Physical Health and Safety for Teens

Photo by Brad Neathery on Unsplash

Being a teen can be both good and tough at times. Even though there are thousands of other people with autism, intellectual disability and/or other neuro-developmental differences, you may feel like you are the only one. On top of that, so much is changing as you’re learning and growing up.

This Toolkit is designed just for you, but remember, no two teenagers are the same. You may find that all the information, exercises or resources are helpful, or just one or two of them are. No need to go in order. Just use this Toolkit in any way that works for you. If you feel that you have questions or concerns that aren’t being answered here, talk with a trusted adult like a parent, teacher or another professional.

If you find it challenging to read the Toolkit, find someone to read it with you. Or break it down into parts. Here’s what you’ll find in this Toolkit.

Taking Care of My Body and My Health

What is Puberty?

My Body, Sexual Health and Romantic Relationships

Personal Hygiene

Medication Management

Nutrition

Fitness

Fun

Managing My Behaviour and Relationships

At the end of each section is a listing of some examples of resources. Keep in mind that there are many more resources. Consult the AIDE Asset Map or check with local service providers to find out what is available in your community.

Taking Care of My Body and My Health

As you get older, you may find that you are learning to make more of your own decisions about your own health, taking care of your body and understanding more about what is good or bad for your health. You will also be learning about what changes are going on in your body.

What is Puberty?

Puberty happens to all teens. Puberty is what happens in your body when you become a teenager. Your body will grow and change. For girls, your face may get oilier and you may develop pimples, your period will begin, your breasts will grow, and hair will grow in your armpits, on your legs and between your legs. For boys, your face may get oilier, you may develop facial hair, your shoulders will widen, your neck, chest and leg muscles will grow and get stronger, pubic hair will grow, and your penis will get wider and your testes will grow larger.

Just remember that every teen is unique and special, and body changes happen differently for each person. Some teens start puberty earlier than others, some grow taller than others, and some show signs of body changes differently than others (like growing hair on your face or legs, or getting pimples).

It is natural to sometimes feel uncomfortable with the changes in your body, so don’t feel ashamed to ask an older friend or relative for help. Just because another person may not have had the exact same experience as you doesn’t mean that they won’t be able to understand what you’re going through and be helpful to you.

Resources:

What’s Happening to Tom? A book about puberty for boys and young men with autism and related conditions. Kate E. Reynolds

What’s Happening to Ellie? A book about puberty for girls and young women with autism and related conditions. Kate E. Reynolds

My Body, Sexual Health and Romantic Relationships

It’s important to know what puberty is about so that you aren’t surprised, worried or scared when your body naturally changes. You can ask your parents or another responsible adult for help in understanding and taking care of your body, being safe and engaging in social behaviours appropriately. For example, some teens may not know what types of information and bodily activities should be private. It’s important to know that it is wrong for someone to not respect your privacy (such as unwanted touching or comments). You have a right not to be treated in a disrespectful way.  If anything disrespectful, upsetting or wrong is happening, talk to a trusted adult and you can seek assistance from a professional such as a teacher, guidance counsellor, police officer, etc.

By the time you are in your teen years, you should know body parts and body functions. You will need to learn how to take care of your body as you mature. Words to learn include: menstruation, testicles, hair, breast development, PMS, sexual or romantic feelings for a same-sex and/or opposite-sex peer, and gender identity, for examples. It will be helpful to talk about what is happening to your body with someone you trust (a parent or older sibling, for example). For example, teen girls will need to learn how to purchase tampons or pads, and how to use them. Teen girls and boys will need to learn about how to deal with increasing sexual feelings and other things (like masturbation, sexually transmitted diseases, and birth control).

You may have lots of questions…

Learning how to interact while on a date or in a romantic relationship (what is physically appropriate, understanding consent, privacy and safety, boundaries, expressing affection) may require conversation and some practice opportunities (such as role-playing and social narratives/books). You may also need to be aware of what is acceptable behaviour in public and what’s acceptable behaviour in private.

