Journal of Autism and Developmental Disorders, Vol. 27, No.

2, 1997

Sexual Behavior in Adults with Autism

Mary E. Van Bourgondiera,1 Nancy C. Reichle, and Anm Palmer
Division TEACCH, University of North Carolina at Chapel Hill

A survey of the sexual behavior of 89 adults with autism living in group homes
in North Carolina found that the majority of individuals were engaging in some
form of sexual behavior. Masturbation was the most common sexual behavior.
However, person-oriented sexual behaviors with obvious signs of arousal were
also present in one third of the sample. The relationship between sexual
behavior and demographic variables and other types of behaviors is explored.
Information regarding group home sexuality policies and procedures are
described.

The importance of sexuality in the lives of people with autism has been
the subject of debate (Elgar, 1985; Money, 1985; Torisky & Torisky,
1985). The controversy has centered largely around how the social defi-
cits of individuals with autism affect their interest in sexuality and what
type of sex education is needed. While professionals try to determine
the importance of sex education for the entire population of people with
autism, parents (DeMyer, 1979) have indicated that the sexual behavior
of their offspring is a major concern to them. Also, many residential
caregivers have expressed concern about the sexuality of their residents
(Mesibov, 1983).
One reason for the debate about the importance of sexual behavior
in the lives of people with autism is the limited empirical data regarding
the nature and frequency of sexual behaviors in this population. Ousley
and Mesibov (1991) compared the sexual interest, knowledge, and experi-
ence of high-functioning men and women with autism to that of individuals
with mild to moderate mental retardation without autism. The results in-
1 Address
all correspondence to Mary E. Van Bourgondien, Division TEACCH, CB# 7180,
Medical School Wing E, Chapel Hill, North Carolina 27599-7180.

113
0162-3257W/0400-0113S12.50/0 © 1997 Plenum Publishing Corporation
 114 Van Bourgondien, Reicble, and Palmer

dicated that many adults with autism were interested in sexuality, but their
experience was limited. Sexual experience, especially among males, was pri-
marily masturbation. A small percentage of females had engaged in sexual
activity beyond kissing and hugging.
In a survey of 100 parents of children with autism ranging in age 9
to 38 years, Ruble and Dalrymble (1993) found that individuals with
autism engaged in a wide variety of sexual behaviors described by their
parents as inappropriate. Sixty-five percent of the sample were reported
to touch their private parts in public, 23% masturbate in public, 18%
touched the opposite sex inappropriately, and 14% masturbated with un-
usual objects.
Haracopos and Pedersen (1992) have completed the most extensive
survey of the sexual behavior of adolescents and adults with autism. In a
nationwide survey in Denmark, they collected extensive data on 87 indi-
viduals with autism (57 men and 24 women) who lived in residential fa-
cilities. The results indicated that 68% of the adults were reported to
masturbate with 60% of those who did masturbate achieving orgasm. Mas-
turbation in public was reported in 53% of the sample, and 31% reportedly
used objects to masturbate.
The survey also included information regarding the person-oriented
sexual behavior of the sample. These behaviors were categorized as asso-
ciated or not associated with definite signs of physical arousal. Person-ori-
ented sexual behaviors with definite signs of physical arousal such as
touching others' genitals or getting others to touch ones own genitals,
touching other parts of the body, or attempting at or succeeding in sexual
intercourse were reported in 42% of the sample. Other person-oriented
sexual behaviors such as hugging, hand-holding, and kissing that did not
include definite signs of sexual excitement in the subjects occurred in 28%
of the subjects. Based on their data, Haracopos and Pedersen (1992)
strongly suggested that people with autism are interested in and are en-
gaging in sexual behavior and that systematic approaches to educating them
regarding the appropriate expression of these feelings are needed.
The limited research suggests that sexuality may be a more important
issue for individuals with autism than has been previously thought (Elgar,
1985). To determine the generalizability of Haracopos and Pedersen's
(1992) findings to other cultures, it is important to replicate this study in
other countries.
The purpose of the present study was to survey community-based resi-
dential programs in North Carolina to determine the degree to which the
residents with autism engaged in sexual behavior, and to investigate the
sexual policies and training programs of group homes.
 Sexual Behavior in Adults with Autism 115

