Program evaluation of a sex education curriculum for women with mental retardation

People with Intellectual Disabilities Talk About Sexuality: Implications for the Development of Sex Education

Existing sex education programmes have failed in involving people with intellectual disabilities in the development of these programmes. Not involving the target population decreases the likelihood that the sex education programme will be effective. This study was conducted to assess the perspectives of people with intellectual disabilities on several sexuality-related topics. Semi-structured interviews were held with 20 people with intellectual disabilities covering topics such as: sex education, relationships, sex, social media, parenthood and support. The reported frequency of sex education the participants receive is low. Their knowledge regarding sex education is mainly limited to topics such as safe sex, contraception and STI's and tends to be superficial. Additionally, knowledge on safe sex does not always translate to safe sex behaviour. Finally, relationships are important for most participants; mainly because they don't want to be alone. Findings from both this study and literature shows that there seems to be a need for high quality sex education. Topics to consider to include are: online relationships, social media and parenthood. It would also be beneficial to focus on sexuality-related skills. Finally, to increase the effectiveness of a sex education programme, it is advisable that a theory-and evidence-based framework, such as Intervention Mapping, is used for its development.

Identifying effective methods for teaching sex education to individuals with intellectual disabilities: a systematic review

Sex education for individuals with intellectual disabilities is important. However, our knowledge about effective methods for teaching sex education to this population is limited. We report the results of a systematic review identifying methods for sex education programs aimed at individuals with intellectual disabilities. In all, 20 articles were included that met the criteria set in terms of topic--the effectiveness of sex education programs--and population of interest--individuals with intellectual disabilities. In these articles, methods for increasing knowledge and for improving skills and attitudes were reported. However, the studies revealed that generalization of skills to real-life situations was often not achieved. There are indications that the maintenance of knowledge and skills still needs extra attention. Moreover, detailed descriptions of the program materials, program goals, and methods used in the programs were often lacking in the reports. Although there is some evidence for methods that may improve knowledge, attitudes, and skills with regard to sex education aimed at individuals with intellectual disabilities, due to the lack of detailed descriptions provided it is unclear under which conditions these methods work. We therefore suggest that authors provide additional detail about methods in future publications or in online supplements.

Predictors of access to sex education for children with intellectual disabilities in public schools

Data from the National Longitudinal Transition Study-2 ( SRI International, 2002 ) were analyzed to identify variables that predicted whether individuals with intellectual disability (ID) received sex education in public schools across the United States. Results suggested that individuals receiving special education services without ID were only slightly more likely to receive sex education than students with mild ID (47.5% and 44.1%, respectively), but the percentage of students with moderate to profound ID that received sex education was significantly lower (16.18%). Analysis of teacher opinions and perceptions of the likelihood of the students benefiting from sex education found that most teachers indicated that students without ID or with mild ID would benefit (60% and 68%, respectively), but the percentage dropped to 25% for students with moderate to profound ID. Finally, across all students, the only significant demographic variable that predicted receipt of sex education was more expressive communication skills. Results are discussed in terms of ensuring equal access to sex education for students with ID in public schools.

Exploring the development of existing sex education programmes for people with intellectual disabilities: an intervention mapping approach

BACKGROUND

People with intellectual disabilities face barriers that affect their sexual health. Sex education programmes have been developed by professionals working in the field of intellectual disabilities with the aim to overcome these barriers. The aim of this study was to explore the development of these programmes.

METHODS

Sex education programmes geared to people with intellectual disabilities were examined in the context of the Intervention Mapping protocol. Data were obtained via interviews with the programme developers.

RESULTS

All programmes lack specific programme outcomes, do not have a theoretical basis, did not involve members of relevant groups in the development process and lack systematic evaluation.

CONCLUSIONS

Based on our findings and the literature, we conclude that these programmes are unlikely to be effective. Future programmes should be developed using a more systematic and theory- and evidence-based approach.

Sexual assault of people with disabilities: results of a 2002-2007 national report in Taiwan

Sexual violence against people with disabilities is widespread and linked to negative public health and social outcomes. The objectives of the present study were to describe and analyze and thus provide an overview of the current state of affairs concerning sexual assault among people with disabilities, including reported prevalence and trends, over the period from 2002 through 2007 in Taiwan. The present study analyzed nationwide data from the 2002-2007 "Sexual assaults report system" derived primarily from the Council of Domestic Violence and Sexual Assaults Prevention, Ministry of the Interior, Taiwan. The data took into account the number of cases and disability type in persons reported to have been sexually assaulted, and to analyze the reported rate of sexual assaults among this section of the population in Taiwan. In addition, the study used a linear estimation model to examine with time (2002-2007) in the rate of reported sexual assaults. The rate of increase of sexual assault reported among people with disabilities was 2.7 times that of the general population (469-173%) during the period of 2002-2007. Government statistics showed that intellectually disabled persons accounted for the largest proportion (>50%) of reported sexual assault cases among the disabled, followed by persons with chronic psychosis, who accounted for one-third of the reported sexual assault cases among the disabled population. The reported rate of sexual assault increased from 0.9 to 2.42 per ten-thousand people in the general population and from 1.24 to 5.74 per ten-thousand disabled persons. Intellectual disability, chronic psychosis and voice and speech impairments were consistently associated with a higher prevalence of sexual assault than the general population. The line of best fit estimated from a linear model showed a significant change over the study period in the reported number of sexual assault cases among disabled people. The results highlight the requirement for further study to explore the needs of people with disabilities with regards to education and other strategies to prevent sexual assault, particularly in the most vulnerable group-those with intellectual disability.

Learning to take the world seriously: an ethnographic study of the management of knowledge in a special school for children with intellectual disabilities

This article reports on an ethnographic and sociological study of the curriculum inside a special school for students with severe intellectual disabilities in the UK. There are few such studies since it is the routing of children into the special education system that has been sociologically captivating. Bernstein's analytical approach to the study of curricula is proposed as useful since it draws attention to the structure of the curriculum and is less concerned with assumptions about its content. It also highlights the social messages that are embedded within the curriculum. The data suggest that two codes were in operation within the curriculum. The first was designed to draw the out-of-school experiences of students into the classroom for greater scrutiny. The second involved the strict regulation of 'dangerous' knowledge, that is sexual knowledge. The implications of findings are discussed in relation to curriculum development, self-identity and the strength and nature of social boundaries.

Enhancing capacity to make sexuality-related decisions in people with an intellectual disability

AIM

The aim of the study was to apply an intervention to the area of sexual knowledge in order to determine if capacity to make sexuality-related decisions could be improved.

METHOD

The study adopted a single subject design using multiple baseline method with four adults with a moderate intellectual disability. The intervention consisted of individually tailored sex education adapted from Living Your Life (Bustard 2003). Treatment was offered to each participant twice weekly for a 10-week period on a one-to-one basis. The Sexual Consent and Education Assessment (SCEA, Kennedy 1993) was used for measurement purposes. The SCEA K-Scale (knowledge) and the S-Scale (safety practices) were administered weekly throughout the baseline, treatment and post-treatment phases of the study. Staff concerns were also assessed using the SCEA Inappropriate Sexual Behaviour Scale.

RESULTS

All four participants improved their decision-making capacity in all targeted areas as measured by improvements in K-Scale and S-Scale scores. Staff concerns were not increased as indicated by results on the Inappropriate Sexual Behaviour Scale. Six-month follow-up data for three of the participants showed maintenance of scores on the S-Scale and some decay in scores on the K-Scale from post-intervention performance.

CONCLUSION

The results demonstrate that tailored sexuality education can improve capacity to make sexuality-related decisions.