Following up from last week’s podcast about supporting the development of self-regulation, this week’s podcast takes it a few steps further into adolescence where we have a slew of new developmental processes to support, especially when our children begin to experience puberty. Dave Nelson returns this week to shed some light on this topic.

Dave Nelson is a Licensed Professional Counselor (LPC), a DIR Expert Training Leader, and the Executive Administrative Director of the Threshold Community Program in Atlanta, Georgia. He’s with us this week to discuss puberty and how we can best support our kids in a respectful way using a developmental approach. He shares with us a fantastic presentation I attended in the Floortime for Adults course this past fall through the International Council on Development and Learning (ICDL). Dave’s presentation made me feel equipped to handle whatever comes. I hope you appreciate it and find it as helpful as I did.

Dave says that the Developmental, Individual differences, Relationship-based (DIR) construct and Floortime approach give us a way to think about and approach issues because we’re not going to have the answer to every problem that comes up, nor will we necessarily be able to plan in advance. This developmental framework really helps us start to think about issues in an anticipatory way rather than being reactive. It helps us put things in context and help the people we’re supporting think about their development in a more ‘big picture’ kind of way. Take a listen!

And then comes puberty... with Dave Nelson

by Affect Autism

Three Core Ideas

Dave says that as we are supporting people with challenges who are becoming adults and as we’re getting better at understanding the importance of self-advocacy and identity for the people we support, sexual identity becomes a really important part of that. Dave lays out three core ideas that guide this presentation:

  • How an understanding of an individual’s unique differences (how our bodies experience the world, our family influences) and functional emotional developmental capacities (how easily and comfortably we are able to engage with others, how interactive we are, how good our ability to engage in social problem-solving and logical thinking with others is) affect the sexual development and education processes, which happens even when the rest of our systems are not maturing at the same rate.
  • How to reduce the risk of individuals being either victims or perpetrators of sexual mistreatment. People can inadvertently become perpetrators and not realize it while being a victim at the same time.
  • How to help caregivers and support team members become effective supports to an individual’s sexual development. It’s quite challenging because we don’t always want to talk about it and the individual may not be comfortable with getting support.

A Challenging Topic

Differing moralities make this topic challenging for us. But also, for those we support, discussing these ideas requires complex language and an ability to know oneself. Some find it challenging to connect their physical feelings to ideas. You have to know what you feel and then control the behaviours that come from those feelings. If you struggle with self-reflection or complex ideas, it makes it challenging to address in a sophisticated way. 

Sexuality is an essential part of being human, so it’s important to support an individual’s ability to understand their feelings and experience relationships as much as possible. Dave says as we get better at understanding that we are helping people to become the people that they can be, not the people we want them to be, then that does demand that we support people in expressing themselves sexually even if we’re not always entirely comfortable with how that expression might look. 

Individual differences

Sensory profiles It makes sense that if your sensory processing system is extreme in some way (under- or over-reactive) that affects how your sexuality develops: what kinds of sensations you seek out or avoid, and how you try to meet those particular needs. For people who have a lot of variety in their reactivity, they might attempt to stimulate themselves too aggressively and hurt themselves physically, etc. Physical touch, hand-holding and kissing are all affected by our sensory profiles as people move into adult relationships.

Motor planning and sequencing How people move in personal space, how you touch somebody or be close to somebody, how those behaviours might be interpreted as aggressive or welcome and friendly, and reading and processing cues such as reading rapid non-verbal signalling from others all affect relationship-building. Somebody struggling to read those cues accurately and rapidly will find it difficult developing relationships that then allow for healthy expression of sexuality when it gets to that.

The DIR Framework

Dave says that the DIR model does well is it helps us stay focused on always strengthening the capacities, even if we are having to manage behaviour in some restrictive ways. Really what we’re trying to do is help people get better at managing their own behaviour because at some point people are going to be out in the world trying to manage their own experience and that’s what’s going to help them not only be safe and not get into trouble, but also to have meaningful, successful relationships.

The DIR framework reminds us, Dave continues, of strengthening someone’s developmental capacities so that over time they can begin to self-regulate and self-manage. That is a moral imperative: to help people be as autonomous as they can be. It’s also what allows people to be as independent as they can be from caregivers, because if you can get to the point where someone can manage their own emotions and sensations, and self-manage their behaviours, that’s going to be a lot more successful.

Developmental Capacities

When people are struggling in their ability to relate, communicate, think and problem-solve, those aspects will really affect our relationship development and sexuality expression. If we are very rule-based and concrete, black-and-white or aren’t good social problem-solvers, it will be harder to connect and flirt with people, to meet and develop potentially romantic relationships with people, and then to figure out how to express ourselves in gradually more physically overt ways. 


