The Right to Love and Be Loved: Sexual Health Education for Students with Intellectual and Developmental Disabilities

Main Article Content

Andrew Roach
Anne Stair

Keywords

Sexual health education, intellectual and developmental disabilities, social connection

Abstract

Although there has been notable progress in educational inclusion for students with intellectual and developmental disabilities (I/DD), they generally receive inadequate sexual health education. This paper outlines the historical factors for this gap, current practices in sexual health education, and related outcomes for this group of students.

Abstract 20 | WORD Downloads 6 PDF Downloads 18

References

Advocates for Youth. (2014). This history of federal abstinence-only funding. https://www.advocatesforyouth.org/wp-content/uploads/storage//advfy/documents/fshistoryabonly.pdf
Albrecht, G. L. (Ed.). (2006). Encyclopedia of disability (Vol. 1). Sage.
Alirksson-Schmidt, A. I., Armour, B. S., & Thibadeau, J. K. (2010). Are adolescent girls with a physical disability at increased risk for sexual violence? Journal of School Health, 80(7), 361-367. https://doi.org/10.1111/j.1746-1561.2010.00514.x
American Psychiatric Association, D. S. M. T. F., & American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
American Association on Intellectual and Developmental Disabilities. (2008). Sexuality. https://aaidd.org/news-policy/policy/position-statements/sexuality#.WujCRk2WxGE
Asher, S. R., & Coie, J. D. (Eds.). (1990). Peer rejection in childhood. CUP Archive.
Balaji, A. B., Claussen, A. H., Smith, D. C., Visser, S. N., Morales, M. J., & Perou, R. Social support networks and maternal mental health and well-being. Journal of Women’s
Health, 16(10), 1386-1396. https://doi.org/10.1089/jwh.2007.CDC10
Barnard-Brak, L., Schmidt, M., Chestnut, S., Wei, T., & Richman, D. (2014). Predictors of access to sex education for children with intellectual disabilities in public schools. Intellectual and Developmental Disabilities, 52(2), 85-97. https://doi.org/10.1352/1934-9556-52.2.85
Biggs, E. E. & Carter, E. W. (2016). Quality of life for transition-age youth with autism or intellectual ability. Journal of Autism and Developmental Disorders, 46, 190-204. https://doi.org/10.1007/978-1-4614-6435-8_102218-1
Blanchett, W. J. & Wolfe, P. S. (2002). A review of sexuality curricula: Meeting the sexuality education needs of individuals with moderate and severe disabilities. Journal of the
Association for Persons with Severe Handicaps (JASH), 27(1) 43-57. https://doi.org/10.2511/rpsd.27.1.43
Blum, R., Resnick, M., Nelson, R., & Germaine, A. (1991). Family and peer issues among adolescents with spina bifida and cerebral palsy. Pediatrics, 88, 280-285.
Bruinius, H. (2006). Better for the world: The secret history of forced sterilization and America’s quest for racial purity. Vintage Books.
Cacioppo, J. T., Hawkley, L. C., Crawford, L. E., Ernst, J. M., Burleson, M. H., Kowalewski, R. B., Malarkey, W. B., William, B., Cauter, E., & Bernston, G. (2002). Loneliness and health: Potential mechanisms. Psychosomatic Medicines, 64(3), 407-417. https://doi.org/10.1097/00006842-200205000-00005
Committee on Bioethics. (1999). Sterilization of minors with developmental disabilities. Pediatrics, 104(2), 337-340. https://doi.org/10.1542/peds.104.2.337
Carter, E. W., Ditchman, N., Sun, Y., Trainor, A. A., Swedeen, B., & Owens, L. (2010). Summer employment and community experiences of transition-age youth with severe disabilities. Exceptional Children, 76, 194-212. https://doi.org/10.1177/001440291007600204
Carter, J.B. (2001). Birds, bees and venereal disease: Toward an intellectual history of sex education. Journal of the History of Sexuality, 10(2), 213-249. https://doi.org/10.1353/sex.2001.0022
Cassell, C. & Wilson, P. M. (1989). Sexuality education. Garland Publishing, Inc.
CAST. (2018). Universal Design for Learning Guidelines version 2.2. http://udlguidelines.cast.org
Cohen, S. (2004). Social relationships and health. American Psychologist, 676-684. https://doi.org/10.1037/0003-066X.59.8.676
Cohen, S., Doyle, W. J., Skoner, D. P., Rabin, B. S., & Gwaltney, J. M., Jr. (1997). Social ties and susceptibility to the common cold. Journal of the American Medical Association, 277, 1940-1944. http://dx.doi.org/10.1001/jama.1997.03540480040036
Cohen, S., Underwood, L. G., & Gottlieb, B. H. (Eds.). (2000). Social support measurement and intervention: A guide for health and social scientists. Oxford University Press.
