Sexual Education for

Adults with Disabilities

Tool 0
Introduction to Tool Kit

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
Preface
As in the past and in 2015, many people still refuse
to recognize that people with mental disabilities have
sexual feelings, needs and desires. This leads to the
situation that disabled persons often do not receive
sexual education. The results of this gap are that
the disabled often have difficulties in understanding
their own desires and needs and in the worst case,
this could lead to sexual abuse.
The Grundvig project SEAD has developed a “tool
kit” to use for sexual education for mentally disabled
people, for those who have no access to information
relating to sexuality.
The tool kit can be used by the target group itself
and parents or persons who work with the target
group.
Eight partners from seven European countries have
gotten together, concentrated their knowledge and
developed something new. The partners have been
accompanied and supported by a board of experts
from Germany, Finland, and the Netherlands.
The result is something to be proud of and can be
used for a longer period in time by the target group.
Now one can find materials and methods that help
explain these topics relating to sexual questions in
an easy and understandable way, making them clear
and visible.
There is for example, the “Word Bank” from the
English partner that explains in a simple expression
sexual terms. Different methods to make contact in
new groups come from the Hungarian group and
finally, as a last example, there are visual aids from
the Dutch partner, which makes understanding
easier.
All the methods and all die visual aids are not equally
suitable for everyone. One has the choice to pick out
the suitable material and methods, depending on
the different environment and people. This is proof
of the diversity and flexibility of the kit which leads
long-term benefits for all involved.
Our partners: (in alphabetical order)
Belgium: Autism Europe
Germany: Bergische Volkshochschule and EUConcilia
England: Change (Leeds)
Finland: Luovi Vocational College
The Netherlands: University Arnhem/Nijmegen
Lithuania: Kaunas Centre for young disabled people
Hungary: Gábor Molnàr workshop foundation
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The SEAD team would be very glad to find many
users, a wide area of application, good results and
insights for interested people. To be able to talk
about sexuality, to understand sexuality is a human
right.

With this tool, the SEAD team contributes to these

goals.

Disclaimer

The European Commission support for the

production of this publication does not constitute
an endorsement of the contents which reflects the
views only of the authors, and the Commission
cannot be held responsi­ble for any use which may
be made of the information contained therein.

3
Sexual Education for
Adults with Disabilities

Tool 1
Drama Play

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
Drama play questions for discussion
There is a wonderful story in the treasure of the 0:00 – 4:00 minutes
world literature, which inspired us to create, and Birth of human. Meeting the world and other
which relied on the drama play. God brought the people. Girl meets boy, watching each other bodies
man to two doors - hell here, but here’s paradise. behavior.
In the Hell to the table sit hungry crowd, unhappy
people who are trying to eat, the most delicious 4:00 – 7:00 minutes
dishes standing in the middle of the table. The Making the contact between girl and boy.
spoon with very long handle is given to each person What the boy is looking at?
to reach the food. People reach the food, but can’t What feeling has the girl?
put it into their mouths, because of the long handle. What do you think feels the boy?
They are angry, blame each other, because they
can’t eat. 5:00 minutes
What are they doing? Do you think they are
In the Paradise everybody are happy, nor the interested each other?
situation is the same, and the table, and the spoons, Do they trust each other?
but here they learnt how to feed others, but not try to How they feel themselves?
put the food in their own mouths. The moral of this
story works and in the sexual education. 7:00 – 9:00 minutes
What kind of feeling do they have/experienced?
The drama play is from two parts, but both parts are What relationship grows/ occurs between them?
intertwined with the same heroes, the story consists What change occurs in the relations? What
of the integral piece. The main idea is, that we all happened?
have to learn how to love, but not how to make love. What kind of feeling has the girl?
In the second part was ruined heroes emotional Doesn’t she feel lonely?
world, destroy everything valuable, leaving the
person, just as a tool for someone for physical settle 9:00 – 12:00 minutes
and the motivation of the rebellion… Does the girl behave properly decided to help the
boy?
Does the boy except the help?
What feelings they are experiencing?

2
12:00 – 15:30 minutes
What do you think they are doing here?
Do they acting correctly?
Whether is acceptable to both?
Is there any negative or positive feelings?
Does the girl trust the boy?
Is the boy attentive/ gentle enough for the girl?
Are they a couple?
Do they feel safe with each another?

15:30 – 20:00
What kind of society surrounds them?
Do the members of society behave correctly?
Are they friendly?
How does the society excepts young people with
disabilities relationships/ love?

20:00 – 25:00 minutes

The society distinguished them!
What kind of feelings came to the girl?
Does the public/people who around her behave
normally?
Sexual violence
How does the girl feel?
Does she need help?
Do other people must help her?
Do they want to help her?
What kind of help the girl need? And how other
people could help her?
Do they behave right when they turn their backs for
the girl?

25:00 – end Disclaimer

What do you think happens now?
Does the boy acts correctly to accept the girl back?
What kind of feelings they have?
Do they feel close to each other?
Do they trust each other?
The European Commission support for the
production of this publication does not constitute
an endorsement of the contents which reflects the
views only of the authors, and the Commission
cannot be held responsi­ble for any use which may
be made of the information contained therein.

3
Sexual Education for
Adults with Disabilities

Tool 2
Bosch Photo Folder

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
“From Head till toe”: folder of 96 pictures for sexual education
Purpose of the pictures is, to give staff, parents,
teachers and special educators of people with
learning disabilities very concrete and direct
material in hand which enables to give good sexual
education.
The pictures are made according to scientific
standards and are tested in several designs before
being finalised in the actual form. Ellen Suykerbuyk
and Erik Bosch from the Netherlands are sexual
educators since more than 25 years and developed
this folder as a result of their experience. They
also wrote many books about their work which are
translated also in German.
At first sight, the dark background and the mixture
of real photos embedded in computer animated
pictures may appear a bit strange. But the result in
the practical context of sexual education with clients
with learning disabilities is that the pictures are well
understood and show exactly what it should: themes
are direct and without abstractions.
This material is a good basis to explain sexuality,
often together with other educational materials
as body- models (as the PAOMI- genital models
included in “The Box”), easy-to-read booklets and
other educational material. Most sexual educators
have a pool of materials where one can choose out
of, fitting to the actual theme of education and the
applicable target group.
Having good material is one side of good education,
the professional education of the person who
educates is the other side. It is important that a
person who does sexual education is especially
skilled for it, and the knowledge about sexual
themes have to be both correct and up to date!
Please reflect your skills and get yourself actual
training if you want to do a good job!
Next to professional knowledge and Materials it
is important to have a pool of learning methods.
Having a variety of methods means the education
will always stay interesting for clients (and yourself)
no matter if you do 2 or 20 units. In “The Box” you
will find a variety of methods.
Last but not least a professional attitude means to
hold back with your own standards and values and
see which attitude the client brings. An exception is
of course when someone’s attitude is harmful to him/
herself or others.
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Topics in the map.
- Development of man and women from Baby till adults
- Having sex with yourself
- Having sex, making love
- Homosexuality
- Using a condom and other contraceptive methods
- Hygiene
- Intimacy
- Private atmosphere
- Social behavior with each other
- Pornography
- Having a baby/ wishing a baby
- Sexual abuse
- Technique and emotions
And all these different topics come back to four main
topics in sexual education work:
- View on male and female body – who are you? Do
you know differences of female and male body?
- Standards and values in society – what is okay,
what is not - how to behave and to speak on an
appropriate way in our society.
- Having relationship – what does it mean to have a
relationship? How can you take care of each other,
are you sensible for the wishes and limitations of
each other? How to speak with each other?
- Self-awareness and self-confidence – am I able to
protect myself against sexual abuse, and am I able
to get myself support when it has happened? Sexual
education is extremely important as prevention of
sexual abuse!
Ideal frame of sexual education
- A room which is big enough with a nice ambiance
and windows where nobody can look inside.
- Be sensible if other staff, parents or teachers wants
to take part of a sex education setting; the clients
and you decide if that is OK!
- Make clear that the persons who stay outside the
session can only be informed on the topics, not
about private questions or statements!
- A clear definition of what time the education starts
and ends.
- Private atmosphere: everything which we talk
about stays between us, no matter if we are in a
group setting or in a personal counseling setting. We
respect and take each other serious!
- Clearing group and behavior rules. We decide
about them together!
- Respect your own limits and those of other
persons. Tell others if you don’t want to speak about
something. Never force someone to say things the
person does not want to!
- Respect other opinions, everybody can tell his own
opinion.
- We laugh with each other, but not about someone
else.
- Take care of an open, joyful atmosphere, with
much laughter and happiness.
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- A sex educator asks a lot of questions, and helps
finding the right answers. Praise the clients for
finding the answers a lot. This way they learn to be
curious and to ask more questions.
- If clients have decided what the topics of interest
are, the educator can prepare one of theses and
select the fitting pictures out of the folder. Also one
can select the methods and other/accompanying
materials he or she wants to use. This way the
educator is well prepared!
Topics/Issues of the pictures and numbers:
- 01-01 until 01-10: development from man and
woman from baby to adulthood.
- 02-01 until 02-06: male erection in different
situations
- 02-07 until 02-09: female change of body as child
and young woman + the period
- 03-01 until 03-09: female body and masturbation
- 03-10 until 03-15: male body, masturbation,
ejaculation
- 04-01 until 04-11: heterosexual sexuality and
sexual intercourse and positions
- 05-01 until 05-06: lesbian couple and sexuality
- 05-07 until 05-12: homosexual couple and sexuality
- 06-01 until 06-03: use of condoms and other
contraceptives
- 07-01 until 07-05: hygiene
- 08-01 until 08-05: spending time together –
heterosexual couple
- 09-01 until 09-06: people touching on a nice way
- 09-07 until 09-15: sexual abuse, talking about it,
emotions
- 10-01 until 10-04: pornography
- 11.01 until 11-07: having a baby
A sexual educator can mix the pictures from the
different chapters!
Much pleasure using this map!
Floris Bottinga, pro familia Solingen, Germany
mailto: floris.bottinga@profamilia.de
Disclaimer
The European Commission support for the
production of this publication does not constitute
an endorsement of the contents which reflects the
views only of the authors, and the Commission
cannot be held responsi­ble for any use which may
be made of the information contained therein.
4
Sexual Education for
Adults with Disabilities

Tool 3
Thematic Card Game

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
Thematic Card Game
The Human Body
Question
Can you get pregnant if you are on your period and
have sex without using a condom?
Question
Do you know the difference between a boy and a
girl?
Envelopes
Puberty
Puberty is when the body physically changes from
that of a child into an adult. The shape of the body
changes, hair starts to grow where it didn’t grow
before, and girls start their periods.
These changes take place in all boys and girls but
they will start at different times.
Vagina and clitoris
Vagina and clitoris are names of female sex organs.
Menstruation or period
A period is when blood leaves the womb through the
vagina.
This happens once a month.
Penis and testicles
Penis and testicles are names of male sex organs.
Penis and testicles come in all shapes and sizes.
Erection
An erection is when the penis becomes hard and
erect
Friendships and Relationships
Question
Have you ever been in love?
How did that feel?
Did you know that…
Love is not the same thing as ‘infatuation’ or ‘being
in love’? A relationship starts with infatuation. When
you’re in love, you only see the good sides of a
person. This changes after a while. Infatuation can
turn into love. If you love someone, you want the
best for them. That kind of love does not just go
away. The feeling of ‘being in love’ may come back
every now and again, but not as intensely as in the
beginning.
2
Envelopes Lesbian
A lesbian is a woman who is attracted to other
Girlfriend or boyfriend (relationship) women.
A girlfriend or boyfriend is someone you like and
who you enjoy being with. This person feels the Heterosexual
same way about you. Heterosexual is when you are attracted to the
opposite sex. Men are attracted to women; women
Friend (relationship) are attracted to men.

A friend is someone you enjoy spending time with. Transgender

Partner A transgender is a person who cannot identify with
A partner is another word for girlfriend or boyfriend. the sex he or she was assigned to at birth. A man
feels that he is a woman, and a woman feels that
Sexual Orientation she is a man.

Question Transvestite
Can homosexual couples have children? A transvestite is someone who dresses temporarily
in clothes of the opposite sex or pretends to be
Did you know that… someone of the other sex. In other words, a woman
In the past, people used to think that homosexuality pretending to be a man, or a man pretending to be a
was a disease. woman.
We know now that this is nonsense. However, there
are people who still find gays and lesbians strange. Sexual Abuse
They even call them names.
What do you think about this? Did you know that…
Loverboys use girls to traffic drugs, take out money
Envelopes loans, transfer a car title to their name or commit
crimes such as shoplifting?
Bisexual
A person who is attracted to both men and women is Did you know that…
called bisexual. Victims of sexual abuse sometimes believe it is their
fault? This is not the case! Nobody has the right to
Homosexual or lesbian force another person to have sex. Not even if you
Homosexual is when you are attracted to a person of are his girlfriend or if you said ‘yes’ the last time. Or
the same sex. Men are attracted to men; women are if you were wearing a sexy dress or let him buy you
attracted to women. a drink. Or if you are a guy and your friends say that
you are a loser if you say ‘no’.

