Video Transcript: Sexuality Education for Persons with ASD and Intellectual Disabilities (Part 1)

Watch Video: Sexuality Education for Persons with ASD and Intellectual Disabilities (Part 1)

That said I will pass the mic over to my colleague Susan Josa and she's going to introduce our guest speaker for today.

- Hi everyone.

I am so delighted to be able to introduce Annamarie Talbot to you this afternoon.

I have worked with Annamarie for many, many years and I feel very fortunate to be able to say I work with her and learn from her.

She's just been a wonderful colleague to work with.

Annamarie Talbot has been a student services, is currently a student services consultant with the Straight Regional for Education here in Nova Scotia.

She has over 27 years experience as a classroom teacher, learning center and resource teacher, and program planning teacher leader.

Annamarie has a masters in education.

She has a diploma in counseling and a masters in guidance.

I have to say that knowing Annamarie, and those of you who know Annamarie know very well that working with students with exceptionalities in ASD is a true passion.

Annamarie works very hard to help students really achieve success in the community and plan for their future.

She has a wealth of experience in transition planning and preparing students with healthy sexuality education is just part of that transition planning process that she undertakes with students and staff.

So I think that today we're in for a real treat to hear what Annamarie has to offer.

And without further ado I'm going to turn it over to Annamarie to talk about healthy sexual education for students with ASD and diverse learners.

- Good afternoon.

It's so lovely to be here.

Thank you very much for the introduction Susan.

And thank you Shelly for organizing everything.

It's wonderful to be here.

I just wanted on the say a little bit about how I arrived at this point.

And I believe that in all of the work I've done working with students with intellectual disabilities and with autism, if it's come out of a need where teachers have asked be for support in dealing with this topic.

And it's not an easy topic.

So, I really became passionate about it and I'm really trying to support others as they go along.

My work is taken from a variety of sources.

And I put references at the back of the PowerPoint, which I know you'll see.

Isabell Hano has been somebody that I use and have referenced many times.

And that has been a great help to me.

So we're going to get started.

So the idea is where do I come from?

And who has had the most influence on your sexuality education?

This is important for you as educators.

You need to think about that.

For myself growing up in the 1970s and 80s the topic of sexuality, or sex in general was not a discussion for the supper table, or anywhere else for that matter.

All of my education either happened in health class at school or with my peers.

I'm sure that was the case for you as well.

And as you enter into this field of supporting students with intellectual disabilities we need to check our own belief systems because it's not up to us to judge.

It's up to us to support.

So the heart of this training is that we need of teach, explicitly teach our students what they need to know to reduce violence and allow for healthy relationships to develop.

Often when I'm going this presentation in front of a group I talk about our family values.

And how do our values influence where we are.

There are positive and negative values of course.

And they're specifically related to gender, sexual orientation, identity, relationships, and sexual activity.

How do our experiences impact our values and influence how sexuality education is or is not provided.

I feel that this is not an easy topic for some people.

And that's okay.

But you need to find the easiest way to get the job done.

When we think about how our parents spoke about sexuality or discussed it with us, what did that look like?

Did they give you a book?

Did they sit with you?

Did you learn it by osmosis or from your friends?

Do you think this was the best method of learning.

Are students with intellectual disabilities need explicit instruction as do our students with ASD, and all disabilities.

I feel they need scripts and rules to follow.

It's well documented that persons with intellectual disabilities or IDs, as I will refer to that as I go along in the presentation, experience sexual abuse at rates far more extreme than their peers without disabilities.

Specifically as many as 80% of women, and 30% of men with intellectual disabilities experience sexual abuse before they're 18 years old.

If that's happening that's happening during their time at school.

The best solution to preventing sexualized violence among people with IDs is to teach relationship skills.

We want persons with IDs to be in healthy relationships with others and believe that all people are worthy and deserving of exploring their sexuality.

So think back to your own sexuality training at school.

Everyone has a different experience.

Unfortunately many of our students with IDs do not participate in these classes with their peers.

This starts to set them apart from the very beginning.

Although they may need lots of follow up instruction this should start in the classroom.

They need to be a part of some part of that lesson.

Can all of our students attend classroom instruction on these topics?

No, but as we as adults need to differentiate so they can attend parts of the instruction.

