Special Ed 440/540: GUIDELINES FOR TEACHING SEXUAL HEALTH WITH STUDENTS WITH INTELLECTUAL DISABILITIES

Thursday, July 17, 2008

GUIDELINES FOR TEACHING SEXUAL HEALTH WITH STUDENTS WITH INTELLECTUAL DISABILITIES

Repeat, repeat and repeat again. It is important to use repetition when teaching youth with intellectual disabilities. You can repeat the same concept from a few different angles to maximize the potential for understanding. Each lesson should begin with a review of the previous lesson(s).

Stay concrete with your examples. Many students with intellectual disabilities do not comprehend well abstract concepts such as love, or that a pregnancy results in having a baby nine months later. The examples used need to be concrete, in the present and almost tangible. Using pictures and videos is a good method.

Don’t overload with information. Going slower with the information is better. If you had wanted to do two sessions of sex education with the group, then schedule four sessions so that you have enough time for the students to process the information, ask questions and have discussions. You can also leave a few days between each lesson so that students have the time to think about the information.

Assume that the students have not had any sex education before (unless you know otherwise). You should start with the basics.

Appreciate that the students ARE sexual and this may be expressed in various ways. For most students, talking about sex will not encourage them to try it. It will just make them more comfortable and informed on the subject for when the moment(s) happens.

Teach the right to refuse. Disabled people can sometimes be trained to be quite compliant.

Remember that context is everything! How does the information fit into their real life? Discuss social situations as examples.

Help youth to practice appropriate affection, with whom and where.

Discuss masturbation. It is important that all students understand the concept and value of masturbation (unless your values are in conflict with this). Students need to know that this is healthy and natural and is entirely appropriate if they are in the right place (private place).

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This Marriage Must Stand

by Eric Adler October 3, 1998. All content © 1998 The Kansas City Star

At this wedding, everybody's crying. You can hear them. You can see them: the bride's mom, the groom's mom, 135 guests. Even the minister is fighting back tears. Guests dab the corners of their eyes. Others swallow hard, choked with emotion as a wedding singer strums his acoustic guitar and the lyrics of "You Are So Beautiful" sail from the choir loft into the sun-streaked sanctuary of Avondale United Methodist Church. It's the song Jim chose for Jodi.

Jim Mason and Jodi Zimmerman, who stand face-to-face and hand-in-hand at the altar at this Sept. 12 wedding. He: 28, short and round in his white tie and black tux. She: 31, short and not as round in her lace and satin gown.
Jerry Daily, the pastor, asks Jim to repeat after him. Staring into Jodi's eyes, Jim speaks carefully in a gentle voice barely louder than a whisper. "In the name of God, I, Jim, take you, Jodi, to be my wife..." No one thought this would ever happen.

Jim? Married? Jodi? Married? To each other? "I thought I would have a child living with me the rest of my life," Ann Zimmerman says of her daughter. Marian Mason concluded the same about Jim. Both Jim and Jodi were born with Down syndrome. It's what their mothers thought the physical and mental limitations of the syndrome demanded. And for generations, doctors thought so, too.They were wrong.

In the decades since Jodi and Jim were born -- let alone in the 100-plus years since British physician John Langdon Down described the mental retardation, short stature and other characteristics of the chromosomal disorder that now bears his name -- virtually every notion about the abilities of those who possess Down syndrome has changed and is changing still. Jim and Jodi's marriage, one of the few like it to occur in the Kansas City area, is evidence of how much.

"In the name of God," Jodi says at the altar, "I, Jodi, take you, Jim, to be my husband, to have and to hold from this day forward, for better, for worse, for richer, for poorer..."

On to self-sufficiency. Indeed, although marriages among persons with Down syndrome are still rare, advocates for the developmentally disabled say they are increasing. They applaud the trend. Because while being born with an extra chromosome creates limitations, it doesn't keep one from falling in love. Jim and Jodi's parents see the issue more simply. "They deserve to be happy like you and I," Ann said.

Child Sexual Abuse Is Serious and Wide-Spread

* The American Medical Association defines child sexual abuse as "the engagement of a child in sexual activities for which the child is developmentally unprepared and cannot give informed consent. Child sexual abuse is characterized by deception, force or coercion.

* Sexual abuse can include fondling, genital exposure, intimate kissing, forced masturbation oral, penile or digital penetration of the mouth, vagina or anus. Child prostitution, pornography and cult (or "ritual") abuse are specific activities also included in the definition. Incest is sexual abuse where the offender is a family member.

* Sexual abuse occurs in rural, urban and suburban areas and among all ethnic, racial and socioeconomic groups. A recent Department of Justice report found that half of the women who reported rapes in 1992 were under the age of 18, 16 percent were under 12.

