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There has been growing concern among stakeholders about individuals with autism spectrum disorder (ASD), their sexual and intimate relationship experience, and their ability to pursue and maintain interpersonal relationships in a healthy manner. ASD is characterized, in part, by communication and socialization deficits, which may lead to miscommunications, inappropriate communications, or inappropriate actions towards romantic interests. This study sought to describe the romantic experiences of a small sample of individuals with ASD and explore any inappropriate courtship behaviors while pursuing a romantic interest. FULL TEXT LINK: (Copy and paste into browser)
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Sexuality and Disability
A Journal Devoted to the Psychological
and Medical Aspects of Sexuality in
Rehabilitation and Community Settings
ISSN 0146-1044
Sex Disabil
DOI 10.1007/s11195-019-09565-8
Dating and Courtship Behaviors Among
Those with Autism Spectrum Disorder
Melanie Clark Mogavero & Ko-Hsin Hsu
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Sexuality and Disability
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Dating andCourtship Behaviors Among Those withAutism
Spectrum Disorder
MelanieClarkMogavero1· Ko‑HsinHsu2
© Springer Science+Business Media, LLC, part of Springer Nature 2019
There has been growing concern among stakeholders about individuals with autism spec-
trum disorder (ASD), their sexual and intimate relationship experience, and their ability to
pursue and maintain interpersonal relationships in a healthy manner. ASD is characterized,
in part, by communication and socialization deficits, which may lead to miscommunica-
tions, inappropriate communications, or inappropriate actions towards romantic interests.
This study sought to describe the romantic experiences of a small sample of individuals
with ASD and explore any inappropriate courtship behaviors while pursuing a romantic
Keywords Autism spectrum disorder· Sexuality· Dating· Stalking· Harassment· United
Autism spectrum disorder (ASD) is a complex neurological disorder characterized in part,
by limited verbal and non-verbal communication and social interaction [1]. Such deficits
may lead to miscommunications when pursuing romantic interests and when attempting
to maintain romantic relationships. Studies have demonstrated that individuals with ASD
have communicated interest in relationships and marriage [17], and displayed sexual inter-
est or engaged in sexual behavior [7, 8, 23, 33] at a similar rate to their peers without ASD
[10, 13, 14, 30]. Research by Mehzabin and Stokes [20], Stokes and Kaur [30], Stokes and
Newton [31], and Stokes etal. [32] noted inappropriate courting behaviors among individ-
uals with ASD, some of which resembled “stalking-type” behaviors. In a literature review,
Mogavero [21] linked many deviant courtship and sexual behaviors exhibited by those with
* Melanie Clark Mogavero
Ko-Hsin Hsu
1 Department ofCriminal Justice, Georgian Court University, 900 Lakewood Ave, Lakewood,
NJ08701, USA
2 Department ofCriminal Justice, Kutztown University ofPennsylvania, Kutztown, PA19530, USA
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ASD to their social and communication deficits and noted there was often no malicious
Literature Review
Interpersonal relationships are an important aspect of one’s quality of life and this is no
different for individuals with ASD [2, 18]. An important social interaction for one’s overall
well-being includes dating and romantic relationships with others. Research has demon-
strated that adults with ASD in romantic relationships, compared to those who were not,
had a greater sense of social/community belonging [24] and a greater sexual well-being
[7, 8]. Byers etal. surveyed adults with ASD and reported that, in general, they had good
sexual functioning and most have been in a romantic relationship for at least 3months [7,
8]. However, individuals with ASD often have delayed social and emotional maturity than
those without ASD and studies that compared the two groups demonstrated that individu-
als with ASD experienced more difficulties with social and sexual functioning [9, 25]. Bal-
lan [4] interviewed parents of children with ASD and reported that some believed that their
children would be unable to achieve romantic or sexual relationships, and avoided discuss-
ing topics such as dating, sexual intercourse, and birth control. Stokes etal. surveyed par-
ents of adolescents and adults with and without ASD and noted that having difficulty read-
ing social cues was a contributing factor to their children’s relationship difficulties [32].
Studies that compared the sexual knowledge among individuals with and without ASD
revealed that those with ASD had less sexual knowledge and received less sexual education
from social sources (e.g., peers, parents) and more from non-social sources (e.g., televi-
sion, Internet) [6, 20, 23]. Because they have fewer opportunities to obtain dating and rela-
tionship knowledge from peers, they often do not have the same sexual outlets throughout
their development as their peers without ASD [3, 5, 6, 11]. Research has also shown higher
percentages of those with ASD identifying as lesbian, gay, bisexual, asexual or other/
unknown sexual orientations [7, 8, 10, 13], which may also hinder opportunities for roman-
tic relationships [7]. Gender differences were also noted in the research, with females hav-
ing more experience with relationships but lower sexual functioning than males [7, 8].
Individuals with ASD often gain social skills with age, but if they enter adulthood with
decreased social/emotional functioning, they may lack the appropriate skills, knowledge,
and scripts to initiate relationships, and maintain romantic relationships. Some adolescents
with ASD have engaged in inappropriate sexual conversations and behaviors when pursing
romantic interests [26, 29, 31].
Courtship involves subtle communication. Therefore, impairments with social interac-
tion and verbal or non-verbal communication may lead some to engage in inappropriate
behavior [5, 26], including harassment and stalking [3032]. Only one empirical study to
date has examined this stalking phenomenon [32]. Stokes etal. [32] revealed that individu-
als with ASD continued to pursue the person of interest longer after the person of interest
did not respond or provided a negative response to their display of interest than those with-
out ASD. Dating becomes extremely difficult when one cannot understand the views and
intentions of others [5]. Hurlbutt and Chalmers [15] interviewed an adult male with ASD
who stated that while pursuing women, he often “drove them away” by calling them too
often and not recognizing their feelings of being harassed. Having the desire for relation-
ships and intimacy, while perceiving these goals as unachievable, may lead to frustration
and hinder one’s overall level of romantic functioning [17]. The result is a concern that the
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communication difficulties may escalate to harassment or stalking charges. Therefore, the
current study sought to describe the romantic experiences of a small sample of participants
with and without ASD and to explore any “stalking-type”/persistent or inappropriate court-
ship behaviors while pursuing a romantic interest in hopes to discover ways to improve
their well being and romantic relationships.