You may be wondering how to decide if you are ready to have a physical relationship with someone else. The first thing to remember is that the only way to make sure you don’t get a sexually transmitted disease is to not have sex. Some people choose not to have sex until marriage perhaps due to guiding religious beliefs or personal convictions. You should consider WHY you are interested in having sex. Is it because you are worried that your significant other will break up with you if you don’t sleep with them? Are you feeling pressure because your friends are doing it? Those are not healthy reasons to have sex with someone. In general, people choose to have sex if they a) love the other person, b) feel respected by the other person, and c) have the desire to express their feelings physically.

If you are choosing to start a sexual relationship, you and your parents and/or your doctor or a trusted adult should talk together about safe sex, being in a healthy sexual relationship, and how to prevent sexually transmitted diseases and teen pregnancy. Be aware of how to keep your body, mind and emotions safe and healthy (for example, don’t let anyone, even a partner, do something to you that you feel is unsafe, uncomfortable, or unhealthy).

LGBTQ2S+ (Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, and Two-Spirit) refers to a person’s sexual orientation or gender identity. For more information, see our LGBTQ2S+ Toolkit on the Aide Canada website.

Sometimes romantic relationships can turn to thoughts about dating, love, long-term relationships, marriage and whether or not you may want to have children of your own one day. It’s okay not to know how you feel about any of those things right now, but it may be helpful to think about what is important to you (for example, trust, loyalty, kindness, not being forced into anything that you don’t want to do or that is unsafe or unhealthy). It is important to be true to yourself and be kind to the person with whom you are in a relationship. You don’t have to be in a relationship to be happy, or stay in a relationship that is unhealthy, unsafe, or making you unhappy.

As for your future, there are multiple ways of creating your own family (having a child, not having a child, choosing to be single, adopting, fostering, etc.). There’s lots of time to figure this out. Talk to a trusted friend or adult if you are unsure about the relationship you are in or what you want for yourself in the future.

Here are some “don’ts”

• If someone doesn’t like you the way that you like them, don’t keep bugging them or harassing them.
• Never let someone touch your private body parts, kiss you, or ask you to do something that makes you uncomfortable without you being prepared, ready and in agreement (giving your consent).
• Never touch someone else’s private body parts, kiss them or ask them to do something that makes them uncomfortable, or they don’t want you to, or they say ‘no’.
• Many people choose to masturbate, but whether you decide to do it or not, it must be done privately.
• Don’t join a group of people who are only interested in sexual behaviours. They usually do not have your best interests in mind.
• Be smart about social media. For example, don’t ask anyone to send you pictures of their private parts and don’t send any pictures to anyone of your private parts.
• Learn what safe sex is. Do not put anyone at risk of having an unplanned pregnancy or getting a sexually transmitted disease by having unsafe sex.
• Don’t make fun of someone or hurt someone if they have sexual feelings for someone of the same sex or if they have a different gender identity than you do.
• Don’t give into pressure to start having sex, even if your friends are. You are not less ‘cool’ if you are not ready. Everyone moves at their own pace and having sex before you are emotionally ready can lead to negative feelings about yourself and others.

Resources:

KidsHealth has a great website designed for teens (has audio capacity as well) and explains what happens to your body during puberty and offers excellent strategies for taking care of your body.

Books Beyond Words: Picture books area available on topics related to caring for breasts, testicles, preparing for a pap smear, starting your period and loving someone safely.

Autism Parenting Magazine

Interactive Autism Network

The Lifeline Canada Foundation

The Asperger Teen’s Toolkit by Francis Musgrave. This book has minimal text and is a fun, comic style book with graphics. It offers information for teens and their caregivers. It explores the science of how the human mind works, and offers tips on how to manage the adult world, responsibilities, health, sex and relationships.

Personal Hygiene

You may not get all the fuss about why teens spend more time with their personal care and hygiene (clean body and clean clothes, no body odor, clean hair, shaving, etc.). On top of that, adolescence is a time when your personal hygiene becomes your own responsibility. It’s an important skill that need to learn.

