Sex Education for Students with an Intellectual Disability: Teachers’ Experiences and Perspectives
1.1. Teachers’ Perspectives on Sex Education for Students with Intellectual Disability
1.2. Context of the Study
- What are teachers’ experiences with and perceptions of sex education for students with an intellectual disability?
- What are the challenges in developing autonomy concerning sex and relationship knowledge and skills in students with an intellectual disability?
2. Research Methodology
2.1. Research Process
2.2. Research Design
Maddison: “And some kids will say, even if they’re lower level, ‘I want to be a mummy!’ That kind of thing. The maternal instinct comes out. But I think a mummy to them is having a doll. (…) They don’t really have a realistic view on what parenthood is!”The second author: “I know when my last daughter went to school, if she wanted to deal with sexuality and being a parent, she was given a doll to take home. Do you do anything like that?”Maddison: “No, we don’t. We’ve never come across that situation where someone seems to intent on having it, and I know there are dolls like that available where there’s time to wake up, and nappy change, and be fed and cry, kind of thing. (…) But in speaking of that, I’m glad you’ve actually brought that up, because I do have a student who (…) wants to be a mother, and I do know she’s sexually active. I’m really glad you brought that up, because that’s just prompted something that mightn’t be a bad idea for her, so thank you! Where do I get it from?”
2.4. Data Analysis
3.1. Sex Education
When we talk about relationships as well with students, we talk about different positive relationships, and what they look like, and different strategies in term of continuously having those positive strategies in place, and then negative relationships and what they look like, and what to do in those situations. … we’re looking at how that effects the students’ mental health, or if we talk about a relationship that’s really negative and you need support besides friends and family, or teachers, what other services are available and who you could go to to seek help for yourself or a friend. (…) We recently even talked about things like abuse in terms of sexual abuse and what that looks like...
At the moment, we’ve been teaching them together. There was a time when we had a boys’ group and a girls’ group, and I think we’ve sort of moved on from that, for a couple of reasons. One, because we sort of felt that girls should know what boys are feeling, and boys should know what girls are feeling.
I don’t do a lot of formal assessments. I find that with our formal assessments, not only do they tend to increase anxiety in our students, but they tend to just be a test of memory, a lot of the time, and our kids really struggle with their working memory, so I do a lot of what we call “formative assessments”, so they’re in-class assessment tasks… (…) I still have to do formal assessments because our students are on the mainstream curriculum, but I do one formal assessment every two terms, instead of doing one or two a term (…) … most of my teaching is basically discussion-based, doing KWL charts, looking at things like—I do exit slips quite a bit, so I might do three stars and a wish, what are the two things we learned about, what’s one thing you’d like to learn about?(Willow)
3.2. Self-Determination and Self-Advocacy Skills
I try and encourage a lot of autonomy and self-advocacy, because I think when it comes, we need to be able to prepare our kids to talk about what they need, even from Year 7, because once they get to Year 12 they’ll have all those skills memorised, so it’ll be something that will just be automatic to them, whereas if we try and teach that in the older years, they haven’t had as much practice with it, so I find that it won’t be as automatic.
3.3. Teachers’ Concerns
3.3.1. Abuse and Violence
One was with a dad, so the student was sort of in a relationship with the dad, and I had to—we had to do a child wellbeing referral, and go to FACS [Family and Community Services] and have that investigation underway, so not only did I have to support her but I had to support her friends who had disclosed to me as well. And we’d spoken about, you know, what they can do to support their friend. And then also, I think because the girl didn’t understand why we were making such a big deal of it. Didn’t understand that there was that abuse of power and that that shouldn’t be happening to her.
… two of our students were sexually abused, and both of the notifications the children made to me, so I was involved with DoCS [Department of Community Services, now referred to as FACS], … and from that, I wanted to find out what can I do to—number one, for counselling for these students, and number two, for resources. I sort of made my own program at the time based on—the Circles program was part of it, but I modified that for the students. … the most important thing we do is about protective behaviours. Rather than about sex, how to protect yourself. We think that’s a priority. The kids can protect themselves.
