Know Me, See Me, Hear Me: A Scoping Review of the Attitudes and Approaches to Relationships and Sexuality Education for Autistic Individuals and Their Families

Background: Even though evidence shows that Relationships and Sexuality Education (RSE) positively impacts personal and social development, different environments and social contexts see it delivered in varied ways. Autism research has shown autistic people experience more adverse life experiences than their neurotypical peers, with fewer and lower quality relationships and higher rates of violence and abuse. Despite this, neurodivergent learners, including autistic individuals, often miss out completely on RSE or are only offered it in response to risk or problematic sexual behavior. As a result, people do not experience the full potential of RSE as a developmental support system. Method: This scoping review explored the literature on attitudes and approaches to RSE for autistic individuals, focusing on the voices of autistic individuals, parents of autistic children, and allied health professionals (AHPs) supporting them. Researchers searched key health care and education electronic databases for studies undertaken by high-income countries from 1990 to the present date, where non-school RSE targeting autistic individuals was the study focus. The researchers established review parameters and search terms through a coproduction approach between autistic and non-autistic researchers. They undertook data extraction (including mapping to a socioecological framework) and a quality assessment and used a meta-ethnographic analysis to determine qualitative themes. Themes were synthesized with quantitative findings from the same data and mapped to a socioecological framework. Results: The review included 34 studies, with the majority reporting on RSE from the perspective of autistic individuals, and a minority of three studies offering the AHP perspectives. Researchers identified four themes as follows: Know Me, See Me, Hear Me, and Let’s Collaborate. Mapping to the socioecological framework revealed a lack of understanding of autism and variable RSE for autistic individuals across the socioecological levels. There was a strong call for a collaborative approach across socioecological levels to deliver RSE, with training for all those responsible for delivering it. Conclusion: Lack of understanding of both autism and RSE (generally) across societal levels results in often sporadic reactive interventions for autistic individuals at the expense of RSE’s purpose for proactive developmental support and health promotion. Effective delivery of RSE requires collaborative and person-centered efforts to achieve optimal quality-of-life outcomes for autistic individuals and their parents. Researchers need to further explore societal barriers to effective RSE, and parents and AHPs need support to fulfill their role in contextualized learning.