3
Envelope
Consent
Consent is when you agree to something. It is
important that both people agree to have sex.
You don’t have to agree to sex if you don’t want to.
Discrimination or homophobia
Discrimination or homophobia is when someone is
treated badly because of their sexual orientation.
For example, when someone is picked on or hurt
because he or she is gay.
Rape
Rape is when someone forces another person to
have sex against their will and without their consent.
Sexual abuse and rape are against the law.
Sexual abuse
Sexual abuse is when someone touches your
body or private parts in a way that makes you feel
uncomfortable.
When someone has you touch his or her body
against your will, this is also called sexual abuse.
Loverboy or lovergirl
A loverboy or lovergirl is someone who seduces and
then abuses you. First they treat you wonderfully and
shower you with attention and beautiful or expensive
gifts, such as a new mobile phone or scooter. You
do fun things together (go to the movies or out to
dinner). When you have been dating for a while, they
force you to have sex with other people.
Some victims are forced to prostitute themselves: to
have sex for money.
Sex and Masturbation
Question
What is an erection?
Question
What is an orgasm?
Envelope
Anal sex
Anal sex is when a man inserts his penis into his
partner’s anus. When you have anal sex, you should
use a condom so that you don’t get an infection or
STD.
Masturbation
Masturbation is when people touch their own bodies
for sexual pleasure. A man masturbates by touching
his penis. As a result, his penis becomes hard.
A woman masturbates by touching her breasts,
vagina and clitoris. As a result, her vagina gets wet.
Oral sex
Oral sex is when you touch, lick or suck someone’s
penis or vagina with your mouth.
Orgasm
Orgasm is the name for the feeling of intense
pleasure and excitement reached when you have
sex with someone or masturbate.
It is a feeling that builds up and goes through your
entire body. When a man has an orgasm, sperm
comes out of his penis. Most women find they get
wetter during an orgasm.
Sex
Sex is when people touch, cuddle, stroke and kiss
each other’s body.
A man puts his penis into the woman’s vagina.
This can cause a woman to get pregnant.
4
Talking About Feelings Question
Have you ever chatted online?
Did you know that… How did you like that?
One out of six girls and one out of 25 boys are talked
into or forced into having sex? This means many Envelope
young people have had sex against their will at some
point in their lives. Remember that it isn’t your fault Online dating
when someone crosses a boundary that you have If you want to meet people, you can date via the
set. Sometimes people don’t listen to you at all and Internet.
there is nothing you can do. But there are things you You can fall in love with someone and meet up.
can do to reduce the chance of this happening. For Attention: always tell an adult that you are meeting
example, by being very clear about what you do and someone. You can also bring someone along on
don’t want. your date.

Question Webcam sex

Have you ever had an experience where someone It is not only possible to see sex online, you can also
crossed your boundaries? have sex online. For example, by using a webcam
or having erotic chatting sessions. Note: make
Envelope sure you know who the other person is. Make clear
agreements with each other.
- Enjoyment
- RegretIn love Values and Beliefs
- Pain
- Startled Question
- Angry Is it allowed to walk around naked everywhere?
- Afraid Question
- Happy Everyone is entitled to their own opinion. Perhaps
- Crying you think differently about certain matters than your
classmates or parents. This can be difficult and
The Internet confusing. What is the truth?
Tip: find out what feels right for you. Respect other
Did you know that… people’s views. Wouldn’t you want to be treated in
Flirting and dating online can be fun and exciting? the same way?
Although the Internet is great fun, it does have
dangers. Adults can pretend to be your age and lure
you into chatting with them.

5
Envelope
Giving and receiving compliments – Norms and
Values
Norms and values tell us how we should and
shouldn’t behave. Some norms are laws, other
norms are formed by the environment.
Values are what we consider to be ‘right’ and
‘wrong’.
Values are wishes and considerations.
Values are usually determined by your environment.
What is ‘right’ and what is ‘wrong’?
Norms and values are written down in laws, but can
also be determined by your environment. Different
religions have different values.
Every person has his or her own norms and values.
What behaviour is appropriate in public and
what not?
There are norms and values about what is
appropriate or not. For example, it is okay to eat in
public but you should have sex in your room. You
can make agreements about this with your care
worker.
How should you treat other people?
There are also norms and values for interacting with
others.
A norm is: it is not okay to make fun of people.
A value is: treat others respectfully and kindly.
Porn
Pictures or movies of naked people having sex is
called porn. In a porn movie, it seems as if people
feel like having sex all the time and everywhere.
They also immediately jump at the chance of having
sex, in all kinds of positions.
Porn is all fantasy. And in a fantasy world anything
can happen and anything goes.
This is very different from reality. In the real world,
there are other norms and values.
Safe Sex
Question
Do you know how to use a condom?
Did you know that…
A penis or vagina can also get sick? This is called an
STD.
Your penis or vagina can get a disease when you
have unprotected sex (sex without using a condom)
with someone who has an STD.
If you have an STD, you need to see a doctor.
Envelope
Condom
A condom is a rubber covering which a man
wears on his penis during sexual intercourse as
a contraceptive. If a condom is used properly, it
protects against infections, STDs and pregnancy.
6
Birth control or contraception
Birth control, also known as contraception, are
methods or devices used to prevent pregnancy
when a man and woman have sex. There are
various forms of contraception. Some contraceptives
are available over the counter in shops, others
require a prescription from a doctor.
Birth control pill
A birth control pill, also called ‘the pill’, is a medicine
that a woman can take so that she doesn’t get
pregnant.
You have to go to the doctor to get birth control pills.
And you must take them exactly as the doctor tells
you.
Sexually Transmitted Diseases (STDs)
STDs are infections which are passed from one
person to another through sex. If you have an
infection, it may hurt when you go to the toilet. Or
your vagina or penis may be sore or itchy.
Articulating Boundaries and Assertiveness
Assertiveness
Assertiveness is being able to stand up for yourself.
When you are assertive, you know what you want
and what you don’t want.
Articulating boundaries
A boundary indicates what you don’t want to happen
or do.
Each person has his or her own boundaries. It
is important that you learn how to articulate your
boundaries.
Saying ‘no’
It is important to say ‘no’ when you don’t want
something. This can be learned. It is also called
‘articulating boundaries’.
Getting attention
There are several ways to get someone’s attention.
There are negative ways to get attention. For
example, by hitting or yelling. You can also get
attention in a positive way, for example, by tapping
someone’s arm or asking a question.

Question Sexuality and Intimacy

Do you know how to say ‘no’?
Question
Question Do you know what sex is?
How do you know when someone wants or doesn’t
want to do something? Question
Do you know what ‘sexy’ is?
Envelope What do you find sexy?

Suitable distance
If you stand too close to another person, he or she
might feel uncomfortable. If you are uncomfortable
yourself, you can show this by saying: ‘Do you mind
taking a step back?’

7
Envelope
Sexuality
Sexuality has to do with your body and feelings. You
can experience sexuality alone or with others.
Sexuality is about making love, touching and how
you feel as a person.
Almost every human being has sexual feelings.
Sexuality encompasses many different aspects of
our lives.
Baby
A baby fully depends on his or her parents or
caregivers.
This costs a great deal of time and energy.
Pregnant
A woman can get pregnant. Being pregnant means
there is a baby growing inside a woman’s body.

Intimacy
You can be intimate with another person. You can
feel close to your parents or a good friend. Giving
someone a cuddle or sharing secrets is a form of
intimacy. Making love is also an intimate connection.

Reproduction

Question
Do you know how a women gets pregnant?

Question
Do you know how long the baby grows in the
mother’s belly before it is born?

Envelope

Contractions/pregnancy
Contractions are cramps that start before the baby
is born. Contractions are very painful, but they help
push the baby out.
Disclaimer
Childbirth
Childbirth is when a baby is born. The European Commission support for the
Baby food & bottle production of this publication does not constitute
Babies need to be fed frequently, both during the an endorsement of the contents which reflects the
day and at night. views only of the authors, and the Commission
cannot be held responsi­ble for any use which may
be made of the information contained therein.

8
Sexual Education for
Adults with Disabilities

Tool 5
Paomi Models

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
Operating instructions for PAOMI - Models of male and female genitals

The PAOMI Models of male and female genitals Woman:

are made to help sexual body education easier and
more in order to learn with all senses. - Vagina
- Labia majora
In “the Box” there is a very simple male Model with - Labia minora
foreskin which does not have the inner sex-organs - Clitoris
shown. These you can order separately at PAOMI. It - Clitoral hood
is also possible to order circumcised penises and for - Urinary meatus
the female Model there is also a bladder available. - Vaginal Opening
- Vagina
The female Model in “The box” comes with a uterus - Uterus
and ovaries as well as 3 possible models of the - Mouth of the uterus
hymen. - Ovaries
- Fallopian Tube
The Models enable to explain the parts and names
of genitals It makes sense to work with more than only the
Models. It is suggested to work with additional
Man: pictures and drawings.

- Penis Together with the BOSCH picture map and the small
- Glans booklets from Change one has a good combination
- Foreskin of materials.
- Shaft
- Urinary meatus
- Testicle
- Scrotum
- anus

2
Themes can be very different.
1) Language: explain the models, and ask the
clients which common names they know.
a. Write them all down; encourage them to name
ALL they know, even the ones that are “not decent”.
b. Then talk about the names you want to use
together with the clients
c. If they can, give them a picture on paper and let
them write the names on it
2) Function: explain the functions, measures of
the different parts.
3) Function of arousal on body parts: what
changes when you have sexual feelings?
a. Man: stimulation, erection of the penis, orgasm
and ejaculation,
b. Woman: stimulation of clitoris, vaginal lubrication
and orgasm
4) Function: function of the menstrual cycle,
menstruation and possibilities of menstrual
products
5) Pregnancy and birth
6) Importance of Hygiene:
a. Men: how and when one should wash his genitals.
Especially under the foreskin of men hygiene is
important.
b. Circumcision of man and the reasons for and
against it.
c. Woman: For woman it is important to know that
only water should be used between the Labia. Soap
or other hygienically products may have negative
consequences on the natural cleaning possibilities
of the vulva.
7) Female genital mutilation
8) Possible diseases: it may be important to
give information about prevention of cancer
(Scrotum for men and uterus for woman).
9) Aids and other sexual transmitted diseases.
10) Information about contraceptive possibilities
and sterilization
11) And many other themes
The PAOMI Models are very popular with the clients
but they must be very taken care of; they can easily
be ripped apart!
They are handmade and can be washed by hand!
A good way of protection is a simple square
Tupperware box.
The PAOMI- Models can be used in group- or in
single counselling setting.
Floris Bottinga, pro familia Solingen
mailto: floris.bottinga@profamilia.de
Disclaimer
The European Commission support for the
production of this publication does not constitute
an endorsement of the contents which reflects the
views only of the authors, and the Commission
cannot be held responsi­ble for any use which may
be made of the information contained therein.
3
Sexual Education for
Adults with Disabilities

Tool 8
Competence Cards

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
Competence Profile
Project SEAD is an international project that focuses
on the lack of knowledge in the field of sex education
for people with intellectual disabilities. SEAD is an
initiative of the European Union and is founded with
a goal to draw attention about the importance of sex
education.
The goal of Project SEAD is to improve sexual
education for people. In addition, Project SEAD tries
to increase the dissemination of knowledge within
these European countries.
Project SEAD has done research and it has
emerged that different kind of competences are
needed for you as a professional to master in
order to respond to sexual issues of people with
intellectual disabilities, their parents, and their
caregivers appropriately.
Through various studies SEAD has detected the
needs of the clients, their parents and upcoming
professionals in the field of sex education. In
addition, the competences a professional should
know how to answer sexual related questions have
been looked at in the research as well.
In order to respond to sexual issues of people
with intellectual disabilities, their parents and their
caregivers, it is important that you as professionals
have mastered different competencies.
In the competence profile, these different
competencies are described. These competencies
are linked to four focus areas. These four focus
areas emerged out of research of Project SEAD and
describes the requirements sexual education has to
meet.
Focus area 1
Knowledge about the sexual development of people
with intellectual disabilities.
Focus area 2
Knowledge of suitable materials that can be used
to answer sexual questions from people with
intellectual disabilities.
Focus area 3
Skills to identity sexual issues of people intellectual
disabilities and respond to them.
Focus area 4
Awareness of your own values towards sexuality and
sexuality of people with intellectual disabilities.
2
How can the competence profile be applied?

