In the second part of this series on Personal Safety and Sexuality Education for children and adolescents with disabilities, Dr. Sangeeta Saksena and Renu Singh of Enfold Trust focus on sexuality education for children and young individuals on the autism spectrum and those with Intellectual disabilities. They even discuss certain myths and concepts.
Read the first part here
We begin with a few common terms and concepts used in this article.
Sexuality: Derived from Latin ‘secare’ meaning to divide or section, sexuality includes all that we do to distinguish our section – male or female or any other – from others. How we dress, talk, sit, what social or gender roles we play. It includes how people experience and express their sexual desires, sexual orientation and gender identity, personally, socially, culturally and in intimate relationships.
Sex: refers to the biological sex female, male or intersex; and the act of sex.
Why is sexuality education required?
Sexuality is an everyday, lived experience of an individual, whatever be their age. Education on personal safety, sexuality or reproductive health is often withheld from children and adolescents, making it difficult for them to experience sexuality with dignity, or recognize and report sexual abuse. Children, especially those with disability are perceived as objects of protection rather than citizens with equal rights. Young people, regardless of disability, have feelings, sexual desire, and a need for intimacy and closeness. To behave in a sexually responsible manner, they need scientific knowledge, discussions on value based behaviour, and emotional support from adults.
Sexual development:
0- 2 years:
Males can have erections in the uterus. Infants touch and rub genitals, can experience orgasm. By about age two, children know their own gender, differences between males and females.
3-7 years
Imitate adult behaviors like kissing. Many play "doctor", looking at each other’s genitals. This normal exploration helps to form sexual map in the brain. By age 5-6, most children become more modest about dressing and bathing. Aware of marriage, role-play about living together.
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8-12 years
Pubertal changes begin, become more self-conscious. Have heard about sexual intercourse, rape and abuse, and want to know more. The idea of actually having sexual intercourse, however, is unpleasant to most preadolescents. Play with friends of the same gender, may explore sexuality with them. This is unrelated to their sexual orientation
13- 18 years
Pubertal changes continue. Explore sexuality with other genders. Many develop romantic feelings, and may have sexual intercourse
Download: Handbook on Menstrual Management and Hygiene for Women with Disabilities
Sexual development in children with IDDs
Adolescents with intellectual development delay, Autism Spectrum Disorders develop sexually in the same way as other teenagers and may experience the full range of sexual and erotic feelings that neurotypical adolescents normally feel.
Children with disabilities may have limitations in understanding genital and other tactile sensations, sexual function and fertility status. Communication issues, ignorance of what is considered appropriate behavior, less frequent opportunities for privacy and lack of opportunity for appropriate sexual expression compound the issue.
Common inappropriate behaviours like talking about or exposing or touching one’s private parts in public or touching other’s private parts, indicate a limited understanding about what is public and private. It can put them at risk of sexual exploitation or being labelled as “perpetrator”
Some myths about sexuality and disability
Myth 1: People with disabilities are not sexual, lack desire for sex
Fact: All people, including PWDs are sexual beings needing affection, intimacy, acceptance and companionship. People’s discomfort with disability and sexuality has lead to this myth.
Myth 2: People with disabilities are childlike and do not possess maturity to learn about sexuality.
Fact: Children with developmental disabilities may learn at a slower rate than peers yet physical maturation usually occurs at the same rate. They need sexuality education that builds skills for appropriate behavior.
Myth 3: People with disabilities are oversexed, with uncontrollable urges.
Fact: No. PWD have sexual urges like any other person. Training on expression of emotions and boundaries from an early age promotes respectful behavior, regardless of disability
Core concepts of sexuality education
- Sexuality is normal and natural. Children too are sexual beings.
- All individuals of all genders are equally human.
- Experience sexuality without guilt.
- Express sexuality responsibly: without harm to self or the other.
- Appropriateness depends on the context.
- Respect bodily functions - there is no shame in any part of the body.
- Shame and respect come from our behaviour, not how the body looks
- Respect oneself, and others - older or younger – and their bodies.
- Respect people for their behaviour and abilities
- Accept and express emotions – including sexual - respectfully.
- Threat to safety often comes from known people, not strangers.
- Distinguish Safe Persons by their behaviour.
- Respect boundaries and consent. Say “No”, and listen to “No”
Imparting sexuality education:
1) Include information 2) Addresses feelings, values, and attitudes 3) Develop the ability to communicate effectively and make responsible decisions
Answer questions as and when asked, in a way that the child understands.
- Learn about the disability
- Learn scientific facts about the subject
- Start early. Refer: Bal Suraksha App (free download in 10 languages on Android at Play Store)
- Use teachable moments in daily life
- Repeat repeatedly
- Teach independent self- care
- Avoid directly touching the child’s private parts. Touch only for health and hygiene purposes. School staff can use gloves.
Sexuality Education for Persons with Autism Spectrum Disorder and other Intellectual Disabilities
Use:
- Incidental teaching. Example: an individual reaches out and touches a female’s breasts while speaking. Take aside, discuss. Show a picture book/read a social story on boundaries
- Role plays: Within prearranged situations. Some can practice appropriate social interaction by viewing and participating in role playing.
- Modeling: Example: A trusted female models the stages of using sanitary napkins using red dye.
- Augmentative communication – photographs, drawings, concrete objects (pads, condoms), films, wall charts.
- Scripted social phrases and scripts with visuals of new situations – Add these as the individual grows
Discussing masturbation
- Sexual self-stimulation is normal and non-harmful behavior
- Social rules apply- private behavior, inappropriate in public.
- Privacy provides safety
- Provide private time and space for self- exploration
- Focus on the context, not the activity.
- Repeatedly state the rules.
- Acknowledge and appreciate adherence to rules.
- Do not blame, shame or punish.
Suvidha Kit, developed by Enfold India includes social scripts on pubertal changes, personal hygiene, erection, wet dreams, menstruation, personal safety rules and boundaries about clothing, touching and talking as well as internet and phone safety.
Authors:
Dr Sangeeta Saksena - Co Founder, Enfold Trust
Renu Singh- Consultant and Trainer, Project Suvidha, Enfold Trust, Special Educator, Parent of a child with Autism
You can reach Enfold India at http://enfoldindia.org/ or https://www.facebook.com/EnfoldIndia/