Dave says this is as much about someone’s ability to develop relationships as it is to express themselves sexually. It’s really about how people connect and relate to each other. The better we are at maintaining relationships, the more context there will be for the sexuality pieces coming into play. Rather than managing a set of raging hormones, we’re using their ability to form relationships to help them with their experiences and feelings.

The Intervention

There are three phases of the intervention. It’s what you do before the crisis happens. It’s what you do to support developmental growth to help and support people. There’s what you need to do in the heat of the moment when the difficult thing is happening, and then what do you do after-the-fact to debrief, reflect, and recover. Please listen to the podcast or watch the video podcast at the 36-minute mark to hear Dave’s example of situations he’s encountered and how they intervened.

Before Provide a lot of play-based Floortime to help the person get better at reading social cues and beginning to manage impulses. You can do this by playing a tickling, hide-and-seek, or peek-a-boo game works on this by having them want something, but not being able to get it right away, i.e., stop and start games.

During The trick is to set firm limits while remaining compassionate and connected, which is hard when we are feeling personally threatened or when the behaviour is disruptive. You can set firm limits if you believe that the person you’re supporting is a good person. You can stop someone from touching or staring, but try to frame that for them so you can validate the feeling they are having while not shaming them. You’re normalizing the feelings, while alerting them to the reaction of others. “Wow, it seems like you really like this person, and they seem to feel really uncomfortable about you touching them because you didn’t ask them.

These are the ideas you want to convey with your tone, affect, and body language, which can be challenging if language is limited. As much as possible, you also want to begin a conversation to fulfill those needs. “It seems like you really like this person. Let’s talk with them about how you can get to know them.” You will also need to be flexible about having these conversations and repeating them over and over again.

It’s very important to not get fatigued, judgmental, or despondent that the person is not learning quickly enough. It’s better to take the position that they are learning, but it’s hard to control these powerful feelings. You can also provide a lot of co-ed peer interaction practice. Please see the video podcast for Dave’s helpful slide describing the suggested strategies.

After You want to make sure that you’re having an ongoing discussion that’s focused on the positive and celebrates this person’s interest in other people and celebrates their desire to be connecting to other people then focuses on healthy ways to do this. You might need to continue to closely monitor and support that.

You want to keep the individual at the centre of the process, and that can be a challenge when you’re not all on the same page.

Dave Nelson

Preventing Risks 

Dave provided us a nice example of how our young adults can become victims or perpetrators at the 46-minute mark. The intervention involves helping the person develop secure, peer relationships with the opposite sex in a safe community, helping the person get more physically comfortable which involved helping the person better understand and advocate for their sensory needs, and generally supporting self-confidence and ego-development.

You can also make sure you’re non-judgmental and be supportive of what they are doing and give them information to be safe, whether it was about safe sex or helping them navigate what might be going on with other people. It helped make the supporters seen as a useful resource. You can also debrief a lot about what might have happened focusing on what went well rather than things that may have gone wrong. You can also use a past crisis as a talking point for discussing the ideas of romantic relationships.

Setting up a supportive team that can communicate in an inclusive and respectful way is important. Everyone on the team needs to communicate regularly so everyone can work from the same story to avoid confusing the person by sending mixed messages. This can be achieved by looking at the big picture and focus on what everyone agrees upon: shared goals of safety, autonomy, and legality.

Important Take-Aways

Dave suggests that the most important thing people can do in a school setting is to have as many people develop trusting, secure relationships with the individual as possible because the more the young person trusts the people they are around, the easier it’s going to be to manage behaviour. It’s very important to avoid shame. So when people are engaging in behaviour that’s not public and should be private, you need to try to create privacy so they see the need for privacy, and label that behaviour as private time since it’s very difficult to physically control behaviour.

It’s important that staff work with the parents to support the child in helping them have their needs met at home if they are uncomfortable at home and are instead engaging in these behaviours at school. It’s also about helping the person realize how others perceive them. It might be that the person hears it makes other people uncomfortable, but is not yet able to manage the behaviour. The longterm goal is to help the person regulate the behaviour later.

Getting them to just stop won’t help them to self-control the behaviour later. This is not about condoning or not condoning the behaviour. It’s about–practically–how are we going to create the most self control the most respectfully and the most quickly as we can. We’re supporting people that don’t fit into the middle part of the bell curve.

Dave Nelson, Threshold Community Program


If you’re interested, listen to the UNIQUELY HUMAN podcast for autistic individuals: Supporting Happy and Positive Sexual Lives – Michael John Carley

Thank you to Dave Nelson for taking the time to share this wonderful presentation with us! If you found Dave’s presentation helpful, informative and useful, please consider sharing this post on Facebook or Twitter! If you have anything to add, question, or an experience to share, please consider leaving a Comment below.

Until next time… here’s to affecting autism through playful interactions!

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