University of Edinburgh
 

5-12 years (VI) - Personal and Social Education: Framework and Methodology with particular attention to Sex Education

From the Conference: Sex Education for Children and Young People with Visual Impairment, Scottish Sensory Centre, March 1998

Julie Sweeting
Head of Education Services for VI, Oldham
Oldham Service for the Visually Impaired

Unique Educational Needs Curriculum Guidelines
Curriculum Area: Personal and Social Education - Sexuality

What is "Sex Education?"

Sex Education is about human sexuality. It is about being male and female and is concerned with the interaction of biological, social, and psychological influences.

Sexuality is, unconditionally, a part of humanity. Everyone has a basic right to be a feeling and informed sexual being. There is a responsibility on all members of society, but especially on those professionals employed to attend to their needs, to ensure parents and pupils are as informed as possible.

The fulfilment of these rights and educational needs can be obstructed by questions, concerns and moral issues which need to be clarified if information is to be imparted in a relevant and appropriate way.

Sex is usually synonymous with sexual intercourse and therefore considered an adult topic, not suitable for young children.

Sexuality is however, about what we are, not what we do. It is a major aspect of personality, not just a physical exercise, and is concerned with emotional, social and cultural growth as well as physical development.

Education with regard to sexuality is a learning experience that enriches childrens' lives, helping them to understand themselves, their families, their peers and society.

The basis of sex education is in the involuntary, non-verbal communication which begins at birth.

Sighted children develop an awareness of anatomical features including their similarities and differences, naturally and almost incidentally, through visual observation.

Parents have a duty to ensure that their children who are visually impaired become aware of gender similarities and differences. By so doing they will enable their children to start school as aware as their peers with regard to this basic knowledge.

Younger children are able to form accurate concepts. They must be given the necessary experiences and information, at the appropriate time, if those concepts are to develop unimpeded by misconception and inaccuracy.

Children disregard explanations which are too complicated for them, they are not harmed by them.

However, the older the pupil is, before he or she receives direct information, the more difficult it will be for them to understand even the most basic concepts. Inadequate preparation can, on the other hand, instil confusion and fear which is hard to overcome.

Raising awareness and imparting information does not lead to sexual misbehaviour. Children will inevitably become adolescents and, with all the biological urges of this age group, hurtle towards adulthood.

Sensitive sources of information, advice, and help are vital for all young people.

The underlying principle in choosing sex education materials and designing a programme of study is that they need to support and reflect individual school and LEA policies.

The responsibility for gradual, appropriate teaching of human sexuality for pupils who are visually impaired must be shared between parents, teachers and other key workers. Programmes of study designed for sighted children often assume that a large amount of visual information has been received. Pupils who are visually impaired may require specific information taught by appropriate, well informed, well prepared professionals.

A pupil who is visually impaired needs to experience a programme of study which is conceptually orientated. Misconceptions can arise because of the lack of opportunity to reinforce and/or modify initial understanding with a variety of visual experiences. Careful discussion will often reveal a lack of basic understanding as a result of incomplete or misinterpreted information, in young people who converse using sophisticated terminology.

The pupil who is visually impaired has a right to the programme of study designed for the whole school population. Certain adaptations may have to be made to ensure the pupil who is visuaIly impaired benefits to the full from those curriculum experiences. This could include the provision of alternatives to visual media as well as opportunities for sensitive discussion.

It is very important that the attitudes and emotions surrounding the pupils' sexuality at all stages of their development, are taken into account.

Gender identity, reproduction processes, sexual and social issues, including health and safety, must be included, in relation to individual pupil need and local authority policy.

