Relationships & Sex Education and Disability – How Do We Include Everyone? | Vicky Walsh
There are many myths and taboos surrounding Relationships and Sex Education (RSE). As a specialist in this subject for two decades, I probably know them all! Imagine, however, the extra level of embarrassment, shame or secrecy that can surround the topic of disability when it comes to sexuality education. As a classroom teacher, I have had the privilege of teaching a broad range of children with additional needs; including cerebral palsy, impaired vision, selective mutism, tics and autistic spectrum disorders. As a non-disabled person, this has greatly informed how I deliver my lessons and ensures that the resources I use or make are representative and accessible.
That being said, what do teachers and senior leaders need to consider when it comes to providing a comprehensive and accessible RSE curriculum to their learners with SEND (Special Education Needs and Disabilities)?
Firstly, we need to tackle mindsets. When you think of ‘disability’, what images come to mind? Someone in a wheelchair perhaps? It is important that all stakeholders in a school community understand that disability falls into many categories. According to the UK Equality Act 2010, you have a disability if you have a physical or mental impairment that has a ‘substantial, adverse, and long-term effect on your ability to carry out normal day-to-day activities’. This means that some people with behavioural, emotional, developmental or intellectual needs are also considered disabled.
There is a long-standing myth that disabled people do not have sexual desires. They are not considered to be sexual beings and can often be viewed or treated in a way that denies their age or maturity. If we imagine that SEND learners are going to stay child-like forever, or that they do not think about relationships and sex in the same way as their peers, then it is far more likely that they will be overlooked when it comes to RSE lessons. In fact, research shows that this cohort often have incomplete or inaccurate knowledge of relationships and sex (Whittle & Butler, 2018; Ferrante & Oak; 2020; Spyropoulou, 2020), signifying that they are at a higher risk of negative sexual experiences; contracting sexually transmitted infections and/or unwanted pregnancies (Baines et al., 2018).
If SEND learners receive little to no RSE education, we can see from much research that this increases the likelihood of sexual assault or abuse. The World Health Organisation (WHO) affirms that disabled people are 4.6 times more likely to be abused and according to the Bureau of Justice Statistics’ 2009–2014 National Crime Victimization Survey, people with disabilities were three times more likely than non-disabled people to experience serious violent crimes such as rape and sexual assault. In addition, having multiple disabilities can increase a person’s risk of rape and sexual assault, and children with mental health or intellectual disabilities are almost five times more likely than their non-disabled peers to experience sexual abuse. LGBTQIA+ people with a learning disability face ‘double discrimination’ due to their sexuality or gender (Snell, 2018). This makes the case that learners with SEND need comprehensive RSE teaching even more than other groups of children and young adults. Excluding them for any reason places them at a greater risk of abuse.
A large part of the RSE curriculum concerns teaching learners where to go for help and support. We can not assume that children would automatically know that there are helplines, websites or local clinics that they can access if they need sexual health or relationship support and it is also our responsibility to direct SEND learners to services that are specific to their needs. Additionally, by including disability in the conversation, we also make non-disabled learners considerate of an often ignored section of the community. The WHO guidance note entitled, ‘Promoting sexual and reproductive health for persons with disabilities’ states that: “Persons with disabilities have the same sexual and reproductive health needs as other people. Yet they often face barriers to information and services. The ignorance and attitudes of society and individuals, including health-care providers, raise most of these barriers – not the disabilities themselves.”
What are the barriers to comprehensive and inclusive RSE being delivered in schools?
Firstly, there is a serious lack of RSE being delivered to anyone at all. Even in England, where RSE was made statutory in 2020, an absence of training for teachers, and negative media coverage, means that delivery of the subject is patchy at best. The Daily Mail’s article entitled, ‘Twelve-year-olds are being taught about anal sex in school while nine-year-olds are told to “masturbate” for homework: The shocking lesson plans used by teachers in UK classrooms,’ is a good example of the media’s fear-mongering tactics. In primary schools, Relationships Education is often left to the Year 6 teacher, who, after a hard year of pushing children to get through their SATS exams, will be asked to deliver a few lessons on puberty to the class. Instead, schools might bring in an expert or organisation to deliver the content, which can be very valuable but will not achieve the depth I believe is needed for effective RSE coverage compared to a weekly series of lessons delivered over the course of a term. RSE needs to start with 4-year-olds in the Early Years, and should be comprehensively and regularly delivered throughout the school. Learners need the opportunity to assimilate the teaching objectives and revisit concepts within a unit of work. A well-written curriculum will be spiral in nature: meaning revising and extending learning each year. It will have safeguarding and managing risk at its core.
Next, we need to consider who we are asking to deliver the subject. Up-to-date training might be difficult for teachers to access. This could be a question of funding, time limitations due to busy roles and other responsibilities or knowing where to find specific training, especially if educators are working in the international sector. As a specialist, I am constantly reviewing my terminology, medical facts and my own understanding of all of the topics that RSE encompasses. When training teachers outside of the UK, I find that staff often need an extra layer of support and guidance due to the complexities of the subject matter in an international setting; for example, language barriers and understanding of local laws and services.