Some autistic people struggle with personal hygiene sometimes because of sensory processing differences. For instance, the feeling of water hitting some people’s skin can be painful or the taste of toothpaste can make some people nauseous. It can take some practice being a ‘sensory detective’ to really narrow down exactly what it is about that part of personal hygiene that is unpleasant. Once you know what you don’t like, you can look for solutions to make it better. For example, if water hitting the skin hurts, it can be worth trying out different handheld showerheads that have multiple pressure options so you can control how much of your body gets wet at once. Below are some common hygiene-related concerns identified by autistic teens.

Tips:

• It may be helpful for you and your parents to create a “body kit” to help remind you of what you need. Your kit could have all the things you will need to keep clean and take care of your body (like: toothpaste and toothbrush, shampoo, deodorant, hairbrush, soap, a razor, shaving cream, a pad or tampon (for girls).
• You could create a picture chart and number each item so that you know when to use them, which order to use them in, and what each one is for.
• Some teens find it helpful to create a visual schedule to help them remember when it’s time to take care of their body.
• You may find it helpful to watch your parents or an older sibling with their hygiene routine like teeth brushing, shaving, washing your face, skin care or putting on deodorant so that you get a sense of each step.
• Try to figure out what makes you uncomfortable. For example, some teens may not like the feel of showering or shaving. What is a solution that feels comfortable for you, but that still gets things done?
• You may find it helpful to have visual cues, lists or charts (like the one described below). Creating a routine and modifying tasks may be helpful in self-care.

Activity for Addressing Personal Care

This is an activity to support you in managing your own person care. Try this…

Create a chart with reminders and directions about daily personal care. This is one example of a personal care task instruction sheet that you can start with and practice until you no longer need reminders or direction.

Download the PDF chart here

Medication Management

Photo by Christina Victoria Craft on Unsplash

As you get older, you may learn to take more responsibility for understanding and taking medicines that you may need. This may include creating a schedule so that you know what medicines to take as well as knowing when to order your prescription and how to pick it up at the pharmacy. A visual chart or a calendar might be helpful.

Make sure you understand what your medication is for, and why it is important for you:

• Talk with your parents or doctor about the reason for a medication so that you understand how it should help you.
• When you start a medicine, it can take time to have an impact, so don’t give up if it doesn’t seem to work right away.
• Set up a schedule so that you take your medications at the same time each day (you could use a dispenser, a chart, a calendar or whatever works best for you).
• Set up a way to remind yourself when to take your medicine. Ideas could include: put an alarm on your phone, ask a parent to remind you, or put a note somewhere that you will see.
• Be aware of any side effects of your medicine, keep track and let your parent and/or doctor know what side effects you are experiencing.
• Don’t mix your medicine with things that might not make the medicine work or that might be dangerous (like alcohol or illegal drugs).
• Take your medications as prescribed, even when you feel like you are feeling better and don’t think you need them anymore.
• If you believe a medicine isn’t working for you, speak with your doctor about the safest way to slowly reduce your medication before you try a different one. Suddenly stopping certain medications can cause long-term damage.

Nutrition

Healthy food helps your body and brain remain healthy, and helps you grow. Some teens may find that healthy nutrition is hard because they may have unique challenges such as: sensitivities to certain foods, stomach (gastrointestinal [GI]) issues, constipation, lack of appetite because of some of their medications, repetitive or restrictive behaviours, disrupted mealtime routines, or preferences for certain food. Your struggles may include finding foods that you can tolerate or like because you prefer certain tastes, textures, smells, sounds or appearances (color, for example). This may make it harder for you to try meals, snacks or other foods that aren’t prepared in the same way each time, and you may prefer a certain brand or type of food which you like to stick with. This may mean that you are eating too many foods that aren’t nourishing, or finding it hard to try other foods that are wholesome.

You may find it helpful to work with a doctor, registered dietitian or therapist to try strategies to find new foods to enjoy.

Registered Dietitians suggest that you try these:

Take notes about what foods that you like and don’t like (for example, taste, smell, sound, color, temperature, texture).

Take a food that you like and add something new to it (like a healthy dip or cutting up a fruit to make it the same shape as the food that you enjoy).

Go with a parent or a friend to a grocery store and see what kinds of foods interest you. Or check out foods on the internet, research them (find out where they are grown, how to prepare them) and decide if you want to try them.