A Note on Policies

The DES circular "Sex Education At School" and legislation, in particular, Section 28, give a framework for those involved in sharing information on sex with pupils of school age:

  • "The awareness of a programme of sex education should he able to present facts in an objective and balanced manner so as to enable pupils to comprehend the range of sexual attitudes and behaviour in present day society; to know what is and is not legal; to consider their own attitudes and to make informed, reasoned and responsible decisions about the attitudes they will adopt both while they are at school and in adulthood."
  • "Teaching about the physical aspects of sexual behaviour should be set within a clear moral framework in which pupils are encouraged to consider the importance of self-restraint, dignity and respect for themselves and others.... Schools should foster a recognition that both
  • sexes should behave responsibility in sexual matters."
  • "Schools have a responsibility to ensure that pupils understand those acts of the lawwhich relate to sexual activity."
  • "Schools cannot, in general, avoid tacking controversial sexual matters, such as contraception and abortion, by reason of their sensitivlty."

Nothing in the legislation should be interpreted so as to prohibit actions which treat or prevent the spread of disease.

All Sex Education policies are to be determined and agreed by the governors of individual schools.

"Probably nothing so greatly influences one'slife pattern as his sex membership. An individuals sense of identity, his ways of thinking and behaving, social activites, choice of associates, mode of dress and many other important factors are conditioned by being male or female"

(Kirkendall 1968)

All areas of learning are inter-connected, for example, co-ordination and movement therapy postively affect and promote reading readiness and development.

  • Recognition of oneself as a unique individual is based on male or female identity.
  • The establishment of gender awareness and language acquisition are related.
  • Learning achievement in general is firmly based in self-awareness and confidence.
  • Gender identity is fundamental to a child's sexual development.

Parents and teachers do not consciously plan the promotion of gender identity with children who are fully sighted. Most children gradually become aware of sex differences from what they see and notice in their day-today experiences. Their curiosity is raised and their observations reinforced or made clear by pertinent and relevant questioning.

Information must be given to all children early and "matter of factly" before taboos about touching and the natural reticence typical of primary age children occur.

Children who are visually impaired do not have their curiosity aroused in the same way as their sighted peers.

Parents of children who are visually impaired may need to be alerted to the importance of raising their children's awareness of general and individual personal characteristics. Understanding is rooted in experience, mutual understanding and communication is ordered through common language.

Appropriate words must be used, and accurate vocabulary established at the time which corresponds to language content in other areas, for example, penis, anus, vagina at the same time as ears, arms nose, legs and feet.

Euphemisms for body parts and functions such as wee wee, ding dong, etc. do not necessarily have to be abandoned anymore than moo cow and baa lamb - but they ought not to be used exclusively.

1. Teaching Anatomical Differences and Similarities

Between male and female; similarities in body hair; differences in anatomy; and variations in size and shape.

  1. Comparative instruction
    At home: bathing together, touching, naming.
  2. More formal situation: with a variety of dolls.
  3. For children with functional vision a mirror can help.
  4. With very small children be positive, tickling and naming games include genitalia, and be the same as with other body parts.
  5. Models enable young people to explore the male and female shape and compare them to their own.
  6. Use adult models and child models; invite comparison and discussion.
    Models can be made more realistic by glueing hair to underarm, chest and genital areas.
  7. Some household tasks aid the promotion of male and female differences and similarities.

A lot of information can be imparted sorting laundry; bring up things for discussion - children who are blind do not know much about clothing worn by the opposite sex, eg;

  • Bra - explore it, describe its function, put it on a model, put it on mum.
    Explain/indicate/discover bras are not necessary or usual male apparel.
  • Underpants - discover the opening, explain its function, discuss why male underpants need the opening, why it is unnecessary on female wear (draw attention to the fact that men stand to urinate).

Sorting clothing also sorts sex differences in:

size - men's and women's stockings and shirts;
texture - nylon, lace, embroidery, and gender determined items: slips, half-slips, suspender belts, jock straps.

school-based projects

lncorporate into lessons activities that will reinforce gender concepts:

  • - most schools draw round figures, cut them out and clothe them;
  • - dressing: start first with outerwear. Find clothes, match on cut out or doll.

