A Randomized Controlled Trial to Investigate the Effects of a Psychosexual Training Program for Adolescents with Autism Spectrum Disorder: Results of the Tackling Teenage Training Program
In adolescence social-communication skills become increasingly important. Friendships play a bigger role in the life of adolescents and most adolescents have their first romantic and intimate relationships. Adolescents with ASD usually lack the required knowledge, insight and skills required for sexual socialisation and therefore they need specific guidance in adolescence. Such guidance is provided in the Tackling Teenage Training (TTT) program. In 18 one-on-one sessions, adolescents with ASD receive psycho-education and practise communicative skills regarding several topics related to puberty, sexuality and intimate relationships.
To investigate whether the TTT program (1) increases psychosexual knowledge; (2) increases friendship and romantic relational skills (3) increases insight in acceptable versus inappropriate sexual behaviours; (4) reduces inappropriate sexual behaviours; (5) increases general self-esteem, and friendship and romantic relational confidence (6) reduces concerns about current and future friendship and romantic relations.
We conducted a randomised controlled trial in the Netherlands with an intervention group and a waiting-list control group. We assessed both self- and parent-report questionnaires on two time points: at baseline (T1) and directly after the TTT program, or after six months on the waiting-list (T2). In addition, the adolescents filled out a psychosexual knowledge test at both time points and performed a test on insight in acceptable and inappropriate sexual behaviours.
160 adolescents, age 12-18 years old (M=14.67, SD=1.72) with ASD and an average IQ (M=106.24, SD=12.88) completed the T1 en T2 assessments. By means of 2x2 Analyses of variance (ANOVAs) we found that psychosexual knowledge significantly increased more in the intervention group than in the control group (F(2, 159) = 14.97, p < .01, η²=0.09). In addition, after following the TTT program, adolescents with ASD reported to have better friendship skills (F(2, 159) = 8.82, p < .01, η²=0.05) and reported to portray fewer inappropriate behaviours, such as inappropriate touching of other people (F(2, 159) = 3.50, p < .05, η²=0.02). In the parent-report questionnaires, no differences were found between the groups over time.
These results show that the TTT program improved psychosexual knowledge and particular behaviours and skills in adolescents with ASD. However, findings are confined to self-report and do not reflect progress in all domains of psychosexual functioning. A follow-up measurement is needed to investigate whether the positive effects of the TTT program sustain, accumulate or diminish over a longer period of time.