As a professional you can see which competence

you have already mastered by looking at what is
described in the competence profile. There will be
a visualisation of the competences you have and
can develop. This gives a nice and clear picture of a
‘professional’ status.

To develop these lacking competences you can

use the toolkit developed within Project SEAD. This
toolkit is set up as a website.

On the website, each focus area is displayed and

presents how a professional can find information
to increase their knowledge in all competences, in
order to respond to sexual issues of people with
intellectual disabilities, their parents and caregivers
in an adequate way.

Disclaimer

The European Commission support for the

production of this publication does not constitute
an endorsement of the contents which reflects the
views only of the authors, and the Commission
cannot be held responsi­ble for any use which may
be made of the information contained therein.

3
Sexual Education for
Adults with Disabilities

Tool 9
Handbooks
Instructional Guide – The Box

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
Instructional Guide – The Box
Introduction Instructions - 3
Content of The Box - 3
You are holding the instructional guide for the tool kit Instructions - 3
that has been developed on behalf of project SEAD.
Resources - 4
The tool kit contains various resources and tools to
The Human Body - 4
support and prepare for teaching sexual education
Sexuality and Intimacy - 4
to people with light intellectual disabilities.
Friendships and Relationships - 5
This document serves as a guide for health
Norms and Values - 5
professionals, parents and clients as to where
Talking about Feelings - 5
information and resources can be found and how
Articulating Boundaries & Hardiness - 5
they can be used. The corresponding instructions
Sex and Masturbation - 6
provide pointers on how to address sexuality and
Safe Sex - 6
intimacy.
Sexual Orientation - 6
Reproduction - 6
Chapter 1 contains instructions on the use of theme
The Internet - 7
cards when providing sexual education to individuals
Sexual Abuse - 7
with light intellectual disabilities.
Books - 7
The Internet - 7
In chapter 2, the available resources are described
per theme. These resources include books, websites Appendix: Answers to Questions - 8
as well as visual and tangible tools. The Human Body - 8
Sexuality and Intimacy - 8
Various questions and ‘did you knows’ are listed Friendships and Relationships - 8
on the back of the theme cards. The answers to Norms and Values - 8
these questions and explanations can be found in Talking about Feelings - 9
appendix 1. Articulating Boundaries & Assertiveness - 9
Sex and Masturbation - 9
Introduction - 2 Safe Sex - 9
Sexual Orientation - 10
Contents - 2
Reproduction - 10
The Internet - 10
Sexual Abuse - 10

2
Instructions The instructional guide ‘Talking about Sexuality
and Intimacy with Clients’ provides advice on how
Content of The Box to teach sexual education and address the relevant
themes. More information concerning sex education
– Dice with 12 detachable theme colours and two and how to approach this topic can be found in the
question marks. other guides.

– 12 theme cards: How to use the dice

Yellow: Sexuality and Intimacy The dice can be used as a support in teaching
Gold: The Human Body sexual education. The first five minutes of talking
Light green: Articulating Boundaries & Assertiveness about sex can be awkward. The dice can make it
Green: Friendships and Relationships easier to choose a topic.
Turquoise: The Internet
Light blue: Reproduction This is how it works. Select a number of themes in
Dark blue: Sexual Abuse advance that you would like to address and attach
Light pink: Norms and Values the matching colours to the dice. The dice is then
Dark pink: Talking about Feelings thrown together with the individual. The colour that
Red: Sexual Orientation appears on top is the theme you will discuss. When
Purple: Safe Sex you have finished talking about this theme, you can
Brown: Sex and Masturbation proceed to another theme or the question mark. The
question mark gives the individual the opportunity
– Red smiley to ask questions. Or you can throw again or pick
– Green smiley another theme. This is up to you and the client.

Instructions Use of dice is optional

The theme cards can be used as a tool for teaching
sexual education. We recommend that you read up You don’t have to use the dice. You can, of course,
on the themes and your client before you start giving also determine which themes to discuss yourself or
sex education, so that you can tailor the information let the client choose.
provided to the level of the individual. Please
complete the questionnaire or hermeneutic circle to Theme cards
determine his or her level and situation in order to use
the themes most effectively. The questionnaire and Each theme has its own colour. The front of the card
explanation of the hermeneutic circle can be found has a graphic that relates to the theme. When you
in the instructional guide. Chapter 2 (Resources) turn over the card, you will see:
contains information on the themes and provides a
list of tools and references to sources that can be
consulted for more information.

3
– A list of various tools that you can use to discuss the
theme.
– Questions and ‘did you knows’ about the theme
which can be useful to get the conversation started.
The answers to the questions and explanations can
be found in the appendix to this guide (see ‘Answers
to Questions’).
– An envelope containing various theme-related
topics with a brief explanation. For a more detailed
explanation, please refer to the resources listed at the
top of the card. See also the chapter on Resources.
Resources
The resources and educational tools listed below
can be used by educators when providing sexual
education to people with intellectual disabilities. For
your convenience, the resources have been listed
per theme. At the end of this chapter are some links
to general information that may be of use to clients
who want to learn more about a certain subject. The
information, resources and tools provided can, of
course, also be used for discussing the themes.
The Human Body
• ‘Wat is seks?’ (What is sex?’) by C. Zwiep
In this book, sexual topics are addressed in a clear
and plain way.
• Artificial penis
• Artificial vagina
• Doll
Learning to name parts of the body by matching the
word with the correct picture.
• http://www.sense.info/ontdek-je-lichaam/
Interactive game called ‘Ontdek je lichaam’
(Discover your body). Undress the man or women
and discover parts of the body and what they do
(includes a very clear explanation).
• http://www.sense.info/meisieslichaam/
Information about the female body. With a quiz at the
bottom of the page.
• http://www.sense.info/jongenslichaam/
Information about the male body. With a quiz at the
bottom of the page.
• http://www.meerdanliefde.nl/themas/Lichaam/
Information about the female and male body, getting
your period, tampons and sanitary napkins.
• Project SEAD has designed an app that can be
downloaded to any smartphone. The app, which can
be found in the Play Store under the name Project
SEAD, focuses on various themes, including the
theme ‘The Human Body’. It also contains a quiz to
test your knowledge about the topic.
Sexuality and Intimacy
• ‘Wat is seks?’ (What is sex?’) by C. Zwiep
In this book, sexual topics are addressed in a clear
and plain way.
• http://www.meerdanliefde.nl/themas/Seksualiteit/
Information about many sex-related themes.
• http://www.meerdanliefde.nl/Quiz/
Information about many sex-related themes.
4
• Project SEAD has designed an app that can be
downloaded to any smartphone. The app, which can
be found in the Play Store under the name Project
SEAD, focuses on various themes, including the
theme ‘Sexuality’. It also contains a quiz to test your
knowledge about the topic.
Friendships and Relationships
• ‘Wat is seks?’ (What is sex?’) by C. Zwiep
In this book, sexual topics are addressed in a clear
and plain way.
• http://canyoufixit.sense.info/
Interactive videos that allow you to guide the
conversation. The video ‘Grappig?!’ (Funny?!) deals
with respecting the other.
• http://www.sense.info/liefde-en-relatiess/
Information about love and relationships.
• http://www.meerdanliefde.nl/themas/Vriendschap/
Information about friends and friendship.
• http://www.meerdanliefde.nl/themas/Partner/
Information about partners.
These two websites can be used to explain the
difference between friendships and relationships.
• Project SEAD has designed an app that can be
downloaded to any smartphone. The app, which can
be found in the Play Store under the name Project
SEAD, focuses on various themes, including the
theme ‘Relationships’. It also contains a quiz to test
your knowledge about the topic.
Norms and Values
• ‘Wat is seks?’ (What is sex?’) by C. Zwiep
In this book, sexual topics are addressed in a clear
and plain way.
– http://www.sense.info/cultuur-en-geloof/
Information about norms and values, culture and
religious beliefs.
• http://canyoufixit.sense.info/
Interactive videos that allow you to guide the
conversation. The video ‘Opgesloten’ (Locked up)
is about setting boundaries and treating each other
with respect. The video ‘Slaande ruzie’ (Blazing row)
is about respecting each other’s norms and values.
Talking about Feelings
• ‘Wat is seks?’ (What is sex?’) by C. Zwiep
In this book, sexual topics are addressed in a clear
and plain way.
• http://canyoufixit.sense.info/
Interactive videos that allow you to guide the
conversation. The video ‘Grappig?!’ (Funny?) deals
with respecting others.
Articulating Boundaries & Hardiness
• ‘Wat is seks?’ (What is sex?’) by C. Zwiep
In this book, sexual topics are addressed in a clear
and plain way.
• http://canyoufixit.sense.info/
Interactive videos that allow you to guide the
conversation.
The video ‘Dirty dancing’ deals with articulating and
crossing boundaries.
The video ‘Opgesloten’ (Locked up) is about setting
boundaries and treating each other with respect.
The video ‘Coming out’ talks about social media and
the risks of chatting online with someone you don’t
know.
5
• http://weetal.nl/weetal/index.php/startpagina/weetal
Interactive comic strips that allow you to guide the
conversation. See the impact of your behaviour on the
other person.
• http://www.sense.info/over-je-grens/
Information about articulating boundaries and sexual
abuse.
• Project SEAD has designed an app that can be
downloaded to any smartphone. The app, which can
be found in the Play Store under the name Project
SEAD, focuses on various themes, including the
theme ‘Hardiness’. It also contains a quiz to test your
knowledge about the topic.
Sex and Masturbation
• ‘Wat is seks?’ (What is sex?’) by C. Zwiep
In this book, sexual topics are addressed in a clear
and plain way.
- http://sekswoordenboek.eu/wp-content/games/oip/
The game ‘Ontdek gevoelige plekjes op je lichaam’
(Discover your body’s sensitive areas)
- http://www.sense.info/ontdek-iezelf/
Information about body awareness.
- http://www.sense.info/vriien/
Information about having sex.
Safe Sex
• ‘Wat is seks?’ (What is sex?’) by C. Zwiep
In this book, sexual topics are addressed in a clear
and plain way.
• Artificial penis
This model can be used to demonstrate the proper
use of condoms, among other things.
• Artificial vagina
• Contraceptives (condom, pill, contraceptive injection)
conversation. The video ‘Te laat’ (Too late) talks about
contraception.
•http://canyoufixit.sense.info/
Interactive videos that allow you to guide the
conversation. The video ‘Te laat’ (Too late) talks
about contraception.
•http://www.sense.info/vriien/veilig-vriien/
Information about safe sex.
•http://www.sense.info/voorbehoedmiddelen/
Information about various contraceptives.
•http://www.sense.info/soas/
Information about Sexually Transmitted Diseases
(STDs).
Sexual Orientation
• ‘Wat is seks?’ (What is sex?’) by C. Zwiep
In this book, sexual topics are addressed in a clear
and plain way.
• http://www.sense.info/ontdek-iezelf/homo-lesbisch-
bi-hetero/
Information about sexual orientation and coming out.
• http://www.sense.info/ontdek-jezelf/transgender/
Information about transgender issues.
Reproduction
• ‘Wat is seks?’ (What is sex?’) by C. Zwiep
In this book, sexual topics are addressed in a clear
and plain way.
• http://www.sense.info/zwanger/
Information about pregnancy.
• http://www.voutube.com/watch?v=GNp6ovSz6V4
Video about pregnancy and childbirth.
6
The Internet
• The book: ‘Wat is seks?’ (What is sex?’) by C. Zwiep
In this book, sexual topics are addressed in a clear
and plain way.
• http://canvoufixit.sense.info/
Interactive videos that allow you to guide the
conversation.
The video ‘Ik haat je’ (I hate you) talks about social
media and the risks of chatting online with someone
you don’t know.
The video ‘Coming out’ is also about social media and
the risks of chatting online with strangers.
Sexual Abuse
• ‘Wat is seks?’ (What is sex?’) by C. Zwiep
In this book, sexual topics are addressed in a clear
and plain way.
• http://canyoufixit.sense.info/
Interactive videos that allow you to guide the
conversation.
The video ‘Coming out’ is about social media and the
risks of chatting online with someone you don’t know.
• http://www.sense.info/over-je-grens/
Information about sexual abuse and articulating
boundaries.
Books
Zwiep. Wat is seks?: Vragen van jonge kinderen
over lichamelijkheid en seksualiteit (What is sex?
Answering young children’s questions about sexuality
and the body)
Harris & Emberly. Seks enzo (Sex Etcetera)
Muller. Oh zit dat zo! Over liefde, seks,
voorbehoedmiddelen en andere belangrijke dingen (Is
that how it works? About love, sex, contraceptives and
other important things)
Piquermal and Witek. Seks, hoe zit dat? De complete
gids van A tot Z, open, eerlijk en zonder taboes! (Sex,
how does it work? The complete guide from A to Z.
Open, honest and without taboos!)
The Internet
• www.sense.info
• www.sekswoordenboek.eu
• www.seksweetjes.nl
• http://weetal.nl/weetal/index.php/startpagina/weetal
Make a comic strip yourself. Terms with explanations
and gestures.
• http://www.rutgerswpf.nl/
Website of Rutgers WPF, the Dutch centre of
expertise on sexual and reproductive health and
rights. The centre’s mission, vision and other
relevant information can be found under the heading
‘About Rutgers WPF’.
The website offers information on current sex-related
topics that have featured in the media, tips on how
to deal with sexuality, and a calendar of upcoming
symposiums, conferences and congresses.
Under ‘Research’ you can read about what type of
research has been done on sexuality and intimacy.
The website also features a web shop where you
can buy books and teaching material designed to be
used as a support for educators of sexual health.
• http://www.seksuelevorming.be/
Flemish website for sex education in the broadest
sense of the word, offering a wide range of training
material for teachers and health professionals. This
website provides a great source of information and
practical tools for sex education classes or sessions.
7
• www.bloembij.nl
The BloemBij website addresses sexual education in
a modern format. BloemBij is led by a health-science
researcher specialised in sexual health promotion.
BloemBij is hired on a regular basis to provide
information and education in various settings. Other
BloemBij initiatives include:
• www.zoenenenzo.nl
Website for young people and adults with disabilities.
Its sister website, www.zoenenenzovoort.nl,
is specifically aimed at parents of and health
professionals working with this group. Both websites
have been initiated by Rutgers WPF.
• www.seksualiteit.nl
Website that deals with sexuality issues from every
perspective, both positive and negative. It also
features activities related to sexual health and
intimacy.
Appendix: Answers to Questions
The back of the theme cards features questions and
‘did you knows’. This appendix contains the answers
to these questions and facts.
The Human Body
Question: Can you get pregnant if you are on your
period and have sex without using a condom?
Answer: Yes.
Question: Do you know the difference between a boy
and a girl?
Answer: A girl’s body is different from a boy’s body.
Girls have a vagina, boys have a penis.
Sexuality and Intimacy
Question: Do you know what ‘having sex’ is?
Answer: Having sex is when a man puts his penis
inside a woman’s vagina. Sex involves body contact,
being naked and kissing and cuddling. But you can
also think about sex. Everyone has sex in their own
way.
Question: Do you know what ‘sexy’ is? What do you
find sexy?
Answer: Sexy means different things to different
people. Sexy is what you find beautiful and attractive
in another person. Round buttocks in tight pants. Or
a see-through blouse.
Friendships and Relationships
Question: Have you ever been in love? How did that
feel?
Answer: Yes or no. Examples of feelings: butterflies
in your stomach, wanting to be near someone, giving
kisses, thinking about that person constantly.
Norms and Values
Question: Is it allowed to walk around naked
everywhere?
Answer: No. Sometimes it is okay to take your
clothes off. For example, if you want to take a
bath. You can make agreements about when it is
appropriate to be naked. For example, in your own
room.
8
Articulating Boundaries & Assertiveness
Question: Do you know how to say ‘no’?
Answer: This is how you say ‘no!’ It starts with a
feeling. Your body doesn’t lie. It tells you what feels
right for you and what doesn’t.
You should first think about whether you want
something or not. When in doubt, just say that you
need time to think.
If you don’t want to do something, say ‘no’ right from
the start. Then explain why. This is how you make
it absolutely clear that you don’t want something to
happen.
Don’t forget to explain your reasons why. But
remember, you don’t have to apologise for not wanting
to do something.
You can also say what you do want. For example,
intercourse no, but fingering is okay.
Are you afraid of disappointing the other person or
hurting his or her feelings? Don’t be. What is hurtful is
when you say ‘yes’ when you actually mean ‘no’.
Have you said ‘yes’ too soon? Don’t worry, you can
always change your mind.
Question: How do you know when someone wants or
does not want something?
Answer: You can probably tell if someone feels or
doesn’t feel like doing something. Just pay attention to
the signs.
‘Yes’ signs:
• The other person is making eye contact and flirting
with you.
• The other person enjoys touching you.
• The other person is taking the initiative to have sex
with you, is trying to seduce you.
• The other person is clearly enjoying having sex (is
moaning, starts breathing more heavily, gets aroused:
girls get wet, boys get an erection).
‘No’ signs:
• The other person does not kiss you back.
• The other person turns away, avoids contact.
• The other person comes up with different excuses
for not having sex with you.
• You always take the initiative, the other person
hardly ever or never.
• When you have sex, the other person does not
seem to enjoy him or herself (is very quite, no heavy
breathing, she doesn’t get wet or he doesn’t get an
erection).
Sex and Masturbation
Question: What is an erection?
Answer: Penises come in all shapes and sizes.
Sometimes a penis will stop being floppy and
dangly and will instead get stiff and stand up. This
is called an erection or hard-on. It is easier to have
intercourse with an erection.
Question: What is an orgasm?
Answer: An orgasm happens when you reach the
peak of sexual arousal. An orgasm is also called a
climax. When a man has an orgasm, fluid comes out
of his penis. This fluid is called semen and contains
sperm cells. When a woman has an orgasm, her
vagina often becomes very wet. For many people,
having an organism is the final stage of the sexual
act.
Safe Sex
Question: Do you know how to use a condom?
Answer: This is where the penis model comes in.
Take the model and a condom. Let the individual
practise with the condom. If he or she cannot get the
condom on the model, try doing it together.
9
Sexual Orientation
Question: Can a gay or lesbian couple have
children?
Answer: You need male sperm cells and female egg
cells to make a baby. Two men only have sperm cells.
And two women only have egg cells. So gay and
lesbian people cannot have children with their partner.
Some couples, however, do have children. They can
adopt a child. Adoption means that you become the
parent of someone else’s child. Women can also go
to a hospital and get sperm cells. The doctor injects
these sperm cells into the vagina. This is how the
woman gets pregnant.
Reproduction
Question: Do you know how a woman gets
pregnant?
Answer: To make a baby, a sperm cell and an egg
cell join together. When a couple wants to have a
baby they cuddle very close. So close that the man’s
penis goes into the woman’s vagina. This is called
sexual intercourse. The sperm cells leave the penis
and go to the woman’s egg in her belly. Not everyone
gets pregnant right away. Sometimes, men and
women have sex several times before the woman
becomes pregnant.
Question: Do you know how long a baby grows in the
mother’s belly before it is born?
Answer: Nine months.
The Internet
Question: Have you ever chatted online?
Answer: This answer may vary per individual. Below
are some tips that may be useful. You can also use
the resources listed in chapter 2 (see section ‘The
Internet’).
Tips
• Do not accept ‘friend requests’ from strangers on
Facebook.
• Make sure your profile information is completely
hidden from strangers. Go to your privacy settings to
do so.
• Never give your address or phone number to
strangers.
• If you think someone is acting suspiciously online
and suspect this person is not who they say they
are, remove this person from your contact list and
talk about it with someone you trust.
Sexual Abuse
For more information on how to address sexual
abuse, please refer to the guide for health
professionals and parents.
Did you know that: A loverboy is a boy who wants to
be a girl’s boyfriend because he wants her to earn
money by prostituting herself. That is why loverboys
are also called ‘pimps’. A loverboy pretends to be in
love with a girl and seduces her. Meanwhile, he is
thinking up a plan to take advantage of her. Actually,
the term ‘lover boy’ is a misnomer. Being a loverboy
has nothing to do with love.
Disclaimer
The European Commission support for the
production of this publication does not constitute
an endorsement of the contents which reflects the
views only of the authors, and the Commission
cannot be held responsi­ble for any use which may
be made of the information contained therein.
10
Sexual Education for
Adults with Disabilities

