Talking to children with cognitive disability about sex

All people, including those with a cognitive disability, have the right to explore and express their sexuality in appropriate ways. Everyone needs ongoing, age-appropriate sexuality education to develop positive attitudes about their sexuality. For people with a cognitive disability, comprehensive sexuality education can help them stay safe, reduce their risk of sexually transmissible infections (STIs) and help prevent an unplanned pregnancy.

Many parents do not provide sex education because they mistakenly think their child will not need it. Others try, but struggle to present the information in a way their child can understand.

What sex education should cover#

Aspects of sex education include:

• correct anatomical language (using proper names for body parts)
• developing social skills, including concepts such as public and private
• how to develop and maintain different types of relationships
• coping with relationship issues or rejection
• sex and relationships, including marriage and parenting
• protective behaviours
• the physical and emotional changes of puberty
• the biology of sex, including reproduction
• appropriate and inappropriate expressions of sexuality
• same-sex attraction
• STIs, safe sex and contraception
• masturbation

Tailor information to your child’s needs#

There is no single model of sexuality education that suits all children with a cognitive disability. Information needs to match your child’s level of understanding. For example, children with a moderate or severe cognitive disability may need more basic information (and in picture format) than children with a mild cognitive disability. This could include the biological differences between male and female bodies, what kinds of touch are appropriate or inappropriate, and how to behave in different social situations.

Preparing for sex education#

Suggestions for parents include:

• Make sure you have all the information you need, and check any details you are unsure about.
• Look at a range of books and other resources on sexuality and disability, including online.
• Ask your child’s teachers or carers about the sex education their school provides; they may be able to give advice or suggest useful resources.
• Talk to a disability support service, a sexual health clinic, and parents and carers from relevant support groups for tips on how best to give your child the information.
• Work through any feelings of unease and embarrassment you may have, possibly with the help of a counsellor.

Decide beforehand which words you are going to use. This can be difficult, because names for reproductive body parts, such as the vagina and penis, are often either vague or slang. Avoid terms such as ‘front bottom’, as these can confuse your child or give the impression that talking about genitals is shameful. Keep your messages positive and non-judgemental.

Different ways to talk about sex#

Make the most of moments when your child shows curiosity — for example, when they see actors kissing on television and start asking questions. Suggestions include:

• As with any child, sexuality education should be delivered over time. Give the simpler facts first, then add to your child’s knowledge as they grow older.
• Try to deliver information as simply as you can, and keep discussions light and fun.
• Anatomically correct dolls can help teach your child about the differences between males and females.
• Children with a cognitive disability often find abstract thinking difficult, so use a range of resources such as books with clear, simple pictures, DVDs, dolls and three-dimensional models of body parts.
• Read age- and developmentally appropriate stories about sex and sexual issues together. A disability support service or sexual health clinic may be able to provide resources.
• Role play can help when discussing relationship skills or assertiveness — for example, helping your child practise saying ’no’ to unwanted physical contact in different settings. This includes asking before physical contact such as hugs, kisses or hand-holding. Extended family should also practise asking permission before physical contact, and listening and acting on the child’s answer.
• Role play can also help your child understand the difference between private and public places.
• Use demonstrations where possible. For example, use dolls to show where babies come from, or take your daughter with you to the toilet to demonstrate pad changing and disposal.
• Masturbation can be discussed as a healthy and natural way to explore and express sexuality on your own, in a private place.

Negotiating more difficult issues#

Some parts of sex education are harder than others. Suggestions include:

• Use praise and positive reinforcement when your child shows they understand a topic or displays the desired behaviour.
• If you don’t know the answer to a question, say so, and suggest finding out together, possibly online.
• It’s okay to feel uncomfortable or embarrassed, as long as you are honest about it with your child.
• There is no single right way to talk to your child about sex — it will be a process.
• Don’t be discouraged if a particular method doesn’t work. Put it behind you and try another approach. What works for some parents may not work for you, so keep experimenting.
• If your child is having trouble grasping a concept, try breaking it into smaller parts.
• Seek advice from a disability support service, a sexual health clinic or relevant support groups.

Following up#

Try to use simple, concrete words and concepts, and use a range of methods for each topic to improve the chance that your child remembers. Suggestions include:

• You may need to cover the same topic several times before your child fully understands, as some children need constant reminding.
• Ask your child questions to check they have understood the information.
• Using dolls or puppets can help your child show their understanding without feeling pressured.
• Keep your child’s carers informed, and make sure that sexuality education from other sources gives the same messages that you provide.

Where to get help#