Why sex education is important in intellectually disabled?

Why sex education is important in intellectually disabled?

Adolescence is the age which is marked with several changes, during this time adolescents experience a great deal of change physically, emotionally and there is rapid bodily growth, increased sexual drive and emotional ups and downs along with a sense of uncertainty about what is happening. It becomes really complicated when adolescent is having Intellectual Disability, because their intellectual disability colors the picture, these adolescents experience a range of circumstances and life events associated with an increased risk of developing mental health problems. A lack of proper understanding of these changes make the adolescent with intellectual disability more vulnerable for sexual abuse and other social and interpersonal difficulties. Intellectually disabled people do not have enough psychological resources to deal with stressful events. For the family which is having a child with intellectual disability face many challenges. Parents of adolescent with intellectual disabilities face difficulty in dealing with the additional demands made on them regarding their adolescent's developing sexuality. A major area of concern is the sexual behavior of the intellectually disabled adolescent. With growing age, sexual, emotional and physical changes occur in body. It seems a great area of concern for parents/ guardians, how to deal with emerging sexuality in adolescent with Intellectual disability. There are differences in both physical & anatomical changes in male and females. There are many barriers identified by the parents in communicating with adolescent regarding sex

Ideally, sex education should include information about certain areas which are important for adolescents with Intellectual disability. Some major areas to be noted are self-esteem, social skills to develop and maintain relationships, public and private body parts, places and behaviors, different types of relationships, areas of safety as the protective behaviors, coping with relationship problems e.g. rejection, sex and relationships which includes marriage and parenting, changes of puberty both physical and emotional, menstruation, reproduction, appropriate and inappropriate expressions of sexuality, sexually transmissible infections or diseases, safer sex, contraception, masturbation, heterosexuality and homosexuality.

The benefits of sex education:

Some of the documented benefits of sex education for young individuals with an intellectual disability include: increased social skills, improved assertiveness, greater independence, an ability to take greater responsibility for their sexuality, reduced risk of sexual abuse, STIs and unintended pregnancy, the language to report an incidence of abuse, changes to behavior, such as adopting more acceptable expressions of sexuality, healthier choices, less chance of risk-taking behaviors.

A child is never too young to learn proper names for body parts including genitals and about ‘public’ and ‘private’. Parents should look out for times when the adolescent expresses interest or curiosity in sex – for example, if they see actors kissing in a film on television and start asking questions. Sex education is a constant process, not a single lecture. Young individuals should be given basic information first and then other areas should be introduced as they mature.

Sex Education to adolescents with Intellectual Disability:

Education about sex and sexuality is essential for all adolescents and teenagers. Parental and caregiver participation in sex and relationship education is important, irrespective of whether a child has a disability. Young individuals with an intellectual disability have the same range of sexual thoughts, attitudes, emotions, desires and imaginations as young individuals without disabilities. Yet, they often have fewer chances to engage in age-appropriate sexual activity than their same age counter-parts. Community attitudes make it especially tough for them to achieve appropriate sexual expression. However, for most of the concerns, appropriate education and sufficient social support can noticeably improve their situation. Sexual education coaches about vital factors for the human being, such as friendship, courtship, marriage, parentage and all type of relations, along with knowledge about sexually transmitted infections, family planning methods, birth control, and pregnancy, personal and genital hygiene, among additional factors. When creating sexual education programs for adolescents, it is important to cover the basic areas detailed as Anatomy and physiology, Maturation and changes in physical appearance, Public and private conducts, Masturbation, Responsibility for sexual conduct.

Sexual behavior in adolescents with Intellectual Disabilities:

Due to inadequate information, adolescents with intellectual disability sometimes may exhibit inappropriate sexual behavior, such as public masturbation, or soliciting sex from minors or in public. This is more possible to occur when the individual lacks more appropriate sexual outlets or has not been delivered with proper education about the complicated social decorum and legal issues around sexual behavior and relationships. Many individuals with intellectual disabilities get little or no sex education and their attempts at sexual expression are either punished or overlooked. In fact, such behaviors may not reflect deviant arousal, but arise from living in a system in which appropriate sexual knowledge and relationships are not supported.

Discussing the sexual issue with an adolescent with intellectual disability

1) If the individual is incapable to communicate without support, address questions straight to the individual and observe their response to the question and to their support individual’s reply. Undertake that the individual understands more than they can express. Try to meet the adolescent alone in part of the communication.

2) Ask the adolescent’s permission to talk over sexual issues. The individual may need assurance that it is acceptable to be sexually active and to talk about it.

3) Use simple language but exact terms for body parts. If the individual uses their own terms, clarifying meaning and match the individual’s language.

4) Ask open ended questions as far as possible.

5) Visual material such as pictures or models can be very helpful, especially for an individual with limited verbal skills.

Why discussing sexual issue is important with intellectual disabled children:

This disability initiates before the age of 18. The terminology has changed over the past century. The term now acknowledged as Intellectual disability has undergone many alterations in name, but has always referred to the developmental period. Adaptive behavior has not been protected from changes including:

• Impairment with one or more of the following:

1) Maturation

2) Learning

3) Social adjustment

• Impairment in two of 10 adaptive skills: communication, self-care, home-living, social skills, community-use, self-direction, health and safety, functional academics, leisure and work. It is stated that there has to be deficits in two or more of these areas.

There are additional worries that families of young individuals with intellectual disabilities may face when compared with those of parents of usually developing adolescents, because it takes a lot more patience & efficiency to teach an adolescent with intellectual disability in comparison with an adolescent having no intellectual disability. Researchers have also reported that parents of young individuals with Intellectual Disability often have negative attitudes or unrealistic beliefs regarding their young individuals’ sexuality. For example, compared with parents of young individuals without intellectual disabilities, parents of young individuals with intellectual disabilities are more likely to be ignorant that their child is sexually active, to believe their child is not interested in the opposite sex, and to believe that discussing sex would encourage sexual behavior or promote inappropriate behavior. Even when communication does occur, it may not always be relevant to the young individual’s needs.

It may be easier for parents to talk with their children about biological details than about the more social and emotional aspects of sexuality, such as relationships and intimacy. This also relates to parents’ uncertainties that their children are potential targets for sexual abuse or exploitation. Parents may be acutely aware of the rights and needs of their sons’ and daughters’ to have sexual experiences, yet they are encouraged to maintain a protective stance as their children may be more susceptible. This is predominantly perplexing for mothers of daughters, who often have additional concerns about their daughters’ potential vulnerability and risk of pregnancy. Factors related with increased likelihood that parents would talk about sexual matters with their children include parents being of a younger age and the increasing age of the children. Findings reported in studies investigating the association between sexual communication and other parental demographic variables, such as parental deprivation, religiosity, and education have been inconsistent.

In general, Intellectual disabilities make adolescents more dependent on their families for support regarding their developing sexuality than their friends and siblings without intellectual disability, who are of same age. Parents of adolescent with intellectual disabilities also face difficulty in dealing with the additional demands made on them regarding their adolescent's developing sexuality. Research has shown that they perceive themselves to be less knowledgeable when talking to their adolescent children about sex and birth control. Parents find it harder to explain sexual matters, and expect that their children will become more embarrassed. But this is not true. One should give proper sex education to their children whether with intellectual disability or without it.

About the Author

Dr. Neha Sayeed
Associate Professor.

Dr Neha Sayeed is an Associate Professor of Clinical Psychology.

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