Body Development and Puberty in Behavior Analysis

Why Body Development Gets Skipped in ABA Programming

Most behavior analysts were never trained on this part of child development. Shalini Solomon opened with three barriers that keep it off the plan. The first is that no one has flagged a problem yet. Teams are busy with functional communication (teaching a learner to ask for things). They are busy with self-injury. Insurance pushes goals toward medical necessity (care a payer counts as needed). Puberty never makes the list.

The second barrier is discomfort and bias. Your upbringing, culture, values, and beliefs shape what you feel ready to say out loud. The caregiver has their own set. So does the school team. The third barrier is scope. Many analysts assume this work sits outside their training. Some of it may. Much of it does not.

Her core point came early in the talk. You do not need a crisis to start teaching. A two-year-old does not need a consent goal. But a parent of a six-year-old can learn a lot in caregiver training. Prerequisite skills can be built long before anyone panics.

there does not need to be a behavioral problem or issue to begin teaching these topics

From the talk — Shalini Solomon

Typical Development From Age One Through Fifteen

She used two loose age bands, not hard cutoffs. Ages one to eight came first. Expect privacy seeking: a child wants the door closed while changing. Expect self-exploration and curiosity about other bodies. Expect questions like where do babies come from. A new baby sister makes that question very likely. Expect slang, jokes, and peer curiosity as social awareness grows.

Ages nine to fifteen bring hormonal and body changes. Breasts grow. Body hair shows up in new places. Menstruation starts for clients with a vulva. Wet dreams and masturbation appear. So do crushes, strong feelings, and notes passed to a peer. Privacy behaviors increase. So does contact with sexual content in shows, music, games, and movies. Two people kissing on screen is enough to spark questions.

All of this is typical. Clinicians often miss it because they are not in the room when it happens. Caregivers may not see it either.

Match the plan to skills, not the birthday. A nine-year-old may not be at a nine-year-old skill level. A six-year-old may be ahead. She shared a line from Dr. Stein on this point: puberty doesn't wait for developmental readiness. And a late start does not mean it never comes.

just because you're not seeing it does not mean that it's not happening

From the talk — Shalini Solomon

Four Patterns That Call for Targeted Support

The first is explicit exposure. That means public exposure, public masturbation, or access to adult sexual content. The same act alone at home is a different conversation. The second is self-injury or unsafe physical behavior. That includes contact with the genital area using hands or objects in ways that can cause harm.

The third is coercion. Any forceful, intimidating, or pressuring sexual behavior counts. With children it can sound like I'll show you mine if you show me yours. We do not want a client doing that. We do not want it done to them either. Age shapes your response too. Adult content with an eighteen-year-old is not the same issue as with a six-year-old.

The fourth comes from the client. If they say a behavior causes them distress, or feels dangerous to themselves or others, that counts. We do not get to overrule them and call it fine.

Then she gave the reminder that reframes this whole list. Topography (what the behavior looks like) does not hand you the function (why it keeps happening). Tactile seeking (wanting touch or texture input) or sensory discomfort often drives behavior that looks sexual. Scratchy shorts can lead to rubbing on furniture or on people. Assess it. Rule out medical causes first.

if you are seeing a behavior that looks sexual in nature, it does not automatically mean that it is a sexual function

From the talk — Shalini Solomon

Consent, Boundaries, and Privacy in Words You Can Teach

She anchored each term in two plain words. Consent is permission and choice. Boundaries are limits and interactions. Privacy is space and being alone. Consent is not only about bodies. It also covers what happens after a yes or a no, on both sides.

That makes low-stakes practice easy to find. Can I pet your dog. Can I join you and play. Can I put my block on top of yours. Can I sit by you. Can I fix your hair. Can I move your wheelchair. When the answer is no, say thanks for telling me, then stop. Dr. Stein's point, as she shared it, was simple. If a no must hold when the stakes are high, it must also hold when the stakes are low.

Be precise about what consent covers. It covers their body and whether they join or go with someone. It is not a veto on every instruction. Otherwise a learner may tell a parent they do not consent to being done with the iPad. Teach that difference on purpose. For boundaries, she likes real bubbles to teach a personal bubble, and an arm's length as a visual. Plan the fading step. She once had a learner who then kept an arm's length from everyone. Teach what to do when a peer ignores a no: get a teacher. Then teach the harder case, when an adult ignores it.

Privacy comes down to three questions. What can I do in private. What should only happen in private. What should never happen alone with another person. Knocking on the bathroom door during toileting routines teaches all three at once. Knock, wait for the yes, then name out loud that you waited. One caution: some moments are out of a client's hands. She described a client who used their words to refuse care, but who needed medical attention anyway. Do not teach that all adults or all doctors are exceptions. Individualize who, when, and why.

if we ask for their permission and they tell us no, we want to show and model that we're going to follow and honor that

From the talk — Shalini Solomon

Teaching Tools You Already Use for Everything Else

Start with correct anatomical terms: penis, vulva, breasts. If saying them out loud feels hard, practice. Practice in the mirror or with a colleague. The clinical reason is safety. A client who says my penis is red and hurting gives you usable information. A nickname does not. A nickname could be a person, a friend, or a character on TV. One attendee offered a nice twist: teach the other body parts along with head, shoulders, knees, and toes.