Use community resources

  • - museums, where nude models can be explored;
  • - department stores - trying on shoes of various sizes, swimsuits, hats, coats, and the mannquins, discovering the variety of different scents, cosmetics and grooming aids.

2. Teaching about Sexual Intercourse

Start with discussion. Aim to:

  • try and find cut what student's current level of knowledge is, not just use of correct words and terminology, but to establish their level of understanding. (Need to know, eg the function of vagina and penis in sexual intercourse, not just their name and name of function).
  • try to identify myths and misconceptions (use models if at all possible; if not make them).

NOTE Pupils need to know that intercourse takes place because it feels nice and is a way of expressing affection - not just for reproduction.

Keep a sense of perspective - is sex dirty?

3. Teaching about Genitals

Most girls are confused about genital openings and often assume that blood and urine come from the same opening. If this persists, tampon use, for example, is difficuIt to comprehend.

Males can also be confused by this. A typical concern is the likelihood of male urinating into the vagina during intercourse.

Females should be encouraged to explore their own genitaI areas privately and become familiar with the various parts.

This is partcularly important, for males and females, it they need to communicate medical problems accurately.

4. Menstruation

Emotional and physical preparation is essential.
Girls need to know how to deal with menstruation on a practical level, and also that menstruation is a normal heatthy part of being female - not a curse.

Girls need to observe - visually or tactilely - other females coping with this. Can be helped with miniature aids such as dolls.
Information needs to be presented sequentially over a period of time.
Keeping dates on a calendar also helps (see hand out).

5. Sexual Exploration and Masturbation

Privacy is a vague concept for people who cannot see.
Establish the need for appropriate time and place.
Blind children do not masturbate more, they just don't realise they can be seen.
Emphasising need for privacy at the lavatory easy to explain.
Parents and professionals often seem to reject or misinterpret masturbation and sex play as partof natural development.
Hugs and kisses from toddlers are acceptable evidence of a child's growth and development, but young people exploring their own bodies is considered potentially damaging and therefore wrong.
Insatiable curiosity brings these actions about.
Children who are visually impaired don't get around very much and often turn to their one constant, their body, and quickly discover the pleasures of erotic stimulation.

The attitude of others towards masturbation - often shock and disgust; and the way it is dealt with - sternly and unsympatheticaIly - can cause harm - emotional harm - but masturbation itself does not harm anyone.
Young people do need to know that it is not appropriate to indulge themselves in these activities in public, and that they are best left to the privacy of their own room.

This includes respect for those siblings and other room mates who may share a bedroom when suggested alternatives such as the bathrcom may need to be made.

Also need to consider: social skills, relationships, life style, grooming, sexual self-protection, and contraception.

In general people are very visually orientated. We rely upon sight, more than any other sense, to perceive and interpret our world.

For most people sight is a basic component in the process of sexual communication and stimulation.

A person who is visually impaired is denied this channel of sexual stimulus. Other stimuli may, or may not, replace the 'visual one, but nevertheless a major element of sexual and erotic communication is missing.

Attitudes within the community, and the all-too common characteristic reticence of visually impaired people can impede the establishment of a relationship.

Visual impairment is not an either-or situation. Levels of vision and their management are wide and varied. Stereotypes and myths abound:

'boys never make passes at girls who wear glasses',
spectacle wearing children are labelled 'swots'

- not great problems in themselves, but they do exist.

Difficulties ensue not only because a visually impaired person has limited vision but also because behaviour as a consequence of that limited vision is open to interpretation and is often misinterpreted and judged. Not returning a smile could be interpreted as "stand offish" when the smile had not been seen.

There are difficulties in addition to stereotyping which have a profound effect on the indivicual with regard to the widest sense of communication.

Things to consider:

  • connotations of disabled
  • hesitant, uncertain movement
  • unusual body posture
  • lack of eye contact
  • facial and body rigidity
  • reluctance to initiate conversation
  • monopolising conversation
  • different communication system
  • sighted use hearing and sight
  • visually impaired people use hearing (augmented by experience and practice)
  • missed body language
  • consequences of over-protection and institutionalisation
  • move from society which has defined protocol to one which is laid back and informal
  • self-control, keeping hands to oneself, fear of invading personal space.

