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PUBERTY, SEXUALITY, AND BEHAVIOR:HOW TO GUIDE YOUNG PEOPLEWITH DISABILITIES

RESOURCES ON SEXUALITY & SEX EDUCATIONFOR INDIVIDUALS WITH DISABILITIES(AND THEIR PARENTS/CAREGIVERS)Books Teaching Children with Down Syndrome about Their Bodies,Boundaries, and Sexuality: A Guide for Parents and Professionalsby Terri Couwenhoven (2007)Boyfriends and Girlfriends: A Guide to Dating for People withDisabilities by Terri Couwenhoven (2015) - Written at a 3rd gradereading level. Great to read together!Sexuality: Your Sons and Daughters with Intellectual Disabilities byMelberg Schwier and Dave Hingsburger (2000)Taking Care of Myself: A Hygiene, Puberty and Personal Curriculumfor Young People with Autism by Mary Wrobel (2003)Sexuality and Relationship Education for Children and Adolescentswith Autism-Spectrum Disorders: A Professional’s Guide toUnderstanding, Preventing Issues, Supporting Sexuality andResponding to Inappropriate Behaviors by Davida Hartmann (2014)Online Resources Center for Parent Information & Resources, Sexuality Education forStudents with Disabilities: y - Sexual Education Resources: http://bit.ly/2K9HPUbAutism Speaks - Sexuality Education for Children and Adolescentswith Developmental Disabilities: An Instructional Manual for Parentsor Caregivers of and Individuals with Developmental Disabilities(Florida Developmental Disabilities Council, Inc.):http://bit.ly/2wAG00HPlanned Parenthood - Information and resources for parents:http://bit.ly/2wqvb10Kids Health: www.kidshealth.orgInner Learning Online: www.innerbody.comSexEd Library by the Sexuality Education and Information Councilof the United States (SIECUS): www.sexedlibrary.org

Puberty, Behavior &SexualityTips & Techniques for Support1

Values Exercise10/10/201722

Fact or Fiction?People with disabilities do not feel the desire to have sex (if disabledin one way disabled in every way)People with developmental and physical disabilities are asexual,childlike, sexually innocent (do not possess maturity to learn aboutsexuality)People with disabilities are sexually impulsive (oversexed and unableto control their sexual urges) men aggressive & women promiscuousPeople with disabilities will not marry or have children so they haveno need to learn about sexuality10/10/201733

Sex shhh How much detail must I tell her? Won’t she just get confused? Is it really necessary to broach the subject of intercourse sinceJohnnie is simply not capable of a close relationship, let alone asexual encounter. Besides, he’ll be accompanied all his life by asupport worker, so what chance is there that he will have sex? Ronda is non verbal—how can I possibly teach her informationrelated to relationships, and what is the chance that she wouldeven understand it? Joey has a severe developmental disability and will be child-likefor the rest of his life. He won’t need that type of information. Bobbie is still young, there is a lot of time to think about teachinghim this type of information in five years or even later. What has"sex" or "sexuality" got to do with him now?4

What is Sexuality?

Social phenomenon (sociological)– Friendship– Warmth– Approval– Affection– Social outlets– Spiritual– Hygiene– dress What we feel about ourselves (psychological)– Whether we like ourselves– Our understanding of ourselves as men and women (genderidentification)– What we feel we have to share with others Having a physical sexual relationship (biological/physical)– Physical sensations or drives our bodies experience– Genital activity is one small part of human sexuality10/10/20176

Harmful Effects of Repression ofSexual Expression Emotional instability Sex related physicalproblems Anger Frustration and confusion Heightened anxiety Verbal/physicalaggression Physical discomfort Social-sexual misconduct Mental health problems Develop poor self esteemPoor decision makingFeelings of lonelinessIsolationAt-Risk behaviorCriminal behaviorLack of impulse controlInferiority complex (beingtold they are bad/evil) Depression

Adolescent Brain DevelopmentID/DDWITHOUT ID/DDBIOLOGICALPuberty dev’t the samePuberty dev’t the sameEMOTIONAL/SOCIALMood swingsSocial-sexual changesMood swingsSocial-sexual changesDIFFERENCE IS IN COGNITIONMore challenging to express feelingsNeed more concrete languageMore variety of ways to express feelingsMay understand more complex language10/10/20178

What is PubertyPuberty is the time in lifewhen a young person startsto become sexually mature.10/10/20179

Puberty: Physical Development FEMALE MALE8-11yrs- Usually begins 9-12 yrs- Usually begins 11-12yrs- Breast Growth, Height andWeight Gain.12-13yrs- Testicles & ScrotumBegin Enlarging.12-13yrs- Breast Growth cont.,Vagina is Enlarging,Produces Discharge as aCleansing Process.13-14yrs- Penis Begins to Growin Length, Hair, Height,and Voice Changes.13-14yrs- Pubic Hair Growth.14-15yrs- Dev’t continues 15yrs- Final Stages of Dev’t,Menstrual Period andOvulation Have UsuallyBegun.16 yrs- Nearing Adult Appearance10/10/201710

Puberty: Social & EmotionalDevelopment. During adolescence, you’ll notice changes in theway your child interacts with family, friends andpeers. Every child’s social and emotional development isdifferent. Your child’s development is shaped by your child’sunique combination of genes, brain development,environment, experiences with family and friends,and community and culture.10/10/201711