Collier, K. L. (2023, May 31-June 2). Sexual and reproductive health education for youth with intellectual disabilities: A mixed methods study of professionals’ practices and needs [presentation]. 31st Annual Meeting of the Society for Prevention Research (SPR), Washington, D.C.
Cornog, M. & Perper, T. (1996). For sex education, see librarian: A guide to issues and resources. Greenwood Press.
Education for All Handicapped Children Act of 1975. Education for All Handicapped Children Act of 1975, 20 U.S.C. §§ 1401-1461 (1975).
Emerson, E. & McVilly, K. (2004). Friendship activities of adults with intellectual disabilities in supported accommodation in Northern England. Journal of Applied Research in Intellectual Disabilities, 17, 191-197. https://doi.org/10.1111/j.1468-3148.2004.00198.x
Eng, P. M., Rimm, E. B., Fitzmaurice, G., & Kawachi, I. (2002). Social ties and change in social ties in relation to subsequent total and cause-specific mortality and coronary heart disease incidence in men. American Journal of Epidemiology, 155, 700-709.
http://dx.doi.org/10.1093/aje/155.8.700
Foley, K.-R., Dyke, P., Girdler, S., Bourke, J., & Leonard, H. (2012). Young adults with
intellectual disability transitioning from school to post-school: A literature review framed within the ICF. Disability and Rehabilitation, 34, 1747–1764. https://doi.org/10.3109/09638288.2012.660603
Forte, M., Jahoda, A., & Dagnan, D. (2011). An anxious time? Exploring the nature of worries experienced by young people with a mild to moderate intellectual disability as they make the transition to adulthood. British Journal of Clinical Psychology, 50, 398-411. https://doi.org/10.1111/j.2044-8260.2010.02002.x
Frank, K. & Sandman, L. (2019). Supporting parents as sexuality educators for individuals with intellectual disability: The development of the home B.A.S.E curriculum. Sexuality and Disability, 37, 329-337. https://doi.org/10.1007/s11195-019-09582-7
Froese, P., Richardson, M., Romer, L. & Swank, M. (1999). Comparing opinions of people with developmental disabilities and significant persons in their lives using the individual supports identification system (ISIS). Disability & Society, 14, 831-843. https://doi.org/10.1080/09687599925920
Goodley, D. (2017). Disability studies: An interdisciplinary introduction. Sage.
Haber, M. G., Mazzotti, V. L., Mustian, A. L., Rowe, D. A., Bartholomew, A. L., & Fowler, C. H. (2015). What works, when, for whom, and with whom: A meta-analytic review of predictors of postsecondary success for students with disabilities. Review of Educational Research, 86(1), 123-162. https://doi.org/10.3102/0034654315583135
Holt-Lunstad, J., Robles, T. F., & Sbarra, D. A. (2017). Advancing social connection as a public health priority in the United States. American Psychologist, 72(6), 517-530. http://dx.doi.org/10.1037/amp0000103
Holt-Lunstad, J. Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. PLoS Medicine, (7)7, e1000316. https://doi.org/10.1371/journal.pmed.1000316
Individuals with Disabilities Education Act of 2004, 20 U.S.C. §§ 1400-1415 (2004).
Kayser, A., Alpert, B., Toevs, K, & Ramachandan, D. (2018). In their own words: Guidelines for supporting the sexual health of young people experiencing intellectual/developmental disabilities. Multnomah County Health Department. https://multco.us/school/sexual-health-youth-developmental-disabilities
Kiecolt-Glaser, J. K., & Newton, T. L. (2001). Marriage and health: His and hers. Psychological Bulletin, 127, 472-503. http://dx.doi.org/10.1037/0033-2909.127.4.472
Kirby, D. (2008). The impact of abstinence and comprehensive sex and STX/HIV education programs on adolescent sexual behavior. Sexuality Research and Social Policy, 5(3), 18-27. https://doi.org/10.1525/srsp.2008.5.3.18
Knox, M. & Hickson, F. (2001). The meanings of close friendship: The views of four people with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 14, 276-291. https://doi.org/10.1046/j.1468-3148.2001.00066.x
Kohler, P. K., Manhart, L. E., & Lafferty, W. E. (2008). Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy. Journal of Adolescent Health, 42(4), 344-351. https://doi.org/10.1016/j.jadohealth.2007.08.026
Koller, D., Le Pouesard, M., Rummens, J. A. (2018). Defining social inclusion for children with disabilities: A critical literature review. Children and Society, 32, 1-13. https://doi.org/10.1111/chso.12223