Go alone or join a parent or friend in a cooking class, and try cooking or baking foods together. You may find that this is fun and gives you some input into how your food is made. There are lots of interesting recipes online for “picky” eaters.

Put a new food on your kitchen counter so you can see what it looks like. As each day passes, you may get more used to it and move it closer to where you are eating and maybe one day to your plate. If you don’t feel like eating it, don’t, but one day you may decide you are willing to give it a go.

Find a place to eat that is not overwhelming with sounds, lights and other things that might be too much for you.

Consider downloading an app on your phone or computer that helps you track what you’ve eaten and may give you some ideas about nutritious food ideas.

Talk to a professional about making sure you are getting the vitamins and minerals that you need and consider adding a supplement to your daily intake.

Note: Above photos of apple by Amit Lahav on Unsplash

Resources:

Unlock Food Canada: Home - Unlock Food

Today’s Dietitian: Today's Dietitian Magazine (todaysdietitian.com)

Autism Treatment Network: Nutrition | Autism Speaks

Academy of Nutrition & Dietetics (US): Eatright.org - Academy of Nutrition and Dietetics

Fitness

Photo by Yuval Zukerman on Unsplash

There are lots of ways to make physical activity and fitness fun and part of your daily routine. Being physically active is also about keeping your body strong and healthy and can help regulate your mood. For some teens it may help to keep their body at a healthy weight. For other teens, it may be helpful to participate in activities in the community. Some physical activities can connect you with other teens your age or can help you with your balance and coordination, management of aggression, concentration and/or energy (too much or too little).

Fitness experts who work with teens with sensory differences recommend fitness that includes pushing, pulling, bending/squatting, rotation and locomotion (like squats, overhead presses and rope swings).

Check out places like your local community/recreation centre or YMCA/YWCA to see if they have sports or fitness programs. You may find it helpful to have a very structured program with a coach or instructor.

For teens who enjoy technology, find an app on your phone or computer that helps you track your physical activities (you can count steps, how far or fast you run, how much time you spend doing something physical, etc.).

Fitness and Sports to Try:

• Swimming
• Martial arts
• Running
• Bowling
• Horseback riding
• Yoga
• Dancing
• Lots of others to try too….
  

Fun

What are fun activities that you can do on your own or with others. There are many things to try. For example, would you enjoy joining a theatre group, computer coding, or taking a cooking or other type of class? There are so many options. You can check out local community centres, recreation centres, the YMCA/YWCA or organizations that provide programs and services. Or check out websites and apps that let you be creative, try new things, invent, make music, be entertained, etc. Here are some sources:

•  Thisissand    Flame Painter
•   Jackson Pollock Jackson Pollock Game | Artsee Kids (wordpress.com)
•   Space the Final Frontier Space Frontier Online - Play now online! | Kiz10.com
•   Specialbites
•   Minecraft
•   Audiobooks
•   Musical Games
•   Sticky Mosaics or Diamond Dotz (these are crafting kits that you can purchase from many different companies)
•   Play the piano or another instrument (make up your own melodies). Try Virtual Piano for a free online game where you can learn a few classical songs

Opportunities

Seek out other teens with similar interests (might be gaming, theatre, swimming, dancing, faith/religion, photography, cooking, music, movies, etc.).

Join an organized club or group such as Girl Guides or Scouts, theatre, dance group or recreational activity that meets regularly.

Find out if there are modified activities or support persons available within recreational programs such as the YMCA/YWCA.

See if there are leadership programs available through local community services such as the YMCA/YWCA.

Seek out social skills groups that are designed to teach and develop social skills.

Create a social or recreational group based on your interests or strengths.

Consider joining a school extracurricular activity or club or find out if you could start one.

Be creative and talk with your family about taking on a family project like cooking a meal together once a week or having a movie or games/gaming night or designing your bedroom. These can be fun opportunities for you and your family to hang out, bond and enjoy.

Follow your passions, interests or hobbies, and see if there’s a volunteer, part-time job, or group that you could apply for or join.

See if there are any overnight camps that might be suitable for you to give you a chance to try a sleepover and build skills for independence. You can check the Jooay app to find fun activities and camps in your area.