Tool 9
Handbooks
To start with...

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
To start with...
Foreward Our pledge at the start of Project SEAD:

The Box has been developed by Project SEAD • We will work together with disabled people, based
(Sexual Education for Adults with Disabilities). on trust and respect.
Approved by the European Commission, this project
has been created with input from various countries, • We will value the expertise of disabled people.
including Lithuania, Finland, Germany, Belgium,
Hungary, the United Kingdom and the Netherlands. • We will share knowledge and experiences in
empowering and accessible ways.
Even today, many people refuse to acknowledge (SEAD, 2012)
that all people have sexual feelings, needs and
desires, regardless of their physical and/or Contents
intellectual abilities. As a result, many people with
an intellectual or learning disability do not receive To start with - 2
sexual education. That often leads to open questions Foreward - 2
for everyone involved, confusion, unintended
situations or even to sexual abuse of or by people Contents - 2
with disabilities. Introduction - 3

SEAD believes that sexuality and intimacy is part Suitability of The Box - 3
of everyone’s life and does not view disability as
being the ‘problem’ of the individual. With the right
resources and tools, education and support, anyone
can have a fulfilling and intimate sex life. This
product draws upon studies, designs and reports
from all partner countries and aims to contribute
to the quality and accessibility of sexual education
materials for people with intellectual and/or learning
disabilities.

2
Introduction

The instructional guide to The Box is aimed at sexual

health educators both in a professional care setting
and at home. We recommend reading the guide
beforehand to gain an understanding of what tips and
tools there are and what information is relevant for
teaching sexual education in your situation.

The guide consists of various booklets, each featuring

a different theme. Each time, you can select a theme
and use the information and tips provided in the
booklet as the basis for your sessions.

The guide to The Box also contains relevant expert

knowledge, tips, resources and tools for providing
sexual education using this tool kit. We have also
included additional tips and tools for talking about
sexual health topics with clients, colleagues and
experts.

Suitability of The Box

Before you get started, it is important to determine

whether The Box is suitable as an educational tool for
you. To determine if it is suitable for your situation, you
can ask yourself the following questions:

• What elements make up The Box?

• Does The Box contain everything you would like to
discuss?
• Is there sufficient information on how to use The
Box and accompanying tools and resources, so
that you feel skilled and confident in your role as Disclaimer
educator?
The European Commission support for the
production of this publication does not constitute
Do the tools and resources offer added value to the
an endorsement of the contents which reflects the
individual you are trying to teach? views only of the authors, and the Commission
(Schaafsma, 2013) cannot be held responsi­ble for any use which may
be made of the information contained therein.

3
Sexual Education for
Adults with Disabilities

Tool 9
Handbooks
Preventative Education

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
Preventive Education
This instructional guide talks about preventive sexual Making sexual education a regular topic has a
education and why it is important. It also offers step- preventive effect and allows educators to detect
by-step guidance and tips for providing information problems and take action at an early stage. The
in a methodological, solution-focused fashion. sooner problems are detected, the more effectively
they can be resolved. The sooner the client has the
Contents chance to ask questions, the quicker they can be
dealt with.
Preventive Education - 2
What is Preventive Education - 2 The better informed the client is, the better he or
and Why is it important? she will be able to react to and deal with undesirable
situations, such as sexual abuse.
Solution-focused Approach to - 2
Sexuality and Itimacy Contrary to reactive strategies, preventive strategies
Talking to the Client - 2 help prevent incorrect perceptions. Once ideas or
Goal Formulation - 3 perceptions are formed, it is very difficult to change
Asking about Exceptions - 4 them. Pornographic material can, for example, give
Scaling Questions - 5 individuals the wrong idea about sex. It is important
Follow-up Sessions - 5 to discuss with the client beforehand that these
Conclusion - 5 images do not reflect reality.
Specific solutions for Dealing with - 6
Sexual Abuse Solution-focused Approach to Sexuality and
Intimacy
What is Preventive Education and Why is it
Talking to the Client
Important?

In teaching sexual education for the first time,

People with intellectual disabilities are extra
there are a number of important points that should
vulnerable. That is why it is important to focus
be considered. The following protocol consists of
in particular on prevention. Preventive sexual
various steps that can be used as a guideline for
education can help reduce risks.
your sessions.

