Teaching Healthy Sexuality – Whose Job Is It?

Here is the abstract:

Introduction: Sexual health education can be confusing. Children with physical disabilities can face even greater uncertainty if their needs and issues are not properly addressed. Although efforts have been made to understand parents’ concerns regarding the sexual health education of their physically disabled children, specific emphasis needs to be placed on recognizing parents’ important contribution as educators.

Research Question/Objectives: Parental perspectives regarding the provision of school-based sexual health education of children with physical disabilities will be described. This presentation will outline strategies occupational therapists can use in partnership with parents to deal with the topic of sexuality in school-based programs for children with physical disabilities.

Design/Methods: A participatory needs assessment was completed using qualitative methods with parents who have children with a physical disability. One-to-one interviews and focus groups were used to understand their experiences with sexual health education.

Practice Implications: Understanding parental perspectives will allow occupational therapists to work with parents to support and assist in the sexual health educational needs of children with physical disabilities.

Conclusion: Sexual health education can play a critical role in helping children with physical disabilities transition into adulthood. Parents can play a vital role in meeting the educational needs of children with physical disabilities but often feel ill prepared or question their own skills in facing various issues. Understanding these challenges will allow occupational therapists to better assist and support parents in the provision of sexual health education to their children with physical disabilities.

Parents find it difficult to discuss their worries and concerns around the topic of sexuality. I am not even sure how honest parents would be in a one-on-one interview for research purposes. It’s hard for us to see our children as sexual beings. One parent I spoke with thought her son would never become sexually aware of himself because he was very cognitively impaired. This is a misconception because the sexuality component is part of being human. Hormones will contribute to this as well.

One thing to keep in mind is the primary sexual relationship people with disabilities will have is with themselves. So what does that mean from a teaching perspective? It means we have to teach masturbation. Some aspects we have to teach is where this is appropriate (not the bathroom as this can transfer into public washroom behavior), when to do it, and how to satisfy oneself. I have heard of people physically harming themselves because they did not know how to bring themselves to climax. This has to be taught just like any other skill.

Who can help? Occupational therapists have to take an active role in this process. Their role can be giving parents videos or materials that they can share with their child. Aspects of sexuality involve the senses so ask your OT for guidance about pressure, safe touching etc. Some of the young OT’s at the conference asked me how do you let parents know about help they can offer? I think the easiest way is to provide clients with a list of topics you can address because parents will not always know who they should ask about various concerns that they have. Seeing it on a list gives a reference point and something they can go back to when needed.

We ran a sexuality seminar in Bournemouth, UK this past year and the presenter, Lynn Moxon, talked about introducing appropriate sex toys. I had never thought of this. This is important because children can use inappropriate objects to masturbate. We need to keep safety uppermost in our minds because our children don’t have those boundaries, know-how, or hidden curriculum social rules in their heads.

I greatly admire the work of David Hingsburger out of Ontario. He has his own on-line store called Diverse City Press. He has great videos that teach masturbation such as Hand Made Love and Finger Tips for women. We carry one of his books called Sexuality: Your Sons and Daughters with Intellectual Disabilities. This book covers sexuality through the lifespan and offers help on what to teach, how, and when to teach it.

Some other great reads – Taking Care of Myself by Mary Wrobel (great with the lower functioning population too), It’s Perfectly Normal (higher functioning) and I like The Care and Keeping of You: The Body Book for Girls for introducing menstruation, personal hygiene etc.)

Keep the dialogue open between parents and professionals around the topic of sexuality. It can be a difficult topic to talk about, but there are good people out there to help parents so you don’t have to go it alone. Teaching healthy sexuality begins early in life and is an on-going process. We want to keep our children safe, healthy and happy.

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