. ASD teens don’t ask the questions that NTs ask. It’s up to parents to anticipate what they need to know and guide them.

Typically, adolescence – the time of emotional and social maturation – begins at around age 11 for girls and 12 for boys. In the previous post, I estimated my son’s emotional age to be around 8 or 9. Therefore, I can guess that he should begin adolescence in 3-4 years. He will be 17 or 18. Before I attended this seminar, I thought that because he recently started indicating a budding interest in dating that he was entering adolescence. This is not the case. He is merely reacting to what he sees with his typically developing peers and the teens he sees in the media. About a month ago he asked me what “flirting” meant. I explained it to him in simple terms, and then he printed out a Wikipedia definition and proceeded to notify me whenever he witnessed what he thought was flirting, based on the Wikipedia description. Even 8- and 9-year-olds have crushes and can indicate an interest in the opposite sex. It doesn’t mean they’re entering adolescence yet, and neither is my son.

When he does get there, the presenters at the seminar recommended teaching the following:

  • How relationships grow
  • How sexual feelings happen and how they can be handled
  • Differences between love and sex
  • Laws and consequences of inappropriate sexual touching of self and others; importance of impulse control
  • How pregnancy can be prevented – abstinence and birth control
  • Sexually transmitted diseases
  • Homosexuality
  • Responsibilities of marriage and parenting

That’s quite a list! I know I’ll need help with that, and I’m sure other parents will, too. Stay tuned for a list of resources, which will be posted in the next installment.

Adventures in Puberty, Part 3

And now, the part that you’ve all been waiting for (I know, because I was, too) – dealing with emotional immaturity during puberty. This is the crux of the matter, I think. This is what makes us wonder what is going on with our ASD kids, why they fly off the handle, why they indicate an interest in dating even though they’re nowhere near ready for it. I went to the Autism and Puberty seminar seeking advice about these points, and I understand a lot more now than I did before.

So far I’ve been able to determine two main issues contributing to problem behaviors during puberty:

1) Learning to deal with hormones. It’s hard enough for NT kids to handle their surging hormones, and for ASD kids, it’s even more difficult. And ASD children who had severe sensory issues when they were younger are going to have a harder time. It took my son, who is now 14, years to learn how to filter out all the sounds and other sensory issues that were agonizing to him as a younger child. Similarly, it took him about a year to learn to filter or “deal with” all the new hormones surging through his body once puberty hit. He seems to have reached a (probably temporary) plateau at the moment, but prior to a few months ago, he was frequently agitated, short-tempered, and volatile.  He seems to have adjusted to the hormones, although I’m bracing myself for future “surges” as we get through the rest of puberty. Hormonal changes are also said to possibly trigger seizures in kids who had not previously had them, up to 1 in 4. (The presenter at the seminar explained that seizures in young ASD kids are caused by a different type of brain activity.)

2) Emotional immaturity. What exactly does this mean? As we know, autism is categorized as a developmental disability, a pervasive one that affects many different areas of development. As ASD kids get older, many of them do develop language and communication abilities, cognitive development improves, and sensory integration can as well. But social and emotional development usually lags behind, even in the presence of high cognitive ability. How behind? It varies, and it depends on something called emotional age. Emotional age is the level on which your child relates to others, and it is usually determined at your child’s school. For example, when Nigel was in fourth grade, his teacher explained to me that his emotional age was four. Yes, four, when he was ten years old. What do they base that on? Usually they do observational testing, but parents can figure it out themselves simply by looking at what age group of children your child seems to relate to the best. At the time, Nigel was relating to preschoolers, and he often acted like one. Over the past four years, he has progressed. He has friends that are his own age, but he does not fully relate to them and they do not relate to him. They like him, they spend time with him, but they have a hard time understanding him. However, there is an 8-to-9-year-old boy in the neighborhood Nigel plays with, and they seem to be on the same level emotionally. This makes me believe that Nigel’s current emotional age is about eight.

I think about what it would be like to be eight years old and going through bodily changes and dealing with hormones, starting to have sexual feelings and not having the maturity to handle them. My son sees his peers interested in girls, he sees his age group being portrayed a certain way in the media, and so he thinks he should be that way because he wants to fit in. Of course, all teens want to fit in. But a 14-year-old with an emotional age of 8 is going to have a much tougher time. And he isn’t ready because he hasn’t even hit adolescence yet.

In the next post: emotional age and adolescence, and what to teach older teens.

