I am not sure son will withstand the pressures from his body successfully

Hi Karen and thanks for your question. This is a very common issue and one that I really see a lot of. I hope that I will be able to reassure you, as I am usually meeting this issue either as puberty is in full swing (resulting in the full-on hormonal froth!!) or just simply as a young person is experiencing a period of real change and growth as they come to college (I work largely in 16-25 provision). Here at college we focus very clearly on public and private, and aim for a completely consistent message from all our LSAs, tutors and support staff, in line with messages from home so that everything is set out very clearly for the young person. I think that this is absolutely key and it sounds like you're giving strong, positive messages about that. What I usually do (using lots of visual cues), is to link public and private body parts, functions, places and activities and build on it bit by bit in a structured way, making sure that I link back each time to build on the information. So we start by working out what "public" and "private" mean - what are your family's definitions of these? Be mindful that they might change depending on what personal care needs your son has and what staff, etc, are providing those - as they change you will have to revisit the definition with him. I am always really specific that there are only really two private places (bedroom and bathroom/toilet); everywhere else is public. I find that this helps with things like gym changing rooms etc, as it helps to reinforce that even though you might be changing your clothes, there are still rules. Private body parts are of course genitals, bottoms, breasts/chest (potentially); we play games to identify what each body part does, and is it public or private? (I usually use some cut-out body parts or a nice clear diagram of the body; I recommend the FPA "Talking Together About" books, which you can find either easily online). Private body parts are only shown in the bedroom or in the bathroom, which are the only places that are really private. Then we look at activities - reading, playing football, going to the toilet, masturbating - anything where you have to touch your private parts is a private activity and therefore has to be done in a private place, which reinforces the message again and brings you back round to public and private places. It can be helpful to make a set of photos of places your son is familiar with - bedroom, kitchen, bathroom, car, minibus, classroom, cinema, shops, etc - and have him sort them into public and private. Here at college we do very well with this system but the key is to keep reinforcing it and prompt your son to move himself to a private place if he needs to do any private touching. You don't mention what sort of communication your son prefers, but here at college I've gone so far as to make cards with the PECS signs for "Public" and "Private" on them and carried them round, so that I can use non-verbal, visual cues for students if needs be. You could also put those on the doors for his bedroom and bathroom, for example, and make the connection that way. Please drop me another message if that wasn't helpful or specific enough!

Hi again Karen! Yes, for some of our students we have found that it is useful to use a combination of tactics, so a firm "no", a modelled gesture or action with a simple instruction (ie "hands on knees" if that's appropriate ), a calm direction to a private place when possible, for example, can work when used consistently over time. With regards the concepts of public/private, again, for students who don't understand them as abstract ideas we can still reinforce appropriate behaviour with our responses, such as guiding students to a private place so that they associate the place/body part/activity. For one young lady who had a repetitive compulsive pattern of behaviour where she pulled her shirt/trousers up/down, we reinforced the tactics described above by encouraging her carers to select tops that had a higher/closer collar line while we were working on helping her to manage the behaviour. However I appreciate that this can be harder with trousers/bottoms, because of the toileting! One thing we are really clear on is avoiding giving it too much attention as that can often make difficult behaviour much more likely as it ensures the focus will be on the young person - we try to be firm but neutral and use distraction to get back to whatever we are doing as quickly as possible and with as little fuss as can be managed (not always easy, I have to admit!). What works for one may not work for another of course but the key is consistency and clarity; communication between everyone working with the young person is invaluable when trying to establish and reinforce behaviour. I hope that is helpful? Thank you so much for your questions!

The toilet and private makaton symbols can be quite lowkey if your son's good at social attention, and nobody else is looking.