METHOD

Sample
The participants included 72 males and 17 females, their mean age
was 28 years, with a range of 16 to 59 years. Twenty-six were African Ameri-
can or another minority and 63 were white. The subjects represented all
levels of autism and mental retardation: 26% were in the mild range of
autism, 23% in the moderate range, and 51% in the severe range. The
cognitive levels were 18% in the mild range of retardation, 22% in the
moderate range, and 60% in the severe range of mental retardation. Sixty
(67%) of the subjects had verbal language and 29 (33%) were nonverbal.
Of the subjects 22 (25%) were not taking any medications at the time
of the survey. Of the 75% that were taking medications, 39 (43%) were
taking medication to control behaviors, 15 were taking seizure control
medications, and 42 were taking medications for other health reasons. Fifty
individuals were taking medications for more than one reason. The per-
centages of individuals taking behavior control medications was comparable
to the results of a recent statewide survey. In a study of children and adults
with autism in North Carolina, Aman, Van Bourgondien, Wolford, and Sar-
phare (1995) found that 43% of the subjects over 20 years of age were
taking one or more psychotropic medications.
The majority of subjects (72) lived in Intermediate Care Facilities for
the Mentally Retarded (ICF-MR), 15 individuals lived in less restrictive
group settings called Developmental Disabled Adult (DDA) homes, and 2
subjects lived in supervised apartments programs. Of the sample 77 (90%)
were judged legally incompetent and had legal guardians.

Procedures

A survey was sent to 35 group homes in North Carolina that serve ex-
clusively adolescents or adults with autism. In addition, 107 homes that serve
adults with developmental disabilities which may have included residents with
autism were also sent questionnaires. These lists of group homes were ac-
quired from the Autism Society of North Carolina and the state listing com-
piled by the Department of Human Resources in North Carolina.
Of the 35 homes for residents with autism surveyed, 23 responded re-
sulting in a response rate of 66%. Of these homes 18 completed question-
naires for a total of 80 questionnaires; 5 homes declined to participate
because of the personal nature of the questions being asked.
Of the 107 homes for the developmentally disabled contacted, 31 re-
sponded. Of those responding, 21 reported that they did not have a resident
 116 Van Boiugondien, Heicble, and Palmer

with autism and 1 declined to participate for other reasons. In North Caro-
lina, most of the homes designed for individuals with mental retardation are
not able to serve individuals with autism. If one assumes that the percentage
of nonresponding homes that do not have an client with autism is at least as
high as the responding group, then the corrected return rate of these homes
is quite high. There were 9 questionnaires returned by these homes.

Measures

The measures included four questionnaires: a demographic form, the

sexuality questionnaire, a survey of the group homes sexuality policy and
training procedures, and the Aberrant Behavior Checklist (ABC: Aman &
Singh, 1986). The demographic form included information such as the sub-
ject's sex, birth date, race, degree of autism, degree of mental retardation,
and verbal abilities. In addition, information about the medications the sub-
jects were taking was obtained. The group home staff member supplied
the information regarding degree of autism and cognitive level based on
the resident's previous clinical assessments.
The sexuality questionnaire was based on the information gathered in
the Haracopos and Pedersen (1992) study and was divided into four cate-
gories covering the following topics: masturbation, masturbation with ob-
jects, sexual arousal from the visual stimulation of looking at objects and
other input not involving direct manipulation of the genitals, and direct
interpersonal behaviors leading to obvious sexual arousal.2 Caregivers were
asked to describe their best knowledge of the subjects' behaviors in the
four categories. To make the survey as simple as possible to complete, most
questions were presented in a checklist format where the responder simply
had to check on a 5- or 6-point scale how often, if ever, a given behavior
occurred. Open-ended questions were kept to a minimum.
Haracopos and Pedersen had demonstrated in their study that this
questionnaire had an interrater reliability rate of .86, and an intercede con-
cordance of .97. In the current study, the questionnaires were completed
by the caregivers most familiar with the clients' behaviors.
All homes were asked to send a copy of their written sexuality policy,
if they had one. In addition, the agency was asked to indicate which sexual
behaviors clients were permitted to exhibit with other residents, members
of the community, or staff members. The suivey also requested information
about the nature of resident training and staff training related to sexuality.
For a subset of 25 subjects, caregivers also completed the Aberrant
Behavior Checklist (Aman & Singh, 1986). This questionnaire was sent out
2For more information about the questionnaire please contact the first author.
Sexual Behavior in Adults with Autism 117