And I guess it took us about two and a half years. It runs from early learning—so, the four and five-year-olds, all the way to secondary, and it’s sort of a skills-based, tiered program, so you start in Early Learning, really basic skills, like identification of who you are, and labelling body parts, and all that sort of stuff, and it builds as you get older, depending on students’ skill levels. … we just sort of split it into three areas, which was Emotions, so that involves not, like, only identifying emotions, but self-regulating, when you’re experiencing intense emotions, and My Body, so that’s about identification and Rules—touching, not touching, exposing yourself, etcetera. And also menstruation was in My Body as well, so we did preparing girls for their periods, and protective behaviours, which is a program we run called Circles, which is like your circles of people in your life. So, me, my family, my friends, and what different rules, I guess, and how you can interact with your family versus strangers. Trying to teach boundaries, and trying to teach consent, which is really hard to teach.
I worked at an SSP [special school] last year as part of my practicum. I think I would really struggle in unpacking the curriculum for students of that comprehension level, … (…)… because I was fairly new to non-verbal modes of communication, it was really difficult to gauge the level of understanding and knowledge. I think I’m a bit more equipped to do that now in terms of understanding different forms of communication, and how you utilise those, but I think that would be my biggest struggle: understanding how to unpack that even further, and making sure the communication stuff is then catered for as well.
Sometimes confidentiality’s an issue as well. (…) They say that if you know of a child being sexually abused, you’re not to pass that on to your colleagues. I really disagree with that, to some extent. I certainly don’t think it should be in the weekly bulletin, but I do think that if a child is going to your class and you don’t know the child’s being abused, I think you need to know so you know what to look out for. So I think there needs to be some passing on of information. Not gossip, not staffroom talk, but some professional dialogue…
I have had another kid who had disclosed to me that somebody on Facebook had met up with them. He was about thirty years old, she was thirteen. She went to his house and they’d had sex, and when we spoke about it she said to me—and she came from a different—it was a very, very low socioeconomic—a lot of drug and alcohol abuse within the family as well—so, came from an environment where there wasn’t a lot of supervision and wasn’t a lot of care in terms of where the child was, because when we called the next day and said, “Your child’s not at school, and her friend’s told us she met up with someone.” “Oh, do you think I should call the police?” “Yes!” “I thought I had to wait until at least 48 h.” “No, you don’t!” So, eventually, it got to the point where I had to phone the police myself because the mum still hadn’t by about one o’clock. She was found at about three, but denied to the detectives that anything had happened, and spoke to me about “Well, he loves me, and he cares for me.” I think it was seeking that emotional affection that she wasn’t getting at home. And I referred her to the counsellor. Did disclose what had been said, but obviously, it wasn’t taken further by the police because she kept denying to them, even though they had my statement, and then I just said to her, “I really hope for your sake that you’re right,” because nothing else will work with her. I just said, “I really hope you’re right, but, sweetheart, someone else of this age only wants one thing from someone your age, and really hope I’m wrong”. And two weeks later she came and she was in hysterics and shattered and… I think that was a big learning experience for her. Not a very positive one …
…our special kids, fall through the cracks, which is something that needs to be addressed. (…) certainly by organisations that do counselling. (…) Our kids have a massive proportion of kids that are being abused. So when I ring, don’t tell me you’re sorry you can’t help me!
3.3.3. Collaboration with Parents
3.3.4. Inappropriate Behaviours
3.3.5. Students and Sex Education
4.1. What Are Teachers’ Experiences with and Perceptions of Sex Education for Students with an Intellectual Disability?
4.2. What Are the Challenges in Developing Autonomy Concerning Sex and Relationship Knowledge and Skills in Students with an Intellectual Disability?