Resources:

The Autism Discussion Page on Stress, Anxiety, Shutdowns and Meltdowns, Bill Nason, Jessica Kingsley Publishers, 2020.

Bloom: 50 Things to Say, Think and Do with Anxious, Angry and Over-The-Top Kids, Lynne Kenney and Wendy Young, Unhooked Books, 2015

The Awesome Autistic Go-To Guide: A practical handbook for autistic teens and tweens

Raising Children Network

A Practical Guide to Happiness in Children and Teens on the Autism Spectrum, Victoria Honeybourne, 2017

Teens with autism can master daily living skills when parents, teach, reach for iPads, Mary Louise Duffy, Michael Brady, Peggy Goldstein, Florida International University, EurekAlert, Oct 2019

Social Stories^TM  and comic strip conversations are helpful in creating social understanding and keeping safe, National Autistic Society

“F-words Agreement” helps teens and parents navigate what they want for themselves/their teen with respect to function, family, fitness, fun, friends and future. Available to download from CanChild.

Canadian Down Syndrome Society

Verywell Health

Autism Fitness®: https://autismfitness.com/

Safety and Well-Being

As you get older, you may spend more time out in the community on your own. Practice using public transit, learn how to understand traffic and pedestrian signs and rules of the road, and learn how to identify who are helpers in your community if you feel unsafe (security guard, neighbour, crossing guard, bus driver, etc.).

Cyberbullying and Internet Safety

Photo by Zoe Fernandez on Unsplash

Many teens are using a number of social media apps on a regular basis. Make sure you know the facts and ways to be safe if you choose to join in.  

•  Never give your personal information like your name, age or address to anyone that you don’t personally know.
• Never send, or ask anyone for, pictures of private parts or anything that has to do with sexual behaviour.
• Never bully someone (like making fun of the way they look or talk).
• Learn what is real and what is pretend or fake.

Remember, once something is put online, it is not possible to fully remove it. Make sure you don’t put things online if you are worried about how some people might respond now or in the future.

Managing My Behaviour and Relationships

Do you ever have times when you feel like your behaviour is making it tough to “fit in” or leads to a difficult time with your parents, teacher or friend? Meltdowns, acting out, being aggressive, saying or doing something that isn’t socially okay, or being disorganized, are examples of behaviours that can be tricky and tough to manage, and sometimes happen at an undesirable time or place. Sometimes this might happen when you are feeling unsure about what is going on around you, or you don’t have the words or feelings to sort something out and you get frustrated, mad or sad. As difficult as these experiences can be, there are ways to identify why it happened, and more importantly, what you can do the next time to help yourself through it differently.

Try this*

Be a “behaviour detective” – what triggers one of these difficult behaviours or experiences?

• Maybe ask a parent, teacher or friend to help you understand what triggered the behaviour.
• Have someone help you describe what the behaviour looked like and felt like for you and for others.
• Practice a different approach to your triggers.

Use a book or picture/comic book or favourite movie to help you figure out what behaviours are positive or not positive and why they happen. What do you think that person could have done differently?

If you start to feel like you are getting triggered or upset, try one of these strategies:

• Stop what you are doing. Take a break. Walk away if you need to. Rejoin if you are ready.
• Remind yourself that things will be okay.
• Do something else instead that brings you relief or comfort (listen to music, find a quiet place, take a nap, play a game, do a puzzle, etc.).
• See if you can think about the thing that triggered or upset you in a different way so that if it happens again, you can think of it in new and more helpful way (some people call this reframing).

Resources:

Raising Children Website

Asking for Help

When you are feeling that you don’t know how to handle something or when something or someone is bothering you, it can be good to ask for help from someone you trust.

Resources:

Kids Help Phone

MORE AIDE CANADA TOOLKITS FOR YOUTH…

Thank you for reviewing this Toolkit. We invite you to also read the corresponding Toolkits in AIDE Canada’s Teen Toolkit Series. The other Toolkits are:

From Just Surviving to Thriving in High School

Mental Health and Sensory Challenges for Teens

Beyond High School: Self Identity and Managing Life