We need to make it easier for them.

They need to be around their peers as they do that.

The issue is that their bodies are ready, but maybe they're not maturationaly ready.

So the risk factors for experiencing sexualized violence have been documented as these six.

So when we think about self help skills children with IDs are often in private spaces, washrooms and bedrooms, with public individuals considerably longer than their peers are, as they may require assistance with personal care tasks such as bathing, dressing and toileting.

As a result, a person with an ID may learn that their right to privacy can be revoked at any time by another person.

They may not be able to differentiate between an abusive touch and a necessary touch.

These touches may have been happening do frequently they may have become acclimatized to them.

In terms of cognitive development and learning opportunities, an intellectual disability is defined by intellectual or cognitive delays limitations.

In response to such delays they may be excluded from sexuality education, as society tends to believe they are incapable of learning, or that the learning is unnecessary.

They may miss out on information about their bodies, their rights, and what they can expect from others.

We talk about social emotional skills, and this is an area that we in the province of Nova Scotia have been focusing on so much, often our students with intellectual disabilities are isolated from their peers for a variety of reasons.

And do to this feeling of isolation they become more vulnerable to the approaches of potential abuser.

Language and our communication deficits, many of our students to not have sufficient language to report sexualized violence.

20% of adult women with IDs were not able to identify a penis, and 12% vulva, indicating there are significant knowledge gaps in accurate terminology.

As you can imagine this is going to lead to serious problems down the road.

Compliance, people with intellectual disabilities are often taught to be compliant, to follow through on tasks and demands.

It is essential to teach self advocacy skills and to speak up.

Think about it in terms of if they are over compliant then they are non-competent.

In terms of gender, it is important to think about how gender impacts sexual abuse.

Women are more likely to be victimized than are men, and this comes from our statistics Canada 2011.

Eugenics, historically the sexuality of disabled people was controlled through eugenics, or the systematic control of breeding.

People with disabilities were deemed unfit for procreation and were sterilized, or institutionalized.

British Columbia and Alberta had legislation to this effect.

And Alberta practiced negative eugenics from 1929 until it was abolished in 1972.

Those are scary stats.

Although the Canadian Charter of Rights and Freedoms prohibits discrimination based on ability, intellectual disabled people are still often treated with a philosophy of preventing sexuality, and therefore reproduction.

Sitting in on individual program planning meetings and discussing goals around life skills, the topic of relationships has become uncomfortable for many around the table.

In my experience it is not until there has been an issue of inappropriate sexual behavior that we get the parents and care givers on board.

I would like to see this taught long before they get into trouble, or make mistakes, or start exhibition inappropriate behaviors that set them apart from their peers.

I'd like to go through some myth or facts with you right now.

And the first one is some people are too delayed to benefit from sexuality education.

This is something that has been said to me many times sitting at individual program plan meetings.

Of course with the right materials and support, almost every person is capable of learning and changing.

It is essential that materials and strategies are developmentally appropriate, considering both chronological age, and developmental level.

Furthermore it is essential to consider the risks of sexualized violence.

As research indicates, the more disabled a person is the more at risk they are at being abused.

Unfortunately there is a lack of appropriate materials and resources available for use.

And there is a lack of professional development opportunities available for educators.

I'm hoping that today will help you with some of those, some of the ideas that have been successful for me.

People with intellectual disabilities are asexual or childlike.

This is often something that I hear from parents that they are so childlike that they do not deserve to be into these classes, or talk about having a sexual relationship.

Every person can love and be love.

Although attention must be paid to developmental level, chronological age is equally as important.

All bodies change and develop.

And all bodies can feel.

Providing developmentally appropriate materials is essential in providing responsive and inclusive sexuality education.

Unfortunately the developmental level of a student is prioritized over chronological age.

Some people with intellectual disabilities already know too much.

This is a very common statement.

Parents and educators feel that if we teach them things then they will know too much and display more inappropriate behaviors.

When in fact, it is likely that they actually do not know enough, or that their knowledge may be surface level.

And they may be copying their peers.

Primarily they do not know the appropriate and legal skills that are essential in healthy sexuality, or they may not have those rights respected.

And example would be privacy of some of our students because they are not afforded the luxury of being private.

