Diana Hinds reports
The growing tide of inclusion has brought to the surface the question of how best to deliver sex education to children with disabilities. In the past, these young people have often missed out - either because schools have failed to adapt the curriculum to meet their needs, because the sex education lesson has been a convenient time for them to see the nurse or speech therapist, or even because sex education was seen as somehow irrelevant.
As one adult with disabilities, quoted in a new publication by the charity, Contact a Family, remembers: "At special school it was terrible. The assumption was that we wouldn't have, and didn't deserve, sexual relationships."
But there is increasing awareness that teenagers with learning or physical disabilities have the same need, and right, to know as any teenager about the process of growing up, forming relationships, having families.
"What we hear increasingly is that teachers feel unprepared for including children with disabilities in every area of the curriculum," says Jill Harrison, director of external affairs at Contact a Family. "In sex education, it's about knowing how to be sensitive about certain issues. For instance, if you are teaching reproduction, there may be young people with physical disabilities who will have difficulties conceiving or carrying a child. There could be someone sitting in your class thinking, 'This doesn't apply to me'."
Different kinds of disabilities present different challenges for planning a sex education programme. Materials to support young people with learning difficulties have become available in recent years, but Contact a Family felt strongly that the sex education needs of those with physical disabilities (who may also in some cases have learning disabilities) had been neglected.
Later this autumn, Contact a Family, with support from the Sex Education Forum and the National Children's Bureau, publishes Sex and relationships education for young people with physical disabilities, a series of three booklets offering separate guidance to teachers, parents and young people.
Privacy, or the lack of it, is an issue that bears heavily on a child who is dependent on the physical ministrations of adults. As the teacher's booklet points out: "Disabled children are usually taught to be 'good for the doctor' and to comply during medical appointments. The notion of private areas of the body may be a concept difficult to understand for a child who is used to having strangers examining his or her body."
A confusion of public and private parts of the body leaves the young person vulnerable to abuse, or inappropriate behaviour. Teachers and parents are right to feel a special protectiveness. But at the same time, Contact a Family insists these young people must not be treated as "eternal children".
A young disabled woman, for instance, is likely to be as keen as a non-disabled woman to use fashion as a way of exploring her sexual attractiveness. It is vital for her self-esteem, just as it is for her non-disabled peer, that she is encouraged in her perceptions of herself in an increasingly adult role.
As the teacher's booklet stresses: "The starting point for teaching disabled children should be the same as for any other - that this pupil will grow up to be able to form close and loving relationships with someone of the same or opposite sex and may or may not go on to have a family of their own."
Teachers also need to flag up particular lessons or topics to other members of staff, such as classroom assistants, who are supporting a disabled pupil.
Liaising closely with parents is a helpful and necessary part. Jill Harrison says that, in 99 per cent of cases, parents are delighted to talk things through with teachers, and advance notice of a sex education lesson allows them to provide back-up at home.
Ensuring that all children with learning difficulties understand what is happening to their bodies as they grow up is a critical part of their education. Karen Watchman, director of Down's Syndrome Scotland, says: "It is not uncommon for young adults with Down's syndrome not to know why they go through puberty." She emphasises that it is vital for their future wellbeing and safety that they get this information at an early stage.
Earlier this year, Down's Syndrome Scotland published a short, illustrated booklet for young people with Down's syndrome, Let's talk about puberty. A group of young people with Down's gave editorial feedback, insisting on clear pictures alongside the text, not photographs or cartoons. "What came out of our focus groups was these young people wanted a boyfriend or girlfriend, but hadn't felt comfortable talking about it," says Watchman.
Living your Life, first published by Brook Advisory Centres in 1991 and revised in 2003, offers PSHE teachers in mainstream as well as special schools a highly detailed sex education programme to follow, with ready-made lesson packages and photocopiable worksheets. It advises on different types of learning difficulties, and comments usefully on the challenges facing pupils with autistic spectrum disorders and their teachers.
Talking together is another practical resource, produced by the Family Planning Association, for use at school or at home. Talking together... about growing up, aimed at children with learning disabilities aged nine-plus, was published in 1999, and last year was followed by a second book, Talking together... about sex and relationships, aimed at 13-plus. Children with learning disabilities "need more sex education, with more explicit materials" than their non-disabled peers, the books argue.
Teachers need to present information in a variety of ways, says Claire Fanstone, learning disabilities project manager for the Family Planning Association England. Pupils with learning disabilities are likely to need repetition of topics. Checklists to take home and talk about with parents can be helpful. Parents may find this easier than they think. "Talking together looks at the whole development of a relationship and how it evolves. It's not just about having sex," she says. "There needs to be an acknowledgement that sex education is about a lot of things that are quite easy to talk about."
Sex and relationships education for young people with physical disabilities, is available from late autumn, free, from Contact a Family.
Tel: 0808 8083555; www.cafamily.org.uk.Let's talk about puberty, free, from Down's Syndrome Scotland. Tel: 0131 313 4225; www.dsscotland.org.uk.Living your Life, pound;50, from Brook Publications. Tel: 024 7654 5557; firstname.lastname@example.org.Talking together... about growing up, pound;12.99, and Talking together... about sex and relationships, pound;14.99, from Family Planning Association. Tel: 0845 1228600; www.fpa.org.uk