2
1 Role clarification
Information on the structure and duration of the
session, whether there will be a break to reflect, and,
if necessary, an explanation of the solution-focused
approach.
2 Matching the client’s style/worldview
The first step consists of building a positive working
relationship with the client by appealing to his or her
experiences and interests.
3 Improvement prior to first session
‘What has changed since we last met or spoke with
each other? The improvement question taps into the
change process that may have already been initiated.
4 Formulation/acknowledgement of problem
‘What brings you here?’
‘How is that a problem for you?’
‘What have you already tried and what has been
useful?’
Acknowledgement is important: listening in a
respectful manner, reflecting on feelings, giving
compliments, defining the relationship between the
professional and the client (customer, complainant,
visitor), ‘walking on two legs’.
5 Goal formulation/miracle question
(or related question)
‘You will go to sleep tonight, and in the middle
of the night, a miracle happens and the problem
that prompted you to talk to me (name problem
specifically) today is solved or nearly solved. What
has changed when you wake up tomorrow morning?
What else?’
6 Exceptions
Are there any exceptions? When is the problem
absent or less noticeable? Together with the client,
the professional looks for differences and exceptions,
and the extent to which the client is able to control the
occurrence of the exceptions.
7 Scaling
If 10 is: ‘I have reached my goal’ and 0 is: ‘I have yet
not reached my goal’, where are you now on a scale
of 10 to 0?
Scaling is used to gain insight into the following areas:
• The client’s progress during the sessions;
• The degree of hope the client has;
• The amount of energy the client is willing to invest in
improving his or her life;
• The confidence the client has in terms of reaching
his or her goal;
• The client’s willingness to put the necessary effort
into reaching his or her goal.
This is explained in more detail later in this document.
8 Competency questions
The hermeneutic circle can be used for asking
competency questions. For more information, see
the guide ‘Talking about Sexuality and Intimacy with
Clients’.
The professional compliments the client directly, asks
competency questions (indirect compliments) and
gives positive character interpretations:
• ‘How brave of you to…’
• ‘Where did you get that good idea to…?’
• ‘It takes a strong person like you to…’, ‘Please tell
me more.’
3
9 Feedback
Feedback to the client consists of three components:
• Compliments for what the client has accomplished
and positive character interpretations. Compliments
are a positive way of reinforcing past successes and
competencies.
• A reason (rationale) for the goal to be achieved
(preferably in the client’s own words). The bridge
connects the compliments to the homework
suggestions or tasks. The bridge often begins with
‘and because...’
• A task or homework suggestions. This component
comprises one or more behavioural or observational
tasks.
The solution-focused professional can introduce a
five-minute break before the feedback, allowing time
to think about what feedback to give.
The feedback provided differs for ‘visitors’,
‘complainants’ and ‘customers’:
• Visitors are not given suggestions for homework
assignments (they do get compliments).
• Customers are given observational tasks and/or
behavioural tasks.
• Complainants are only given suggestions for
observational tasks.
(Roeden & Bannink, 2009)
Goal Formulation
Goal formulation is an essential part of a solution-
focused approach. It encourages the client to
envision a future without the problem or in which the
problem occurs to a lesser extent.
The first small steps are defined in a clear and
concrete manner. The miracle question is a goal-
setting question that can be used to help the client
picture his or her preferred future. See step five of
section ‘Talking to the Client’.
(Roeden & Bannink, 2009)
Asking about Exceptions
Finding exceptions
Exceptions are circumstances in which the stated
problem does not occur or occurs less often or
intensely. These moments or experiences need
to be examined because they form the building
blocks of solutions. To discover these exceptions,
the educator asks questions to find out what the
client did differently or in what way the situation was
different. A solution-focused approach
focuses on the ‘who, what, when and where’ of the
exception, rather than the ‘who, what, when and
where’ of the problem.
Asking for details
Clients with intellectual disabilities may experience
difficulties in exploring the past to retrieve
exceptions. Therefore, the use of a technique called
topographic analysis can be useful. Topographic
analysis describes specific behaviour at a specific
time and place. If topographic analysis is solution
focused it will focus on the exceptions and magnify
the desired behaviour.
Finding resources
When clients receiving sexual education encounter
problems, they often forget that they have the
competencies to solve the problem. They may
also not be aware of the available resources. The
educator should therefore provide information on all
available resources that can help them.
4
Scaling Questions
Scaling questions can be used to communicate with
the client about sexual issues.
For instance, they can be used at the start of
teaching sexual education to see where the client
is now as well as to measure progress during the
sessions. The client indicates his or her present
situation on a scale of 10 to 0. There are several
ways to ask scaling questions. For example, you
can use a scale from 10 to 1 (leaving out the
worst possible situation). It has been shown that
clients using a scale from 10 to 0 tend to rate their
experience higher. The advantages of scaling
questions are:
• Numbers can be compared: more, less, equal
• Numbers are measurable: half way, far removed,
close
• Numbers are flexible
• Numbers have a personal meaning to the client:
‘his or her’ number
• Numbers have no emotional meaning or
connotation and are therefore more neutral than
words
• Numbers allow you to look at the problem from a
distance
• Numbers simplify a complex situation
• Numbers can be used to compare different
persons’ estimations
Scaling questions can also be used in combination
with pictograms. For example, ‘0’ is a thundercloud
and ‘10’ is the sun. There are, of course, many more
possibilities to ask scaling questions.
Follow-up Sessions
After the first session, several follow-up sessions
are scheduled to determine whether the client’s
circumstances have improved. In almost all cases,
minor improvements can be found. It is important to
focus on them and to encourage the client to repeat
these successes. If nothing has improved, make
sure the client tries new things rather than doing
more of the same. Follow-up sessions also offer the
opportunity for evaluation.
An opening question for a follow-up session could
be: ‘What is better?’ This question can be answered
in four ways: ‘Things are better’, ‘Things are the
same’, ‘Things are worse’ or you may disagree on
this issue.
Conclusion
From the very first sexual education sessions,
clients are stimulated to construct a vision of a future
situation. This is done by using positive behavioural
terms and attainable goals. As an educator, it is your
job to give clients hope and confidence in their ability
to reach these goals.
There are several ways to end a sexual education
programme. In a solution-focused approach,
creative elements are incorporated into the teaching
method. Below are some examples:
• Make a certificate with a list of compliments.
• Make a certificate or pamphlet stating the ‘miracle’
that the client has
accomplished.
• Ask how the client would like to celebrate
completing the programme and incorporate this in
the last session.
5
• Celebrate with cookies, potato chips or flowers.
• Ask how the client would like to celebrate his or her
accomplishment.
• Ask who the client would like to invite.
• Ask the client to make a drawing of his or her
starting situation and the end result.
• Mark the occasion with a cuddly toy or other item
(transitional object).
• Ask if the client would like to help others with
similar problems as a mentor.
• Self-nurturing rituals, e.g. beauty treatments,
give clients permission to pamper themselves with
pleasurable activities as opposed to condemning
themselves.
• Present-focused learning. Learning a new skill or
hobby geared towards leading an active life now and
in the future.
(Roeden & Bannink, 2009)

Specific Solutions for Dealing with Sexual Abuse

Clients with a history of sexual abuse often suffer

from negative thoughts and are more likely to end
up in a downward spiral. A methodological approach
to sexuality and intimacy issues involves actively
stimulating clients to improve the quality of their
life. Various interventions have been developed to
influence positive behaviour in a structured way in
one-on-one situations, including:

• Making a list of positive things in life. This can be

used to remind clients of good things in life or as a
prompt of enjoyable activities that they can do.
• Bodywork, e.g. dancing, to develop an awareness
of touch as a pleasurable rather than negative
medium.
• Artistic self-expression. Find a medium through
which to express positive emotions and experiences
which acts as a counterbalance to verbal
expressions of guilt and self blame.
• Identifying a healing symbol such as a plant or
animal to be nurtured and act as a symbol of the Disclaimer
person’s emotional and personal growth. (Note:
determine whether the client is able to handle this The European Commission support for the
responsibility. production of this publication does not constitute
an endorsement of the contents which reflects the
views only of the authors, and the Commission
cannot be held responsi­ble for any use which may
be made of the information contained therein.

6
Sexual Education for
Adults with Disabilities

Tool 9
Handbooks
Talking about Sexuality
and Intimacy with Clients

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
Talking about Sexuality and Intimacy with Clients
This instructional manual contains tips, working
methods and tools for discussing sexuality and
intimacy with individuals with intellectual disabilities.
Topics covered include motivational discussion
techniques, tools to prepare for sexual health
instruction and respecting the norms and values of
yourself and others.
Contents
Tools to Get Started
Initiating a conversation about sexuality and intimacy
can be daunting. Below are some important things to
consider before you start teaching sex education to
your client:
• Establish what knowledge and skills the client
already has.

Talking about Sexuality and
Intimacy with Clients
Contents
Tools to Get Started
Hermeneutic Circle (E.Bosh, 2010)
Vocabulary/language
Discussion Techniques
Tone of voice
Positice approach
Motivating and encouraging
Dealing with Norms and Values
Social norms and values
- 2 • It is also important to have a clear picture of the
client’s social-emotional level, well-being and
- 2 understanding of concepts and terminology. There is
often a discrepancy between these three things.
- 2
- 3 • Clients with light intellectual disabilities and a
- 3 ‘normal’ appearance and demeanour may give the
impression that they have adequate social skills and
- 4 are able to set and respect boundaries. People often
- 4 jump to this conclusion too soon. It is especially
- 5 important to gain insight into clients’ perceptions
- 5 on sexuality if they have never been confronted
with sexual education as part of their upbringing or
- 6 development.
- 6