Current Study
The participants for this study were drawn from online advertisement posts on the social
media site, Facebook®. After receiving approval from the University’s Institutional
Research Review Board, the lead author contacted the administrators of ten autism-related
Facebook groups/pages to obtain permission to use their group/page as a forum to dis-
seminate the survey. Four granted permission (Asperger Syndrome Awareness; ADHD,
Asperger’s, and Autism-Support Network for Families; Asperger’s Syndrome; Autism Risk
& Safety Management). The authors also posted the ad on their personal Facebook pages
and requested contacts (i.e., friends) to share the survey ad in order to obtain a wider and
diverse sample of individuals with and without ASD. The authors increased the response
rate by periodically reposting the survey ad or “bumping” the ad in the groups/pages to
obtain more responses. This was repeated every three to 4weeks, at various times of day
and days of the week until reposting or “bumping” the ad ceased to bring any additional
responses. The current study explored the following research questions:
Question 1 Do adults with ASD have less knowledge and understanding of romantic
relationships compared to adults without ASD?
Question 2 Do adults with ASD engage in more inappropriate or “stalking-type”/persis-
tent courting behaviors than adults without ASD?
The participants were administered a modified version of the Courting Behaviour
Scale1(CBS) [32], in which the items were constructed in accordance with previous
research that identified specific issues and behaviors relevant to this research [12, 19, 29,
30]. The survey included questions about demographics, participants’ knowledge and
behaviors related to dating and romantic relationships, and included open-ended questions
about their knowledge and experiences, including any contact with the criminal justice sys-
tem. To measure romantic functioning (i.e., relationship knowledge and experience), nine
items on the CBS were combined, similarly to Stokes etal. [32] (see Appendix Table3.)
Most of these items were dichotomous (0 = no, 1 = yes); item-9 was reverse coded so that
higher scores indicated higher functioning levels. The “stalking-type”/persistent court-
ing behavior was measured using eight behaviors from the CBS (see Appendix Table4:
4, 5, 6, 11, 12, 13, 18, 19), which were recoded as dichotomous (0 = no, 1 = yes). Higher
scores indicated higher levels of “stalking-type”/persistent courting behaviors. Inappropri-
ate courting behavior was measured using three behaviors from the CBS (see Appendix
Table4: 14, 15, 16), which were recoded as dichotomous (0 = no, 1 = yes), where higher
scores indicated higher levels of inappropriate behavior.
1 Omitted questions regarding social relationships. For CBS, see Stokes etal. [32]. Because the current
study sought a self-report, the questions in the CBS were reworded to a self-perspective.
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Descriptive Statistics
One hundred forty-eight individuals responded to the survey, and two were removed for
not completing the survey. Twelve participants reported that they had ASD but did not
receive a formal diagnosis and were removed from the sample. A final sample consisted
of 134 participants, 46 with ASD and 88 without ASD. Table1 displays the demographic
Table 1 Demographic
characteristics (N = 134)
*** p < .001 ** p < .05 * p < .10
N (%) N (%)
46 (34.3) 88 (66.7)
Age*** Range 19–57 Range 18–55
Mean (SD) Mean (SD)
33.16 (9.8) 26.23 (9.4)
Country/region*** N (%) N (%)
North America 24 (53.3) 78 (96.3)
Europe 15 (33.3) 3 (3.7)
Australia 6 (13.3) 0 (0.0)
Male 21 (45.7) 26 (29.5)
Female 19 (41.3) 55 (62.5)
Transgender/non-binary 6 (13.0) 7 (8.0)
X2 = 5.49 df = 2 p < .06
White/caucasian 39 (84.8) 66 (81.5)
African American 0 (0.0) 4 (4.9)
Hispanic 2 (4.3) 5 (6.2)
Asian 4 (8.7) 3 (3.7)
Others 1 (2.2) 3 (3.7)
Sexual orientation**
Heterosexual 28 (60.9) 72 (81.8)
Bisexual 2 (4.3) 6 (6.8)
Lesbian/gay 4 (8.7) 2 (2.3)
Others 6 (13.0) 1 (1.1)
Declined answer 6 (13.0) 7 (15.2)
X2 = 13.9 df = 4 p < .016
Education attainment**
Less than HS 2 (4.3) 0 (0.0)
High school 4 (8.7) 9 (11.1)
Some college 24 (52.2) 49 (60.5)
College 11 (23.9) 6 (7.4)
Grad./professional 5 (10.9) 17 (21.0)
X2 = 11.98. df = 5; p < .035
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characteristics of the sample. The ASD group was approximately 8years older, and had a
higher percentage of males, those who identified as transgender/non-binary, and a minority
sexual orientation than the non-ASD group.
Table2 displays the relationship knowledge, experience, and courting behaviors among
the sample. Almost all reported having knowledge about sex and relationships but there
Table 2 Relationship knowledge, experience, and courting behaviors
***p < .001 ** p < .05 * p < .10
N (%) N (%)
Possess knowledge of
Sex 36 (87.8) 78 (94.0)
Relationships 41 (89.1) 83 (94.3)
Initiate relationships *** 25 (54.3) 72 (85.7)
X2 = 15.4 df = 1 p < .001
Mode of learning how to initiate romantic relationships
Parents* 12 (26.1) 36 (40.9)
Teachers 4 (8.7) 15 (17.0)
Peers*** 14 (30.4) 69 (78.4)
Siblings 3 (6.5) 11 (12.5)
Media** 14 (30.4) 47 (53.4)
Social observation*** 23 (50.0) 66 (75.0)
Parents: X2 = 2.3 df = 1 p < .09 Peers: X2 = 29.49 df = 1 p < .001
Media: X2 = 6.4 df = 1 p < .01 Obser: X2 = 8.40 df = 1 p < .004
Currently in relationship** 19 (41.3) 53 (60.2)
X2 = 4.3 df = 1 p < .04
Length of current relationship
< 1year 3 (17.6) 14 (29.8)
1–5years 7 (41.2) 24 (51.1)
> 5years 7 (41.2) 9 (19.1)
Average length of previous relationships
< 1year 22 (48.9) 31 (35.2)
1–2years 4 (8.9) 13 (14.8)
> 2years 19 (42.2) 44 (50.0)
Number of relationships
0 9 (19.6) 9 (10.2)
1 6 (13.0) 23 (26.1)
2–3 14 (30.4) 29 (33.0)
4 + 17 (37.0) 27 (30.7)
CJS involvement 3 (7.3) 2 (2.6)
Mean (SD) Mean (SD)
Romantic functioning** 10.9 (3.0) 12.1 (2.5)
F = 5.7 df = 1 p < .02 n = 123
Stalking-type behaviors*** 10.5 (4.9) 7.8 (3.7)
F = 12.1 df = 1 p < .001
Inappropriate courting 0.50 (1.4) 0.24 (0.7)
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was a statistically significant difference between the percentages who reported they knew
how to initiate relationships (54.3%, 87.7%). Individuals with ASD reported smaller per-
centages in each category as to how they learned to initiate relationships, with statistically
significant differences among parents, peers, media, and social observation. With regard to
relationship experience, fewer with ASD reported currently being in a romantic relation-
ship (41.35%, 60.2%) and they tended to have fewer and shorter relationships, but these
differences were not statistically significant. Individuals with ASD appear to overall, have
a lower level of romantic functioning than those without ASD (means = 10.9; 12.1), and
are engaging in more “stalking-type”/persistent courting behaviors (0.50; 0.24). Although
those with ASD reported more inappropriate courting behaviors, the differences were
not statistically significant. No significant gender differences were found with any of the
knowledge, experience, and courting behaviors.