They always have an adult with them.

Additionally, because society is nervous, uncomfortable, and/or unfamiliar with the sexuality of persons with disabilities, when sexualized behaviors are observed they are perceived as too much.

And people with intellectual disabilities are caught more often than their neurotypical peers because they are never alone and never given privacy.

Some people with IDs are hyper sexual.

Of course this myth is likely that every person is not hyper sexual, but rather that they have not learned the appropriate expressions of sexuality.

More over they have never been given the opportunity to practice the skills they have learned.

For example, how can they practice sexualized behaviors in private if they are never afforded privacy.

To often I am told that they are not allowed to shut the door in their bedroom, and they're sleeping with someone in the room with them.

They're never allowed to go to the bathroom on their own.

So these are problems that arise.

Teaching sexuality education might give a person with an ID ideas.

People with ID already have ideas.

They have seen relationships in movies and TV, in public, or in their own home from their parents and siblings, or at school and work.

Unfortunately many of them see negative relationships as well on the internet.

Relationships are everywhere.

The skills about how to navigate a healthy relationships are not.

Those are learned skills, and therefore must be taught.

Think about the first time you heard about sex.

How did you react?

Were you grossed out and thought, I'm never going to do that?

This did not give people positive ideas.

We do not give our students their sexuality.

It belongs to them.

Our role is to educate and support them in exploring their healthy sexuality.

In terms of relationships for students the PEERS programs, which is the Program for the Education Enrichment of Relational Skills by Elizabeth Logason is a place to start.

This has been a priority across the province of Nova Scotia.

PEERS is a manualized social skills training intervention for youth with social challenges.

This evidence based program has certainly made a difference with many of my students in supporting with making and keeping friends.

Having friendships to be the precursor for romantic relationship.

People with IDs can not be good parents.

For most people, most of the time, sex is not about making babies.

Just think about all of the reasons that people have sex.

Anyone can be a good parent just as anyone can be a bad parent.

All parents are challenged by their parenting role and some might need extra support.

I'm sure we can all think about parents that need extra support.

But unfortunately with stigma attached, and when there are no supports it can be more challenging to be a parent with an ID.

We cannot teach sexuality education because of moral and/or religious reasons.

Of course this myth, it is a myth.

And it is responsibility of families to teach their own values.

If you're not a family member your job is to be an educator, not a moral compass.

It is well documented that the lack of sexuality education, or abstinence only education does not demonstrate long term positive impacts on a persons sexual health and well being.

Comprehensive sexuality education instead offers a sex positive, diverse, and inclusive model with far reaching benefits, including safer sex practices.

Children who participate in comprehensive sexuality education and do experience sexual assault are less likely to feel shame or assign self blame.

People with disabilities are undesirable as sexual partners.

This is untrue.

Disabled people can be sexual desirable just like everyone else.

They can form sexual and romantic relationships.

While the hope is that these relationships are mutual and consensual, beware letting this myth prevent you from recognize that disabled people can be objects of unwanted, or nonconsentual sexual desire and activity.

The underlying truth, ableist beliefs reinforce this belief, as persons with disabilities are not shown in popular culture as sexual beings.

Disabled persons also may be fetisized in a sexual explicit material, or sought out as sexual partners because of their disability.

And this is very scary.

When we think about anatomy and sexual health where do we start?

For me we need to start about teaching anatomy and sexual health with learners with intellectual disabilities.

We need to explain how learning about anatomy and sexual health can reduce the risk of experiencing sexual trauma.

And we need to describe the risks of engaging in unhealthy sexual behavior if a person does not have access to knowledge about anatomy and sexual health.

Why should we teach an individual about their body?

Our students need the accurate terminology so they will understand if they have been abused.

So that the person will have the skills to report their experience and be believed and understood.

If they use an inaccurate term it could lead to a misunderstanding.

I was working at an adult service center last week and one of the care workers said to me that she had a struggle with one of the clients going to the doctor.

And I asked what was the issue.

And she told me that the adult with intellectual disability had an itchy flower and that when she went to the doctor's office to tell him that she had an itchy flower he was very, he didn't know how to answer her.

So, it took quite a long time to determine that her itchy flower was actually an itchy vagina and that where it was sore, was it inside or outside.