Profile of an Ideal Educator - 7

Dealing with inappropriate Sexual - 8

Behaviour

Dealing with Porn - 8

2
The hermeneutic circle is a useful tool that can
be used to assess the cognitive and emotional
capacity, social development, skills, background and
special circumstances in the lives of individuals with
intellectual disabilities. The circle provides a total
picture of the person, allowing you to understand
them better and look beyond their physical or social
limitations and accept them for who they are.
See ‘Appendices’ for a detailed explanation and
hermeneutic circle diagram. (E. Bosch, 2010)
Hermeneutic circle, (E. Bosch, 2010)
The circle provides a method to look at the world
from the client’s point of view, allowing you to create
a client-oriented programme and approach. It can
also serve to make a client’s request for help more
concrete. (Suykerbuyk & Bosch, 2010)
Another tool to assess a client’s current knowledge,
beliefs and behaviours in the domain of sexual health
is the questionnaire. After the questionnaire has been
completed and scored, the educator will have a clear
idea of what themes to focus on and what themes the
client is already familiar with.
Vocabulary/language
During the sex education sessions it is important that
you are aware of your choice of words. Be sure to
adjust your language to respond to the client’s level
of understanding. In addition, it is also important to
know which words are considered uncomfortable,
inappropriate, strange or filthy. You could, for
example, consider making a spider diagram or
glossary (see example below).
3
The client can add words to the glossary that he or
she uses or is familiar with. Here too, it is important
to connect to the experiences of the client as much
as possible. Educators should also make clear
what words are socially acceptable and which are
offensive and can best be avoided. (Suykerbuyk
& Bosch, 2010) (Gedragsdeskundige, 2014)
(Hulpverleners, 2014).
Discussion Techniques
It is useful to use a motivational conversation
technique for giving sexual education. This style of
conversation helps create a personal atmosphere.
The tone of voice used elicits information from the
client and promotes an active and open attitude
towards the information offered. In short, it supports
educators in motivating their clients. Furthermore,
educators should be able to show empathy, deal
with possible resistance in a flexible way, and
support personal effectiveness. It is also important
to focus on where the client is at now and where he
or she can go (Miller & Rollnick, 2011).
These are five discussion techniques that can be
used throughout the interaction with the client.
1) Ask open questions: Particularly in the first
sessions, it is important to build an atmosphere of
acceptance and trust. The client will do most of the
talking. You can encourage this by asking open
questions. Asking open questions gives you a good
chance to understand your client and his/her needs.
2) Listen reflectively: Reflective listening (also
called active listening or emphatic listening) focuses
on the educator’s response to what the client is
saying. This can involve repeating or paraphrasing
the information you hear in your own words. Be
sure to reflect on what is being said on a deep level
as opposed to merely repeating words back to the
person.
3) Confirm: It is also important to validate the
client’s feelings and provide support. Be sure to
notice and confirm the client’s strengths and efforts
in an appropriate manner.
4) Summarise: Summarising allows you to connect
and reinforce different elements of the conversation.
Be sure to give the client the opportunity to add to or
correct your summaries.
(Miller & Rollnick, 2011).
Tone of voice
• An important part of providing sexual education to
individuals with light intellectual disabilities is that
things are explained in clear and plain language.
• Treat adults as adults. Do not patronise or talk
down to clients with low social skills. As an educator
you should, however, take their emotional level
of maturity into account. This shows that you are
treating them maturely and responsibly.
4
• Giving clients space to be who they are or want to
be, gives you the opportunity to engage with them in
a constructive and mature way.
- Use plain language and an appropriate tone
of voice (a tone of voice that shows you care
about the client).
- Confirm what he or she is doing well.
- Show that you have a good relationship with
the client.
- Address the client in such a way that shows
you have a cooperative and equal By responding to the needs of the individual,
relationship, despite differences in you are already aligning yourself with his or her
intellectual level.
Positive approach
Talk about body awareness with your client. When
individuals with intellectual disabilities are only told
what they should not do and are kept from exploring
possibilities, their (subconscious) needs are not
met which increases the chance of inappropriate or
unacceptable sexual behaviour.
By talking openly about sexuality and the
possibilities that are out there, rather than focusing
on things that are forbidden, you are helping clients
along the way towards emancipation and personal
development. By avoiding the subject of sexuality
and intimacy, you are depriving them of the chance
to learn, overcome fears and get rid of taboos. This
can have many undesired consequences, such as
fear, suppressed feelings and needs, and ultimately
frustration and inappropriate or disinhibited
behaviour. Offering alternatives is a positive way to
change and direct behaviour in a desired direction.
It is very important to allow individuals to learn how
to experience pleasure, give them the freedom to be
themselves, provide information on body awareness
and help them to reach their full potential within their
own realm of capabilities. This is how you create
an atmosphere free from oppressive behaviour and
promote emancipation (Bosch, 2006) (E. Bosch,
2010).
Motivating and encouraging
interests. Furthermore, it is important to make the
threshold low. Maybe the individual would first like
to leaf through a book by himself or herself or visit a
website? Another way to start is with an introductory
game or by doing a quiz (‘Did you know that...’).
Creative approaches and games often make the
subject less intimidating and more playful.
If you set the right example and act in an
enthusiastic, relaxed and curious way, the individual
will copy your behaviour. So be aware of your
attitude and how you project it. Being taught
sexual education can be daunting for individuals
with intellectual disabilities. Many clients have had
negative experiences or think sexuality is something
that should not be talked about. By focusing on the
positive sides and possibilities of sexuality, it will
become more normal to talk about it and gradually
sexuality will become less of a charged issue.
(Hulpverleners, 2014) (Gedragsdeskundige, 2014).
As mentioned earlier, a motivational conversation
technique is an important part of encouraging and
motivating individuals for learning about sexuality.
5
Dealing with Norms and Values
Everyone has different norms, values and opinions
when it comes to sexuality and intimacy. Although
it may be difficult put your own values and beliefs
to one side, it is important to be aware that sexual
education focuses on the needs of the recipient. It
is your job as an educator to help the client discover
his or her own norms and values.
Individuals with intellectual disabilities can be
impressionable and may copy values, beliefs or
opinions of role models. Do not let your norms
and values interfere with the process of teaching
sexuality. Recognise when you are unable to
assist and don’t feel uncomfortable about asking
your partner (or if you are a health professional, a
colleague or behavioural expert) to take over (Bosch,
2006).
Social norms and values
Besides the norms and values of the educator and
the client, there is also such a thing as social norms
and values. Social norms and values define what
behaviour is considered normal when interacting
with other people. It is in everyone’s interest that
the norms and values that are instilled are positive
ones. This way, socially appropriate behaviour can
be strengthened. For you as an educator, this means
you should find a middle way between meeting the
needs of the individual and communicating what
behaviour is considered ‘normal’ and ‘abnormal’ in
society. By doing so repetitively and in a pleasant
and non-judgemental way, the individual will learn
the difference between desired and undesired
behaviour.
Some individuals with intellectual disabilities
have little or no sense of shame. This may be
due to interacting cognitive, emotional and
social processes, in combination with poor
socialisation. For individuals with a history of being
institutionalised it may be perfectly normal to, for
example, have a shower with six people. Having
different professionals help you with personal
hygiene, bathing and dressing can also make clients
feel less inhibited. Although privacy is a big thing
nowadays, many persons with intellectual disabilities
have already been shaped by their past or
upbringing. It is important to take this into account.
By acknowledging positive behaviours that express
certain norms and values, you can reinforce that
behaviour. Some individuals need another person
to be their ‘external conscience’, someone who tells
them right from wrong.
Questions that clients frequently ask include:
‘Where can I be naked and where not?’, ‘Where
can I masturbate and where not?’, ‘Do you need to
lock the door when you take a shower or use the
toilet?’ and ‘Should I close my legs when I sit on the
sofa?’. In addition to explaining the social values that
relate to these questions, it is also important to offer
alternatives specific situations. For more information,
see ‘Dealing with Inappropriate Sexual Behaviour’.
6
Profile of an Ideal Educator
What is the way to offer sexual education? We have
developed a profile that provides guidelines for how
to become a good educator.
The ideal educator:
- Has affinity with sexuality and intimacy issues
in the lives of individuals with (light) intellectual
disabilities. Supports the vision that sexuality,
relationships and intimacy are part of life, and
articulates this vision through actions, e.g. by
displaying role-model behaviour.
- Is able to discuss sexuality in an open and
supportive way, and is aware of his or her personal
and professional boundaries. Maintaining
boundaries is especially important in an imbalanced
or dependency relationship. Due to the intimate
nature of the subject and inequality of the
relationship, it is important for the client to stay in
control of the conversation and maintain a sense of
equality and independence.
- Is able to identify potential problems with regard
to teaching sexual education and discuss them
with colleagues. Is able to show vulnerability and
admit when he or she cannot cope with teaching
sexuality. This way, someone else can take over and
the educator can seek professional development in
areas of weakness.
- Is sensitive to feelings, opinions and boundaries
with regard to sexuality and intimacy of the client and
other professionals, family members and colleagues,
and does not pass judgements. Respects the values
and beliefs of others, based on the notion that there
is not a single truth but there may be many truths
(unless the client’s behaviour is harmful to himself or
herself or to others).
- Possesses a number of skills: is a good listener, is
able to empathise, cooperates with others, is able to
gain the trust of others and lead group meetings. Is
able to apply the right attitude at the right time.
- Is able to relate to others and has an understanding
of clients’ emotional and social capabilities.
- Knows when to shift styles in order to show
closeness or appropriate distance.
(E. Bosch, 2010)
Dealing with Inappropriate Sexual Behaviour
The most important part of dealing with
inappropriate sexual behaviour is to offer
alternatives to replace problem behaviour.
Sexual needs will find a way to the surface one way
or the other. Hence, suppressing these feelings
or behaviours will lead to frustration. Below are a
number of techniques for channelling inappropriate
behaviour in more acceptable directions (also
referred to as ‘sexual canalisation’):
7
1. Masturbation:
Explain what masturbation is, and how and when to
masturbate. The use of visual support (e.g. pictures
or videos) can form part of the explanation. Make
clear that masturbation is nothing to be ashamed
of or feel guilty about, but that it is enjoyable,
acceptable and normal.
2. Sex workers/sexual services:
The SAR (Stichting Alternatieve Relatiebemiddeling)
is a Dutch agency that connects disabled men and
women with responsible sex workers.
Sex workers provide a safe environment in which
they provide sexual experiences to persons
with disabilities. This is done in gradual steps to
avoid overwhelming them. In addition, they give
information about potential problems or difficulties
associated with disability. Making use of the services
of a sex worker also provides an opportunity to talk
about personal hygiene and how to be considerate
of your partner’s wishes. It is the most physical and
practical method because it approaches a real-life
situation. Before making use of the services of a
sex worker, it is advisable that the care worker or
educator meet with the sex worker to discuss the
client’s needs and questions.
3. Relationship:
If the individual has a relationship, it is possible
to offer alternatives ways of physical contact and
expressing sexual behaviour. These interactions can
then open up a way to talk about values and beliefs.
Dealing with Porn
Based on the notion that sexual education should
focus on the recipient, it is important to provide
opportunities to explore alternative ways to manage
sexual behaviour. The use of pornographic material
is not a good part of this. Here too, you should be
aware of your personal norms and values and how
they influence your interactions with the client.
- Pornographic images may influence the way in
which sexuality and intimacy is perceived. Clients
often get access to pornographic pictures or
magazines through family or friends, school or the
institution where they live. This way the client will get
an incomplete and inaccurate picture of sex. And
if he or she is not educated at a later stage, these
ideas won’t change. These ideas may range from ‘It
is okay to slap women’s behinds’, ‘Men always have
an erection’ to ‘Women are there to have sex with’.
People with light intellectual disabilities are more
likely to accept what they see as truth because of the
way they think.
- Perceptions of people can be influenced. A big
part of teaching sexual education is talking about
these perceptions. Testing what your client thinks
about certain subjects allows you to find out whether
his or her views are accurate or not. If your client’s
perceptions or ideas are not in line with reality, he or
she should be confronted with other images in order
to rectify these thoughts. (E. Bosch, 2010)
Disclaimer
The European Commission support for the
production of this publication does not constitute
an endorsement of the contents which reflects the
views only of the authors, and the Commission
cannot be held responsi­ble for any use which may
be made of the information contained therein.
8
Sexual Education for
Adults with Disabilities

Tool 9
Handbooks
Talking about Sexuality and
Intimacy in your Environment

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
Talking about Sexuality and Intimacy in your Environment
This guide offers tips and methods to address How and When To Ask For - 5
sexuality and intimacy in your environment. It Assistance
also explains the importance of providing sexual
education and what advantages this offers. Training and Professional - 6
Development
Contents
Health Professionals in a Team
Talking about Sexuality and - 2
Intimacy in your environment
When providing information on sexuality and
Contents - 2
intimacy it is important to talk about it to the people
around you. Health professionals should address
Health Professionals in a Team - 2
sexual health issues in their team and with experts
within the organisation. In some cases, it can be
Parents in a Home Situation - 2
useful to collaborate with the client’s family or
friends. Sexual health education can also form a
Before You Start - 3
recurring theme in team meetings. This can make
talking about sexuality and intimacy easier and lower
What Topics To Address and How - 3
the threshold for talking about this subject.
To Address Them
Vision, policy and protocols (of - 3
Parents in a Home Situation
institutions)
Successes and difficulties - 4
In a home situation, it is also important for parents
Boundaries - 4
and partners or caregivers to be on the same
Definition of sexuality and intimacy - 4
page when it comes to sexual health issues. Some
Spider diagram - 4
institutions offer support in this area, for instance as
(Hulpverlenersteam, 2014)
part of the ambulatory care provided. In any case it
Vocabulary/language - 5
is important to talk about sexual education with the
Matter of fact - 5
organisation.

2
Before You Start
Bosch’ communication triptych (2006) provides
a good basis from which to formulate a vision on
sexuality and intimacy, define an attitude that reflects
this vision and a method for critical self-reflection on
this vision.
When you create a vision on sexuality and intimacy
and act on this vision, the individual receiving sexual
education does not have to share the professional’s
or parent’s personal views or values on this subject.
Emancipation is important in this respect. Individuals
with disabilities should have the opportunity to
develop themselves sexually just like any other
person, based on their own values and ideas of ‘right
and wrong’.
As you attempt to see the world from the individual’s
point of view, it may prove difficult to put your own
norms and values to one side. If, as a result, this
undermines the ability of the health professional
or parent to talk freely, it may be a good idea for
someone else to take over. This way, the individual’s
personal development is not compromised. In
the case of a parent, this can be a care worker or
behavioural specialist from the organisation. In the
case of a health professional, this can be a parent,
behavioural specialist or sexual educator.
By looking critically at your attitude, you are giving
others the opportunity to express and develop their
own norms, values and opinions. If you have a clear
understanding of who you are and are aware of how
your attitude and actions influence others, you also
know when you should give the other person space to
learn. This is the true essence of self acceptance and
may help to accept the situation and your perception
of it. It is possible to examine your norms and values
individually or as a group. In a group setting, you can
share experiences and talk about how you feel about
certain norms and values. (Bosch, 2006)
What Topics To Address and How To Address Them
Talking about sexuality and intimacy at home or in a
team is important for creating an atmosphere in which
potential problems or situations can be discussed
openly. The needs and wishes of the educator
will become clear during this process. By making
sexuality a topic of open discussion, everyone will be
more alert and aware of related issues. It is, however,
important to make time for these discussions, for
example during team meetings or informal moments,
and involve others in the process. The ultimate
goal is to get all stakeholders on the same page
(Hulpverleners, 2014) (Leidinggevenden, 2014).
Vision, policy and protocols (of institutions)
The policies and protocols of healthcare institutions
usually offer tools on how to deal with sexuality and
intimacy. These tools will help you to move forward
and give you insight in how to deal with certain
situations. It is important that the institution’s policy
is at the top of the team’s agenda. This means that
themes are discussed openly, everyone is aware of
the policy and everyone has easy access to policy
information. In short, sexual education should be
fully integrated into all aspects and at all levels of the
programme (Hulpverleners, 2014) (Schaafsa, 2013).
3
Successes and difficulties
Making sexual issues a topic of open discussion
within your team or environment can make you feel
vulnerable. Although not everyone is comfortable
with talking about this subject, sharing successes
and difficulties with colleagues or significant others
is key for improving sexual education. For example,
if you are open about what you are comfortable with
or capable of, your colleagues can step in and take
your place if necessary. An open atmosphere also
stimulates knowledge sharing and the exchange
of ideas on how to approach subjects or solve
problems, ultimately benefiting the quality and
effectiveness of the sexual education provided.
Discussing successes (and failures) in team
meetings also helps to improve sex education and
will motivate colleagues or partners to do the same
(Hulpverleners, 2014).
Definition of sexuality and intimacy
‘Sexuality’ and ‘intimacy’ mean different things to
different people. Terms like these are open to wide
interpretation, but can also be narrowed down to a
single aspect. That is why it is important to discuss
with your colleagues or partner what you understand
by ‘sexuality’ and ‘intimacy’ in order to arrive at a
clear definition that can be used consistently. A
spider diagram can be a useful brainstorming tool
in this context. The illustrations below are examples
of spider diagrams used by a team of care workers
to explore the definition of sexuality. The team
made a distinction between sexuality in general and
sexuality for clients.
This illustration features words that the team
members associated with sexuality for clients.

