About AASN

In January of this year, I got together with public health nurse Lyba Spring to develop a workshop for our girls on how to deal with getting your period. Some of the mothers had been telling me about the problems their girls were facing with this new challenge. Several of the girls flatly refused to hear a word about it from a parent and it was clear that what they were learning in sex ed classes in school wasn't enough. What follows is what we came up with

How to Talk to Your Pre or Teenage Girl with Aspergers about Girl Stuff
When designing any programming for a group of children with AS, or just working with your own daughter, there are several key features of the syndrome to keep in mind. These factors include:

heir social/emotional age. This is generally lower than their chronological age (it is considered to be about 2/3 -3/4 of the chronological age).

Insecure identity. People with AS often grow up feeling different from others and being treated as "different" while they may long to be more like others. They feel confused about what part of their identity is the Aspergers and what part is the real me.

Difficulty handling emotions. Children with Aspergers often fail to be aware of what they are feeling and become easily overwhelmed.

A tendency to lock their focus into detail and miss the bigger picture.

Rigidity and difficulty with abstract thinking.

Anxiety. Their anxiety is close to the surface triggered easily.

And it tends to build quickly. Girls with AS may find the anxiety itself scrarey, and out of control, if and react by becoming more anxious

Lower Social/emotional age:

Because of their lower social/emotional maturity kevel, girls with AS can be considered "early Bloomers" at almost any age. If you are looking for information over the internet, go to sites for girls who begin early. These sites take into account the kind of social and emotional support girls with AS may need.

Stigma: Feeling Different

Girls who have any serious diagnosis like AS may already feel "different" from their peers. And they may have been treated as "different" by a series of adults in their life who had little understanding of AS. So a girl with AS can grow up more sensitive to anything that may make her stand out. Added to this, many AS girls do not form the kind of emotional bonds with other girls that allow them to experience their peers as a supportive group as other girls do.

A major preoccupation for her at school may be "Can anyone tell?".. The girl with AS may be out of the social loop and probably unaware of which other girls in the class are menstruating. She may feel isolated and fear that if other people knew, they would be labeled as "weird" or "gross" and further ostracized

However you choose to deal with your daughter's feelings around this will depend on how you have approached the whole area of 'feeling different' so far. Is she aware of her diagnosis? Does she look at it as strength or a weakness? I think its s important to emphasize that her feelings of being different, in this case, are NOT a result of having AS but are a common reaction that many girls have. This is one example of a circumstance in which many girls feel "different" and self conscious. She needs to be able to separate these very typical feelings from any fears she has about not being "normal" because of the AS.

Suggestions on how to keep things private:

Explain that although the pads feel bulky, they aren't noticeable on the outside. Ask her if she has ever noticed anyone wearing one?

One girl recommended keeping spare pads in a purse, not a knapsack as other kids will rummage in a knapsack but respect the privacy of a purse.

Some girls may be sensitive to smell and be afraid other can smell the odor. Again, ask her if she has ever noticed anyone else with that smell. Lyba Spring explained that although you can notice an odor when you pull down your pants, that is because the blood is coming into contact with the air. When your pants are pulled up, no one can smell anything.

Who should you tell?

You might want to tell the teacher so she won't be surprised by any unusual behavior and perhaps she can extend some special privileges to your child. Privileges might include using the staff washrooms (for girls in elementary school where the girl's bathrooms don't have proper receptacles) and allowing her to go to the bathroom more often than usual.

And ask the teacher who your child should go to in an "emergency" if she needs a pad- the nurse? The office secretary? Have a back up plan for your daughter.

Dealing with emotions

Recognizing and dealing with feelings is often hard for children with AS. The new and powerful feelings that emerge in adolescence, such as sexual awareness and interest in boys can be confusing, overwhelming and create emotional chaos.

Girls who have not previously been self conscious may begin to experience feelings of shame. embarrassment and vulnerability when faced with their own changing body and people's reactions to those changes.

This can bring up a sudden interest in the opposite sex, inappropriate language and themes or any of the other interests kids suddenly develop as they near their teens.

It can also result in crushes, whether it be on the boy next door or a movie star. The difference in our girls is that the crush can become an obsession easily- a new "special interest" that is human rather than a thing

As for the new interest in taboo topics and language, you can't realistically ban this sort of thing all together because is she can hear it on the radio all day long. And they hear about it from all the other kids at school. Instead it might be best to sit down with a slang dictionary and look at what kinds of words, phrases and ideas are appropriate for what situations. (You might divide them into OK anywhere, OK with peers at recess but not around teachers, OK with close friends in private, NOT OK anywhere!)

It might look like this (eg. "Fuck off! - OK with bothersome peers at recess when the teacher is not around, "I got my period today. It's so gross": is OK for a close friend in private.)


Most of all, these girls can feel be confused and scared. People with AS need predictability and familiarity in the external world to offset the chaos that often reigns within. Menstruation is, therefore, a real blow. Girls are suddenly confronted with a major event that occurs every few weeks, over which they have no control and which they cannot predict the course of.

They cannot tell exactly when it will begin. They can't tell when it will end. They cannot know in advance how strong the flow will be one hour to the next. They don't know when the pad will be full and need changing. They can't tell when they will be able to stop wearing a pad. They don't know if they will have cramps etc.

For children who need to be warned in advance for minor changes in their daily routine, this is huge.


Getting your period can be compared to catching a cold. It lasts for about a week. Sometimes for a few days only, sometimes for a full week. You know it will end in about a week but you can't tell for certain which day or hour. In fact, you won't know the cold is over until you have been feeling better for a day. You may feel all better one afternoon but you feel stuffed up and tired that evening.