Use the assessment tools already on your shelf. She named indirect questionnaires (caregiver rating forms about behavior) like the QABF, the FAST, and the MAS. These can point you toward function before you stack on extra intervention. Frame curiosity and body exploration as healthy and typical, not as a problem. Your framing is a model. A client who learns this is shameful may not tell you when something is wrong.

The teaching methods are familiar. Task analysis (breaking a skill into small steps) fits putting on a pad or inserting a tampon. Natural environment teaching (teaching skills during everyday routines) fits home, school, and community. Discrete trial training (short, structured practice trials) fits body parts, the same way it fits animals and foods. Video modeling (learning by watching a short video) is a favorite of hers with older learners. Watch the video, then talk about what you saw and how it felt. Functional communication teaches no too. A learner might use an AAC device (a tool that helps someone communicate without speech) or a red and green card.

Discrimination training (learning which setting allows what) carries the public versus private work. The bathroom at home is private. Is the bathroom at the grocery store private too. Can I do the same thing there. And keep one fact in front of your school teams.

a school setting is an entirely public place

From the talk — Shalini Solomon

Risk, Ethics, and Mandated Reporting

She shared the numbers behind the urgency. Research shows people with intellectual and developmental disabilities face a 3.7 to four times higher risk of sexual violence. Prior literature also shows autistic people want instruction on gender identity, sexual orientation, consent, and assertiveness more than non-autistic peers do. Those risk figures only count reported cases. Much goes unreported. Some reports come from adults describing what happened to them as children.

Language shapes risk. A learner may use an AAC device or a PECS system (a picture based way to communicate). That learner cannot start yelling the way a vocal peer can. Compliance training shapes it too. We teach a lot of compliance, and not everything should be complied with. Ask yourself when your client actually gets to say no.

On reporting, she was direct. We are all mandated reporters (people required by law to report suspected abuse). Reasonable suspicion is enough, and you do not need proof. Investigating is not your role as a BCBA. Reporting is. Check your state and federal rules for how to do it.

She pointed to BACB (Behavior Analyst Certification Board) ethics codes 1.7, 1.10, 2.9, and 2.12. Those cover scope, responsiveness to diversity, awareness of your own bias, involving clients and stakeholders, and considering medical needs. She said she likes the core principles even more. They call for benefiting others and treating people with compassion, dignity, and respect. They also call for acting with integrity and maintaining your competence. Then she left the room with a thought worth sitting with. For a client with no other services, you may be the only person raising this at all.

our role as a mandated reporter is to report. So if you see something, say something.

From the talk — Shalini Solomon

Coaching Families, RBTs, and the Rest of the Team

Values come first. Check in with caregivers, guardians, and staff about their values and preferences. Your job is not to walk in and say research says, so do this. Look for common ground instead. When you feel stuck, lead with safety. Every parent wants their child protected, and that is shared ground.

Train language next. Model neutral, objective behavioral terms rooted in dignity and safety. Remember that your client can hear you unless they are deaf or hard of hearing. Watch what adults say near them. Respect gender identity, sexuality, and orientation without assuming. Asking what pronouns you should use is a small, respectful move. It also signals that you are a safe person to talk to.

Then align the work across settings. Push the value of starting now instead of later, even if that means teaching prerequisite skills today. Rule out medical causes before any behavior plan: a UTI (urinary tract infection), a rash, or a side effect of a new medication. Coordinate with speech, occupational therapy, and physical therapy, since body goals touch everyone's plan. If a client needs an accommodation, get it written into the plan, not just recommended in a meeting.

Finally, watch the environment. Adult reactions can reinforce behavior without anyone meaning to. A client with no same-age friend group may aim peer behavior at adults. Poking a friend in the tummy does not land the same way with a grown-up. That is a discrimination problem, not always a sexual one, much like cursing with friends but not everywhere. And constant supervision removes every chance for private behavior to stay private. It pushes that behavior into public view.

We are all here to make sure that this client is safe.

From the talk — Shalini Solomon

Resources You Can Hand a Caregiver This Week

Her top pick was amaze.org. It has short videos, about two to three minutes each. Categories include puberty, masturbation, body odor, and disability and sexuality. She has watched them with many adults. You can also use them in supervision with your RBTs.

She also pointed to work by Landa Fox, a BCBA in this space. Landa Fox created the Positive Connections resource and a guide on sexual health development by age group. For books, What's Happening to Tom fits clients with a penis. What's Happening to Ellie fits clients with a vulva. She described them that way on purpose. With a teenager still figuring out identity, boy and girl labels may not fit. Good Pictures Bad Pictures Jr. covers which pictures are okay to look at, and there is a version for teens.

Visuals are not a shortcut. She cited Row and Wright (2017): visuals considerably aid sexual knowledge and understanding for students with an intellectual disability. Talking alone is hard to follow for many learners. Visuals can also make the topic less awkward for them, even if you are completely comfortable.

Resources also solve a practical problem. Some families will not want you teaching this directly, and that is their call. Meet them where they are and hand them tools instead. In clinic settings, check the family's comfort level and your funding rules, since some goals may not pass as medical necessity. Caregiver training is often the better route.

How can we work with you caregiver about this so that you can do this with your child?

From the talk — Shalini Solomon