Summary ofQualitative Responses ofParticipants withASD
Individuals with ASD reported fewer learning sources as to how they acquired romantic
dating skills and knowledge. When participants were asked, “How did you learn how to ini-
tiate romantic relationships? some participants with ASD selected “other” and responded
with, “haven’t really learnt,” “don’t initiate, don’t know how,” and three participants
reported, “trial and error”. There is nothing intrinsically unusual about trial and error, but
not one participant without ASD responded as such. When participants were asked, “What
is difficult for you to understand,” some expressed problems with verbal and non-verbal
communication (e.g., “difficult to know when a conversation should be ended,” “whatever
isn’t direct,” “misunderstand signals,” “social cues,” “hard to see when they aren’t really
interested,” and, “how to read body language and what a person is thinking or feeling”).
When it comes to initiating and pursuing romantic relationships, such indirect and non-ver-
bal cues provide valuable information as to whether or not to continue to pursue a romantic
interest. Not one participant without ASD provided comments to this question.
Another finding from this study may be the result of a lack of knowledge and under-
standing of relationships, and the lack of acquiring this knowledge from social sources.
Many participants with ASD responded that they did not understand how relationships
work. When one is unaware how relationships work, it becomes difficult to recognize
unhealthy or inappropriate behavior when courting or being courted, and how to handle
various dating situations in a healthy manner. Establishing sexual boundaries is of great
importance, particularly in the early stages of a relationship, to learn respect for one’s
body, to teach others to respect them, and to learn how to avoid being taken advantage of
[22, 28]. For example, one female participant with ASD found it difficult to understand,
“How people are supposed to refrain from sex in the early days of a relationship when it
is so enjoyable”. Despite this belief, the physical and emotional consequences to sexual
intercourse must be taught at an age-appropriate level [5, 6, 11]. Another reported, “Mostly
I was drunk and coerced into being someone’s “girlfriend”. Victimization, as this comment
suggests, is beyond the scope of this paper; but a safety measure that must be explored and
explained through education on dating, relationships, and sex.
Although criminal justice system involvement in this study was rare among both groups
(ASD: n = 3; No ASD: n = 2), safe dating skills are necessary to avoid legal consequences
for one’s behaviors. A male described his reaction when caught engaging in sexual behav-
iors on school grounds with a high school classmate:
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“I lacked emotional maturity at the time and didn’t realize the gravity of the situation
until the police were involved. The incident knocked my confidence and put me off roman-
tic relationships for 10years until my mid 20’s when I began dating again”. Another male
stated he was, “Used by the other person when convenient….couldn’t handle confusion
of on and off again and got angry and aggressive”. This participant reported that he was
arrested and ordered to perform community service.
Many with ASD have successful romantic relationships with others, while others appear to
be struggling with such. Although individuals with ASD appear to be receiving knowledge
about sex and about types of relationships, many are not receiving adequate knowledge
about initiating and maintaining relationships, particularly from social sources such as par-
ents and peers. Therefore, the authors conclude that there is a dire need for dating and
relationship knowledge to be a part of overall social skills and sexual education training.
Such education must not only teach appropriate courting/dating behaviors, but how to do
so safely, particularly if they are meeting potential partners online, as this brings its own
safety concerns [16, 27]. Personal communication with Amy Gravino,2 M.A., Certified
Autism Specialist, noted that there is often a “missing piece” when implementing social
and dating skills training into actual practice, which is often in formal settings. Gravino
stated that it is important for those with ASD to learn the rules of courtship and be taught
how to recognize when someone is not interested, and when someone is feeling harassed
(personal communication, January 21, 2018).
As noted in the current study and others [4, 10, 13], minority sexual orientations have
an increased prevalence among individuals with ASD, which must be addressed and nor-
malized in sexual education programs to reduce sexual anxieties and to allow individuals to
explore their sexuality. The current study also noted a higher percentage of minority gender
identities among those with ASD, which must also be addressed and normalized in sexual
education programs. Therefore, one must not assume a heterosexual orientation, a binary
gender identity, a lack of interest in sex or romantic relationships, and one must not avoid
discussing such topics [4, 22]. Instead, it is important to identify those with ASD who
desire romantic relationships, assist them with identifying the sexual orientation that cor-
responds with their sexual desires, assist them with social and dating skills, and assist with
providing opportunities to implement those skills in non-formal settings.
Although the results of this study offer valuable information about relationships
and courting behaviors of individuals with ASD, the results must be interpreted with
caution, as this study is not without limitations. This was a purposive and conveni-
ence sample of Facebook® users, and only captured a small percentage of the popu-
lation of individuals with and without ASD. There is also the possibility of response
bias, as individuals who chose to participate may be different from those who chose not
to. Another limitation of this study is that the authors measured experiences by self-
report, and with all self-report studies, participants may not be truthful or may have
faulty memories. Despite these limitations, the results provide a preliminary description
2 Amy Gravino is a woman on the autism spectrum who has become an accomplished international speaker
and author. Amy is also known as "The Dr. Ruth of the Autism World," for her passionate interest in the
area of autism and sexuality.