Puberty: Social & EmotionalDevelopment Social changes and emotional changes showthat your child is forming an independent identityand learning to be an adult. Remember that the rate of social and emotionaldevelopment varies widely, both for typicallydeveloping children and children with a disability.10/10/201712

Puberty: Social and EmotionalDevelopment Have difficulties monitoring and expressing emotions Difficulties with peer and social relationships Might have difficulties making and keeping friends Moodiness, has more arguments with you Sees things differently from you Antisocial behavior and risk-taking behavior Difficulties balancing emotions and behavior Wants to spend less time with family10/10/201713

So What May I See? Sees things differently from you Antisocial behavior and risk-takingbehavior Might have difficulties monitoringand expressing emotions Difficulties with peer and socialrelationships Might have difficulties making andkeeping friends Moodiness, has more argumentswith youDifficulties balancing emotions andbehaviorWants to spend less time withfamily10/10/201714

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Where do I start? What do I know?What do I still need to know?Where can I find information?Who else can help me? What information does my child alreadyhave? What information does my child need? How quickly is the information needed?10/10/201716

Where Do You Want Your Childto Learn About Sexuality?– Peers– Media– School– Parents– Internet10/10/201717

Why Social-Sexual Education? Decreases the Likelihood of Abuse. Combats Myths & Misinformation. Promotes Social Skills, Personhood,Pleasure. Reduces Fear, Anxiety, Worry. Increases Self-Awareness, Gender Comfort. Allows for Maturity, and HealthyRelationships.10/10/201718

Mild IDD Similar to average or normative psychosocial-sexual behavior insociety. Explores, adapts, and controls sexual impulses and urges in similarways as majority of society. Responds to verbal mode of sex education/sex counseling/sextherapy. Capable of developing appropriate adaptive skills with current sexeducation/counseling/therapy methods

Moderate IDD Secondary sexual characteristics may be delayed. Functions more on a primary reward and basicreinforcement system level. May respond to verbal mode of sexeducation/counseling to develop more appropriateadaptive behavior; however, may require techniques ofbehavior modification systems to be effective.

Severe/Profound IDD Very poor control of sexualimpulses. Functions primarily by havingbasic needs met. Lack of development ofadaptive psychosocial-sexualbehavior. Predominant reactions areimpulsive. Problems comprehendingsocietal rules, especiallyprivate vs public, anddeveloping adaptive behaviorsin these areas. The technique of behaviormodification may be mosteffective in affecting change inthis group Limited ability to predict orforesee consequences ofsensual/sexual behavior. Pleasure seeking frequently inself-stimulating. Often masturbates excessivelyor in a harmful wayunknowingly.

CHALLENGES People with disabilities may have:––––Difficulty learningLimited genital and other tactile sensationsCommunication problemsUncertainty about their sexual function and fertility status Issues that may hinder development of healthy bodyimage and self-concept include:–––––Use of braces, crutches, wheelchairBladder and bowl management routinesPhysical differences from peers (atrophy)Diminished gender role expectations from societyMistrust of own body10/10/201722

Socialization Children with disabilities have:– -Fewer opportunities than their peers to observe, develop andengage in appropriate social and sexual behavior– -Fewer opportunities to acquire information from peers -Often held back by social isolation as well as functionallimitations . By fostering development of social skills, parents andeducators can provide opportunities to learn about thesocial contexts of sexuality and the responsibilities ofexploring and experiencing ones own sexuality.23

Socialization National Dissemination Center for Children withDisabilities (NICHCY) recommends:– Helping children develop hobbies and pursueinterests or recreational activities in the communityand after school– Children with disabilities should engage in socialopportunities and to grow and learn from social errors– Extra-curricular activities present opportunities forfriendship based on commonality of interests andprovide opportunities to develop competence andself-esteem

Why “Behaviors”? Inappropriate sexual behavior by individuals with disabilities can stem from:– Lack of opportunity for appropriate sexual expression– Ignorance of what is considered appropriate behavior– Poor social education Behavior that leads teens with disabilities into trouble as perpetrators maynot necessarily be atypical for adolescents but it also involves either badjudgment on the part of the person with a disability or a hasty reaction onpart of parents, school, employer. Opportunities for privacy are less frequent for people with special needs Comprehensive sexuality education often withheld from this population Not surprising that teens with disabilities display sexuality inappropriately Whether sexual behavior is considered appropriate depends on the locationin which the behavior takes place – need to look at problematic behavior inits context10/10/201725

Issues Problems most frequently mentioned by parentsregarding sexuality education are:– Inability to answer questions– Uncertain of what children know or should know– Confusion, anxiety and ambivalent attitudes towardsexuality of their children– Equate learning with intentions to perform sexualactivities10/10/201726

Parents as Sex Educators Parents of children with developmental disabilities tendto be uncertain about the appropriate management oftheir child’s sexual development Concerned about–––––––Overt signs of sexualityPhysical development during pubertyGenital hygieneFears of unwanted pregnancySTI’sEmbarrassing or hurtful situationsFear that their child will be unable to express sexual impulsesappropriately– Targets of sexual abuse or exploitation10/10/201727

Parents are the First SexEducators Parents need to help their child develop life skills Without appropriate social skills young peoplemay have difficulty making and keeping friendsand may feel lonely and different. Without important sexual health knowledge,young people may make unwise decisions andor take sexual health risks.10/10/201728