separately at a later date to all homes, but only this subset responded to
this second mailing. The ABC is a scale designed for rating the inappro-
priate and maladaptive behaviors of individuals with mental retardation in
residential settings. The ABC consists of five subscales derived empirically
through factor analysis: Factor 1. Irritability, Agitation, Crying (15 items);
Factor 2. Lethargy, Social Withdrawal (16 items); Factor 3. Stereotypic Be-
havior (7 items); Factor 4. Inappropriate Speech (4 items). The frequency
of occurrence of each item is rated by the individual's primary residential
caregiver. The internal consistency of the ABC is high with mean alpha of
.90 with the U.S. standardization sample. Test-retest correlations also are
high, ranging from .96-.9S for the subscales. The validity of the ABC also
is well established (Arnan & Singh, 1986).

Analysis

Appropriate descriptive techniques were used to analyze the data. T

tests and chi-square analyses were conducted as appropriate to assess bi-
variate relationships. Logistic regression procedures were employed to es-
tablish appropriate multivariate models.

RESULTS

Overall, 68% of the entire sample were reported to masturbate (Table

I). Of the 58 individuals reported to masturbate, 54 were men and 4 were
women. According to caregiver reports, 54 subjects masturbated at least
weekly, while one third of the sample did not masturbate at all. These
overall ratios are generally consistent with the data for males only. How-
ever, for females there were a greater percentage (75%) for whom the staff
members were not aware of masturbation occurring at all.
Of the men who masturbated 70% were reported to have an erection
while masturbating most of the time; 47% of the men who masturbated
reached orgasm most of the time (Table II); 36% of men who masturbated
reportedly rarely or never reached orgasm. For the women, it appeared

Table I. Masturbation
No. who
Group n masturbate % of total
Men 72 54 75
Women 17 4 24
Total 89 58 68
118 Van Bourgondien, ReicMe, and Palmer

Table II. Outcome of Masturbation

No. appearing frustrated % of those
No. achieving % of those who by lack of success in who
Group n organism masturbate masturbation masturbate
Men 54 37 69 14 26
Women 4 1 25 2 50
Total 58 38 66 16 28

Table HI. Masturbation with Objects

No. Who use objects % of those who
Group n to masturbate masturbate
Men 54 14 26
Women 4 0 0
Total 58 14 24

more difficult for the staff members to rate their levels of arousal as much
of the data was missing. Staff members reported that 16 subjects exhibited
signs of frustration (Table II) when they were not able to masturbate to
orgasm (28% of those reported to masturbate). The signs of frustration
reported by staff members included indicators such as anxiety, agitation,
or aggression toward self or others when their masturbation was interrupted
as well as sounds of frustration and repeated attempts to go to the bedroom
or bathroom.
According to caregiver's report, masturbation occurred in the clients'
bedrooms (54 subjects), in the bathroom (18 subjects), or in other locations
within the residential setting (17 subjects). Masturbation rarely occurred
outside of the group home; 11 subjects reportedly masturbated at the day
program and 4 masturbated in the community.
Caregivers reported that 14 (24%) of the subjects who masturbated
used objects (Table III) to directly stimulate their genitals during mastur-
bation. A wide variety of objects were used including jars of condiments,
pillows, trash bags, eggs, magazines, books, stuffed animals, and blankets.
Caregivers reported injuries from the use of objects in only two instances.

