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Ronda is non verbalhow can I possibly teach her information related to relationships, and what is the chance that she would even understand it?
Joey has a severe developmental disability and will be child-like for the rest of his life. He wont need that type of information. Bobbie is still young, there is lots of time to think about teaching him this type of information in five years or even later. What has "sex" or "sexuality" got to do with him now?
We must guard against making inaccurate assumptions by avoiding misinformation and a restrictive attitude towards sexuality of people with disabilities
Attitudes of people with disabilities has not changes as fast as the laws enacted to support them especially in sexuality and disability 9
Socialization
Important goals of any human sexuality education program include promoting a positive self-image as well as developing competence and confidence in social abilities
Socialization
National Dissemination Center for Children with Disabilities (NICHCY) recommends:
Helping children develop hobbies and pursue interests or recreational activities in the community and after school Children with disabilities should engage in social opportunities and to grow and learn from social errors
Extra-curricular activities present opportunities for friendship based on commonality of interests and provide opportunities to develop competence and self-esteem
What is Sexuality?
According to the Sex Information and Education Council of the U.S. (SIECUS): Human sexuality encompasses the Sexual knowledge, beliefs, attitudes, values, and behaviors of individuals. Anatomy, physiology, and biochemistry of the sexual response system Roles, identity, and personality; with individual thoughts, feelings, behaviors, and relationships.
What is Sexuality
Having a physical sexual relationship (biological/physical) Physical sensations or drives our bodies experience Genital activity is one small part of human sexuality Social phenomenon (sociological) Friendship Warmth Approval Affection Social outlets Spiritual Hygiene dress What we feel about ourselves (psycological) Whether we like ourselves Our understanding of ourselves as men and women (gender identification) What we feel we have to share with others
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Avoid times and strategies that do not work well for your child and your situation
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Issues that may hinder development of healthy body image and self-concept include:
Use of braces, crutches, wheelchair Bladder and bowl management routines Physical differences from peers (atrophy) Diminished gender role expectations from society Mistrust of own body
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When inability to perceive visual stimuli is impaired, knowledge of sexuality stems from input of other senses Individual can feel reality of their body, concept of body of opposite sed not formed, nor does person have a reference for understanding descriptions such as fat, tall, pretty, muscular Teaching Plan includes Concrete teaching Use of other senses (distinguish males from females by smell) Opportunities for social learning (may not understand abstract concepts or which there is a visual reference e.g., masturbation) Reinforcement from peers & socialization to generalize and validate information learned Talking books, large print books, books in braille
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Teaching strategies
Written texts or workbooks, videotapes signed in ASL, overheads, diagrams/charts, handouts, written materials
Sexuality Education for Persons with Spinal Cord Injury including Spina Bifida
Impact of spinal cord injury on sexual function dependent largely on age of person Childhood Usually a parents lowest priority Mostly interested in childs ability to walk, play sports, As children approach adolescence it is normal to being to develop interest in sexual concerns, abilities, & relationships Parents tend to feel protective and deny childs sexuality
Adulthood
Adult with SCI has a sexual history with expectations, a partner who will be impacted
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Sexuality Education for Persons with Spinal Cord Injury including Spina Bifida
Changes in sexual response based on location and degree of the SCI Many men and women are counseled to focus on improving their sexual arousal rather than on achieving orgasm Men and women with intact sensation and specific nerve reflexes can achieve orgasm but it might take longer or a longer amount of stimulation
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Sexuality Education for Persons with Spinal Cord Injury including Spina Bifida
Capable of understanding a wide range of concepts and facts and would not need information to be presented in alternate formats
Might need specific information about how the physical disability affects expression of sexuality and participation in a sexual relationship Some physical disabilities directly affect sexuality by the disablement of genital function, most do not Absence of sensation does not mean absence of feeling Inability to move does not mean inability to please Presence of deformity does not mean absence of desire inability to perform does not mean inability to enjoy
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Adapting Sexuality Education and Materials for Students with Developmental Disabilities
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Stranger-friend errors
Hugging or kissing a stranger Being overly familiar with an acquaintance
Both types of mistakes can put people with disabilities at risk for sexual exploitation or breaking the law perpetrators
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Public/Private Places
Teaching behaviors appropriate to the public & private place encourages responsible social and sexual behavior Pwd are capable of learning how to behave appropriately in public and private places Many inappropriate actions and activities reflect confusion, lack of awareness and limited judgment Many social problems indicate a limited understanding about public and private places, private parts of the anatomy and public and private behaviors. Discouraged from public engaging in activities such as: Exposing private parts of the anatomy by undressing, pulling down or lifting up clothing Scratching or touching genitals Fixing or adjusting underclothing 34 Self-stimulation
Inappropriate Self-Touch
Sexual self-stimulation or masturbation is normal, natural and non-harmful behavior throughout the life cycle
Self-stimulation can be a way of learning to be more comfortable with and/or enjoying ones sexuality by getting to know ones body
Self-stimulation is a private behavior and inappropriate in public places
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Stranger-Friend Errors
Circles Method of Teaching Social Behavior Social Circles is a graphic way of showing children the different levels of familiarity we are to have with people we know and don't know. Start by drawing a small circle on a large piece of blank paper. Write the child's name in the circle and/or paste his picture there. Tell him this is his personal space, his body, and that only certain people can get real close to him. Draw a larger circle around the child's circle and write family in this larger circle. You can write and/or paste pictures of immediate family members (mom, dad, brother, grandmothers, grandfathers, close uncles and aunts) in this circle. Explain that these people are family members. They may kiss or hug him and its okay to sit on their lap, etc. Explain the sort of behavior that you feel is appropriate with these people.
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If human sexuality education is written into the IEP, it is more likely to be designed and delivered around the unique needs of the student
General strategy
adapt the pace and presentation of information to the childs particular needs Knowledge of how a particular disability affects development, learning and sexual expression important in adapting curriculum 40
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Small blocks of content presented at a time Simple and concrete terms Special materials More time and repetition
Multisensory activities Illustrations, anatomical models, slides, photos, audio-visual, interactive games (e.g., full body drawing or chart to show where body parts are and what they do)
Use photos, pictures or other visual materials as often as possible as well as the library, other parents, websites, educators and health care providers as resources Showing family pictures may help children understand different types of families and relationships Repetition, practice, frequent review, feedback & praise
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Blooms Taxonomy
Example: Cognitive domain Organized in sequence from basic factual recall to higher order thinking with key words that describe each behavior Knowledge: list, tell, identify, show, label and name Comprehension: distinguish, estimate, explain, generalize, give examples, summarize Application: apply, find, perform, demonstrate, dramatize Analysis: criticize, debate, distinguish, compare, Synthesis: plan, set up, design, arrange Evaluation: judge, score, approve, appraise
In the absence of a policy different staff members would respond to incidents haphazardly and counter productively Consistency of response is an essential component to alter maladaptive behavior
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Bring these lessons and any props you develop to class Be prepared to present and/or model your lesson for a small group of your peers.