More to sex education than facts, more than just providing models (Scandinavian 'living doll' or Blue Peter toilet roll middles and yoghurt pot, but about taking adequate account of the relationship and communication aspects of sex.

Lack of vision limits a young person's opportunities for observing others in a variety of situations, participating in recreational activities, developing concepts about human sexuality and even understanding their own visual impairment and the implications for daily living.

Limited experiences may, in turn, effect the development of a positive and realistic self-concept

Sensitive intervention by adults may be needed to promote the development of appropriate social and emotional skills necessary for vocational, interpersonal and family relationships.

Social Skills

Most sighted people develop social skills from observing and copying others. Children who are visually impaired will need to be taught certain behaviours and have explained to them when and why people need to behave in certain ways.

Non-verbal communication is often a critical aspect of social interaction for sighted people. Aspects of non-verbal communication will need to be specfically taught to young people who are visually impaired.

Affective Education

Unless the emotional needs of young people who are visually impaired are dealt with, there will be serious implications with regard to their academic, social and vocational growth.

Developing an accurate self-concept is vital. Research has shown that the self-concept of sighted youngsters is generally more accurate than the self-concept of young people who are visually impaired.

Vision plays a critical role in a young child's knowledge of themselves as an individual, someone apart from others and other objects.

Not being able to use a mirror limits the awareness of a child who is visually impaired, as to how they look to others.

Pupils who are visually impaired often feel devalued because they cannot carry out common tasks in and around school.

There is also a danger that only talents or strengths may be over-emphasised resulting in an unrealistic self-concept which may be deflated in adolescence or adulthood.

Young people who are visually impaired need to be helped to cope with teasing in a constructive way which enables them to maintain a positive image of themselves.

Adolescence brings many emotional challenges. The student needs to learn how to deal with learned helplessness, dependency, over-protective families and sexuality.

Recreation

The range of recreational and leisure time activities, in and out of schcoI, available to a pupil who is visually impaired may be limited.

The pupil needs to be exposed to a variety of options, some of which they may not be aware of and others which they may not feel competent about.

Sighted children find out about what is going on through sources not available to children with little or no sight, and they can watch how something is done and try it for themselves.

Sighted children can also take themselves off to places in a way denied to the child who needs training in mobiIity and orientation to learn new routes.

Individual and group activities must be found which give children the opportunity to develop recreational skills - to include art and music.

Psychological Implications

Many of the problems faced by young people who are visually impaired are based in their own lack of understanding and acceptance of their eye condition.

Many are unable to name or discuss their eye condition in answer to everyday queries.

Many are uncomfortable doing so because they are forced to acknowledge that they have a visual impaiment.

It is very important for young people to understand and acknowledge their visual impairment as part of their identity. In this way they can be supported in developing a healthy attitude and dealing with the stereotypes and prejudice found in our society.

If pupils are comfortable about themselves then they will promote comfortable and acceptable attitudes towards them.

Human Sexuality

Visually impaired students need a much more intensive and conceptually orientated sex education programme than their sighted peers.

Sighted pupils have access to a range of media denied to their non-sighted peers.

While pupils who are visually impaired may be able to speak about information accurately, further conversation reveals their understanding to be rather superficial.

Anatomically correct models are a vital part of sex education programmes. Visual media are of no use in promoting learning based on understanding.

It is important to deal with attitudes and emotions at each stage of physical growth and general intellectual development.

Stigmas attached to disability and sexuality can cause confusion and undermine confidence, seriously affecting pupils' self-image.

Existing programmes of study used in schools should be adapted for visually impaired pupils to ensure gender identity, reproduction processes, sexual and social issues, and health and safety precautions - in relation to individual pupil need, cultural background and moral code with due regard for schcol policy and procedures.

