Teaching Healthy Sexuality, Boundaries, And Safety To Children With Special Needs
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PSN Team 
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Starting discussions about sexuality and relationships early can help make these conversations easier as your child ages. Discover how to foster open and honest communications with your child throughout their life.
TEACHING HEALTHY SEXUALITY, BOUNDARIES, AND SAFETY TO CHILDREN WITH SPECIAL NEEDS
In today’s digital age, children are exposed to sexualized content more than ever before. For parents, especially those raising children with special needs, teaching healthy sexuality, boundaries, and safety is more crucial than ever.
Parenting Special Needs Magazine spoke with Dr. Susan Kaufman, an obstetrician gynecologist specializing in pediatric and adolescent gynecology, and Dr. Amiee Morrison, a pediatric and adolescent gynecologist, to discuss how parents can navigate these challenges, initiate age appropriate conversations, and empower their children to make safe, informed choices in our increasingly sexualized culture.
Don’t worry if you don’t feel like reading; you can enjoy the podcast by listening below on YouTube.
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Two Real-Life Scenarios Why Early Education Is Crucial
Real-life scenarios such as the ones we share here occur all the time. Parents often do not realize when they should have the talk about private parts and sexuality with their children, and these scenarios highlight the importance of early conversation
1. Understanding Boundaries
A young boy (7 years old) with autism attends a public school in an autism setting program and then goes to an aftercare program. He made an inappropriate comment about “tickling her gorilla,” and proceeded to tickle her private area above her pants in a public area with staff all around. This resulted in his suspension from the school. His mother stated that he still takes baths with his younger sister, and she never realized she should discuss private parts.
2. Navigating Social Interactions
At a school, a neurodiverse young lady started flirting with one of the older neurotypical student volunteers, making him uncomfortable.
Her behaviors included shaking her hair, rubbing shoulders, flirting, and touching. He reported it and her parents were contacted.
These situations address the need for discussions about sexuality and sexual safety from a young age, and what parents need to know in terms of teaching and guidance.
How and When to Start Human Sexuality Discussions
Dr. Kaufman and Dr. Morrison shared the early discussions about human sexuality should start around 2, 3, and 4 years of age for all children, both with and without special needs.
Our culture has problems with talking about sexuality and parents don’t receive education or manuals on how to talk about this with their children.
The best place to start is by defining what a private part is, not in a sexualized way, but explaining the differences between girls and boys. Topics to address in these early conversations include:
- Who is allowed to touch or see these private parts
- Where and when it is appropriate for these areas to be touched
- What to do if someone touches these areas in a way that feels inappropriate
It is also crucial to use anatomic terms so that adults and doctors know what they refer to. Once that’s been established, a parent can ask them questions such as:
- What would you do if a stranger tried to touch that area?
- Would you stay or would you go?
- Would you keep it a secret or would you tell somebody?
When discussing private parts, it is also essential to include the mouth. Private parts are not just those parts of the body under bathing suits.
Take It One Step At A Time
When introducing sexuality to young children, you don’t want to scare them. This is knowledge for them to accumulate over time. That’s why we begin with using proper terms when speaking about body parts and not sexualizing them. Once you call them by slang names, you sexualize them. It’s essential not to scare them or shame them about their bodies.
When a child starts noticing anatomical differences, such as those of a sibling or parent, it is also time to explain them. That is also when to begin quietly separating bath and dress times. You want to keep the conversations educational so they don’t feel shameful or hesitant to ask questions as things come up. It’s crucial to maintain an open and honest attitude and normalize the privacy of one’s body. We want children to feel safe reporting something uncomfortable.
Here are some foundational concepts to start with and build over time:
Correct Anatomical Terms
Using accurate terms like “penis,” “vagina,” “vulva,” and “breasts” helps normalize body parts.
If children mention them by other names they’ve heard, calmly explain the correct terminology
Explain Private vs. Public
Explain which body parts are private and give clear guidance about who can see or touch them, for example, doctors and caregivers, and why that might be necessary.
Have caregivers and doctors explain why they might need to see or touch an area before doing so.
Introduce the Concept of Consent
It’s essential that children feel in control of their bodies and learn how to avoid inappropriate or unwanted touch. This extends beyond private parts, as some children might not want hugs or kisses.
Explain that it is never appropriate for a stranger to touch them unless there’s some form of consent, and why that might be necessary (such as with a new doctor).
Family, friends, and acquaintances often present physical touch, and you can discuss with the child what they are comfortable with.
Some children may prefer holding hands or a fist bump over a hug or kiss.
Consent Is More Than Sexual
Consent can also extend to control over other areas of one’s body, as children can say yes or no to what they eat and what type of clothes they want to wear.
This can help them feel more comfortable saying no when someone wants to kiss or touch them.
As previously mentioned, the mouth can be seen as a sexual organ along with its importance for eating and talking.
You can talk with children about kissing, whether they want to kiss somebody on the lips or the cheek, and how people kiss them.
We often tell kids to hug relatives, especially when they come for holidays, but perhaps they don’t want to.
Consent is not just sexual; teaching it early that they have control over their bodies in general is crucial.
Even older adults don’t always like to be hugged or touched, and we need to be aware of that ourselves in social situations.
As adults, we often think, I’m just going to touch that baby’s foot. We need to stop and ask the parents for permission.
It’s a mindset that we need to develop. Instead of telling a child to hug the aunt, we need to ask if they would like to hug the aunt.
If they or the aunt say no, that has to be ok. Pushing the child to give the hug teaches them that they don’t have control over what they do or what someone does to them. That can also be used as a teaching moment for other adults in the room.