4.3. Recommendations for Policy and Practice
4.4. Recommendations for Research
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
We use the term “desexualised” in alignment with Kim’s (2011) definition of desexualisation as a process “of creating distance between sexuality and people with disabilities through the fear of disability reproduction and contamination” (pp. 482–83). We further acknowledge that some people with (intellectual) disability are “asexual”, which is a term with a distinctly different meaning. Indeed, asexuality belongs on the sexual continuum and “presents distinct identities and embodiments” (p. 490).
- Aderemi, Toyin Janet. 2013. Teachers’ perspectives on sexuality and sexuality education of learners with intellectual disabilities in Nigeria. Sexuality and Disability 31: 1–12. [Google Scholar] [CrossRef]
- Akbas, Seher, Ahmet Turla, Koray Karabekiroglu, Ozan Pazvantoglu, Tülay Keskin, and Omer Böke. 2009. Characteristics of sexual abuse in a sample of Turkish children with and without mental retardation, referred for legal appraisal of the psychological repercussions. Sexuality and Disability 27: 205–13. [Google Scholar] [CrossRef]
- Alexander, Natasha, and Miriam Taylor Gomez. 2017. Pleasure, sex, prohibition, intellectual disability, and dangerous ideas. Reproductive Health Matters 25: 114–20. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Archibald, Mandy M. 2016. A collaborative strategy with potential for mixed methods research. Journal of Mixed Methods Research 10: 228–50. [Google Scholar] [CrossRef]
- Barnard-Brak, Lucy, Marcelo Schmidt, Steven Chesnut, Tianlan Wei, and David Richman. 2014. Predictors of access to sex education for children with intellectual disabilities in public schools. Intellectual and Developmental Disabilities 52: 85–97. [Google Scholar] [CrossRef]
- Björnsdóttir, Kristin, Ástridur Stefánsdóttir, and Gudrun V. Stefánsdóttir. 2017. People with intellectual disabilities negotiate autonomy, gender and sexuality. Sexuality and Disability 35: 295–311. [Google Scholar] [CrossRef]
- Borawska-Charko, Magdalena, Poul Rohleder, and W. Mick. L. Finaly. 2017. The sexual health knowledge of people with intellectual disabilities: A review. Sexuality Research and Social Policy 14: 393–409. [Google Scholar] [CrossRef]
- Brantlinger, Ellen, Jimenez Robert, Klinger Janette, Pugach Maureen, and Virginia Richardson. 2005. Qualitative studies in special education. Exceptional Children 71: 195–207. [Google Scholar] [CrossRef]
- Byrne, Gary. 2018. Prevalence and psychological sequelae of sexual abuse among individuals with an intellectual disability: A review of the recent literature. Journal of Intellectual Disabilities 22: 294–310. [Google Scholar] [CrossRef]
- Cannella-Malone, Helen I., Scott A. Dueker, Mary A. Barczak, and Matthew E. Brock. 2021. Teaching academic skills to students with significant disabilities: A systematic review of the single case design literature. Journal of Intellectual Disabilities 25: 387–404. [Google Scholar] [CrossRef]
- Chandroo, Roshini, Strnadová Iva, and Therese M. Cumming. 2018. A systematic review of the involvement of students with autism spectrum disorder in the transition planning process: Need for voice and empowerment. Research in Developmental Disabilities 83: 8–17. [Google Scholar] [CrossRef]
- Chappell, Paul, Rebecca Johns, Siphumelele Nene, and Jill Hanass-Hancock. 2018. Educators’ perceptions of learners with intellectual disabilities sexual knowledge and behaviour in KwaZulu-Natal, South Africa. Sex Education 18: 125–39. [Google Scholar] [CrossRef]
- Collings, Susan, Iva Strnadová, Julie Loblinzk, and Joanne Danker. 2020. The benefits and limits of peer support for mothers with intellectual disability experiencing domestic and family violence and child protection involvement. Disability & Society 35: 413–34. [Google Scholar]
