Helping autistic teens master puberty, health and hygiene

Kelly McKinnon-Bermingham is director of behavior intervention at the University of California-Irvine’s Center for Autism and Neurodevelopmental Disorders, in Santa Ana, California. Nick Riley and Nick Tellier are graduate students in the center’s Families and Schools Together program. UC-Irvine’s center is one of 13 sites in the Autism Speaks Autism Treatment Network.

Autism and teaching hygiene

Our families enthusiastically welcomed the recently published ATN/AIR-P Puberty and Adolescence Resource. This guide for parents and teens was made possible by the Autism Speaks Autism Treatment Network in its federally funded role as the Autism Intervention Research Network on Physical Health.

Created by ATN specialists and parent volunteers, the tool kit is filled with tips, scripts and visuals to help parents explain the physical changes of puberty and the emotional and social transitions of adolescence to tweens and teens on the autism spectrum.

How to teach privacy, appropriate hygiene and routines that adolescents need to master

Here is a sample script for starting the ongoing conversation:

And here is a visual schedule for introducing the importance of regular showering:

At the same time, our families were asking for more. They wanted in-person guidance with an opportunity to ask follow-up questions on how to talk with and teach a child with autism about puberty.

Many children in special autism classes aren’t included in their school’s standard puberty talks. Or they're included, but the information isn’t adapted to fit their unique learning styles.

We developed “Just for Girls” and a “Just for Boys” hygiene and puberty classes using the Autism Speaks Puberty Tool Kit as a guide

Each program involved four weekly classes on the following topics:

Just for boys

Week 1: What is puberty? (and noticing changes in your body)

Week 2: What to do with body changes unique to a boy

Week 3: Hygiene schedules and healthy living

Week 4: Shaving, grooming and putting it all together

Just for girls

Week 1: What is puberty? (and noticing changes in your body)

Week 2: What to do with body changes unique to a girl

Week 3: Hygiene schedules and healthy living

Week 4: Caring for your menstrual cycle and putting it all together              

Each session included a small group of children and parents, and we used a multi-sensory approach with written, video and hands-on lessons.

For instance, for each week’s topic, we created an illustrated handout. Using this as our guide, we discussed the science behind the topic, providing written definitions and descriptions, such “What is puberty?”

We supplemented this written information with short videos. And we practiced some of the skills, such as washing our faces, putting on deodorant, brushing our teeth, shaving, and using and disposing a maxi pad.

We gave each student a hygiene kit. Hygiene kits for boys included a comb, deodorant, toothbrush, toothpaste, face soap, shaving cream and razor. Hygiene kits for girls included a comb, deodorant, toothbrush, toothpaste, face soap, shaving cream and razor and maxi pads.

We invited parents (dads in the boys class and moms in the girls class) to participate and share their personal experiences and expectations.

Each week’s homework consisted of a hygiene and puberty checklist, which the parent and child handed in completed the following week.

When the class ended, we gave parents and children a final homework page that summarized the skills they practiced, along with supplemental visuals schedules that we encouraged them to post in appropriate locations in their homes. We also showed the students and their parents how to add reminders to iPad calendars and cell phones.

Based on feedback, we think the program was a success.

“I love this class!” one of our students wrote. “I like meeting the girls like me!”

And from a parent: “This particular class was timely for us as Allison’s public school will approach this subject in a few weeks, but I am sure there approach will be much more ‘clinical” and not as hands on for what she needs.”

We look forward to offering these classes again soon and as well as share our curriculum with other autism centers in the months and years ahead.