As they get older and feel attracted to somebody, they may want to kiss them. It’s okay if they say no to consent; it goes both ways. It’s essential to teach that there is no shame or fear in saying no.
Differences In the Special Needs Population
Children with special needs always try to please someone, whether it’s their parents, teachers, or therapists. They may avoid saying no to something uncomfortable or not understand socially unacceptable behavior, such as always hugging and kissing someone in public.
Because people with special needs are more susceptible to sexual abuse, these conversations are crucial throughout life. Some people will always depend on caregivers for help bathing, dressing, and even changing diapers when they are older. We must help them understand there are still boundaries even though they need a lot of physical care.
Navigating Sexuality and Sex Education
Children with special needs go through the same hormonal changes that teenagers without disabilities have.
Still, because they are often thought of as asexual, nobody envisions them growing up to be sexually active.
It is crucial to eliminate that stereotype because it inhibits conversation and education.
This is especially important with young women with special needs who need to understand safe, non-abusive relationships and what it means to be sexually active.
Young people with special needs do not always know how to express their sexual feelings, and we have to help them do that and educate them on appropriate behaviors.
It can be uncomfortable at times to have these discussions with older children who may be exploring their sexual feelings for the first time.
They may be doing inappropriate behaviors in front of others as they explore new physical sensations. Bringing your child to a doctor who can speak with them about this can help solve problems together.
Some parents of children with special needs take their kids out of sexual education classes in school.
That can be a big mistake as it provides crucial information these children need to know, especially about contraception and sexual behaviors.
Girls can learn about their periods and the products to use as early as fourth or fifth grade.
It’s essential to remove any stigma about these topics and provide children with this information.
While some students cannot be part of those classes, most can and should.
The Importance of Starting Young and Building On the Topic
By starting young, you open a conversation and discuss what is age-appropriate.
Allow for questions and provide answers based on their age.
This helps build trust so the child feels comfortable coming to you when other questions arise.
Address situations as they come up, knowing you are not starting from square one, which can lead to too much information all at once.
Sexual vs. Romantic Relationships
It is natural for young adults with special needs to feel and experience romantic relationships.
However, some parents find this subject difficult to discuss and may monitor the time spent together instead.
Some questions to discuss with your child include:
- Do you want to kiss your boyfriend/girlfriend?
- How does that make you feel?
- Do you initiate the kissing?
- How does your boyfriend/girlfriend approach you when he/she wants to kiss you?
- Do you ever want to touch other body parts or want other parts of your body, such as your breasts, touched?
These questions can be difficult, but you can slowly build the conversation.
It is also beneficial to speak with the other party’s parents to see what discussions they have had.
Sexual and romantic relationships can overlap, but openly discussing intimacy with kids with special needs is crucial. Romantic relationships and companionships are a beautiful thing.
If there is any concern for sexual activity or desire for sexual activity, which is different from romantic relationships, it is crucial to discuss contraception, pregnancy prevention, and STI (sexually transmitted infection) prevention.
It’s an important conversation to have with people with special needs to stay safe and avoid pregnancy if they want to be sexually active with a partner.
And, again, discussing and preventing sexual and physical abuse.
Young people with special needs may not understand the difference and do not realize that abuse is occurring. It’s essential to protect them from sexual abuse by a partner and to understand consent.
Resources Are Available
Online resources are available to help parents discover how to talk to their children of all ages.
Many illustrated books discuss consent and body parts that can be incorporated into bedtime routines, which can help parents open discussions on this topic. Some of these books feature diversity, which can help children feel included.
Dr. Kaufman discussed her book about a young girl with autism who goes through puberty and begins to have periods.
It is a picture book that parents can use as early as six or seven to teach a girl how her body changes. It can be read a few pages at a time, covering only the changes happening now and building on them as the child matures.
Dr. Kaufman’s book: Nora and Her Body: A Guide to Puberty For Girls With Neurodivergence and Strong Girls Everywhere.
Kennedy Krieger has many resources.
National Library of Medicine
Let’s Talk About Sex: Sex and Relationship Education for People with Intellectual Disabilities
Final Takeaways: Start Early and Maintain Open Communication
Some key lessons and takeaways from this discussion are:
- Start early: Begin conversations as young as 2, 3, and 4, to explain body parts in their proper terminology and teach body safety.
- Maintain open communication: Encourage questions and evolving discussions as the child grows.
- Normalize the conversation: Do not apply any shame – let the child feel safe discussing these topics.
- Explain consent: Let them know they have control over their bodies from toddlerhood, including hugging, touching, and kissing.
- Understand and recognize romantic and sexual development and relationships: Have the crucial discussions to protect your child from abuse, pregnancy, and STIs.
By starting early in childhood and fostering open and honest discussions, parents can help their children navigate the physical and sexual changes that occur as they grow.
Providing age-appropriate discussions can help ensure a child’s safety and well-being.
Related: Gynecologic Care for Young Women with Special Needs: A Must-Know Guide for Parent
About Experts
Susan I. Kaufman, DO, FACOG
I am a pediatric and adolescent gynecologist practicing in South Jersey. I provide specialized care for girls, teens, and young adults, including those with neurodivergences and physical differences.
Dr. Aimee Morrison, Assistant Professor of Clinical Obstetrics and Gynecology, Weill Cornell Medicine.
Dr. Morrison is a board-certified Obstetrician and Gynecologist. As a specialist in Pediatric and Adolescent Gynecology, she treats young patients with a wide range of gynecologic and reproductive needs.
Dr. Morrison is a board-certified Obstetrician and Gynecologist. As a specialist in Pediatric and Adolescent Gynecology, she treats young patients with a wide range of gynecologic and reproductive needs.