It was quite a long procedure.

She did not present well as a person with intellectual disability because she did not have the correct terminology.

Now, let's think.

If she was reporting a sexual assault she would not have had the words to explain that someone had put a penis into her vagina.

So what should we teach?

We need to name the accurate terms for body parts and sexual activities.

We need to explain how their bodies mature, and the difference between the bodies of adults, adolescents, and children.

The reason we need to do that is specifically because when they are looking at things on the internet they struggle with the theory of mind, and they do not understand what is the difference between an adult and a child.

And they can get themselves into a lot of trouble that way.

We need to be specifically teaching about how to reduce STBBIs, which are sexually transmitted blood born infection.

That was new for me last year as well, and how to prevent becoming pregnant.

They need to recognize that their body is their own and only a person has the right to a body that lives in it.

Identify reasons to engage I sexual activities and reasons why people may not want to engage in sexual activity.

Research has found that children who know the correct terms for body parts are more likely to report sexual abuse.

Moreover, court testimony from child victims who use correct terms is more likely to believe, to be believed, and of course that goes back to my flower story.

So, this is where we start.

So we need to make sure that students are able to understand that they have been abused.

They have the skills to resort their experience and be believed and understood.

The teaching of anatomy and sexuality is essential in reducing the experiencing of sexual trauma.

When I was working with Emily Martinello her approach was all the body is private and some parts are special.

Often we talk about using the bathing suit and that's what covers our private parts.

I really believe that all of the body is private and that some parts are special gives us a good way to explain it.

Teaching about sexuality and anatomy gives the opportunity for a person to understand if their boundaries have been breached.

While I was thinking about IPP goals, these can be attached to science courses in high school, or health in elementary.

It could also be attached to life skills goals in IPPs or biology, wherever it fits.

For example, a female student will be able to name and understand the functions of her body.

A specific goal could be that she would be able to match the eight parts of the vulva with their function.

Or if this is too complex it could be a simple matching activity to learn the proper terms.

This may take a long period of time to practice.

You could put it in a teach task and have it as something that is done regularly until she is comfortable.

There is a website, teachingsexualhealth.

ca, which I reference several times in the PowerPoint, and it's at the back.

That's somewhere what has a lot of examples that can help you.

So what to do when you are doing it, and by it we mean anything sexual.

So as you start your teaching this checklist gives you a guideline of topics that need to be discussed.

How do you obtain consent?

Are you legally able to consent?

And remember that consent is ongoing and can change at any time.

In my experience consent is very difficult to teach.

We need to take a significant amount of time to work on it.

Protection, what is the safest and most comfortable type of protection for the person?

Do you know how to use a condom?

Are you aware of expiration dates?

Privacy, is there a private spot where no one can see you, what does that look like?

Many of my students get into trouble because they are doing private things in public places, sorry.

So where is a safe place for a date?

Does someone know where you were?

What do you want out of a relationship?

Can you communicate your wants and desires?

What about going to the doctor?

Can you go to the doctor if you're talking about your flower, or do you need to use the proper words for a pap test?

Do you need to understand about your breasts and what type of exam you would need to have.

Do you need to understand about a testicular exam?

Do you have to talk about STDBI testing, birth control?

All of these are very complicated topics that we need to teach.

And then decisions, what do you want in a relationship?

Many of my students tell me that they don't want to have sex.

They tell me they want to have a person that they can do something with that might hold their hand and be present in their life.

We always jump to the fact that that's what they want is to have sex.

But really they want a person.

They want to have someone in their life just like all of us.

We also need to be aware of what can happen when they have unprotected sex.

So we need to have a plan for the what ifs.

So what to do when you are teaching it.

So, as on the previous slide, these are the areas that need specific teaching.

But there's too many topics.

We can not teach all of these topics at once.

In my experience consent is a very difficult concept as I mentioned a minute ago.

As last spring I was working with a family getting connected to the adult side of Department of Community Services, and my student had to give his father consent to speak and work on his behalf.

We were trying to access some funding for transportation to an adult service center.

The care coordinator had done the initial meeting and felt the student could advocate for himself.

As this student presented with a very capable vocabulary his communication was excellent and we did not anticipate that we would have any difficult with that.