Girls have to begin to pay attention to and trust their own bodies. Keeping track can work for some girls. They can use a journal or the computer to make notes about each day- how strong was the flow, what time of the day was it heaviest etc.

Over time, they may see patterns emerge. But it still needs to be reinforced that it isn't a science. They will never know exactly what will happen with certainty.

They need to spend their persevoration on planning, instead, and eventually they will learn that they are able to survive each unexpected occurrence quite well.


This is where the anxiety part comes in. The unpredictablilty of it all, the inability to control what is going to happen in her own body can make a young girl very anxious.

Almost everything written already touches indirectly on the issue of anxiety.

But for the very anxious child who is seeking constant assurance, the only thing that will work is good planning.

Some girls express their anxiety by asking a continual flow of questions thatreally, have no answer ; "When will it start?" "Will I need to change pads before lunch?" "Will I still need to wear a large pad on Friday?"

"If I don't get it this week does that mean that I will skip the whole month or will I just get it late?"

What they are doing is seeking assurance, looking for some certainty in the confusion. But that's exactly what you can't provide. By reassuring your daughter, you just set yourself up for more questions "But, are you SURE I won't need to change my pad before lunch? Are you POSITIVE?"

The only constructive thing you can do is have a firm back up plan that your daughter understands and feels conmfortable with. "You should check your pad at morning recess.

If it looks like you will need to change it soon, you can ask to be excused during reading time just before lunch and go to the washroom when it will be empty to change it."

If your daughter knows that she will be able to get through her feared scenario. She won't be anxious about it any more. Or she may still be anxious, but not paniking.

Therefore, the answer to anxiety is always GOOD PLANNING.

Sensory issues

Hypersensitivity to touch can make wearing pads excruciating. Some girls will take a long time to get used to the feelings but others will reject them altogether and might be more comfortable with a disposable panty.

Girls who are hyposensitive may not be aware of when the pad is soaked and needs changing


For hypersensitive girls, it can be helpful to start letting them wear pads around the house long before actually begin menstruating. That way, they can deal with one issue at a time. Allow her to try on as many pads as possible and wear each around the house for a while, like trying on shoes, until she finds one, or several of different absorbencies, that she is most comfortable with.

Girls who are hyposensitive need to be put on a schedule of changing the pad every two (or three) hours. They may need to be cues until it becomes a habit.

Concrete language

I remember when I was in school, all the girls received pretty pastel colored pamphlets called "fresh as a daisy" which were full of euphemisms. I wonder how many girls really understood what it meant. People with Asperger's require concrete language in everything and especially in a subject about which there is so much mystery, myth and confusion.


You need to be straightforward. The first thing to do is agree on language. Define your terms. Let your daughter/class know what words you will be using and what they mean.

Attention to detail:

If you aren't careful, you could do an entire sex ed talk and the child will come out of remembering one obscure detail (like the longest pregnancy ever on record), or can only recall a few anatomical words that she now loves to giggle over.


People with AS are better able to process and recall small bits of information rather than the larger picture. So be very careful only to give them bits of information you want them to recall.

Stick to the topic. Don't try to include everything in this talk and don't let your self get distracted by questions that relate to pregnancy and adult sexuality. Save them for another lesson. Those issues may have greater emotional value and interesting details. And if your girl is having problems dealing with menstruation, she will find a way to avoid taking about it by focusing on extraneous topics. So don't present them.

It's best to stay low key. Run through the scenario, one step at a time, from noticing blood to placing the pad correctly. Don't neglect the important area of proper disposal - roll it up and wrap ONE layer of toilet paper around (don't make it into a mummy) and throw in garbage.

Public Versus Private

Where and when should people talk about these things? Who do share this kind of information with? Should you tell your friends? Can you ask other girls if they have their period yet? Would you talk about it on a bus? In a restaurant? In the washroom? In your bedroom?

People with AS often don't discriminate well between what one can say and do in private v. what can be said and done in public. Language pragmatics can still be a real problem despite the girl's advanced verbal skills. Since it isn't practical to ban all conversation about periods, you will have to discuss the finer point of where and when to have these conversations. In public? A flat NO with the exception of sex ed class in a school or community setting.

In private? Sometimes. Remind your girl that just because someone is female doesn't mean she wants to talk about it even in private. Many girls are extremely embarrassed about it and don't want it mentioned at all. And if she does ask another girl if she has it yet, and the other girls says no, that still doesn't mean your girl is the only girl in class who is menstruating. You will need to explain that some girls are too embarrassed to admit it or just don't want to talk about it and it may be better for her to talk to you or the school nurse just for now if she has questions. The girls will become more honest and responsive as they get older.

OCD - contamination fears

This is not something that every girl will have so it's best addressed by the parent of the child individually, not in a group program. If the parent is aware that her daughter washes her hands a lot, avoids touching things or has any fears of contamination, she should begin working on this before the child even begins to menstruate. Girls with the tendency towards contamination/touching issues often develop phobias around touching the used pads.

It's a lot easier to ensure that avoidance behavior never develops than to deal with it once it's become entrenched. There are many ways to approach this. If tactile issues are present, it could mean handling dry pads at first, moving on to wet (with water) pads until the child knows what to expect and won't be put off by the sensation of handling a wet, heavy pad.

If fear of germs alone is the issue, you could allow her to handle pads that have dropped on the floor. Or you can start a reward system for handling pads before she actually needs to wear them. Or find a therapist with training in cognitive-behavioral therapy who works with children. You know your girl best and will be the best judge of what will work for her.

© Beth Lesser 2003

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since February 3, 2005 (When this page was moved to this site)