Koster, M., Pijl, S.J. , Nakkhen, H., Van Houten, E. (2010). Social participation of students with special needs in regular primary education in the Netherlands. International Journal of Disability, Development and Education, 57, 59-75. https://doi.org/10.1080/10349120903537905
Ladau, E. (2021). Demystifying disability: What to know, what to say, and how to be an ally. Ten Speed Press.
Laidlaw Foundation. (2003). Thumbs up! Inclusion, rights and equality as experienced by youth with disabilities. Laidlaw Foundation.
Matheson, C., Olsen, R. J., & Weisner, T. (2007). A good friend is hard to find: Friendship among adolescents with disabilities. American Journal on Mental Retardation, 112, 319–329.
McDaniels, B. & Fleming, A. (2016). Sexuality education and intellectual disability: Time to address the challenge. Sexuality and Disability, 34, 215-225. https://doi.org/10.1007/s11195-016-9427-y
McPartland, J.C., Law, K., & Dawson, G. (2016). Autism spectrum disorder. In H.Friedman (Ed.), Encyclopedia of Mental Health (2nd ed.). Academic Press.
Murphy, N. A. & Elias, E. R. (2006). Sexuality of children and adolescents with developmental disabilities. Pediatrics, 118(1), 398-403. https://doi.org/10.1542/peds.2006-1115
Murphy, N., & Young, P. C. (2005). Sexuality in children and adolescents with disabilities. Developmental Medicine & Child Neurology, 47, 640-644. https://doi.org/10.1111/j.1469-8749.2005.tb01220.x
National Coalition for Sexual Health (2019). Goals. https://nationalcoalitionforsexualhealth.org/about/goals-values
National Conference of State Legislatures (2020). State policies on sex education in schools. https://www.ncsl.org/research/health/state-policies-on-sex-education-in-schools.aspx#sex%20ed%20and%20states
Pijl, S. J., Frostad, P., & Flem, A. (2008). Social position of pupils with special needs in regular schools. Scandinavian Journal of Educational Research, 52(4), 387-405. https://doi.org/10.1080/00313830802184558
Preston, M. (2013). “Very, very risky”: Sexuality education teachers’ definition of sexuality and teaching and learning responsibilities. American Journal of Sexuality Education, 8(1-2), 18-35. https://doi.org/10.1080/15546128.2013.790223
Pérez-Curiel, P., Vicente, E., Morán, M. L., & Gómez, L. E. (2023). The right to sexuality, reproductive health, and found a family for people with intellectual disability: A systematic review. International Journal of Environmental Research and Public Health, 20(2), 1587. https://doi.org/10.3390/ijerph20021587
Pitonyak, D. (2003) Loneliness is the only real disability: Implications and recommendations for policymakers [handout]. National Association of Developmental Disabilities Directors 2003 Annual Meeting. http://dimagine.com/wp-content/uploads/2018/03/NASDDS.pdf
Repke, A., & Ipsen, C. (2019). Differences in social connectedness and perceived isolation among rural and urban adults with disabilities. Disability and Health Journal, (13). https://doi.org/10.1016/j.dhjo.2019.100829
Robertson, J., Emerson, E., Gergory, N., Hatton, C., Kessissoglou, S., Hallam, A., & Linehan, C. (2001). Social networks of people with mental retardation in residential settings. Mental Retardation, 39, 201-214.
Sala, G., Hooley, M., Attwood, T., Mesibov, G., & Stokes, M. A. (2019). Autism and intellectual disability: A systematic review of sexuality and relationship education. Sexuality and Disability, 37, 353-382. https://doi.org/10.1007/s11195-019-09577-4
Santelli, J. S., & Kantor, L. M. (2008). Introduction to special issue: Human rights, cultural, and scientific aspects of abstinence-only policies and programs. Sexuality Research and Social Policy, 5(3), 1-5. https://doi.org/10.1525/srsp.2008.5.3.1
Schaafsma, D., Kok, G., Stoffelen, J. M. T., & Curfs, L. M. G. (2017). People with intellectual disabilities talk about sexuality: Implications for the development of sex education. Sexuality and Disability, 35(21-38). https://doi.org/10.1007/s11195-016-9466-4
Seruya, F. C., Losher, S,. & Ellis, A. (1972). Sex and sex education: A bibliography. Bowker Company.
Shakespeare, T., Gillespie-Sells, K., & Davies, D. (1996). Identity and Imagery. In T. Shakespeare, K. Gillespie-Sells & D. Davies (Eds.), The sexual politics of disability: Untold desires. Cassell.
Shapiro, S. & Brown, C. (2018). Sex education standards across the states. Center for American Progress.
Shattuck, P. T., Orsmond, G. I., Wagner, M., & Cooper, B. P. (2011). Participation in social activities among adolescents with an autism spectrum disorder. PLoS One, 6, e27176. https://doi.org/10.1371/journal.pone.0027176