It was not until we started working on the concept of teaching consent did we both realize his limitations.

So, how did we work on this?

We started practicing daily.

Unfortunately this explicit daily teaching between the teachers and myself was not enough.

I was practicing by calling.

I would call the school every day and I would get him on the phone and we would practice what that might look like.

I would pretend, do a role play that I was the care coordinator and I would ask that question over and over every day.

He could not answer the question.

It was the word consent that was throwing him off.

So the care coordinator just needed to be able to ask the question and he would answer.

But he was really struggling.

So, after about six weeks he was comfortable on the phone with me, and then I thought, well, perhaps the solution is I host a three way call so that I can prompt him from the teaching that had been done previously.

And then once we were on the phone the coordinator asked the question, I explained and prompted.

He was able to repeat after me and all was well.

So that took six weeks to have that student give consent for his father to speak on his behalf to secure funds for transportation.

Now, think about giving consent for sexual activity.

So you think our students with intellectual disabilities can do this?

Do you think it's gonna take more than six weeks?

I can assure it will take a lot longer than six weeks.

When I think about what consent entails in terms of the yes and the no it is exceptionally complicated.

What is important in sexuality education?

What does a sexually healthy adult look like?

As I mentioned earlier it's not always all about sex.

Of course it's more than penises, vaginas, and intercourse.

And how do our own values impact how you teach sexuality education?

So, I know non of you are thinking it is all about putting penises into vaginas, but how can we teach about sex and love?

How do we do that at school?

How can we put our own values aside and teach about sexuality education?

A question I received, I was doing a presentation at an adult service center last week and one of the workers said me, "Annamarie, one of my students wants to date two "people at a time.

" And I said, well what are the dates entailing?

And she said, "Well, she's going for coffee "with both of them.

"But she's going on Tuesday with one, "on Wednesday with the other.

" And I said, okay.

And she said, "Well, Annamarie she shouldn't be "dating two people at once.

" And is said, who's value is that.

And she said, "Oh, it's my value.

" And I said, she's going out for coffee.

She's not going to have sex with these two gentlemen at the same time.

She's not doing anything illegal.

So do you see how our values can impact?

She felt it was wrong that she was trying to decide between these two men if she wanted to date them.

So, we really do have to check our own values.

They come into play without us even realizing.

So, what is sexuality education, and what are the goals and intentions?

Unfortunately, sex education tends to be fear driven, just like that lady I mentioned.

She assumed the worst, that it was going from coffee at Tim Horton's to a motel room.

And so, based on the idea that people should wait as long as possible.

Because sex is very bad.

Think about what Maslow said, and where he placed sex on the hierarchy of needs, at the base.

We have to remember that.

It's always important to teach what to do, never what not to do.

Your job is to help others identify their values, not your values, and to live their lives according to their values.

We can not teach with judgment.

This is very important.

So as we get to personalizing teaching tools we know that our students require a discrete analysis of a step by step process for many routines.

If we are going to create a personalized tool for our learners as the generic ones don't work.

So when we think about our hand washing, visual schedules, bathroom routines, et cetera, I think that our students need more of these types of visuals that are individualized to suit their needs.

So this is a generic example of a young lady I was working with who was transitioned to the Achieve program at NSCC.

We were having, we were there having a visit and we both ended up in the bathroom at the same time.

Now, the social story that I had put in place was how to change her menstrual pad safely.

She was having a lot of difficulty with that.

And so I did it in a power card format.

So I took every one of those little bits and I put them on a ring, and she had them in her purse.

I also bought, we organized a purse that she could have different power card rings for each type of activity.

So we went to the bathroom and she, of course, wanted on the tell me that she was using her power cards.

And I said that was excellent.

And we both went into where our separate stalls, and you know, no more talking.

I had talked to her about that.

And she was taking quite a long time, and I said, I'll meet you back in the classroom.

Being private and allowing her some time, and she started to cry.

And I said, it's okay, don't cry.

I said, I can wait for you, no problem.

She said, Annamarie, I used my power card on how to change my pad, but I don't know what to do next because there's no garbage in the bathroom stall to throw out her soiled pad.