- Corona, Laura L., Stephanie A. Fox, Kristin V. Christodulu, and Jane Ann Worlock. 2016. Providing education on sexuality and relationships to adolescents with autism spectrum disorder and their parents. Sexuality and Disability 34: 199–214. [Google Scholar] [CrossRef]
- de Reuters, Liset, Jill Hanass-Hancock, Sophie Henken, and Wim van Brakel. 2015. Challenges in providing HIV and sexuality education to learners with disabilities in South Africa: The voice of educators. Sex Education 15: 333–47. [Google Scholar] [CrossRef]
- Elo, Satu, and Helvi Kyngäs. 2008. The qualitative content analysis process. Journal of Advanced Nursing 62: 107–15. [Google Scholar] [CrossRef]
- Eastgate, Gillian, Mieke L. Van Driel, Nicholas G. Lennox, and Elly Scheermeyer. 2011. Women with intellectual disabilities. A study of sexuality, sexual abuse and protection skills. Australian Family Physician 40: 226–30. [Google Scholar]
- Feldman, Maurice, David McConnell, and Majorie Aunos. 2012. Parental cognitive impairment, mental health, and child outcomes in a child protection population. Journal of Mental Health Research in Intellectual Disabilities 5: 66–90. [Google Scholar] [CrossRef]
- Finlay, W. M. L., Paul Rohleder, Natalie Taylor, and Hollie Culfear. 2015. Understanding as a practical issue in sexual health education for people with intellectual disabilities: A study using two qualitative methods. Health Psychology 34: 328–38. [Google Scholar] [CrossRef]
- Frank, Katherine, and Linda Sandman. 2019. Supporting parents as sexuality educators for individuals with intellectual disability: The development of the Home B.A.S.E Curriculum. Sexuality and Disability 37: 329–37. [Google Scholar] [CrossRef]
- Frawley, Patsie, and Nathan J. Wilson. 2016. Young people with intellectual disability talking about sexuality education and information. Sexuality and Disability 34: 469–84. [Google Scholar] [CrossRef]
- Gill, Michael. 2010. Rethinking sexual abuse, questions of consent, and intellectual disability. Sexuality Research and Social Policy 7: 201–13. [Google Scholar] [CrossRef]
- Gill, Michael. 2012. Sex can wait, masturbate: The politics of masturbation training. Sexualities 15: 472–93. [Google Scholar] [CrossRef]
- Gil-Llario, Marie Dolores, Vicente Morrell-Mengual, Irene María Díaz-Rodríguez, and Rafael Ballester-Arnal. 2019. Prevalence and sequelae of self-reported and other-reported sexual abuse in adults with intellectual disability. Journal of Intellectual Disability Research 63: 138–48. [Google Scholar] [CrossRef]
- Gil-Llario, Marie Dolores, Vicente Morrell-Mengual, Olga Fernández-García, J. Castro-Calvo, and Rafael Ballester-Arnal. 2020. Development and psychometric properties of an instrument for the Assessment of Sexual Behaviour and Knowledge of people with Intellectual Disability. Journal of Applied Research in Intellectual Disabilities 35: 976–87. [Google Scholar] [CrossRef]
- Girgin-Büyükbayraktar, Çagla, Rukiye Konuk-Er, and Sahin Kesici. 2017. According to the opinions of teachers of individuals with intellectual disabilities: What are sexual problems of students with special education needs? How should sexual education be provided for them? Journal of Education and Practice 8: 107–15. [Google Scholar]
- Grove, Linsey, Dianne Morrison-Beedy, Russel Kirby, and Janet Hess. 2018. The birds, bees, and special needs: Making evidence-based sex education accessible for adolescents with intellectual disabilities. Sexuality and Disability 36: 313–29. [Google Scholar] [CrossRef]
- Hanass-Hancock, Jill, Siphumelele Nene, Rebecca Johns, and Paul Chappell. 2018. The impact of contextual factors on comprehensive sexuality education for learners with intellectual disabilities in South Africa. Sexuality and Disability 36: 123–40. [Google Scholar] [CrossRef]