Adventures in Puberty, Part 2

When my boys were little, one of my favorite things to do was inhale their scent at the backs of their necks and on the tops of their heads. And in doing this on a regular basis, I came to know their scents quite well. Consequently, I knew without a doubt when puberty had hit.

Thus we come to the next topic in the puberty series: Teaching self-care and hygiene. We increase the frequency of showers, introduce deodorant, teach about menstruation and body changes, etc., but we do it keeping in mind that repetition is essential to ASD kids absorbing any type of social learning like this. My fourteen-year-old son needs constant reminders when it comes to hygiene! But the difference between him and a typically developing fourteen-year-old is that my son will need reminders for much longer than the other.

As mentioned in the previous post, continue to teach sex education at your child’s level of comprehension. Once your child reaches puberty, it’s important to teach appropriate levels of affection with different circles of people in your child’s life. Convey the difference between hugging family and close friends and shaking hands with people in the community. It’s also important to remind your child about ways to recognize inappropriate touching by others and what to do about it if it happens. Teaching this to your child can help them if they are targeted for sexual abuse, which is unfortunately high among those with developmental disabilities. Many are trusting and have been taught to be over-compliant, which also puts them at risk. It’s also recommended to teach the basics of reproduction at this age, whether it be written into your son or daughter’s IEP as an educational goal or something that we parents teach at home.

Given the choice, we’d also rather not teach our kids about masturbation, but with ASD kids, it’s really important to discuss issues of privacy. Again, this is an area that will probably require some repetition about when and where it is appropriate to masturbate. Safety issues can also be a concern; they might insert things that could be harmful. If too much masturbation seems to be a problem, the presenters at the seminar I attended suggested increasing other physical activity during the day and decreasing downtime. Part of the reason for frequent masturbation is a need for sensory input, and often ASD kids don’t have the ability to realize that themselves.   

Tune in tomorrow for a discussion about emotional immaturity during puberty – understanding it and what to do about it.

Adventures in Puberty, Part 1

The Autism Society of Oregon recently hosted a seminar on puberty and sexuality, and even though I had to drive 352 miles round-trip to attend, I made it a point to do so. I could not pass up an opportunity to obtain valuable information regarding this challenging stage of development.

The seminar covered strategies in dealing with puberty, teaching our ASD children about sex education, how sexuality develops over the span of childhood and teenage years, and why this information is important for kids with developmental disabilities to learn. Because such a wealth of material was presented, I intend to break up what I learned into several posts over the coming week or so.

“Nothing is delayed about puberty!” This was probably the most important point of the seminar.  The second most important point was the distinction between puberty and adolescence. Puberty refers to the physical changes happening with the body, whereas adolescence pertains to the emotional and social changes in development. The two do not usually occur simultaneously with ASD kids. This important fact hit home with me. I thought about my son and how I had just assumed that because he was indicating an interest in girls that he had hit adolescence, and that is not necessarily so. I learned that he is probably indicating an interest in girls because he is reacting to his typically developing peers, whom he wishes to emulate. It doesn’t mean that he’s emotionally ready for it, even though his body is keeping up with the typically developing peers. In fact, I also learned that in some cases, puberty in ASD kids can occur earlier than in non-ASD kids. But adolescence usually occurs later. As one of the presenters aptly put it, “Adolescence is fractured from puberty.”

Some parents don’t want to think of their ASD children as sexual beings due to believing that they will be childlike forever. This is a common stereotype about people with developmental disabilities. Other stereotypes include assumptions that they are “asexual,” that they are unable to understand sexual desires, or that they have uncontrollable sex drives. Belief in these stereotypes discourages a perceived need for sex education. But without it, ASD kids are at risk for sexual abuse, inappropriate behavior in public, and possible diseases or pregnancy. It is imperative that our ASD kids are taught sex education at a level that they can comprehend, which can be accomplished by writing an IEP goal around Health/Human Sexuality Education. Of course, it can also be taught at home. 

How do we do that? The short answer: Start young. The seminar presenters recommended starting off at an early age by teaching self-acceptance and an awareness of all body parts, including gender-specific parts. This also should include a talk about privacy and which parts should not be touched by others, etc. It is just as important to provide this information for ASD children as it is for typically developing children. They need to have this awareness. Even non-verbal children can absorb some of the information, and it may help to protect them. For their sake, we need to try.

Up next:  What to teach during puberty – self-care and hygiene, personal space, masturbation, and appropriate levels of affection with others.