Nurturing High Self-Esteem

Balancing a child's social, emotional and academic developments with realistic goals relating to their ability promotes positive self-esteem. Promoting strengths rather than weaknesses encourages a child's eventual appreciation of their worth as an individual.

The same factors influence the development of high self-esteem in all children regardless of individual differences such as disability.

The abilities, interests, pleasures and fears of each child need to be taken into account. It is important that pupils are included in discussions and decision making.

Parental qualities which enhance self-esteem in their children are characterised by consistency in relationships with their children and others, and an affectionate tolerance of people in general.

When parents discover their child has a visual impairment they experience a range of emotions - disbelief, shock, guilt and disappointment.
- Why me? Why my child? Will we share all I dreamed we'd share?

It is essential that emphasis from being concemed about what cannot be done to focussing on what can be achieved.

Ensuring children benefit from a broad range of experiences requires ingenuity, not just on the part of parents and professionals but also from the young persons themselves

Appropriate training must be built on the young person's natural capabilities. This training must be tempered with a sense of proportion - young people need to know that sighted people are not super beings - that they make mistakes. Attention needs to be drawn to the mistakes of others ("dad's spilled the gravy") to enable young people to put their own mistakes into perspective and not over react to them.

Parents of children who have a high sense of self-esteem show concern for their children's opinions, and are generally attentive to them. They structure their world along lines they consider appropriate and proper, and at the same time allow freedom within these guidelines.

Standards of behaviour need to be clearly stated and upheld with due regard for what is typical for a child of that age group. Skills are mastered in an atmosphere of encouragement and praise for work well done. Acknowledgement of acceptable behaviour encourages its repetition and raises self-esteem.

Noting achievement and keeping a record helps the child develop a sense of pride. Confident children believe in themselves. Children who know they are capable of getting things right realise failure is ternporary and accept criticism and punishment more easily. Children have a right to fail and know is not the end of the world

Children, unless they are helped to deal with questions about their disability, can find such queries traumatic which may have a negative effect on their self-esteem.

Children should be given facts about their disability in a way which they can understand and in a language which is age appropriate.

Obvious and commonly asked questions can be raised in family discussion. The child will experience how natural and direct answers can be given to personal questions. Questions are asked out of natural curiosity rather than malice. Children should be assisted in answering questions at first, but gradually encouraged to take responsibility for answering themselves.

Self-esteem is greatly enhanced by opportunities to take part in meaningful leisure activities. Basic skills can be learnt in the family setting when the child is young. By falling, twisting and tumbling themselves, children understand and relate to the experiences described by others.

Involving children in a wide variety of experiences out of school time, with people outside the family increases awareness of activities other than those followed at home. It can be sobering for a young person to realise that they may not be able to follow the life style or job enjoyed by their parents because of their low vision. They need to be aware of other options.

Parents need to show their children that they are loved and valued just the way they are and that they are not overtly concerned about their disability or the effect that it may have on their future.

Everyone needs to bear in mind the typical characteristics of fully sighted children and young people - the terrible twos tantrum, three year olds suddenly exhaust themselves, ten year olds giggle, twelve year olds find it impossible to suppress their lavatorial humour, and fourteen year olds can be characteristically lonely and self-conscious.

Young people who are visually impaired are more like their sighted peers than they are different, but sometimes we need to take into account their special needs.

Extra time may be needed to complete routine tasks - give time but don't limit the expectation of acceptable behaviour. Constant praise is essential for success.

lnstil the philosophy that it is what a person does that is more important than how they do it. No matter what technological advances there are, no matter how sophisticated low vision aids become, unless young people have the skills and confidence to use them in public they will be ineffective.

The hairstyles or dress codes of modern teenagers may not appeal to you, but teenagers need to look the part if they are to enjoy an active social life. Young people gain confidence from the positive comments of their peers.