- Hollomotz, Andrea. 2009. Beyond ‘vulnerability’: An Ecological Model approach to conceptualizing risk of sexual violence against people with learning difficulties. British Journal of Social Work 39: 99–112. [Google Scholar] [CrossRef]
- Kamberelis, George, and Greg Dimitriadis. 2005. On Qualitative Inquiry: Approaches to Language and Literacy Research. New York: Teachers College Press. [Google Scholar]
- Kim, Eunjung. 2011. Asexuality in disability narratives. Sexualities 14: 479–93. [Google Scholar] [CrossRef]
- King, Matthew T., Meghan M. Burke, and Heather Dalmage. 2018. Advocacy unit probation officers reporting risk factors for young offenders with intellectual or developmental disabilities. Research and Practice in Intellectual and Developmental Disabilities 5: 168–77. [Google Scholar] [CrossRef]
- Löfgren-Mårtenson, Lotta. 2012. “I want to do it right!” A pilot study of Swedish sex education and young people with intellectual disabilities. Sexuality and Disability 30: 209–25. [Google Scholar] [CrossRef][Green Version]
- McDaniels, Brad, and Allison Fleming. 2016. Sexuality education and intellectual disability: Time to address the challenge. Sexuality and Disability 34: 215–25. [Google Scholar] [CrossRef]
- Nelson, Becky, Karen Odberg Pettersson, and Mmmelin Emmelin. 2020. Experiences of teaching sexual and reproductive health to students with intellectual disabilities. Sex Education 20: 1–16. [Google Scholar] [CrossRef][Green Version]
- Platt, Laura, Laurie Powers, Sandra Leotti, Rosemary B. Hughes, Susan Robinson-Whelen, Sherri Osburn, Elesia Ashkenazy, Leanne Beers, Emily M. Lund, Christina Nicolaidis, and et al. 2017. The role of gender in violence experienced by adults with developmental disabilities. Journal of Interpersonal Violence 32: 101–29. [Google Scholar] [CrossRef]
- Rohleder, Poul, Leslie Swartz, Marguerite Schneider, and Arne H. Eide. 2012. Challenges to providing HIV prevention education to youth with disabilities in South Africa. Disability & Rehabilitation 34: 619–24. [Google Scholar]
- Rowe, Becky, and Courtney Wright. 2017. Sexual knowledge in adolescents with intellectual disabilities: A timely reflection. Journal of Social Inclusion 8: 42–53. [Google Scholar] [CrossRef]
- Schaafsma, Dilana, Gerjo Kok, Joke M. T. Stoffelen, and Leopold M. G. Curfs. 2015. Identifying effective methods for teaching sex education to individuals with intellectual disabilities: A systematic review. The Journal of Sex Research 52: 412–32. [Google Scholar] [CrossRef][Green Version]
- Spriggs, Amy D., Pamela J. Mims, Wilhelmina van Dijk, and Victoria F. Knight. 2017. Examination of the evidence base for using visual activity schedules with students with intellectual disability. The Journal of Special Education 51: 14–26. [Google Scholar] [CrossRef]
- Strnadová, Iva, and Jan Walmsley. 2018. Peer-reviewed articles on inclusive research: Do co-researchers with intellectual disabilities have a voice? Journal of Applied Research in Intellectual Disabilities 31: 132–41. [Google Scholar] [CrossRef]
- Strnadová, Iva, Bernoldová Jana, and Zdeňka Adamčíková. 2019a. “She will know that her mother’s doing something for her…”: Women with intellectual disabilities assuming the mother identity. Disability & Society 34: 68–94. [Google Scholar] [CrossRef]
- Strnadová, Iva, Collings Susan, Loblinzk Julie, and Joanne Danker. 2019b. Parents with intellectual disabilities and their perspective of peer support: “It depends on how they give it”. Journal of Applied Research in Intellectual Disabilities 32: 879–89. [Google Scholar] [CrossRef]
- Strnadová, Iva, Loblinzk Julie, and Joanne Danker. 2021a. Importance of sex education for a successful post-school transition: Experiences of high school girls with intellectual disability. British Journal of Learning Disabilities 49: 303–15. [Google Scholar] [CrossRef]
