B-58: Neuropsychological Review of Interventions for Adolescents with Autism and Intellectual Disability

Abstract

Objective: Adolescents with autism spectrum disorder (ASD) and intellectual disability (ID) are at elevated risk for sexual behavior problems (SBPs), including public masturbation, boundary violations, and obsessive fixations. Neuropsychological deficits in theory of mind, social cognition, and executive function impair psychosexual development and limit access to adaptive sexual behavior. This review synthesizes the evidence on behavioral, educational, and cognitive interventions for reducing sexual behavior problems (SBPs) in this population. Method/Data Selection: Databases searched included PsycINFO, PubMed, ProQuest, and EBSCO using terms such as "sexual behavior problems," "autism spectrum disorder," "intellectual disability," "intervention," and "adolescents." Inclusion criteria required participants aged 10–25 with a developmental disorder and an intervention targeting sexual behavior problems. Pharmacological treatments were excluded. After screening 40 records, 10 studies met criteria, including two systematic/rapid reviews to contextualize earlier literature. Results/Data Synthesis: Four intervention modalities were identified. Psychosexual education programs improved sexual knowledge and reduced sexual behavior problems, particularly in early adolescence. Parent training enhanced caregiver communication and generalization of treatment gains. Applied behavior analysis (ABA) strategies, including response interruption and redirection (RIRD) and differential reinforcement of alternative behavior (DRA), effectively reduced automatically reinforced sexual behavior problems. Cognitive behavioral therapy (CBT), particularly a group-based program, reduced harmful sexual behavior and cognitive distortions while improving victim empathy. Most studies were single-case or small-N designs; only two utilized randomized controlled trial methodology. Conclusions: Multimodal, individualized interventions targeting the neuropsychological underpinnings of sexual behavior problems show efficacy for adolescents with Autism and Intellectual Disability. Future research should prioritize randomized control trials, diverse samples, long-term follow-up, and culturally adapted approaches.