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and exploration into the relationship experience, dating behaviors, and overall romantic
functioning of individuals with ASD. The ASD group was on average, older than the
non-ASD group; but due to the social and emotional delays noted in the research among
individuals with ASD [2, 3, 17, 25], this may be a “fairer” comparison, as it allowed
those with ASD more time to develop interest in romantic relationships. However, an
aggregated matched sample may offer a more valid comparison of the different courting
and relationship experiences between those with and without ASD. The current research
has found that individuals with ASD have been or are currently in romantic relation-
ships, however, the quality of those relationships was not examined and warrants further
evaluation. Victimization during courtship or victimization by romantic partners among
individuals with ASD would be an important addition to this topic.
Compliance with Ethical Standards
Conict of interest The authors declared no potential conflicts of interest with respect to the research, author-
ship, and/or publication of this article.
Human and Animal Rights All procedures performed in studies involving human participants were in accord-
ance with the ethical standards of the institutional and/or national research committee and with the 1964
Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent Informed consent was obtained electronically from all individual participants included
in the study.
See Tables3 and 4.
Table 3 Romantic functioning items
1 Do you think you have knowledge about sexually related behavior?
2 Are you aware of the different kinds of intimate/romantic relationships (e.g., dating, marriage, etc.)?
3 Do you desire to have an intimate/romantic relationship?
4 Do you know how to initiate intimate or romantic relationships (e.g., ask for a date, resume or maintain
a relationship)?
5 Have you ever attempted to pursue a romantic interest?
6 Are you currently in an intimate relationship?
7 How many intimate or romantic relationships have you had?
8 How long have you maintained an intimate or romantic relationship (on average)?
9 Do you have difficulty understanding what is and is not appropriate (e.g. persistently calling someone of
romantic interest even after that person asked them not to)? (reverse coded)
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1. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th edn.
Author, Washington, DC (2013)
2. Attwood, T.: The complete guide to Asperger’s Syndrome. Jessica Kingsley Publishers, London (2007)
3. Attwood, T., Henault, I., Dubin, N.: The autism spectrum, sexuality, and the law. U.K., Jessica Kings-
ley Publishers, London (2014)
4. Ballan, M.S.: Parental perspectives of communication about sexuality in families of children with
autism spectrum disorders. J. Autism Dev. Disord. 42(5), 676–684 (2012). https ://
s1080 3-011-1293-y
5. Beddows, N., Brooks, R.: Inappropriate sexual behaviour in adolescents with autism spectrum disor-
der: what education is recommended and why. Early Interv. Psychiatry 10(4), 282–289 (2016). https ://
6. Brown-Lavoie, S.M., Viecilli, M.A., Weiss, J.A.: Sexual knowledge and victimization in adults with
autism spectrum disorder. J. Autism Dev. Disord. 44, 2185–2196 (2014). https ://
7. Byers, E.S., Nichols, S., Voyer, S.D.: Challenging stereotypes: sexual functioning of single adults with
high functioning autism spectrum disorder. J. Autism Dev. Disord. 43(11), 2617–2627 (2013). https :// 3-013-1813-z
8. Byers, E.S., Nichols, S., Voyer, S.D., Reilly, G.: Sexual well-being of a community sample of high-
functioning adults on the autism spectrum who have been in a romantic relationship. Autism 17(4),
418–433 (2012). https :// 61311 43195 0
9. Dekker, L., van der Vegt, E., van der Ende, J., Tick, N., Louwerse, A.: Psychosexual functioning of
cognitively-able adolescents with autism spectrum disorder compared to typically developing peers:
the development and testing of the teen transition inventory—a self- and parent report questionnaire on
psychosexual functioning. J. Autism Dev. Disord. 47(6), 1716–1738 (2017)
10. Gilmour, L., Schalomon, P.M., Smith, V.: Sexuality in a community based sample of adults with
autism spectrum disorder. Res. Autism Spectr. Disord. 6(1), 313–318 (2012). https ://
11. Hayward, B., Saunders, K.: Sexual behaviours of concern in young people with autism spectrum disor-
ders: 10th Annual Disability Support Worker Conference. Melbourne, Australia (2010)
12. Haugaard, J.J., Seri, L.G.: Stalking and other forms of intrusive contact among adolescents and young
adults from the perspective of the person initiating the intrusive contact. Crim. Justice Behav. 31(1),
37–54 (2004)
13. Hellemans, H., Colson, K., Verbraeken, C., Vermeiren, R., Deboutte, D.: Sexual behavior in high-
functioning male adolescents and young adults with autism spectrum disorder. J. Autism Dev. Disord.
37(2), 260–269 (2007). https :// 3-006-0159-1
14. Hellemans, H., Roeyers, H., Leplae, W., Dewaele, T., Deboutte, D.: Sexual behavior in male adoles-
cents and young adults with autism Spectrum disorder and borderline/mild mental retardation. Sexual.
Disabil. 28(2), 93–104 (2010). https :// 5-009-9145-9
Table 4 Courting behaviors
1. Telephoned 10. Fantasized about them
2. Sent letters, emails, texts 11. Showed obsessional interest
3. Sent gifts 12. Strongly believed must reciprocate feelings
4. Waited outside home or work 13. Contacted their friends or family
5. Followed them from home or work 14. Made inappropriate sexual gestures
6. Monitored their activities 15. Made inappropriate comments
7. Initiated social contact 16. Touched inappropriately
8. Asked them out on a date 17. Threatened to self-harm
9. Showed exaggerated affection 18. Made threats towards interest
19. Pursued in a threatening manner
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15. Hurlbutt, K., Chalmers, L.: Adults with autism speak out: perception of their life experiences. Focus
Autism Other Dev. Disabl. 17(2), 103–111 (2002)
16. Katz, G.: Adolescents and young adults with developmental disabilities interface the internet: six case
reports of dangerous liaisons. Mental Health Aspects Dev. Disabil. 4(2), 77–84 (2002)
17. Konstantareas, M.M., Lunsky, Y.J.: Sociosexual knowledge, experience, attitudes, and interests of
individuals with Autistic Disorder and developmental delay. J. Autism Dev. Disord. 27(4), 397–413