Table IV. Sexual Arousal from Visual Stimulation

Looking at objects and
other sensory stimuli Looking at other people
Group n Total % Total %
Men 72 7 10 12 17
Women 17 1 6 3 18
Total 89 8 9 15 17
Sexual Behavior in Adults with Autism 119

Table V. Person-Oriented Behavior with Obvious Signs of Sexual Arousal

%• of total sample
Behavior Men Women Total (N = 89)
Touching or being touched by others 15 5 20 22
Holding hands or hugging 16 3 19 21
Kissing 7 2 9 10
Attempted sexual intercourse 3 1 4 4
Any person-oriented sexual behavior 25 5 30 34

Objects or other sensory stimuli were reported to lead to sexual

arousal even when not directly used to manipulate the genitals (Table IV)
in 8 (9%) of the subjects. The examples of sensory stimuli reported to lead
to arousal included a suitcase, black chairs or any black shiny object, maga-
zines, books, shoes, shampoo bottles, coupons or paper, and body parts
such as legs. In addition, 15 subjects reportedly became sexually aroused
from looking at other people.
Overall, caregivers reported that 30 (34%) of the subjects engaged in
person-oriented behaviors leading to obvious sexual arousal (Table V).
These behaviors included touching others or being touched by other people
(20 subjects), holding hands or hugging (19 subjects), kissing (9 subjects),
and attempting sexual intercourse (4 subjects). Only 1 subject was known
to have successfully had intercourse.
Of the 30 subjects who exhibited person-oriented sexual behaviors,
most (67%) were not directed toward any one specific individual in the
resident's life. The sexual behavior tended to be directed most frequently
at staff members (43%) and other residents (30%) with very little directed
at peers in the community (13%) or strangers (3%). Sixteen of the subjects
directed sexual behaviors toward members of the opposite sex while 6 resi-
dents directed these behaviors toward members of the same sex.
Overall, 76% of the sample engaged in one or more sexual behaviors.
Chi-square analyses of person-oriented behaviors and masturbation, or-
gasm, and signs of frustration yielded no significant results.

Relationship of Sexual Behavior to Demographic Variable

The sexual behaviors also were examined to evaluate patterns based

on level of autism, level of metal retardation, the presence of verbal lan-
guage, age, the use of behavior control medications, and the presence of
opposite-sex individuals in the home. The relationship between these demo-
graphic variables and the dependent variables of masturbation, masturba-
tion to orgasm, frustration due to lack of orgasm, and person-oriented
sexual behavior were assessed. Logistic regression procedures were em-
 120 Van Boutigondieii, Rekhie, and Palmer

Table VI. Masturbation to Orgasm: Adjusted Odds Ratios Based on Logistic

Model
95% confidence
Independent variables Odds ratio levels
Degree of autism 1.26 0.06-24.70
Degree of mental retardation 12.06 0.22-649.67
Presence of verbal language 6.99" 0.98-49.84
Autism x Mental Retardation interaction 0.64 0.14-2.80
ap = .05.