And I said, oh, I said, in my, and in the generic social story, of course, there was a garbage in every, that's what I thought.

I assumed that.

I didn't think about preparing for what if there wasn't a garbage inside the stall.

So I said, well that's okay.

Make sure you wrap it well in toilet paper, and then when you're finished in the bathroom you bring it out and there's a garbage you can put it in.

So she followed my directions well and we moved on.

And it made me think, how many other students struggle with small parts of a regular routine when they're in new places?

How can we predict that?

And how can we help them?

The next issue came as I was working on having her use public transportation.

Her school bus always had assigned seats but the public bus did not.

On one of our practice trips she got upset as someone was in her seat, or her so called seat.

So I created a power card about what to do when you get on the public bus.

These are two examples where there was lots of explicit teaching being done, but we couldn't predict what they might need.

We need to give them the ability to ask for help and not be upset.

The same holds true for all of the topics we will teach in the area of sexuality.

Think about if this young girl was in a sexual relationship and she was trying to get a condom on a penis and the condom broke?

What if she didn't have another one?

What was she supposed to do?

How do we help them get through that?

How can we prepare for all those steps?

Well we might not be able to predict all of them, but we have to some problem solving and think outside the box.

We need to think about activities for teaching anatomically correct language.

This starts at 16 months of age.

Our students need the appropriate terms for their visits to doctors and nurses.

Think about the need for appropriate terms if they have been abused.

Sit with your students and show them a picture of an anatomically appropriate body.

You can do matching activities at the beginning until they can label them independently.

One of the Brigance sub tests have them name their body parts.

Take it a step further.

And of course then comes slang terms.

The idea of teaching all of the words can be uncomfortable for us.

And that goes back to our values and how we judge.

We have no ideas what words our students have learned to represent their biological terms.

I have never heard the word flower before.

The only way to do this is to find out what they call it.

So we need to use those diagrams.

Give them the appropriate words, but ask them what they call it.

Many people with IDs may not have access to their peers to gather these terms.

So it's also helpful for them to be aware.

Students need a safe environment with an adult they trust to start learning about this vocabulary.

When I am working with teachers we complete an activity that looks at all of the slang terms for penis, vulva, breasts, and buttocks.

Everyone is always surprised at the new words they learn.

Where would our students with IDs fit into this continuum.

Emily Martinello has been compiling a list since 2013, and at this time she has 445 words for penis, 417 words for vulva, 160 words for buttocks, and 298 for breasts.

So keeping a current list helps you navigate conversations that are culturally and age appropriate.

So with all of those different words I'm sure you're going to be surprised when students give you something new.

So it's important to know what they call it so that we can teach them the proper way.

They may have some family values that they use around this language, and that's fine, but they do need the accurate words as well.

So I'd like to show you some of the diagrams that I have that are been successful.

So the first one here is the male reproduction system.

You can see that it's a fairly simple picture, nothing too complicated.

I mean, the body is complicated in terms of biology, but you can see how we could pick a few of these words, just the ones that they might need.

So this is just a simple diagram.

Again, I wouldn't use all of these terms.

We might start with a couple that might be important.

So, if we wanted them to know their penis, and we wanted them to know their testicles here, and maybe their anus, maybe those three.

So I would not go with many.

I would just use three to start.

And we might take the other words out.

Many of these might not be necessary for them to ever know.

They may need to know about their bladder at some point, that sort of thing.

So you can pick and choose what you might need from that.

Okay, so this is the female reproductive system.

Again, we may just pick a couple of topics, a couple of the words to use.

I would always start with a matching activity first and keep it simple for them.

Again, this is like the male one I showed you.

We might not need all of these.

Although, for the ladies we might need to do the vagina and maybe the ovary because sometimes, you know, that's something that they might need to know, that sort of thing.

Okay, so these pages came form Isabelle Henault's book, Asperger's Syndrome and Sexuality from Adolescence Through Adulthood.

And I just have it referenced here for you, but you can Google that.

There's awesome lessons there for junior high and high school, not for elementary.

But there's lots of lessons there about how to teach these things.

And then, of course, I have referenced for you the teachingsexualhealth there is another area that I've used frequently.

So the role of self pleasure, masturbation is a normal activity, but it is to be done in a private place.