- Strnadová, Iva, Danker Joanne, and Allie Carter. 2021b. Scoping review on sex education for high school-aged students with intellectual disability and/or on the autism spectrum: Parents’, teachers’ and students’ perspectives, attitudes and experiences. Sex Education. [Google Scholar] [CrossRef]
- Swango-Wilson, Amy. 2011. Meaningful sex education programs for individuals with intellectual/developmental disabilities. Sex Disability 29: 113–18. [Google Scholar] [CrossRef]
- Turner, Georgy W., and Betsy Crane. 2016. Pleasure is paramount: Adults with intellectual disabilities discuss sensuality and intimacy. Sexualities 19: 677–97. [Google Scholar] [CrossRef]
- United Nations. 2006. Convention on the Rights of Persons with Disabilities. Geneva: United Nations. [Google Scholar]
- United Nations Educational, Scientific and Cultural Organization. 2018. International Technical Guidance on Sexuality Education: An Evidence-Informed Approach. Paris, France: UNESCO. [Google Scholar]
- Walmsley, Jan, and Kelley Johnson. 2003. Inclusive Research with People with Learning Disabilities: Past, Present and Futures. London: Jessica Kingsley Publishers. [Google Scholar]
- Walmsley, Jan, Iva Strnadová, and Kelley Johnson. 2018. The added value of inclusive research. Journal of Applied Research in Intellectual Disabilities 31: 751–59. [Google Scholar] [CrossRef] [PubMed]
- Wissink, Inge B., Eveline van Vugt, Xavier Moonen, Geert-Jan J. M. Stams, and Jan Hendriks. 2015. Sexual abuse involving children with an intellectual disability (ID): A narrative review. Research in Developmental Disabilities 36: 20–35. [Google Scholar] [CrossRef]
|Pseudonym||Age||Gender||Teaching Experience||Qualifications||Type of School||Training in Sex Education|
|Summer||48||Female||25 years||Bachelor’s in Education||Mainstream school||Some professional development|
|Maddison||62||Female||45 years||Diploma in Special Education||Mainstream school||Some professional development; |
Family Planning NSW training
|William||28||Male||6 years||Master’s in Education||Mainstream school||No training in sex education|
|Audrey||37||Female||10 years||Master’s in Special Education||Special school||One professional development event ran by school|
|Hannah||26||Female||4 years||Bachelor’s in Occupational Therapy||Special school||One professional development event ran by school|
|Mila||29||Female||7 years||Bachelor’s in Occupational Therapy||Special school||No training in sex education|
|Jasmine||28||Female||1 year||Bachelor’s in Education||Special school||No training in sex education|
|Willow||28||Female||6 years||Master’s in Special and Inclusive Education||Mainstream school||No training in sex education|
|Jack||52||Male||30 years||Graduate Diploma in Special Education||Mainstream school||No training in sex education|
|Samuel||45||Male||15 years||Master’s in Inclusive Education||Mainstream school||Training in Physical Development, Health, and Physical Education (PHPDE)|
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Strnadová, I.; Loblinzk, J.; Danker, J. Sex Education for Students with an Intellectual Disability: Teachers’ Experiences and Perspectives. Soc. Sci. 2022, 11, 302. https://doi.org/10.3390/socsci11070302
Strnadová I, Loblinzk J, Danker J. Sex Education for Students with an Intellectual Disability: Teachers’ Experiences and Perspectives. Social Sciences. 2022; 11(7):302. https://doi.org/10.3390/socsci11070302Chicago/Turabian Style
Strnadová, Iva, Julie Loblinzk, and Joanne Danker. 2022. "Sex Education for Students with an Intellectual Disability: Teachers’ Experiences and Perspectives" Social Sciences 11, no. 7: 302. https://doi.org/10.3390/socsci11070302