ployed to establish multivariate models due to the categorical nature of

the variables.
The level of autism, the level of mental retardation, and the presence of
verbal language are highly related factors. Therefore, the effects of these three
variables and the interaction between degree of autism and degree of mental
retardation were examined first for each of the four dependent variables
(Model 1). A second model was then created for each dependent variable using
only verbal language, age, use of behavior control medications, and presence
of opposite-sex individuals in the home to account for the variance. Verbal lan-
guage was selected as the representative cognitive variable in this second model
because it was the most meaningful variable from a clinical perspective.
None of the six demographic variables accounted for a significant por-
tion of the variance related to masturbation in either Model 1 or Model
2. The results of the two multivariate analyses for frustration due to not
achieving orgasm during masturbation were also nonsignificant.
For the masturbation to orgasm variable, the multivariate analysis
(Model 1) utilizing the cognitive variables of degree of autism, degree of
mental retardation, the interactions of these two factors and presence of ver-
bal language revealed a trend for the verbal language factor, WALD x2(1)
= 3.7590, p = .0525. Individuals with verbal language were almost 7 times
more likely to achieve orgasm when masturbating than those without verbal
communication skills (Table VI). Although the odds ratio for the degree of
mental retardation is 12.06, this finding does not represent a statistical trend
due to the wide confidence interval. The second logistic model that included
verbal language, use of psychotropic medications, age, and the presence of
opposite-sex individuals in the home found no significant effects.
The logistic regression model for the cognitive variables (Model 1) and
person-centered sexual behavior with obvious signs of sexual arousal did
not yield significant predictors. However, the second logistic regression
model for this dependent variable (person-oriented sexual behaviors) that
included verbal language, age, behavioral medications, and presence of op-
posite-sex individuals in the home was significant (Table VII). The results
indicated that individuals with verbal language exhibited significantly less
 Sexual Behavior in Adults with Autism 121

Table VH. Person-Oriented Sexual Behavior: Adjusted Odds Ratios

Based on Logistic Model
95% confidence
Independent variables Odds ratio levels
Verbal language 0.33b 0.11-0.97
Subjects' age 1.06" 0.99-1.12
Medication for behavior control 3.97C 1.43-11.07
Subjects share house with same sex 1.18 0.42-3.29
ap = .07.
bp < .05.
cp < .01.

person-oriented sexual behavior, WALD x2(1) = 4.0996, p = .0429, than

those without language. Nonverbal individuals were three times as likely
as verbal individuals to engage in person-oriented sexual behavior. Indi-
viduals who were taking behavior control medications reportedly displayed
four times as much person-oriented sexual behavior, WALD x2(l) =
6.9563, p = .008, than those who did not take behavior control medications.
There was also a trend, WALD x2 = 3.1059, p = .0780, for older subjects
to exhibit more person-oriented sexual behaviors.

Relationship of Sexual Behavior to Behavior Difficulties

For a subsample of 25 individuals, caregivers rated behavior using the

ABC. Scores were used from this measure to determine the relationship be-
tween sexual behavior and various types of behavior problems. In the area
of masturbation, there was a significant relationship between masturbation
and exhibiting high levels of stereotypic sexual behavior, t(22) = 2.2179, p -
.04. Frequent masturbation was also significantly related to lower levels of
unusual speech, t(22) = 2.2989, p = .03. Individuals who exhibited repetitive
speech patterns masturbated less frequently than those who did not speak or
who did not show unusual speech. There were no relationships between the
ABC subscales and person-oriented sexual behaviors in this subsample.
The 25 individuals in this substudy were comparable to the larger sub-
ject pool in their age, degree of autism, and presence of verbal language.
There was a trend for the subgroup to have more individuals in the severe
category of mental retardation. In terms of their sexual behavior, the 25
individuals tended to masturbate more frequently, x2(1) = 3.517, p = .061,
and to reach orgasm significantly more often, X2(l) = 4.895, p = .027, than
the overall sample. In addition, there was a trend for this group to exhibit
more person-oriented sexual behaviors, X2(l) = 3.178, p = .075.
 122 Van Bourgondien, Reichle, and Palmer

Table VIH. Number of Group Homes (Out of 14) Whose Policies Permit Interpersonal
Sexual Behaviors
Between residents Between residents
Between residents: and member of and staff members:
Opposite Sex/Same community: Opposite Opposite Sex/Same
Sexual behavior Sex Sex/Same Sex Sex
Holding hands 12/5 10/4 2/2
Hugging 8/6 7/5 2/3
Kissing 8/2 7/3 0/0
Fondling genitals 3/2 4/2 0/0
Intercourse 2/1 3/1 0/0

