This author, a neurodivergent occupational therapy doctorate student with extensive experience working with the disabled community, has witnessed the intense difficulties that arise as a result of puberty for ND adolescents.
(Richardson, 2025)
Unique Challenges
Puberty is a uniquely challenging time for neurodivergent (ND) adolescents. Because of the inherent differences in neurodivergent brains, the experience of puberty is different for ND kids.
Pre-existing challenges often become more intense and new difficulties arise. The primary challenge areas for ND kids going through puberty are sensory processing, emotional regulation, social connection, sexual behavior, and menstruation. The challenges are compounded by difficulties with communication, interoception, praxis, and executive functioning.
Understanding these unique challenges allows caregivers, providers, and the kids themselves receive the support they need to manage this challenging time.
- Heightened sensory challenges
- Greater sensitivities
- Increased sensory seeking
- Intensified dysregulation
- Dressing
- Bras and binders
- New clothes: changing style expectations and growth spurts
- Hygiene
- Body odor management- showering, genital hygiene, deodorant
- Acne- face washing and skin care treatments
- Body hair management
- Periods
- Physical sensations (wet, products) and smells
- Increased emotional dysregulation
- Anxiety
- Anger
- Moodswings
- Sensitivity
- Agitation
- Misunderstandings and Miscommunication
- Challenges recognizing and responding to mood swings
- Difficulty expressing emotions
- Misinterpretation of emotional experience by others
- Behavioral manifestation
- Impulsivity
- Distress
- Meltdowns
- Shutdowns
- Aggression
- Disrobing
- Communicating about sexual behavior and making inappropriate comments
- Masturbation
- Hypermasturbation
- Masturbating in inappropriate contexts
- Masturbating with inappropriate objects
- Masturbation is inaccessible
- Consequences
- Restricted community access
- Legal ramifications
- Injury to self
- Harm to others
- Social isolation
- Social contexts
- Increased self-awareness
- Decreased use of supports and accommodations
- Desire for connection increases
- Passion and need to engage in special interests increases
- Family
- Lack of independence vs need for autonomy
- Communication and comfort
- Increase in demand avoidance
- Safety
- Danger awareness and recognition
- Vulnerability to abuse and exploitation
- Risk of Sexual Disease
- Dating and Sex
- Changing and new social norms
- Non-verbal communication
- Boundaries and consent
- Lack of independence & general negative impact on well-being
- Tracking cycle
- Isolation
- Managing products
- Routine Disruption
- Period pain
- Sensory sensitivities
Supporting ND Kids Through Puberty
We must prioritize neurodiversity-affirming, trauma-informed, and individualized holistic care when supporting ND individuals during puberty.
Anyone providing sex education to ND individuals should understand ND learning and communication styles and know how puberty can affect this population.
- We should encourage collaboration between all team & family members to minimize confusion and misinformation.
- We should provide information about the social and emotional aspects of puberty and opportunities to learn about topics that may be considered taboo.
- We should use multi-sensory and accessible approaches when providing education. Structure, visual aids, and physical demonstrations are all beneficial tools.
- We should create spaces where anyone, regardless of age, neurotype, etc, feels comfortable asking questions and seeking information.
- We also must ensure that that non- and minimally-speaking individuals have access to the words needed to talk about puberty and sexuality.
- Sexuality Education Counselling and Consultancy Agency (SECCA)
- Free resource downloads
- Puberty: The Wonder Years: 7-part series on Disability and Sexuality
- Introduction to Disability and Sexuality
- Accessible and Inclusive Lessons
- Body Boundaries and Consent
- Disability and the Physical Changes of Puberty
- Disabilities and the Social-Emotional Changes of Puberty
- It Takes a Village: Working with Support People, Educators, and Health Professionals
- Intersectionality and Disability
- TASCC
- Navigate Life Texas: Puberty and Sexuality and Children with Disabilities
- Devon Breithart: Puberty and Sexuality for Teenagers with Disabilities
- Every Body Curious
- UW Health: How to help teens with special needs navigate puberty
- TASCC: FREE Online Self-study Sexual Health Courses
- SECCA:
- Mad Hatter Wellness
- FREE live support for parents: Each month, Mad Hatter Wellness in the USA offers a monthly free call for parents and caregivers to discuss relationship and sexual health concerns with one of their Education Specialists. All calls are hosted on Zoom and are free for anyone attending.
- National Council on Independent Living:
- Sex Ed for People With I/DD: YouTube playlist of sex education videos for people with ID/DD. Topics cover sex, gender, relationships, pregnancy, and safe sex. Made by and for people with I/DD, includes a discussion guide.
- My Rights, My Life: A Curriculum for Safer Relationships
- “Inclusive and Accessible Healthy Relationship and Safer Sexuality Curriculum for young adults with Intellectual and Developmental Disabilities”
- jooux
- “jooux is a sexual wellness center designed to provide high quality and affordable sexual wellness services to Deaf, DeafBlind, DeafDisabled, Hard of Hearing and Late-Deafened communities.”
- Birds + Bees + Kids:
- The Birds & Bees Solutions Center for Parents of Neurodivergent Kids: A paid course guiding parents providing sex education to neurodivergent children.
- Sexual Health Victoria: Cognitive Disability Education & Support Planned Parenthood:Sex Ed To-Go for StudentsThe Porn Conversation: Educational ToolsGrowing Into You!: Puberty- Puberty Workshops for Families