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Sexuality and the Disabled Child

As a parent of a child with special needs, you will most likely, at some point in your child’s life, be concerned with his or her sexuality. You may not know how to address your child’s sexual development, and may even feel that since your child is disabled, sexuality education is not something you need to focus on. But, issues of sexuality are as important to children with disabilities as those without disabilities. Children with disabilities need sexuality education to help them attain a life with more personal fulfillment and to protect them against unwanted pregnancies, sexually transmitted diseases, and sexual exploitation. So, whether your child is mentally retarded, physically disabled, or learning disabled, he or she will one day have a genuine need to learn about sexuality. Because children with disabilities have fewer opportunities to learn about sexuality from their peers, and because many children may have a disability that limits them from reading about sexuality on their own, parents are generally the primary sex educators of their children.

 

Development of Sexuality

Sexual feelings are present throughout the entire life cycle of human beings. During the infant through 3 years stage, children enjoy bodily sensations and exploration; fascination with genitals is common during this period. This is the time to begin teaching a child the difference between behaviors that are appropriate when they are with others (public) versus when they are alone (private). Therefore, if the child is touching his or her genitalis in public, a simple, "We don’t do that in public" would be appropriate, whether or not the child is capable of understanding the direction.

During the preschool years, ages 3 through 5 years, parents are usually teaching the names of body parts to their children, although depending on the child’s disability, this may happen much later. Teaching your child the correct name of his or her body parts (in a matter-of-fact approach) is important, as it sends the message that sexual organs are not considered taboo. In addition, it saves having to re-teach terminology at a later time. At this point, it is also critical to explain to children that their body belongs to them and that he or she has the right to tell others when they don’t want to be touched.

In the early school years, ages 5 through 8 years, it is important to become more specific in teaching children about sexuality. Suggested topics to address are: correct names for body parts, differences and similarities between girls and boys, basics of reproduction and pregnancy, qualities of a good relationship, and avoiding and reporting sexual exploitation. Also during this period, activities that can bolster self-esteem (such as household tasks that they are capable of performing) are especially important to disabled children. Completing activities allows children to feel successful and competent.

Pre-teens, ages 8 through 11 years, are very involved in social development, becoming preoccupied with what friends think of them, and are concerned with body image. Children with disabilities affecting the body, may, therefore, have low self-esteem in this area. To help your child improve his or her self-esteem in regards to body image, it is very important that you listen to your child and allow him or her to express all types of feelings. It is also important to acknowledge your child’s feelings calmly and tactfully; do not pretend that the issues are not there. Encourage your child to focus on and develop their strengths instead of becoming stuck on the bad points of their physical appearance. Also, sometimes you can help your child improve body image by teaching them things such as grooming, diet, and exercise, and by providing them with fashionable clothes.

In addition to working on self-esteem, it is important to discuss the changes that their bodies will undergo in the pubescent years. Girls should know about menstruation and boys should be told about nocturnal emissions; to have these experiences without prior knowledge can be very traumatic. Topics which can also be discussed include: more information on reproduction and pregnancy, communication within the family unit about sexuality, abstinence from sexual intercourse, sexually transmitted diseases, and masturbation.

During the adolescent period, ages 12 through 18 years, it is important that your child has more privacy and a greater degree of independence. This period is also marked by feelings of extreme sensitivity about the body. Again, your child may be very concerned about body image, so remember to listen to his or her concerns. Refocus your child to concentrate on strengths, and remind him or her about grooming, exercise, and diet. Reinforce your child’s feelings by explaining that what he or she is feeling, is all part of growing up. Topics to discuss with your adolescent are: dating, love, and intimacy; how drugs and alcohol can influence decision-making; sexual intercourse; birth control and child-bearing; and condoms and disease prevention.

One area that many parents find difficult to discuss, and that is very common during this period, is masturbation. To help ease your mind, the medical community believes that masturbation is normal and harmless (it is only a problem if it is practiced in an inappropriate place or is accompanied by strong feelings of guilt or fear). If you need help preparing yourself for a conversation with your child, talk to your child’s doctor, school nurse, or clergy. Also, reading books on this topic are helpful. It is important that you are comfortable discussing the subject because as the parent, through your actions or reactions, you have the power to instill guilt and fear in your child. On the other hand, you also have the power to communicate that the behavior is okay and can explain the difference between appropriate and inappropriate places for this behavior.

Though the development of sexuality takes place in all children, your child’s disability dictates the approaches you need to take in providing information that is comprehensible to your child. For example, for the child who is:

Therefore, it is important to identify how your child’s disability affects his or her learning abilities, and then you, and professionals dealing with your child, can come up with an individualized plan for effectively teaching your child about sexuality.

 

Reproduction and Birth Control

Though there are disabilities that make it impossible for individuals to become pregnant or impregnate another, most individuals with disabilities are capable of having children. Therefore, understanding reproduction and how pregnancy occurs are very important concepts to teach your child. When discussing these topics with your child, you should not only provide information on how a child is conceived, but also about the responsibilities of child-bearing (reinforcing the idea that an individual must be mature enough to deal with these responsibilities). Once this part is communicated and understood by your child, birth control may then become an issue.

The decision to have children and when to have children is a very personal one; many individuals will want to have children, while others will not. The type of birth control to use will also vary from person to person; some methods are more suitable than others, depending on the individual’s disabilities. The best thing to do is consult with your child’s physician to decide what is best for your child.

If you have a child who is not capable of understanding the consequences of sexual activity, sterilization may be an option. There are, however, very strict laws regarding sterilization, and they vary from state to state. In most states, the person who is requesting sterilization must give his or her informed consent. Therefore, if you are considering this option of birth control for your child, you will need to check with the sterilization laws in your state.

 

Sexual Exploitation

One of the greatest fears a parent has is that their child with a disability will be sexually exploited or abused. Some of the reasons for these concerns are that: a) when a child has physical limitations, it may be difficult to defend oneself; b) when a child has cognitive limitations, they may not be able to distinguish between a safe and dangerous situation; c) the child may have limited knowledge of sexuality and may then be more vulnerable; d) the child may not know to report these types of incidences; e) the child may have poor self-esteem; and f) the child may simply be lonely due to a lack of social opportunities. Statistics confirm these concerns. According to the National Center on Child Abuse and Neglect, 36 of 1000 children (in their sample study) with disabilities were maltreated, which is a rate 1.7 times higher than that for children without disabilities!

So, what can you do to reduce the risk of your child being exploited or abused? Experts suggest the following steps to help parents protect their children:

The next best thing to do is educate yourself. There are physical signs of abuse such as bruises in the genital area, genital discomfort, torn or missing clothing, and sexually transmitted diseases. There are also behavioral signs such as depression, withdrawal, atypical attachment, excessive crying spells, regression, sleep disturbances, noncompliance, eating disorders, self-destructive behavior, and inappropriate sexual behavior.

 

Conclusion

Because children with disabilities will mature and one day be adults functioning in the community, they have a right to receive accurate information about what sexuality means, what responsibilities it involves, and what pleasures and joys it can bring. Through education, parents and professionals alike can prepare children with special needs to make responsible decisions and form relationships with others, so that they can experience life to the fullest.

For a comprehensive listing of resources regarding sexuality issues (i.e., sexual development, sexual orientation, reproduction and birth control, protection against STDs, and protection against sexual exploitation and abuse) visit the NICHCY web site at http://www.nichcy.org and review the publication listed below.

Reference:

 

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