18. Mazurek, M.O.: Loneliness, friendship, and well-being in adults with autism spectrum disorders.
Autism 18(3), 223–232 (2014). https :// 61312 47412 1
19. McCann, J.T.: A descriptive study of child and adolescent obsessional followers. J. Forensic Sci. 45,
195–199 (2000)
20. Mehzabin, P., Stokes, M.A.: Self-assessed sexuality in young adults with high-functioning autism. Res.
Autism Spectr. Disord. 5(1), 614–621 (2011). https ://
21. Mogavero, M.C.: Autism, sexual offending, and the criminal justice system. J. Intellect. Disabil.
Offending Behav. 7(3), 116–126 (2016). https :// -02-2016-0004
22. Nichols, S., Blakeley-Smith, A.: I’m not sure we’re ready for this: working with families toward facili-
tating healthy sexuality for individuals with autism spectrum disorders. Soc. Work Mental Health 8(1),
72–91 (2010). https :// 98090 29323 83
23. Ousley, O.Y., Mesibov, G.B.: Sexual attitudes and knowledge of high-functioning adolescents and
adults with Autism. J. Autism Dev. Disord. 21(4), 471–481 (1991)
24. Pearlma-avnion, S., Cohen, N., Eldan, A.: Sexual well-being and quality of life among high-func-
tioning adults with autism. Sexual. Disabil. 35(3), 279–293 (2017). https ://
25. Peterson, C., Slaughter, V., Paynter, J.: Social maturity and theory of mind in typically developing chil-
dren and those on the autism spectrum. J. Child Psychol. Psychiatry 48(12), 1243–1250 (2007). https :// .x
26. Ray, F., Marks, C., Bray-Garretson, H.: Challenges to treating adolescents with Asperger’s Syn-
drome who are sexually abusive. Sex. Addict. Compulsivity 11(4), 265–285 (2004). https ://doi.
org/10.1080/10720 16049 09006 14
27. Roth, M.E., Gillis, J.M.: “Convenience with the click of a mouse’’: a survey of adults with autism
spectrum disorder on online dating. Sexual. Disabil. 33(1), 133–150 (2015). https ://
s1119 5-014-9392-2
28. Ruble, L.A., Dalrymple, N.J.: Social/sexual awareness of persons with autism: a parental perspective.
Arch. Sex. Behav. 22(3), 229–240 (1993). https :// 41768
29. Spitzberg, B.H., Cupach, W.R.: What mad pursuit? Obsessive relational intrusion and stalking
related phenomena. Aggress. Violent Behav. 8(4), 345–375 (2003). https ://
-1789(02)00068 -X
30. Stokes, M.A., Kaur, A.N.: High-functioning autism and sexuality: a parental perspective. Autism 9(3),
266–289 (2005). https :// 61305 05325 8
31. Stokes, M.A., Newton, N.: Autistic spectrum disorders and stalking. Autism 8(3), 337–338 (2004)
32. Stokes, M., Newton, N., Kaur, A.: Stalking, and social and romantic functioning among adolescents
and adults with autism spectrum disorder. J. Autism Dev. Disord. 37(10), 1969–1986 (2007). https :// 3-006-0344-2
33. Van Bourgondien, M.E., Reichle, N.C., Palmer, A.: Sexual behavior in adults with autism. J. Autism
Dev. Disord. 27(2), 113–125 (1997). https :// 83622 4
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... Autism Spectrum Disorder (ASD) is a developmental disability characterized by impairments in social communication and interaction, including difficulties forming and maintaining relationships with others [1]. Although the majority of autistic individuals 1 express interest in being in a romantic relationship [4,5], most autistic adults without an intellectual impairment indicate that they are not currently in a romantic relationship [4][5][6][7][8][9][10]. In particular, males with ASD report less relationship experience than females with ASD [5,11], despite indicating a greater desire for a romantic relationship and experiencing more distress at not being in a romantic relationship [5]. ...
... When Strunz et al. [5] asked single autistic participants to indicate what prevented them from entering a romantic relationship, the most commonly referenced reasons were: "contact with others is too exhausting for me" (65% of participants), "I am afraid of not fulfilling my partner's expectations" (61%), "I don't know how to meet a potential partner" (57%), and "I don't know how a romantic relationship works or how to behave in a romantic relationship" (50%). When reviewing qualitative responses from participants with ASD about aspects of relationships that were challenging to understand, Mogavero and Hsu [9] identified verbal and nonverbal communication as a common challenge (e.g., "difficult to know when a conversation should be ended", "hard to see when they aren't really interested", "how to read body language and what a person is thinking or feeling"). Compared to individuals with typical development, autistic individuals also report more worry about future relationships, such as finding a partner, building and sustaining a positive romantic relationship, and having one's own behavior misinterpreted by a romantic partner [12,13]. ...
... Fourth, participants in this study self-identified as heterosexual males or heterosexual females. As individuals with ASD experience more variability in gender identity and sexual orientation than neurotypical individuals [9,55], future research should expand to more broadly include these populations. Finally, although previous research has demonstrated that MTurk is a reliable data collection platform [31,[56][57][58], multiple and unique screening methods are needed to filter out bot responses, automated form fillers, and/or low effort responses [27,[29][30][31]. ...
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While many individuals with Autism Spectrum Disorder (ASD) desire a romantic relationship, they often report anxiety and uncertainty about what behaviors are expected in a dating context. The goal of the current study was to determine how individuals in the general population respond to dating behaviors that may be perceived as unexpected, confusing, inappropriate, or unattractive. Participants responded to fifty behaviors on the Dating Behaviors Questionnaire (e.g., “asks too many questions about you”), indicating their willingness to continue dating someone showing each behavior. Participants also completed the Short Autism Spectrum Quotient to index the degree to which they personally experienced autistic traits. A principal components analysis supported a four-factor structure for this questionnaire: Rude and Unattractive, Intrusive, Distant, and Idiosyncratic Behaviors. Gender significantly predicted variability across the four factors, such that women perceived the dating behaviors more negatively than men, especially Intrusive Behaviors. This result suggests that men may maximize romantic interest from a female partner by proceeding moderately in demonstrations of their own attraction. Compared to those with low autistic traits, participants with elevated autistic traits were significantly more willing to date others with Rude and Unattractive Behaviors and Idiosyncratic Behaviors and marginally more willing to date others showing Distant Behaviors. As such, individuals who are autistic or have elevated autistic traits may be more receptive to romantic relationships with other autistic individuals. However, individuals with autistic traits may have difficulty recognizing rude or inappropriate behaviors in a dating context, potentially leading to a heightened risk of sexual victimization.