Boundaries
An important part of teaching sexual education is
articulating, setting and maintaining boundaries.
Not just for the individual receiving sex education,
but also for you, your team or partner. This requires
an awareness of your boundaries and being able
to maintain them. Role play is one way of exploring
personal boundaries and addressing issues. It offers
the possibility to act out a role relevant to real-life
situations and practise how to respond to them.
Your actions can then be discussed as a group
(Hulpverleners, 2014) (Leidinggevenden, 2014).

Spider diagram (Hulpverlenersteam, 2014)

The second illustration features examples of words

that were associated with sexuality in general

4
 Games like these help to get over the awkwardness
of using these types of words and allow you to get
on the same page in terms of which terminology to
use. Talk about if your terminology is correct or may
Spider diagram (Hulpverlenersteam, 2014)
cause confusion.

Vocabulary/language
Matter of fact
Effective sexual education involves communicating
Talking about sexuality and intimacy in a more
in an unambiguous way. Intentional use of words is
matter-of-fact way during work handovers or
an important part of this process. One way of finding
household chores such as doing the dishes and
out which words your colleagues or partner prefer
cooking makes it less of a charged subject. In fact, it
and feel comfortable using to talk about sex is by
will become a normal subject of conversation if you
writing them all down.
talk about it regularly.

Pick a word and write down any synonyms you and

How and When To Ask For Assistance
your partner or colleagues can think of.

As mentioned earlier, some sex education situations

may be difficult for you to deal with. In such a case,
it can be useful to ask for help. If your organisation’s
policy does not have anything specific on this, then
turn to a colleague, partner or expert for help.

Reasons for requesting assistance from

colleagues, partners or experts:

• If you need information or advice on possible

difficulties that may arise when giving sexual
education. For example, if you don’t know how to get
the conversation started with the individual.

5
• If you don’t feel skilled or experienced enough in
certain areas of sex education (e.g. sexual abuse).

• If the situation is too complex and you are confused

as to what steps to take.

• If your own norms and values put you in a difficult

situation.

• If you feel that your personal boundaries are being

crossed. That is why it is important to know what
your boundaries are and how to maintain them.

Training and Professional Development

Training plays a key role in sexual education and

instruction on sexuality and intimacy topics. It should
not be assumed that every person has the skills
to provide sex education. That is why training and
professional development is important. Training will
improve the confidence of educators and support
them in their role as teachers of sex education.

In addition, training and professional development

are also opportunities to review knowledge gained.
This way, knowledge and skills remain current and
new methods can be learned.

Disclaimer

The European Commission support for the

production of this publication does not constitute
an endorsement of the contents which reflects the
views only of the authors, and the Commission
cannot be held responsi­ble for any use which may
be made of the information contained therein.

6
Sexual Education for
Adults with Disabilities

Tool 9
Handbooks
Appendices

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
Appendices
This booklet contains appendices to the instructional Protocols for a Solution-focused - 5
guide and toolkit. It includes interesting theoretical Approach
information, resources and references to sources Appendix 3: Protocol for Finding - 7
and methods that stimulate educators of individuals Exceptions (see also chapter 7)
with intellectual disabilities to look beyond the Appendix 4: Feedback and Task - 8
information provided in The Box. Framework (see also chapter 10)
Figure 10 - 8
Contents Appendix 5: Protocol for Follow-up - 9
Sessions (see also chapter 11)
Appendix 6: Guidelines for Crisis - 9
Appendices - 2
Situations
Appendix 7: Guidelines for - 10
Social Development Stages in - 2
Involuntary Clients
Children

Social development in infancy - 2 Social Development Stages in Children

(0-3 years)
Social development in toddler and
preschooler years (3-6 years)
Social development in school-age
years (6-12 years)
Social development in infancy (0-3 years)
- 3
One-and-a-half years:
Basic trust versus basic mistrust: the child
- 4 develops trust or mistrust, depending on how the
parents respond to his or her needs.

Social development in - 5 Autonomy versus shame: the child gains a sense

adolescence (12-20 years) of autonomy if he or she is encouraged to explore,
whereas over protection or limitation of exploration
The Hermeneutic Circle - 5 foster feelings of shame.

Recommended Methods - 5
and Sources for Training and
Professional Development

2
During infancy, attachment between the child and a
specific individual is formed. This is usually one of the
parents, but may also be a different caregiver in other
situations. There are various styles of attachment:
secure attachment, anxious-avoidant attachment, or
anxious-ambivalent attachment.
Attachment classification in infants
(Attachment classification in infants, Feldman, 2009)
At the end of the first year, infants go through a phase
known as stranger suspicion, where they become
extra wary of people outside their immediate family. In
a big and unfamiliar world, infants search for familiar
things. Unfamiliar situations or objects elicit fear
responses. When infants do not know how to respond
to an unclear wsituation, they look at the facial
expressions and behaviour that others display in order
to obtain clarifying information (social referencing).
Around the age of two infants start to show empathy,
an emotional response that corresponds to the
feelings of other persons.
Social development in toddler and preschooler
years (3-6 years)
Initiative versus guilt: the child is faced with conflicting
feelings – the desire to act independently from his
or her parents and guilt caused by unintentional
consequences of his or her actions.
Moral development is a process through which
children develop a sense of justice, right and wrong,
and associated attitudes and behaviours. During this
development, children go through a stage in which
they start thinking in terms of heteronymous morality.
They see the world as an unchangeable collection of
rules that are beyond anyone’s control.
3
Abstract modelling ensures that toddlers no longer
directly copy the behaviour of others, but start to
develop abstract principles about the behaviour they
see around them.
Around the age of three children start to form real
friendships. These friendships are based on the
desire to have someone to play and have fun with.
Older children also form friendships based on things
such as trust, support and common interests.
Social development in school-age years
(6-12 years)
Industry versus inferiority: during this phase the
child learns to master competencies to cope
with problems relating to parents, peers and
environment.
Social comparison is self-evaluation through
comparing own behaviour and skills with that
of others. This may also have an effect on the
development of self-esteem, i.e. how the child
perceives himself or herself.
During school-age years, three stages of friendship
can be distinguished:
1. 4-7 years: Friendships are based on likeability
and sharing toys and activities. Friends are often
children who the child spends most of his or her time
with. Personal traits are not yet that relevant.
2. 8-10 years: Personal traits and characteristics
come into play when forming friendships. The
rewards of friendships also start to play a role.
Friends are children who are there when you need
them. Abused trust is not forgiven that easily.
3. 11-15 years: Views on friendship are often
maintained in adolescent years. Intimacy and loyalty
are important factors. This stage is characterised
by psychological closeness and mutual openness.
Less emphasis on common interests and the
psychological benefits of friendship.
Social development in adolescence (12-20 years)
Identity versus identity confusion: during this period
the child, now an adolescent, learns how to answer
‘Who am I’ by identifying what makes him or her
different from other people.
In the adolescent’s social world, ties with people
outside the family become increasingly important,
while the relationship with family may change or
become more difficult.
In school years, adolescents develop autonomy,
become independent and gain control over their
lives.
Adolescents often have a certain group of people
who they identify themselves with. This reference
group, or clique, exercises a lot of influence, which
may lead to peer pressure.
During this stage of life the composition of groups of
friends often changes. While children usually have
same-sex friendships throughout their elementary
school years, cross-sex friendships are much more
common as they grow older and adolescence kicks
in. Social pressure to engage in (heterosexual)
relationships increases and sexual organs start to
mature, creating a strong interest in the other sex.
Peer pressure can also be a factor in friendship
formation.
4
Puberty opens the door to a significant new stage
in terms of relationships. For many teens, sexuality
is a big issue. Masturbation and various forms
of intimacy (kissing, massaging, oral sex) often
precede one of life’s major milestones: sexual
intercourse.
Another important topic on the agenda of many
adolescents is sexual orientation. However, the
threshold to give into same-sex attraction is often
high due to prejudice and ignorance.
• The circle can be completed based on your
experience with the individual, based on information
from his or her file, or based on discussions where
he or she explains the reasoning behind the
decisions made. Note: good judgment is asked of the
educator to ensure the individual is not overwhelmed
by the process.

(Feldman, 2009)

The Hermeneutic Circle

The hermeneutic circle is a circular understanding

process that gives a complete picture of a person by
looking at various developments in his or her life, as
well as the person’s life history and ability to cope.
There are two ways to complete the hermeneutic
circle:

• Problem-focused: the circle is completed by listing

skills and resources that the individual lacks, for
example on a social or cognitive level.
• Solution-focused: the circle is completed by listing
skills and resources that the individual possesses.
This is done by taking his or her personal history into
account and the challenges, if any, that were faced
and overcome along the way. Crucial moments
and their impact on the person’s life can also be
discussed here.
Recommended Methods and Sources for Training
and Professional Development
To be completed by the country concerned.
Protocols for a Solution-focused Approach
The following pages contain protocols to help you
get started with a methodological, solution-focused
approach. The tools and tips provided can be used
in teaching sexual education.

5
Appendix 1: Protocol for First Session
1 Role clarification
Information on the structure and duration of the
session, whether there will be a break to reflect, and,
if necessary, an explanation of the solution-focused
approach.
2 Matching your client’s style/worldview
The first step consists of building a positive working
relationship with the client by going along with the
client’s worldview.
3 Improvement prior to first session
‘What has changed since we last met or spoke with
each other? The improvement question taps into
the change process that may have already been
initiated.
4 Formulation/acknowledgement of problem
‘What brings you here?’
‘How is that a problem for you?’
‘What have you already tried and what has been
useful?’
Acknowledgement is important: listening in a
respectful manner, reflecting on feelings, giving
compliments, defining the type of relationship
between the professional and the client (customer,
complainant, visitor), ‘walking on two legs’.
5 Goal formulation/miracle question (or related
question)
‘You will go to sleep tonight, and in the middle of
the night, a miracle happens and the problem that
prompted you to talk to me (name specific problem)
is solved or nearly solved. What has changed when
you wake up tomorrow morning? What else?’
6 Exceptions
Are there any exceptions? When is the problem
absent or less noticeable?
Together with the client, the professional looks for
differences and exceptions, and the extent to which
the client is able to control the occurrence of the
exceptions.
7 Scaling
If 10 is: ‘I have reached my goal’ and 0 is: ‘I have yet
not reached my goal’, where are you now on a scale
of 10 to 0?
Scaling is often used to gain insight into the following
areas:
• The client’s progress during the sessions;
• The degree of hope the client has;
• The amount of energy the client is willing to invest
in improving his or her life;
• The confidence the client has in terms of reaching
his or her goal;
• The client’s willingness to put the necessary effort
into reaching his or her goal.
8 Competency questions
The professional compliments the client directly,
asks competency questions (indirect compliments)
and gives positive character interpretations:
• ‘How brave of you to…’
• ‘Where did you get that good idea to… ?’
• ‘It takes a strong person to…’ ‘Please tell me more.’
6
9 Feedback
Feedback to the client consists of three components:
• Compliments for what the client has accomplished
and positive character interpretations. Compliments
are a positive way of reinforcing past successes and
competencies.
• A reason (rationale or bridge) for the task
(preferably in the client’s own words).
The bridge connects the compliments to the
homework suggestions or tasks. The bridge often
begins with ‘and because...’
• A task or homework suggestions. This component
consists of one or more behavioural or observational
tasks.
The solution-focused professional can introduce a
five-minute break before the feedback, allowing time
to think about what feedback to give.
The feedback provided differs for ‘visitors’,
‘complainants’ and ‘customers’:
• Visitors are not given suggestions for homework
assignments (they do get compliments).
• Complainants are only given suggestions for
observational tasks.
• Customers are given observational tasks and/or
behavioural tasks.
Appendix 2: Protocol for Goal Formulation
1 Goal formulation (miracle question or another
goal-oriented question)
•‘What is your goal?’
•‘What would be a good result for you?’
•‘What do you want to replace the problem with?’
2 Elicit details
• After the miracle: ‘What is the first thing you notice?
What else?’
‘Who else will notice when the miracle happens?’
‘What will you do differently? What else?’
• ‘What will your day be like after the miracle?’
And so on.
3 Towards solutions
‘What is needed to have (a small) part of the miracle
happen?’, ‘How might that happen?’, ‘Who could
help you with that?’
4 Task
• Visitors are not given tasks.
• Complainants are given suggestions for
observational tasks.
• Customers are given suggestions for observational
or behavioural tasks.
Appendix 2: Protocol for Finding Exceptions
1 When the clients talks about the problem, ask:
2 ‘When was the problem absent?’
Or
‘When was the problem less intense or less
frequent, even if the difference was small?’
Or
‘What days were better?’
Or
‘When was your last good day?’
3 Ask for details and explore how the exception
came to be
‘What did you do to make that happen?’, ‘What did
you notice?’, ‘What did you say?’, ‘What happened?’,
‘What was different?’, ‘What did you find useful?’,
‘How did you manage that?’, ‘How did that feel?’,
‘What else?’, ‘Please, tell me more!’
7
4 Reinforce/Pay compliments
Nonverbal: lean forward, raise your eyebrows,
make notes (do what you would naturally do when
someone tells you something important).
Verbal: show interest. ‘Was this new for you?’, ‘Did it
surprise you that this happened?’
Pay compliments and ask competency questions:
‘That must have been pretty difficult for you’, ‘It
required courage for you to do that’, ‘Where did you
get such a good idea?’