Sexuality Policy and Procedures

Three group homes responded to the request to mail a copy of their

written sexuality policy. Also, 14 of the 26 programs completed the survey
indicating which person-oriented behaviors are permitted between their
residents and other residents, members of the community, or staff mem-
bers.
The results which appear in Table VIH indicate that the majority of
these homes permit holding hands between residents and between residents
and members of the community. About half of the programs allowed op-
posite-sex residents or residents and community members to hug and kiss.
These behaviors between same-sex individuals were less acceptable. Only
two to three group homes said that residents and staff members were per-
mitted to hold hands or hug. No group homes permitted kissing, fondling
of genitals, or intercourse between residents and staff members.
Twelve of the 14 programs (39 subjects with autism) that responded to
this portion of the survey indicated some type of informal sexual education
was available to the residents. In this small subsample, there was a trend for
clients who did not receive sex education to reportedly exhibit more frequent
masturbation, x2 = 2.06, p = .151. There was no relationship between client
training and the frequency of orgasm or signs of frustration being reported.
Subjects who exhibited person-oriented sexual behavior were significantly
more likely to have received sex education than those who did not exhibit
these types of behaviors, x2 = 4.82, p = .028. It was not possible to determine
which came first, the person-oriented sexual behaviors or the sex education.
Six of the 14 (39 subjects with autism) programs reported that staff
members received training in conducting sex education or sex counseling
with the residents. In this subsample, there was a trend, x2 = 3.292, p =
.07, for staff members without training to report more frequent masturba-
tion in their clients than did staff members who had received training.
Sexual Behavior in Adults with Autism 123

DISCUSSION

The results of this study are consistent with the findings of Haracopos
and Pedersen (1992), and indicate that the majority of individuals with
autism in residential settings were engaging in a variety of sexual behavior.
The most common sexual behavior was masturbation. However, one third
of the sample engaged in person-oriented sexual behaviors with obvious
signs of sexual arousal. These person-centered behaviors generally included
touching and holding hands with some kissing. Known attempts at sexual
intercourse were rare.
Unlike the Haracopos and Pedersen study, the majority of the sexual
behaviors in this study reportedly took place in the privacy of the individ-
ual's bedroom, bathroom, or home. Few sexual behaviors were reported to
occur in community settings. To what to attribute this finding is unclear.
Perhaps it relates to the degree of staff supervision in community settings.
Although the objects used in masturbation were somewhat unusual, this
sample did not report a high incidence of the use of objects to masturbate.
The relationship of verbal language to certain sexual behaviors sug-
gested that individuals with more language were more successful in mas-
turbating to orgasm and less likely to be observed being aroused by
person-centered activities. Perhaps the language capability made them
more aware of the goal of masturbation. Increased social awareness
through the increased verbal skills could also lead to a lower frequency of
sexual behaviors in presence of others. In addition, the successful mastur-
bation practices of verbal individuals may be satisfying their sexual needs.
Another finding of interest was the relationship between behavior prob-
lems as measured by the Aberrant Behavior Checklist and sexual behaviors
in the subsample. For some individuals with autism, masturbation may be
another form of stereotypic behavior as individuals in this subsample who
masturbated were significantly more likely to engage in stereotypic behaviors.
The lack of a relationship between irritability, agitation, and aggressive be-
havior (Factor 1 on the Aberrant Behavior Checklist) and masturbation,
reaching orgasm, or person-centered sexual behavior is also important to
note. Anecdotally, many caregivers hypothesize that individuals who are not
getting their sexual needs met are likely to be more irritable and more ag-
gressive. The results of this study do not support this hypothesis.
The results indicate that person-oriented sexual behaviors were more
prevalent in individuals who were taking psychotropic medications for be-
havior control. One possible explanation is that individuals who are given
behavior control medications are more impulsive overall in their behaviors
including their sexual behaviors toward others. Although it is possible that
the medications may be increasing the sexual arousal of these individuals,
 124 Van Bourgondien, Reidile, and Palmer