... Autistic individuals may engage in comparable rates of sexual behaviors (Fourie et al., 2017;Gilmour et al., 2012); 96% expressed an interest in sexuality (Hellemans et al., 2007), and 47% reported living with a spouse or romantic partner (Gotham et al., 2015a). Although autistic adults may desire sexual and romantic relationships, several studies have found that autistic adults are less likely to be in a relationship (Bush, 2018;Dewinter et al., 2017;Hellemans et al., 2010;Mogavero & Hsu, 2020a), have fewer opportunities to date (Hancock et al., 2020), and have less dating experience (Mogavero & Hsu, 2020a) than their non-autistic peers. The source of the gap between the desires of autistic adults and reported experiences has been the topic of nascent literature regarding adult sexuality over the past decade. ...
... Autistic individuals may engage in comparable rates of sexual behaviors (Fourie et al., 2017;Gilmour et al., 2012); 96% expressed an interest in sexuality (Hellemans et al., 2007), and 47% reported living with a spouse or romantic partner (Gotham et al., 2015a). Although autistic adults may desire sexual and romantic relationships, several studies have found that autistic adults are less likely to be in a relationship (Bush, 2018;Dewinter et al., 2017;Hellemans et al., 2010;Mogavero & Hsu, 2020a), have fewer opportunities to date (Hancock et al., 2020), and have less dating experience (Mogavero & Hsu, 2020a) than their non-autistic peers. The source of the gap between the desires of autistic adults and reported experiences has been the topic of nascent literature regarding adult sexuality over the past decade. ...
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Autistic adults have similar levels of desire for sexual and romantic relationships as their non-autistic peers. However, autistic adults are less likely to be in relationships and have less dating experience. We compared sexual knowledge, experiences, and pragmatic language ability in a community sample of young adults with (n = 27, mean age = 22.11) and without autism (n = 122, mean age = 19.47). Receipt of sex education and sexual knowledge did not differ between groups. However, autistic adults had significantly fewer partnered experiences and impaired pragmatic language. Within both groups, pragmatic skill predicted accurate sexual knowledge above and beyond general communication abilities. Findings suggest that sex education for autistic adults must address the social communication component of healthy romantic and sexual relationships.
... Byers et al., (2013aByers et al., ( , 2013b found that 12% of the ASD sample were unlabeled and 5% were unsure about their sexual attraction orientation. The difficulty experienced by ASD individuals in defining themselves according to sexual orientation categories also emerged in five other studies (Lewis et al., 2020;Mogavero & Hsu, 2019;Rudolph et al., 2018;Sala et al., 2020aSala et al., , 2020bStrunz et al., 2017), in which participants rejected of traditional ways of categorizing sexual identity or were unable to label their sexual orientation using the categories provided. ...
... Secondly, several studies (Barnett & Maticka-Tyndale, 2015;Bush, 2019;Bush et al., 2020;George & Stokes, 2018a;Hillier et al., 2019;Kock et al., 2019;Sala et al., 2020aSala et al., , 2020b on sexual behavior in the ASD population showed that many autistic individuals describe themselves using labels typical of the asexual umbrella. Others (Byers et al., 2013a(Byers et al., , 2013bRudolph et al., 2018;Strunz et al., 2017) found that people with ASD either did not identify with classic categories of sexual orientation (homosexuality, heterosexuality, bisexuality) or were unsure of their sexual attraction/sexual orientation (Byers et al., 2013a(Byers et al., , 2013bFernandes et al., 2016;Lewis et al., 2020;May et al., 2017;Mogavero & Hsu, 2019;Sala et al., 2020aSala et al., , 2020b. ...
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Asexuality is a lack of sexual attraction to any gender. There is some evidence to suggest that many self-identified asexuals have a formal diagnosis of autism spectrum disorder which is characterized by deficits in social interaction and communication, as well as by restricted and repetitive interests and behaviors. Additionally, the literature shows that asexuality and lack of sexual attraction or low sexual interest is overrepresented in people with autism spectrum disorder compared with neurotypical samples. Nevertheless, no studies have been conducted to investigate the relationship between autism and asexuality in depth. We conducted a systematic review of the literature to examine whether asexuality and autism spectrum disorder are connected. We conclude that asexuality and autism share various aspects, such as a possible role of prenatal factors, reference to romantic dimensions of sexual attraction and sexual orientation, and non-partner-oriented sexual desire, but future research should explore and clarify this link.
... Common challenges to romantic relationships identified by autistic individuals and their families are consistent with this interpretation, and further include maintaining boundaries when pursuing a potential partner, engaging in inappropriate behavior (e.g., unsolicited undressing or masturbating in the presence of another person), lack of relationship education and knowledge, and reduced engagement in social opportunities (Hancock et al., 2017). Importantly autistic individuals report difficulties interpreting subtle, nonverbal cues and making small talk, which can further impact social access (Barnett & Maticka-Tyndale, 2015;Mogavero & Hsu, 2019). ...
Autistic individuals report similar levels of interest in romantic relationships to their nonautistic peers but experience greater challenges with the initiation and maintenance of these relationships. This systematic review synthesizes the factors that contribute to romantic relationship initiation and maintenance among autistic individuals to inform relationship support programs. Both successes (e.g., ability to initiate relationships and maintain a satisfying relationship) and challenges (e.g., relationship dissatisfaction) were investigated. Out of 1403 potentially relevant articles, 11 articles comprising 13 studies met the inclusion criteria (investigated factor[s] of romantic relationship success of challenges, involved participants with a formal autism diagnosis and/or their partners, presented quantitative results in relationship factors, and was available in an English-language version). Social and communication challenges were studied to the greatest extent and were associated with difficulties in both relationship initiation and satisfaction. Several factors relating to the partner of the autistic individual were associated with successful relationships, including reciprocal liking, partner support, and the ability to meet the autistic partner's needs. Conclusions are limited by the small number of studies but provide initial indications that social and communicative factors, as well as the role of nonautistic partners, are important to the success of romantic relationships for autistic individuals. In keeping in line with the community's preference for identity-first language (i.e., “autistic individual” rather than “individual with autism”), this language has been used throughout this review.