SIECUS: Sexuality Information and Education Council of the United States. (2014). http://siecus.org
SIECUS: Sexuality Information and Education Council of the United States. (2016). Federal programs cheat sheet.
SIECUS: Sexuality Information and Education Council of the United States. (2020). https://siecus.org/wp-content/uploads/2020/01/Georgia-PDF.pdf
Siperstein, G. N., Parker, R. C., & Norins Bardon, J. (2007). A national study of youth attitudes toward the inclusion of students with intellectual disabilities. Exceptional Children, 73(4), 435-455. https://doi.org/10.1177/001440290707300403
Skarbeck, D., Hahn, K., & Parrish, P. (2009). Stop sexual abuse in special education: An ecological model of prevention and intervention strategies for sexual abuse in special education. Sexuality and Disability, 27(3), 155-164. https://10.1007/s11195-009-9127-y
Smith, S. G., Zhang, X., Basile, K. C., Merrick, M. T., Wang, J., Kresnow, M., Chen, J. (2018). The National Intimate Partner and Sexual Violence Survey (NISVS): 2015 Data Brief – Updated Release. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
Snowdon, A. (2012). Strengthening Communities for Canadian Children with Disabilities. The Sandbox Project: Toronto, ON.
Stanger-Hall, K. F. & Hall, D. W. (2011). Abstinence-only education and teen pregnancy rates: Why we need comprehensive sex education in the U.S. PLoS ONE 6(10), e24658. https://doi.org/10.1371/journal.pone.0024658
Stein, S. & Dillenburger, K. (2016). Ethics in sexual behavior assessment and support for people with intellectual disability. International Journal on Disability and Human Development, 16(1), 11-17. https://doi.org/10.1515/ijdhd-2016-0023
Stern, A. M. (2005). Sterilized in the name of public health. Race, immigration, and reproductive control in modern California. Journal of Public Health, 95(7), 1128-1138. https://doi.org/10.1016/S0145-2134(00)00190-3
Sullivan, P. M. & Knutson, J. F. (2000). Maltreatment and disabilities: A population-based epidemiological study. Child Abuse and Neglect, 24(10), 1257-1273. https://doi.org/10.1016/S0145-2134(00)00190-3
Swango-Wilson, A. (2011). Meaningful sex education programs for individuals with intellectual/developmental disabilities. Sexuality and Disability, 29, 113-118. https://doi.org/10.1007/s11195-010-9168-2
Taft, A., Hegart, K., Ramsay, J., Feder, G., Carter, Y., Davidson, L., & Warburton, A. (2009). Screening women for intimate partner violence in health care settings (Protocol). Cochrane Database of Systematic Reviews 2008. https://doi.org/10.1002/14651858.CD007007
Treacy, A. C., Taylor, S. S., & Abernathy, T. V. (2018). Sexual health education for individuals with disabilities: A call to action. American Journal of Sexuality Education, 13, 65-93. https://doi.org/10.1080/15546128.2017.1399492
Trenholm. C, Devaney, B., Fortson, K., Quay, L., Wheeler, J., & Clark, M. (2007). Impact of four Title V Section 510 abstinence education programs: Final report. Mathematica Policy Research, Inc.
Van Dyke, D., McBrien, D., & Sherbondy, A. (1995). Issues of sexuality in Down syndrome. Down Syndrome Research and Practice, 3(2), 65-69. https://doi.org/10.3104/reviews.53
Ward, K. M., Atkinson, J. P., Smith, C. A., & Windsor, R. (2013). A friendships and dating program for adults with intellectual and developmental disabilities: A formative evaluation. Intellectual and Developmental Disabilities, 51, 22-32. https://doi.org/10.1352/1934-9556-51.01.022
Ward, K. M., Windsor, R., Atkinson, J. P. (2012). A process evaluation of the friendships and dating program for adults with developmental disabilities: Measuring the fidelity ofprogram delivery. Research in Developmental Disabilities, 33, 69-75. https://doi.org/10.1016/j.ridd.2011.08.016
Williams, M. E. (2006). Sex: Opposing viewpoints. Greenhaven Press.
Zablotsky, B., Black, L. I., Blumberg, S. J. (2017). Estimated prevalence of children with diagnosed developmental disabilities in the United States, 2014-2016. NHS Data Brief, (291),1-8. https://www.ncbi.nlm.nih.gov/pubmed/29235982
Zablotsky, B., Black, L. I., Maenner, M. J., Schieve, L. A., Danielson, M. L., Bitsko, R. H., Blumberg, S. J., Kogan, M. D., & Boyle, C. A. (2019). Prevalence and trends of developmental disabilities among children in the United States: 2009-2017. Pediatrics, 144(4). https://doi.org/10.1542/peds.2019-0811