Teenage years are harardous enough. Young people who are visually impaired have an additional crisis to face. No amount of wishing will make it possible for a young person with a severe visual impairment to drive a car. This disappointment will be made more easy to bear if they have a full, active, and independent a life as possible.

Menstrual Care

Confident menstrual care comes from the development of an efficient technique and routine which ensures good protection and promotes confident menstrual care.

Menses is often irregular in the beginning which makes it difficult for girls to anticipate the start of 'bleeding'. Keeping a calendar or diary helps them recognise the cycle. It can help to wear a "mini" pad around the time the period is due.

The choice of protection - tampons or pads - depends upon personal preference. The more skilful, relaxed and aware a girl is of what is happening the more informed her choice will be.

Whatever sanitary protection is chosen it will need to be changed regularly.

It helps to establish a regular timetable for change which is determined by the individual's flow and school or daily routine.

It is very important that girls take responsibility for remembering to change pads or tampons.

Keeping to the same timetable throughout each period, even when flow lightens, saves confusion. Changing tco frequently is better than not changing enough.

It is also important for girls to know the true cost of sanitary protection, and where it is purchased.

Using a Menstrual Pad - which to choose

Packets with a draw string or pillow slip open/close are easy to open without tearing and also keep pads fresh when not in use.

- self-adhesive pads

Method:

Take pad from packet;

Locate adhesive protector strip and remove it;

Either place pad adhesive side down, evenly centred on knicker gusset and press firmly; or hold pad firmly between legs over vaginal opening and pull knickers up, pressing pad to knickers.

Using a Tampon - which to choose

Tampons with applicators may be difficult to unwrap but those without an applicator are easier to use. A tampon can be inserted more accurately using a finger.

Method:

Tampons come with step by step instructions and diagrams specific to each type. These can be read out, and even demonstrated on the young person.

Confident and comfortable tampon use comes with practice and perseverance through several periods.

  1. Taking the tampon from the carton
  2. Unwrapping the tampon
  3. Holding the tampon in the correct position for insertion
  4. lnserting the tampon
  5. Removing the tampon.

Disposal of pads and tampons
There is a need to learn how to fold and wrap the pad before disposing of it. Some pads are now sold with plastic wrappers for their disposal. Few public conveniences encourage the disposal of any sanitary protection in the lavatory.

Girls need to know:

  1. The possible location of rubbish bins to dispose of the self-adhesive cover.
  2. The possible location of bins in the toilets for the disposal of used sanitary protection.

Appropriate training in personal hygiene - washing hands after use and so forth needs to be stressed.

Unique Educational Needs Curriculum Guidelines.

Curriculum Area ..... Personal and Social Education:
General Points to consider when working with pupils who are Visually Impaired

Always refer to pupil by name so that they know when they are being addressed.

Workshop 1: 5-12 years (VI) - Personal and Social Education: Framework and Methodology with particular attention to Sex Education

Pupils who are visually impaired may need additional experiences and reinforcement in order to ensure complete understanding. Real experiences, accompanied by appropriate language and opportunities to touch, feel and examine whenever possible recommended.

As wide and varied a range of experiences as possible must be provided. Understanding will be facilitated if the pupil who is visually impaired can be alerted to relevant information and those aspects of learning which the fully sighted pupils acquired almost incidentally.

Careful and sensitive use of support staff can be of great help in mediating what is happening, to include raising awareness of nuances of behaviour and dress.

Tutorial time could be an advantage in discussing on a personal level the pupil's concerns with regard to peer group interaction and developing appropriate communication skills to include; raising awareness of "body language", "eye contact" and the need to have "personal space".

This obviously can take extra time, but if misconceptions and lack of confidence are to be avoided it is vital that experiences are as complete, carried and meaningful as possible.

It is important to include all pupils in all aspects of the curriculum. Working collaboratively with peers can be helpful. Small groups, often ensure the pupil who is visually impaired is included.

Socially acceptable behaviour must be encouraged at all times.

Forward planning is vital to ensure the necessary materials are available for the large print/tactile reader.