It is not our job as educators to teach students how to masturbate.

However, it is our job to assist them in getting support with their doctor or health nurse.

For students on the spectrum, in terms of their theory of mind they assume if they can't see you then the reverse is true.

When we think about the steps they would need it's quite lengthy.

There are lots of resources available from David Hingsburger, and Diverse City Press.

You can Google them.

I have purchased them with great success.

I never expect that our educators at any time are teaching anyone how to masturbate, but I do use them with the school health nurses, and I mostly give them to parents.

And that's really helpful.

So I will show you this story, My Special Private Times.

You'll notice that they're on a bed, so in their bedroom.

The idea is my body is mine.

I can touch myself.

Some touches feel very good.

I like to touch my private parts.

No one should see me.

My bedroom is a private place.

This topic of a bathroom being a private place, I do this on an individual basis.

I don't feel that a bathroom is a private place if it is a home where the bathroom is shared.

Some of our students are lucky enough to have their own private bathroom, in which case then the bathroom can be a private place.

This is a topic for discussion that you will have with families around the table.

So, close the door.

Touching my private parts is something I do when I'm alone.

If mom or dad knocks on the door I must say I'm busy.

I can look at a magazine with pretty girls.

This may cause some issues as well, I have to tell you.

People get upset with that.

But I'd rather that than them looking at child pornography.

So there's other ways you can go with that.

So, it's okay of me to touch my own penis and testicles.

My penis may go up.

It's called an erection, and it's okay.

My penis might get big and firm.

This is okay.

It will get soft again.

A little sticky liquid might spurt out of my penis, this is okay.

It is not pee, it is semen.

So if it feels sticky I must clean it off with a towel or washcloth.

I can put my clothes on and wash my hands when I'm done.

I don't tell mom and dad or anyone about my special private times.

Touching myself is one way I make myself feel good and that's okay.

So this is an example.

I don't love all of it.

I really prefer to individualize it and I do have some of those that I will be sharing if I can get everything to work here.

But, we'll go back now.

So, we need to identify the importance of privacy and sexual health with learners with intellectual disabilities.

Explain how learning about privacy can reduce the risk of experiencing sexual trauma.

Describe the risk of a person engaging in sexual behaviors publicly, and distinguish private and public conversations, body parts, activities, and locations.

Before I did a lot of research I was really just working on private body parts.

But really there are lots of private conversations we need to think about, private activities, of course, is another one that we've, I've often focused on.

But private locations and conversations we really need to be teaching that.

So Emily Martinello maintains that teaching privacy allows an individual to understand that they have control over their home body, that they have the right to decide where and when they touch others, are touched by others, are naked, or are having conversions about personal matters.

If a person with an ID does not know their rights and becomes accustom to the violation of their boundaries they may become complacent.

This starts in childhood, and when they don't transition to having modesty, or being modest about their own bodies they can cause issues at any age.

Think about the teacher assistants completing completing changing routines, or bathroom routines, with their students.

Do we ask questions like, may I help you take your pants off?

May I touch you now to clean your bum?

May I come in?

A case I had this year was working on trouble shooting where a student was struggling with a shower routine.

To maintain modesty the student and the TA each wore a bathing suit.

The TA was then able to get into the shower with her and coach and prompt her through the steps.

When she wasn't able to focus on the visuals when we first started.

So eventually we did get to a visual schedule, and then the TA was able to then come outside of the shower, still with the bathing suit on in case she had to go in and do prompts as needed.

Then she was able to back off to she just stayed there with her clothes on, and was able to talk her through it, to now the student is able to shower daily at school without any support at all.

The visual schedule is there and she gets it done.

This was not quick.

It probably took, I'll say about six months of decreasing the amount of prompting and support.

But her, she really wanted to be independent.

And that's the goal.

And these steps to independence need to be supported in a way that teaches modesty as well.

So when we're able to distinguish between private and public body parts, activities, conversations, and locations, it really makes a difference.

When I think about spaces I can close a door and lock it.

People will know and wait for my answer.

I can close the curtains, or the blinds, and I will be alone and no one will see or hear me.

Are all of our students okay with locking a door?

I think some of them may struggle with locking a door.

It might be scary for them.