the chemical mechanisms of most of these medications makes this a less

plausible hypothesis.
Given the preponderance of sexual activity in these subjects, it is inter-
esting to note that, of the 26 homes completing questionnaires, only 3 re-
sponded to a request to review the programs' sexuality policy statement. These
three policies along with the policy survey were consistent and clear in stating
that sexual behavior between clients and staff members are not acceptable and
that public displays of sexual behavior by clients are not appropriate.
One responder pointed out the variety of factors one must consider
in the area of resident sexuality: resident ability, resident legal status, family
involvement, and exploitation potential. In addition to autism, all of the
subjects were functioning at varying levels of mental retardation. Ap-
proaches to sexual behaviors and training procedures vary based on these
cognitive factors. Ninety percent (77) of this sample were judged legally
incompetent and had legal guardians appointed for them. In these cases,
decisions regarding sexuality and training are made by the guardian rather
than the individuals with autism. In addition, families, when available, are
typically involved in a resident's program and decision making even if they
are not the legal guardian. Finally, as caregivers, the residential program
often takes the role of determining whether the individuals involved in any
interpersonal relationship both understand and agree to the interaction.
These factors and their interactions make it difficult to have general resi-
dent sexuality policies and procedures.
However, given the high frequency of sexual behaviors in individuals
with autism at all levels of functioning, it is important for residential pro-
grams to provide systematic training to their staff members of how and
when to provide training to their residents to facilitate the appropriate ex-
pression of sexual feelings. Of the subset of programs that responded to
the sexual policy question, the majority indicated the occurrence of some
type of sexuality training for the residents. However, the majority of staff
members had not received any training in how to conduct sex education
for their residents.
Use of staff report measures instead of direct observation of subjects
most likely resulted in an underestimate of the frequency of sexual behavior
in this population. The reporters were especially uncertain about the sexual
responsiveness of the females, since their degree of arousal is less obvious
to an observer than is that of a male subject. Future studies need to address
the reliability of staff members' observations of client behaviors.
The fact that all of the subjects were functioning in the mentally re-
tarded range of intelligence limits the generalizability of these findings to
individuals with autism with normal intelligence.
Sexual Behavior in Adults with Autism 125

In summary, the majority of adults with autism surveyed were engaging

in some type of sexual behavior. Some residents received informal sex edu-
cation; however, the majority of staff members have not received any train-
ing in how to help individuals with autism appropriately address their sexual
feelings.

REFERENCES

Aman, M. G., & Singh, N. N. (1986). Aberrant Behavior Checklist Manual. East Aurora, NY:
Slosson.
Aman, M., Van Bourgondien, M. E., Wolford, P, & Sarphare, G. (1995). Psychotropic and
anticonvulsant drugs in subjects with autism: Prevalence and patterns of use. Journal of
the American Academy of Child and Adolescent Psychiatry, 34(12), 1672-1681.
DeMyer, M. K. (1979). Parents and children in autism. New York: Wiley.
Elgar, S. (1985). Sex education and sexual awareness building fcr autistic children and youth:
Some viewpoints and considerations. Journal of Autism and Developmental Disorders, 15,
214-216.
Haracopos, D., & Pedersen, L. (1992). Sexuality and autism. A nationwide survey in Denmark.
Unpublished manuscript.
Mesibov, G. (1983). Current perspectives and issues in autism and adolescence. In E. Schopler
& G. Mesibov (Eds.), Autism in adolescents and adults (pp. 37-53).
Money, J. (1985). Response to Sybil Elgar. Journal of Autism and Developmental Disorders,
15, 217-218.
Ousley, O., & Mesibov, G. B. (1991). Sexual attitudes and knowledge of high-functioning
adolescents and adults with autism. Journal of Autism and Developmental Disorders, 21,
471-482.
Ruble, L. A., & Dalrymple, N. J. (1993). Social/sexual awareness of persons with autism: A
parental perspective. Archives of Sexual Behavior, 22, 229-240.
Torisky, D., & Torisky, C. (1985). Sex education and sexual awareness building for autistic
children and youth: Some viewpoints and considerations. Journal of Autism and Develop-
mental Disorders, 15, 213, 221-223.