Parenting teen w/mild developmental delay

[Jo]

Hi- My son is 16 and has mild developmental delays. He gets crushes on younger girls (about 12). They match him developmentally, but he is still 16. He is a junior in high school and most of these girls are in middle school. He is good looking and fun on Instagram (his only social media) as he's a cheerleader and posts videos of himself doing gymnastics. These girls respond positively to his attention and will (at his request) send him pictures. Some are pretty innocuous (stick out your tongue) and some are not. I'm concerned, with reason, that he's going to get in a lot of trouble.

We have talked A LOT about sex, sexual identity, gender identity, consent, and laws around sexual behavior. In part because of his disability, my son is impulsive and blind to consequences. Not only is is the behavior itself problematic (it is- it needs to stop) but we live in a very white town and my son is biracial Latino/Black.

I'm looking for ways to set clear boundaries about who and what is appropriate (our rules are that girls he interacts with must be people he's met in real life and who are in high school). We have a lot of parent controls on his phone and we've banned him from all social media in the past. In fact he was on a flip phone for two years to try to keep him out of legal trouble. But he's a year and half from 18 and he isn't impacted by his disability enough that we'd have guardian rights once he's 18. We NEED him to learn how to be appropriate about who he interacts with online and how he behaves.

He is still maturing (his neuropsych said he's maturing at about 2/3 time) so I don't think he'll stay fixated on 12 year-olds, but I do think it's going to be a problem that he's interested in girls who are too young for a long time- 17 and 13 is just as bad and 18 and 14 is worse.

He's had a therapist but she stopped taking our insurance and there are long waits to get in with anyone else. We'd love to get him to see a guy or someone who was Black or Latino/Hispanic, but it's very difficult to find anyone accepting new patients.

I would appreciate any suggestions or resources you might have.

(I work at a University and I refer my students here all the time. I've also directed both my kids to come here with questions they don't want to bring to us. So thanks for all of your excellent work.)

[Heather]

Hey there, Jo. You sound like such a thoughtful parent, a thing that always makes my day.

I can certainly understand your concerns. I also hear you on the waits: we're in one for some mental healthcare for young people in my household right now, too, and it's so tough

Can you fill me in a little on what you know already works for him behaviorally? For instance, might incentivizing some of this in some way to help him transition into being able to keep himself safe be something that might work for him? What about gradually letting off the controls little by little and creating incentives for him being able to work with less of them? Do you have anything around any of this that's either worked really well or failed spectacularly?

Also, if you like, I can poke around in my networks and see if I can drum up any therapists who might fit the bill you're looking for and have telehealth openings, if you'd like?

[Heather]

While I was answering you, a therapist friend of mine who, in non-pandemic times, lives in MA part-time said hi so I asked them if they know anyone with openings right now.

They said that this group may have them, and if not, could probably help you find someone: https://www.sayftee.com/mission

That same amazing friend has also created this document and keeps it current: https://docs.google.com/document/d/1C0l ... ujqXFZ9cL4

[Jo]

Hi Heather- thank you so much for your reply. I will reach out to the group you recommended and use the linked resources.

In response to your questions, my son is a bit tricky on that front. He responds well to subtle reinforcements but gets angry if he thinks we are trying to manipulate him. We keep a checklist of chores he is required to do around the house (putting his laundry in the basket, emptying the dishwasher, wiping the table after meals). He does them more readily when they are just mandatory than he does when they are linked to his allowance. I think (pure conjecture) that this is related to his impulsivity and difficulty with planning ahead. If a reinforcement isn't immediate, it doesn't exist. And the kinds of reinforces we can provide immediately aren't ones he is motivated by. So I think he sees them as manipulative instead of affirming.

He accepts consequences pretty well. He'll yell for a bit, but then calms down and can talk about how the consequences are naturally resulting from the behavior. For example, in the past when he's gotten in trouble online we've reduced the time frame in which he can access the Internet on his phone or blocked apps like Instagram or Snapchat. However, knowing the consequence will happen doesn't seem to change his behavior. Here is an example of how extreme this is- in sixth grade he started talking to strange girls online who were likely bots (I hope). We told him it was not allowed, talked a lot (more) about online safety and sexuality and safe ways to express himself. He said he understood. He did the same thing the next day. So we took away his access to the Internet for a week. The first day he had it back, he did it again. So we took it away for a month. Same result. So we put him on a flip phone and only let him use the Internet in our presence. This continued until 8th grade. As soon as he got some freedom, he went right back to the same behaviors. That's when we started therapy.

Overall, he's really a good kid. He's very much a people pleaser and gets anxious at the thought of breaking most rules. He has no filter at all and tells us everything he is thinking and doing (I know exactly what he did with his last girlfriend and what he wishes they had done) so I'm pretty confident in saying that I know where his limits are. This seems to be a distinct issue for him that I'm struggling to resolve in a way that keeps him and others safe and doesn't make him ashamed of his sexuality.

[Heather]

Thanks for all this information.

It sounds to me like your best approach is in line with what you usually do, and that you'd do best to link it to behaviours, rather than feelings. In other words, there's nothing wrong with him having interest in or feelings towards girls who aren't of an appropriate age for him to pursue or have intimate relationships with. The trouble exists when he engages in any actions regarding those feelings that aren't appropriate. Can you make a list with him -- I feel like with is always the way to go, because the conversations that happen when doing something like that can be an engaged way of learning -- of behaviours that aren't okay, with consequences that will happen if he engages in them?

I know that sounds a lot like what you've been doing, but I do think what you've been doing sounds like the way to go with him.

I also wonder if there's any way to get him connected (virtually for now, obviously) with peers, including peers who are girls, around his same age who also have developmental disabilities? Peer connection always does all of us good, whatever our development, but I also feel like that might be a way for him to perhaps experience the emotional connection he has with people too young for him who are at or around his same age. That might be something you can do by accessing some parent support forums for parents of DD teens and work together to create a space for?