5 Project exceptions on situations in the future ‘What

is needed to make this happen again?’
‘What should you do?’
‘Who can help you with that?’

Appendix 4: Feedback and Task framework

Feedback: compliments; rationale or bridge (reason

Figure 10
for the task); task suggestions for when client wants
to do a task

8
Appendix 5: Protocol for Follow-up Sessions
EARS:
Eliciting (drawing out stories): ‘What is or what is
going better?’
Amplifying (asking for details): ‘How does that
work?’, ‘How exactly do you do that?’, ‘Is this new for
you?’, ‘What effect does that have on…?’, ‘What is
different between you and...?’
Reinforcing (confirming): Give compliments
and positive character interpretations and ask
competency questions.
Start again (start over): ‘And what is or what else is
going better?’, ‘What else?’, ‘What is needed to do
that again or more often?’
If nothing has improved: ‘How do you manage?’,
‘How do you survive that?’, ‘How come things aren’t
worse than they are?’, ‘How do you do that?’
Scaling progress: ‘Where are you now on a scale
from 10 to 0?’, ‘How did you manage that?’, ‘What
would a higher rating look like?’, ‘What would be
different?’, ‘What do you need to accomplish this?’,
‘Who will be the first to notice?’, ‘How would he or
she notice this?’, ‘How would he or she respond?’,
‘What rating is your ultimate goal?’
Optional: scaling motivation and confidence
Feedback: compliments; rationale or bridge (reason
for the task); task suggestions for when client wants
to do a task.
Is it necessary or would it be useful for you to come
back? If so: ‘When would you like to come back?’
Or:
Is it necessary for you to talk more about… If so:
‘When shall we meet?’
Appendix 6: Guidelines for Crisis Situations
Acute care
Chevalier (1995), Berg and Szabó (2006),
Gersons and Olff (2005) provide guidelines for
initial therapeutic care for people in acute crisis
situations. These guidelines mainly consist of natural
responses given by the client’s family and friends:
• Give comfort and hope.
• Listen to the client’s story.
• Accept the client’s view of the world.
• Relate to the client’s language.
• Create a sense of calm and order in chaos.
• Inform significant others.
• Use important people from the client’s immediate
environment to cope with the crisis.
• Ensure the client drinks and eats enough.
• Make a follow-up appointment.
Solution-focused approach
Contrary to a general misconception, it is possible
to deal with crisis situations in a solution-focused
manner. Because a crisis takes care professionals
by surprise, they are often inclined to take control of
the situation in a problem-oriented way. However,
most clients in a crisis situation stabilise quickly if
they are encouraged to focus their attention on what
they would like to be different (goal formulation) and
make use of past successes and competencies.
Solution-focused interventions include:
• Inquire about the client’s competencies.
• Explore how the client is coping with the current
crisis: ‘How are you managing?’, ‘How are you taking
care of yourself?’
• Pay compliments.
• How did the client solve a previous crisis?
• Focus on the client’s strengths.
• Ask goal-oriented questions: ‘What helps you the
most?’
9
• Ask relationship questions.
• Ask scaling questions that focus on the goal.
• Ask scaling questions that focus on progress in
terms of coping.
Please refer to chapter 18 for solution-focused
questions for clients in a crisis situation.
Appendix 7: Guidelines for Involuntary Clients
Lans, Medema & Rakers (2003) give practical
advice for working with clients who find ambulant
care to be intrusive (involuntary clients). The
following pointers and strategies may prove useful:
• Sit next to the client. Show that you are working
from a position alongside the client, rather than
confronting the client.
• Frequently use the word ‘together’.
• ‘Getting a foot in the door’ is an expression that
symbolises a personal approach: the professional
who is often (literally) confronted with a closed door
shows that he or she is involved by visiting the client
more often, leaving an invitation, calling or by getting
information from neighbours or housemates.
• Show respect for the client by asking questions
without being dismissive or judgemental. This is
essential for maintaining a good relationship.
• Find solutions that result in a win-win situation
for all parties. In doing so, display a cooperative
attitude. Explore, together with the client, how
broken or distorted relationships with other persons
or institutions can be restored within the context of
common interest.
• Show an interest in the client. Generating trust,
informing and building up a relationship is essential
in times when the client is not under pressure of the
problem. Make good use of these calm periods.
Clients with intellectual disabilities are considered
involuntary clients if they do not acknowledge their
part in the problem’s creation and set goals to solve
it, while others (e.g. parents or care workers) do
acknowledge this. Involuntary clients include clients
with uncontrollable anger issues who professionals
don’t know how to deal with, or ambulatory patients
with financial or addiction problems who refuse help.
De Jong and Berg (2004) give a number of
guidelines for conversations with involuntary clients:
• Approach the client from a visitor relationship
perspective. Assume that the client has good
reasons to think or act in the way that he or she
does.
• Do not pass judgement and accept the client’s
viewpoints causing his or her cautious, defensive
attitude.
• Listen to who or what is important to the client,
especially when the client is angry or critical.
• When the client openly expresses anger or
criticism, find out what the person or institution could
have done differently to change the outcome.
• Ask the client what would be in his or her best
interest. In other words, what would the client like to
achieve?
• Listen to the client’s terminology and parrot his or
her language when summarising, paraphrasing or
giving feedback.
• Make use of the client’s context in the conversation
by asking relationship questions.
• Provide information about non-negotiable
conditions in a respectful way, and ask how the
client feels about these conditions.
• Work from a not-knowing position.
10
For clients with intellectual disabilities, using people
from the client’s immediate environment can be a
useful addition to the individual sessions. Stories
of significant others may especially be of use to the
solution-focused professional if the client refuses
or is unable to articulate his or her problems. A
combination of client stories and those of significant
others form a good start for a solution-focused
approach. Involving others in the sessions cannot
be done without the client’s consent. Chapter 16
contains a case study of cooperation with significant
others in the case of an involuntary client. Solution-
focused questions for visitors are listed in chapter
18.

Disclaimer

The European Commission support for the

production of this publication does not constitute
an endorsement of the contents which reflects the
views only of the authors, and the Commission
cannot be held responsi­ble for any use which may
be made of the information contained therein.

11
Sexual Education for
Adults with Disabilities

Tool 9
Handbooks
Figures

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
Figures

Clients
Porn, contraceptive, assertiveness, hygiene,
needs, consent, lust, unsafe, careful, natural, equal,
compulsive, masturbation, network, tips, shame,
privacy, boundaries, norms and values, action,
Life History
together, love
Physical Development
Cognitive Development
Social Development
Psychological and/or Psychiatric Problems

Emotional Development
Coping Ability

2
Sexuality
Body, discovery, contact, fucking, intimacy, trigger,
children, porn movies, needs, man/man, intimate,
sex toys, together, having an orgasm, normal,
kissing, alone, contraception, woman/woman,
man/woman, reproduction, private, boundaries,
pregnancy, enjoyable

Disclaimer

The European Commission support for the

production of this publication does not constitute
an endorsement of the contents which reflects the
views only of the authors, and the Commission
cannot be held responsi­ble for any use which may
be made of the information contained therein.

3
Sexual Education for
Adults with Disabilities

Tool 10
Keep Me Safe Project
Links:
http://www.ippfen.org/keepmesafe

http://www.ippfen.org/sites/default/files/KMS%20
TRAINING%20manual%20for%20INTERMEDIARIES%20
-%20designed.pdf

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
Sexual Education for
Adults with Disabilities

Tool 11
The Hermeneutic Circle

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
The Hermeneutic Circle
Initiating a conversation about sexuality and intimacy The circle provides a method to look at the world
can be daunting. Below are some important things to from the client’s point of view, allowing you to create
consider before you start teaching sex education to a client-oriented programme and approach. It can
your client: also serve to make a client’s request for help more
concrete. (Suykerbuyk & Bosch, 2010)
• Establish what knowledge and skills the client
already has.
• It is also important to have a clear picture of the
client’s social-emotional level, well-being and
understanding of concepts and terminology. There is
often a discrepancy between these three things.
• Clients with light intellectual disabilities and a
‘normal’ appearance and demeanour may give the
impression that they have adequate social skills and
are able to set and respect boundaries. People often
jump to this conclusion too soon. It is especially
important to gain insight into clients’ perceptions
on sexuality if they have never been confronted
with sexual education as part of their upbringing or
development.

The hermeneutic circle is a useful tool that can

be used to assess the cognitive and emotional
capacity, social development, skills, background and
special circumstances in the lives of individuals with
intellectual disabilities. The circle provides a total
picture of the person, allowing you to understand
them better and look beyond their physical or social
limitations and accept them for who they are
(E. Bosch, 2010).
Hermeneutic circle, (E. Bosch, 2010)
Disclaimer
The European Commission support for the
production of this publication does not constitute
an endorsement of the contents which reflects the
views only of the authors, and the Commission
cannot be held responsi­ble for any use which may
be made of the information contained therein.

2
Sexual Education for
Adults with Disabilities

Tool 12
Easy-to-read UN Charta
Links:
http://www.equalityhumanrights.com/human-rights/human-rights-
practical-guidance/area-generic/united-nations-convention-on-the-
rights-of-people-with-disabilities-easy-read-guide

http://www.equalityhumanrights.com/sites/default/files/documents/
publications/uncrpd_guide_easyread.pdf

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
Sexual Education for
Adults with Disabilities

Tool 13
Model Policy Abuse 1 & 2
Links:
http://www.speakup.org.uk/?page_id=1412

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
Sexual Education for
Adults with Disabilities

Tool 19
Icebreaking activities

The European Commission support for the production of this publication

does not constitute an endorsement of the contents which reflects the views
only of the authors, and the Commission cannot be held responsi­ble for any
use which may be made of the information contained therein.

1
Icebreaking activities for first dates
– Talk about: – What personal qualities are needed for an ideal
– 20 random facts about yourself and himself/ relationship?
herself – What conversation topics are you afraid of, and
– 3 of your fears prefer to avoid?
– 10 things that you would tell to your 16-year-old – What’s the most interesting thing that has
self (do it, don’t do it) happened to you in a relationship?
– 5 things that makes you happy nowadays – What where the most significant changes in your
– 3 obsessions of yours life?
– 5 people who have influenced your life in some – What is the strangest thing ever happened to you?
way – What book influenced you?
– The most embarrassing thing in your life – Would you have a plastic surgery, if yes, what
– 5 little things that make you angry would you change on yourself?
– The 3 best thing ever happened in your life – What was the most stupid thing you did as a child?
– 3 important events in your childhood – What was the most stupid thing you did since you
– 5 of your hobbies were a child?
– about your best friend – If you had a biographical book, what would be the
title?
– Describe a usual day! – What do you think of…… ? (some actual news)
– Describe 3 of your strengths! – If you were a superhero, what kind of superpower
– What’s the hardest thing you have ever lived would you like to have?
through? – If I was a golden fish, what 3 wishes would you like
– What’s your dream job? to have?
– If you could live anywhere in the world, where – Which song makes you dance on a party?
would you live?
– What do you think, how would other people
Disclaimer
describe you?
– Where do you think you will be in 5 / 10 years’ The European Commission support for the
time? production of this publication does not constitute
– If you were a film actor, who would you be? an endorsement of the contents which reflects the
– If you built a house, what would it look like? views only of the authors, and the Commission
– Which animal is similar to you? cannot be held responsi­ble for any use which may
be made of the information contained therein.