... Autistic youth are unfortunately no less likely to experience dating abuse. In convenience samples of autistic youth, 11% report engaging in date stalking-related behaviors (Mogavero and Hsu 2020), 12% report experiencing dating violence victimization (Weiss and Fardella 2018), and 26% have experienced coerced sex by a dating partner (Hartmann et al. 2019). 1 Dating violence prevention is a public health priority (U.S. Centers for Disease Control and Prevention 2016). Victimization is associated with a number of adverse mental and physical health outcomes including self-harm and suicidal behavior (Chiodo et al. 2012), risky sexual behavior (Hanson 2010), unhealthy weight control (Ackard et al. 2007), and additional partner violence victimization experiences that persist into adulthood (Exner-Cortens et al. 2013). ...
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The purpose of this brief report is to share the results of a feasibility test of a six-session online class on dating violence prevention for autistic adolescents. The feasibility of delivering the online intervention was tested with a sample of N = 11 autistic youth ages 15–19 years old. The intervention was delivered once a week for 6 weeks. Participants completed self-report surveys at baseline and approximately 6 weeks after baseline. Participants also participated in one-on-one telephone interviews approximately 2 weeks after the intervention. It was feasible to teach an online class to autistic adolescents about healthy dating relationships and dating violence. Participant feedback suggested the class was acceptable to users. Further, we found it was feasible to collect self-report survey data on dating violence-related topics from autistic youth using an internet platform. Although the study was not designed to test intervention efficacy, we did observe changes in participant opinions in the desired direction about the healthiness of dating behaviors. Autistic youth have romantic and sexual relationships and deserve the benefit of healthy relationships education that is designed for them and effective for them. The results of this feasibility test suggest it is possible to deliver an online class to autistic youth and to collect dating abuse-related data from them online, indicating that a larger-scale, two-group evaluation study is feasible and warranted.
In this chapter, the five steps used to conduct the scoping review are outlined. It begins by explaining how the research questions were formulated. The purpose of these questions was to support the focus of this scoping review; namely, to uncover the experiences and insights of autistics about their sexual behaviours, relationships, sexuality, and gender identity. The search terms, academic databases consulted, and the inclusion and exclusion criteria are then outlined. The studies included and excluded from this scoping review are then listed, followed by an explanation of the characteristics that were identified in the studies that could address the research questions and the focus of this scoping review.
In this chapter, the results of this scoping review are presented. It begins by describing the basic characteristics of the studies collected, such as the study’s publication year or location. It then explains the findings in the literature about the sexual orientation and gender identity of autistic participants. The focus of this chapter then shifts from reviewing the sexuality and gender identify of autistics towards describing their relationship status. It then concludes with a review of the literature about the online sexual activities of autistics.
During the analysis of the literature about the sexual behaviours and intimate relationships of autistics, several gaps in this body of research were identified, namely experiences of contraception; domestic violence, which largely occurs within relationships; lesbian, gay, bisexual, transgender, intersex and asexual experiences (LGBTQIA+); parenting; pregnancy and childbirth for autistic adults. In this chapter, several explanations are given as to why not much research in these areas has been conducted along with several recommendations and justifications for why more research should be conducted about these areas in the future. The direction of this chapter then changes to describing autistic-friendly approaches that researchers can use to help participants on the autism spectrum discuss the gaps identified that they might find sensitive and concerning. The main objective of this chapter is to outline a possible a path forward in the creation of new research about the relationship and sexual experiences of autistics.
The desire for intimate relationship and sexual well-being in closely tied, and characterizes all human-beings. Intimate relationships, and healthy sexual life that come with it, can promote the life the individual, and create a “calling-card” to enter society. Nevertheless, social standards and norms that can help the establishment of romantic and sexually characterized relationships may make them challenging for people on the Autism Spectrum Disorder (ASD). This chapter opens with a description of the importance of sexuality as a central aspect of adult life in general, followed by an exploration of the link between sexuality and aspects of quality of life among people, especially females, with ASD, being a minority within a minority, through contemporary literature review. The differences in ASD symptomology between males and females directs to key issues regarding sexuality among females with ASD including: interest and attraction, behavior, and orientation, and the impacts each of these have on sexuality and sexual functioning in this population. Findings regarding greater diversity in the gender identity and greater flexibility in sexual attraction among people with ASD that is more pronounced among females than males, as well as higher vulnerability and risk of abuse, raise a concern regarding the link between sexuality and victimization among females with ASD. The chapter addresses some relevant recommendations for professional staff and therapists.
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The current research addresses the effect that being in an intimate relationship has on quality of life and well-being among high-functioning young adults on the autism spectrum (HFA). The research included 31 participants: 14 involved in intimate relationships (HFA-R) and 17 not (HFA-NR). In this integrated (quantitative and qualitative) research, participants completed on-line questionnaires on demographics, quality of life and sexuality. We hypothesized that HFA-R will report higher quality of life and sexual well-being than HFA-NR. Further, a correlation was predicted between quality of life (including: satisfaction, productive capacity, social belonging/community inclusion and independence and empowerment) and sexual well-being (including: self-esteem, sexual depression and sexual preoccupation/sexual worries), especially among HFA-R. Despite the lack of significant differences in quality of life, differences were found in the indices’ content areas. There was a higher sense of social belonging/community inclusion among HFA-R, and a positive correlation between sexual well-being and productive capacity among this group. A correlation was found between high productive capacity and low sexual worries among HFA-R, but not among HFA-NR. Contrary to expectations, a positive correlation was found between sexual well-being and satisfaction among HFA-NR, while no such correlation was found among HFA-R. The findings are discussed in the context of healthy sexuality and social development and acclimation of people with HFA. The results highlight the importance of promoting social dialogue and research on the subject.
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To gain further insight into psychosexual functioning, including behaviors, intrapersonal and interpersonal aspects, in adolescents with Autism Spectrum Disorder (ASD), comprehensive, multi-informant measures are needed. This study describes (1) the development of a new measure of psychosexual functioning in both parent- and self-reports (Teen Transition Inventory; TTI) covering all three domains of psychosexual functioning (i.e. psychosexual socialization, psychosexual selfhood, and sexual/intimate behavior). And (2) the initial testing of this instrument, comparing adolescents with ASD (n = 79 parent-report; n = 58 self-report) to Typically Developing (TD) adolescents (n = 131 parent-report; n = 91 self-report) while taking into account gender as a covariate. Results from both informants indicate more difficulties regarding psychosexual socialization and psychosexual selfhood in the ASD group. With regard to sexual/intimate behavior, only parents reported significantly more problems in adolescents with ASD. Electronic supplementary material The online version of this article (doi:10.1007/s10803-017-3071-y) contains supplementary material, which is available to authorized users.
