Sexualised Behaviour following an ABI

Disinhibition is a common effect of acquired brain injury (ABI), particularly when the frontal lobes are affected. It refers to a reduced ability to control impulses, emotions, or behaviours that are typically regulated by social norms. 

This can lead to actions that are inappropriate, risky, or socially unacceptable—such as speaking out of turn, aggression, or sexualised behaviours like public masturbation. 

Disinhibition is not intentional; it results from damage to the brain’s executive control systems, which normally help a person pause, reflect, and choose appropriate responses. 

Understanding this helps carers and professionals respond with empathy and structure, rather than punishment.

Sexual behaviour is a natural part of human development, but it exists on a spectrum from typical (or “normal”) to concerning or harmful.

Normal sexual behaviour is developmentally appropriate, consensual, mutual, and occurs in private. It reflects curiosity, is spontaneous, and does not cause harm or distress to self or others. For example, private masturbation or age-appropriate interest in relationships can be considered typical.

Abnormal or concerning sexual behaviour may be developmentally inappropriate, coercive, aggressive, persistent despite redirection, or occur in public settings. It may also involve significant power imbalances or lack of consent. In individuals with intellectual disability or ABI, such behaviours may stem from disinhibition, trauma, lack of education, or unmet sensory or emotional needs.

Understanding the context, intent, frequency, and impact of the behaviour is essential in determining whether it is a cause for concern and requires intervention.

A restrictive practice is any intervention that limits a person’s rights or freedom of movement. In the context of responding to sexualised behaviours of concern, care teams may unintentionally use restrictive practices such as:

Physical restraint to stop a person from touching themselves

Environmental restraint by locking doors or removing access to private spaces

Chemical restraint through medication used primarily to suppress sexual behaviour

Seclusion by isolating someone after an incident

Restrictive routines like constant supervision or removing all privacy

These actions may be well-intentioned (e.g. to protect dignity or prevent public exposure), but if they limit a person’s rights without proper safeguards, they must be reported and regulated under the NDIS Quality and Safeguards Commission.

Understanding that sexual desires and behaviours are completely normal, in the right context and setting is key to respection someones rights and dignity whilst still maintaining socially appropriate boundaries.

ESS Behaviour Specialists

Website: engagedpbs.com.au

Scope: National (NDIS registered)

Focus: ABI, sexual behaviours of concern, complex behaviour support

Family Planning Tasmania – SHIELD Program

Service: Tailored sexuality and relationship education for people with disability and/or additional needs.

Topics: Consent, public vs private, masturbation, relationships, online safety, accessing sex workers, and more.

Format: 1:1 or small group sessions with a support person.

NDIS: Not registered, but services can be claimed under Capacity Building – Daily Living.

Website: https://www.findhelptas.org.au/program/relationship-sexuality-and-sexual-health-education-and-support/

Sexual Health Services Tasmania (Department of Health)

Locations: Hobart, Launceston, Devonport

Services: STI testing, sexual functioning support, gender-affirming care, HIV management, and sexual health counselling.

Access: No referral needed. Appointments required.

Website: https://www.health.tas.gov.au/health-topics/sexual-and-reproductive-health/sexual-health-services