Alina Mirela Craiu
Alina Mirela Craiu has a double specialization: clinical psychology and special psychopedagogue and has been working in supporting children diagnosed with autism and their families for over 17 years.
She is the founding president of the Butterfly Club Association and, over time, she has developed a series of training programs for teachers on the topic of school inclusion of children with ASD and ADHD, as well as support projects for parents.
In recent years, she has developed training programs for parents and therapists who work with adolescents with autism, emphasizing the need to prepare them for puberty, sexual education and the development of children's personal autonomy skills. She provides support to families through psychoeducational and psychological counseling sessions and programs to increase their life quality.
Presentation at the ABA International Conference 2025
Preparing the child with autism for puberty: when do we start and what aspects do we aim for?
Abstract:
Puberty is a time of many changes in the life of a child with autism and their family. From hormonal changes to physiological changes to the restructuring of neural networks. Physical and hormonal changes can exacerbate the basic difficulties of autism – such as, the sensory sensitivities, emotional regulation problems and repetitive behaviors – so that the level of functioning can deteriorate with the entry into adolescence.
In everyday life, these changes will lead to behaviors that can sometimes be difficult to manage. Mood swings may manifest more often, and the behaviors that occur at these times become increasingly difficult to regulate due to the physical capacity of the preadolescent. Sexual behaviors begin to appear and greatly influence the inclusion of the preadolescent in the peer group, but also his own safety. Body hygiene and the way in which the preadolescent takes care of his body have an impact on his health and relationships with those around him. In the case of girls, the appearance of menstruation requires special care.
Although the physiological changes are predictable, many intervention programs and complementary therapies do not explicitly include preparation for puberty. As a result, many parents and therapists feel unprepared, and children may exhibit confusing behaviors, heightened emotional expressions, and social difficulties as their bodies change.
Studies show that early development of personal hygiene and daily living skills has a major impact on the personal autonomy and quality of life of children with autism and their families.
This paper aims to bring to the forefront the need to address early those skills that the child with autism needs during puberty.
Following the practice, three major areas emerge: personal hygiene, emotional management, and sex education. Personal hygiene is all the more necessary since we are also talking about girls who need special care (which seems easy but requires multiple skills).
Adolescents with ASD may exhibit inappropriate sexual behaviors due to insufficient understanding of puberty and lack of sex education. Specific education and development of social skills can make a difference.
Depression, anxiety, and eating disorders are more common in autistic adolescents. But aggressive behavior can also intensify during this period. The existence of targeted programs through which parents benefit from parenting education and training specific to these situations can help the child adapt to the changes that are coming.
The skills that are part of these areas can bring autonomy to the life of the child with autism and freedom and balance to the life of his family. A parent who does not have to bathe his 13-year-old child is a parent whose stress level is lower.
Psychoeducational interventions need to involve the development of key skills that the child with autism can rely on during this specific period in his life. And especially to aim to increase the degree of personal autonomy.
Puberty preparation should start early because the specifics of Autism Spectrum Disorder show us that learning and developing skills require time and practice. The more the child's family is prepared, trained and supported in implementing psychoeducational interventions with puberty-targeting goals, the more the child has a long-term chance of reaching their potential and having a greater degree of autonomy. Puberty preparation programs (such as the EERS Program) have the potential to facilitate social inclusion and increase personal safety for young people with ASD.
Keywords: autism, puberty, sex education, personal autonomy, early intervention.