* Most children are abused by someone they know and trust, although boys are more likely than girls to be abused outside of the family. A study in three states found 96 percent of reported rape survivors under age 12 knew the attacker. Four percent of the offenders were strangers, 20 percent were fathers 16 percent were relatives and 50 percent were acquaintances or friends. Among women 18 or older, 12 percent were raped by a family member, 33 percent by a stranger and 55 percent by an acquaintance.

* Abuse typically occurs within a long-term, on-going relationship between the offender and victim, escalates over time and lasts an average of four years. Offenders often develop a relationship with a targeted victim months before beginning the abuse. Sexual abuse often occurs in successive generations of the same family. In non-familial child abduction, one study found two-thirds of reported cases involved sexual assault.

* In up to 50 percent of reported cases, offenders are adolescents. In 82 percent of accusations recently studied the accused offender was a heterosexual partner of a close relative of the child's. Researchers estimate that between 96 to 100 percent of accused abusers are recognizably heterosexual. Another study found that almost half of offending fathers and stepfathers also abused children outside their family.

* Children are most vulnerable between ages 8-12. The average age for first abuse is 9.9 years for boys and 9.6 years for girls. Victimization occurs before age eight in over 20 percent of the cases. Another study found 24 percent of female child sexual abuse survivors were first abused at age five or younger.

* Estimates of child sexual abuse rates vary for many reasons. Less than 10 percent of abuse is reported to the police. Definitions of both abuse and the age of maturity affect frequency rates. Protective services only record reported cases and typically focus on intra-familial abuse, thus excluding non-caretakers.

* Even in self-reporting surveys, abuse may be under reported because many people are afraid or ashamed to reveal victimization, have repressed memories of abuse, refuse to participate in studies or deny that what happened was "real" abuse.

* The National Resource Council estimates the percent of the U.S. population which has been sexually abused to range from a low of 20-24 percent to a high of 54-62 percent of the population; the higher estimate includes sexualized exposure without touching, such as masturbating in front of the child. The largest retrospective study on the prevalence of child sexual abuse found 27 percent of women and 16 percent of men reported abuse.

* Studies examining victimization of boys have recorded rates ranging from 3 to 31 percent of all men. Male victimization is particularly hard to estimate due to beliefs that only girls can be abused; that sex between older women and boys is desirable; that male victimization of boys indicates lack of masculinity and/or acquiescence by the child.

* One study found less than 2 percent of abuse reports made by children and 6 percent of those made by adults were judged false, suggesting that false allegations are rare. In one study, all but two children who revoked claims of abuse later disclosed new incidents of abuse. These researchers view revocation of abuse reports as part of the disclosure process rather than an indication of false claims.

Certain Teens Are at Increased Risk for Sexual Victimization

* The primary markers for increased risk for child sexual abuse for girls are: few friends, absent or unavailable parents, a stepfather, and conflict with or between parents.

* Other risk factors include: physical or mental disability; separate living arrangements from both biological parents; mental illness, alcoholic or drug abuse in the family; a parent who was physically or sexually abused as a child; homes with other forms of abuse, prostitution or transient adults.

* One study examined eight of these indicators in girls and found sexual abuse histories in 6 percent with no risk factor, 9 percent with one factor; 26 percent with two factors and 68 percent with three factors. Another study found 78 percent of sexually abused children studied had at least three risk factors.

* Gay, lesbian and bisexual youth may be at greater risk because they tend to be socially isolated and are easier targets for abuse. In one study, male sexual abuse survivors self-described as homosexual almost seven times, and as bisexual almost six times, more often than nonabused peers.

Things to consider when teaching sex education to intellectually disabled youth

Lack of knowledge about sexual issues. Any info may come from misinformed peers rather than reliable sources like books, parents or teachers. Parents and teachers have been traditionally less likely to speak about sex with youth who have disabilities;
Mental age may be lower than their physical age;
They may learn at a slower rate;
May be at greater risk for sexual abuse because of their willingness to place total trust in others & their tendency to be overly compliant. May also be more dependent on parents and caregivers;
May be overprotected from parents or caregivers. May have less opportunity for sex with oneself or with others due to a lack of privacy;
May have difficulty with abstract thinking (ex: what is love?) or understanding the long term consequences of pregnancy or some sexually transmitted infections;
Youth with intellectual disabilities may have trouble distinguishing between private and public behaviors, or private and public body parts.

Special Ed 440/540

Thursday, July 17, 2008

GUIDELINES FOR TEACHING SEXUAL HEALTH WITH STUDENTS WITH INTELLECTUAL DISABILITIES

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Links and Resources

Greg Smith: ON A ROLL

This Marriage Must Stand

Child Sexual Abuse Is Serious and Wide-Spread

Certain Teens Are at Increased Risk for Sexual Victimization

Things to consider when teaching sex education to intellectually disabled youth

WILSON ROCK: The Making of a Disabled Pornstar

The author