Once a well-trained teacher is delivering suitable and up-to-date content, only then can we think about making the topic accessible to learners with additional needs.
How do we go about this?
The student with SEND will likely have a support assistant or caregiver who understands a huge amount about the learning style and maturity level of the student. They are an invaluable resource when it comes to planning lessons. Can support assistants and SEN teams also be trained to ensure consistency throughout the school and to serve as an important resource for the RSE teacher/s? A 2020 NIHR study noted that support workers are often a key source of advice as well as emotional and practical support for people with learning disabilities and Bates et al, 2017 note that, “In some cases, support staff have reportedly been instrumental in helping the development of relationships, especially for those with higher support needs.”
The parents should be consulted too, to give the teacher a clear picture of starting points and suggested approaches. Planning time and transparency with all parties associated with the learner is vital for a successful programme. It undoubtedly takes extra time but can pay dividends when it comes to teaching the content.
Finally, once all of those important factors are in place, we need to consider representation – do any of the resources being used include people with a range of disabilities? They should do so, regardless of whether there is a person with disabilities in the room or not. From experience, bought-in RSE materials can lack that dimension of true representation throughout their picture and scenario resources.
How does RSE contribute to abuse prevention?
If a thorough programme is being delivered across a school from the youngest pupils onwards, these topics, taught well, play an enormous part in keeping individuals safe. Sexual predators will most likely target children who are vulnerable, and that can include children who do not know the names of their body parts, have low self-esteem, are easy to convince to keep secrets and children who do not know their body boundaries.
Which topics specifically address this?
1. The naming of body parts and why that is important
2. What ‘private’ and ‘public’ mean
3. The difference between secrets, privacy and surprises
4. A child’s safety team
5. What consent is
6. How to recognise and manage risk-loving vs controlling behaviour
7. How to prevent STIs
8. How to prevent unintended pregnancy
9. Values and attitudes towards relationships and sex
10. Self-esteem/image and how that relates to relationships
11. Legal rights
12. Access to local services
As can be seen, RSE is not just about preventing STIs and unintended pregnancies; a large part of the curriculum covers topics such as self-image, self-esteem, emotions, values and attitudes, relationships, sexuality, health, safety and positive adult behaviour.
People with disabilities are as much sexual beings as anyone else. They have desires and romantic interests, hopes and dreams. It is vital for their personal growth and safety that they are included in well-planned lessons and are protected by school policies. This means it is our job as educators to make sure the information is appropriate and accessible to our learners. We see from the statistics what can happen if they are denied this right.
If you are a school leader, I shall leave you with the following questions:
- Do you have a trained member of staff who can confidently deliver comprehensive RSE to all age groups in the school?
- How are you supporting them?
- How are you monitoring them?
- How confident are they in delivering content to learners with additional needs?
- How are you supporting them with this?
- Are your learning support/SEN team trained in this area and included in planning sessions?
- Have you ever asked your learners with disabilities their opinions about the lessons they are receiving?
When all stakeholders in the school, including the parents, are on board and aware of the vital role RSE plays in education and safeguarding, then all children in the school benefit. When teachers make sure that lessons are accessible and representative, it helps not only SEND learners but everyone in their sexual health and emotional and social journeys into adulthood.
Vicky Walsh is a British qualified primary school class teacher who for the past 20 years has also coordinated and delivered Personal, Social, Health, Citizenship and Economics Education; a subject she feels covers some of the most important topics we can teach our children in order for them to live healthy and well-informed lives. Relationships and Sex Education falls under this curriculum, which became her passion at the very beginning of her career. Vicky has trained with many UK-based organisations, including Working With Men, The Christopher Winter Project and is an accredited ACET UK Esteem Network Member. Vicky has decades of experience with children aged 4-18 years old, and her counselling qualification and interest in healing therapies such as Reiki inform her relationships with young people. As a consultant, Vicky coordinates and mentors teachers in the delivery of this subject; delivers workshops for parents and children; consults with schools, creates resources and is currently also delivering the Relationships and Sex Education programme to Years 6-13 at St George’s International School, Rome.
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Baines, S., Emerson, E., Robertson, J., & Hatton, C. (2018). 'Sexual activity and sexual health among young adults with and without mild/moderate intellectual disability'. BMC Public Health, 18 (1), 667.
National Institute for Health Research (NIHR) (2020). 'Exploring support for adults with learning disabilities to find loving relationships'. https://www.sscr.nihr.ac.uk/wp-content/uploads/SSCR-research-findings_RF122.pdf.
Snell, J. (2018). 'Ending bigotry faced by LGBT people with learning disabilities'. Learning Disability Practice, 21 (1), 8-11.
Whittle, C., & Butler, C. (2018). 'Sexuality in the lives of people with intellectual disabilities: A meta-ethnographic synthesis of qualitative studies'. Research in developmental disabilities, 75(2), 68-81.