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Purpose There has been growing concern among stakeholders about individuals with autism spectrum disorders (ASD) and sex offending as research supports an indirect association. The purpose of this paper is threefold: first, bring more awareness of the sexuality and deviant/criminal sexual behavior among those with ASD to stakeholders in the criminal justice system (CJS); second, demonstrate that much of the deviant or sexual offending behavior exhibited among those with ASD is often a manifestation of their ASD symptoms and not malice; and third, demonstrate the necessity to address specific needs of individuals with ASD who enter the CJS due to criminal sexual behavior. Design/methodology/approach This paper provides an overview of the ASD symptomology, including the diagnostic changes, a review of the literature on ASD and sexuality, which includes deviant sexual behavior and sexual offending. Findings The author linked examples of deviant or sexual behavior in the research literature to the ASD symptomology and described how the symptomology explains such behavior. Originality/value Sexual offending among those with ASD has received little research outside the mental health field. This review is of particular importance to those in the CJS unfamiliar with ASD, as they should handle them differently with regard to formal interviewing, measures of competency, capacity, and sentencing.
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There is a significant gap in understanding the risk of sexual victimization in individuals with autism spectrum disorders (ASD) and the variables that contribute to risk. Age appropriate sexual interest, limited sexual knowledge and experiences, and social deficits, may place adults with ASD at increased risk. Ninety-five adults with ASD and 117 adults without ASD completed questionnaires regarding sexual knowledge sources, actual knowledge, perceived knowledge, and sexual victimization. Individuals with ASD obtained less of their sexual knowledge from social sources, more sexual knowledge from non-social sources, had less perceived and actual knowledge, and experienced more sexual victimization than controls. The increased risk of victimization by individuals with ASD was partially mediated by their actual knowledge. The link between knowledge and victimization has important clinical implications for interventions.
Sexual predators on the Internet can pose a danger to anyone. Adolescents and young adults with developmental disabilities (DD) who can access the Internet are particularly vulnerable because of their naivete and their revealing profiles when they log on. In this article, examples of problems encountered on the Internet and with computers generally are described in six adolescents and young adults with DD. Problems ranged from sexual and emotional victimization, and debt and unrewarding liaisons, to simply getting into trouble. The interventions used together with the known outcomes are summarized in tabular form, along with a list of strategies to prevent abuse. As programs become increasingly "user friendly" and adolescents and young adults with DD learn computer skills, it is suggested that sexual and safety education, supervision, and the provision of alternative socialization activities can play a role in reducing the risks of these young people's victimization.
AimAutism spectrum disorder (ASD) is a neurodevelopmental disorder impairing social skills and communication. Adolescents with ASD have sexual needs, but may not understand their physical and emotional development resulting in inappropriate sexual behaviour. The aim of this review is to describe the type of inappropriate behaviour that presents in these adolescents, explain why such behaviours occur, suggest what education is suitable and identify current gaps in research.Method The databases EMBASE, OVID MEDLINE and PSYCINFO were searched for relevant articles. In total, 5241 articles were found, with an additional 15 sources found via soft searches, of which 42 met inclusion criteria and were subsequently reviewed.ResultsSexual behaviours that occur in these adolescents with ASD include hypermasturbation, public masturbation, inappropriate romantic gestures, inappropriate arousal and exhibitionism. Such behaviours are thought to be caused via a lack of understanding of normal puberty, the absence of appropriate sex education, the severity of their ASD and other associated problems. It is suggested that individualized, repetitive education should be started from an early age in an accessible form. Social skills development is also important before more technical aspects of sex education are taught.Conclusion Despite being such a common problem for schools, institutions and families to manage, it is surprising how sparse literature is particularly regarding why inappropriate behaviour occurs and what education is effective.
Adults with Autism Spectrum Disorder (ASD) have difficulty forming romantic relationships despite having motivation to establish them. The lack of success through traditional, face-to-face dating may lead to pursing relationships through other modalities, such as online dating, which present both advantages and disadvantages for the population. However, little is known about how adults with ASD utilize online dating services. Therefore, a preliminary survey on online dating in a sample of adults with ASD was conducted. Seventeen individuals with ASD participated in an online survey. Results indicated that slightly more than half of the sample used online dating services in the past with variable success. Additionally, participants discussed their opinions of online dating. The most frequently endorsed disadvantage of online dating was safety concerns. The results of the survey suggest that the population may benefit from additional research in learning how to navigate the online dating world successfully and safely.
Few studies have examined the sexual attitudes and behaviours of individuals with high functioning autism spectrum disorders (ASDs) living in community settings. A total of 82 (55 female and 17 male) adults with autism were contrasted with 282 members of the general population on their responses to an online survey of sexual knowledge and experiences. Findings revealed that individuals with ASD display an interest in sex and engage in sexual behaviours and showed no significant differences in breadth and strength of sexual behaviours and comprehension of sexual language when contrasted with non-ASD participants. However, despite these similarities, a higher rate of asexuality was found among individuals with ASD. In addition, the results of the current study indicated that females with ASD show a significantly lower degree of heterosexuality when compared to males with ASD. The results also suggested a higher degree of homosexuality among females with ASD although this effect did not reach significance.
This study examined the relations among loneliness, friendship, and emotional functioning in adults (N = 108) with autism spectrum disorders. Participants completed self-report measures of symptoms of autism spectrum disorders, loneliness, number and nature of friendships, depression, anxiety, life satisfaction, and self-esteem. The results indicated that loneliness was associated with increased depression and anxiety and decreased life satisfaction and self-esteem, even after controlling for symptoms of autism spectrum disorders. In addition, greater quantity and quality of friendships were associated with decreased loneliness among adults with autism spectrum disorders. Multivariate models indicated that friendship did not moderate the relationship between loneliness and well-being; however, number of friends provided unique independent effects in predicting self-esteem, depression, and anxiety above and beyond the effects of loneliness. This was the first study to examine the relations among these aspects of social and emotional functioning in adults with autism spectrum disorders, and the results indicate that this topic warrants further clinical and research attention.