And what if they worry that they won't be able to unlock it, and then they're not able to relax.

Maybe we need to come up with an alternate plan.

So, one of my cases that I worked on this was the problem, so we put a sign on the door.

He just had a little door hanger.

He actually created it himself.

He hung a little door hanger on and it just said private.

And that was it.

He put that on the door when he wanted some private time.

No one ever discussed with him what he was doing while he was having private time.

But it was an indicator for anyone who walked by his door that they should not knock or enter.

It's important that no one has the right to touch any part of your body.

Too often the bodies of our students with intellectual disabilities are mistreated and not valued as private.

Unfortunately too often the sexuality of our persons with intellectual disabilities becomes a topic of discussion with staff.

I often will say to them, do not discuss the student in front of them.

We must remember their rights to privacy.

And if we can be present for solutions they should be privy to the conversation.

So, if we're going to try to problem solve they need to be sitting at the table.

Every sexualized activity is private.

In order to be safe, legal, and respectful, private activities should take place in private locations.

We need to teach the difference between safe activities for public and safe activities for private.

So, public versus private are the places where I begin.

I've included some copies for you.

The game and social story can be used as a daily teaching tool.

I also create personalized social stories that reference the same words in the stories.

So, teaching privacy allows a person to recognize and assert their rights.

One consequence is that we may learn that a person has been sexually assaulted.

So it's important to remember all the body is private and some parts are special.

Oh, that was the one.

So, unfortunately our persons with IDs are more likely to be caught in inappropriate behaviors than their non-disabled peers as they may lack privacy and perform sexualized behaviors publicly as a result.

Without access to private spaces and an understanding of personal boundaries intellectually disabled persons may invade the privacy of others.

The rules about body privacy seems blurry when your body is never treated that way.

This lack of knowledge and the resulting behavior explains the over representation of persons with intellectual disabilities as perpetrators of sexual assault and the widely held myth that persons with IDs are hyper sexual.

Finding private locations is one of the greatest challenges in exploring healthy sexuality for persons with IDs.

We need to teach that a private location is where nobody can see or hear you.

Creating privacy comes challenging in shared spaces.

In my experience I only teach that a private place is in their bedroom with the door closed and the expectation that someone needs to knock before entering.

Some parents do not like the idea of a closed or a locked door.

The bathroom at home, if it is not shared, can be private as well.

I always say that bathrooms at school are public places.

I feel we need to avoid teaching that this can be a private place.

So in terms of prevention, unfortunately because they are more likely to be caught engaging in inappropriate sexual behaviors then their non-disabled peers, because of their lack of privacy, they do often perform sexualized behaviors in public.

Again, is a bedroom a private place?

If it's not shared with someone I believe it can be with the proper teaching in place.

Privacy rules should be established to determine what behaviors are acceptable in what spaces.

If we teach that you can masturbate in your bedroom with the door closed it's important that not all bedrooms are private places.

These specific details need to be taught.

For example, it is your bedroom and not when you are visiting your grandmother and the bedroom that she gives you there.

Visuals would be reminders about public and private places around the home.

Teach one symbol for private and maintain it.

Everyone needs on the respect their privacy.

This could be a learning shift for parents.

- [Susan] Annamarie I just see a really great question in the chat box, and actually it was one that I had written down too, so I think it's even greater, but what are your thoughts about providing a private place at school.

And is there such a thing as a private place at school?

- So I have a very clear opinion about that and there are no private places at school to do any masturbation of any kind.

I have run into many times when students are masturbating at school and we go right to teaching, where do you masturbate.

I use the masturbation social story, and then we do public versus private.

We never, ever allow masturbation at school.

But I do teach them that it's okay to masturbate, and that where we do it is home in the privacy of their bedroom with the door closed.

So that is always how I teach.

I've had principles and teachers ask me about masturbation tents and that sort of thing.

I do not recommend any of that.

I only ever recommend at home with the door closed.

- [Susan] Thank you very much.

- So in terms of creating privacy let's talk about how we can support teacher assistants and teachers to increase a students privacy during a toileting routine, and what types of environmental changes and what types of helper changes.

So, when I think about, I had a situation where there was a young boy who was nonverbal who had autism, had became quite aggressive when being changed.

Throughout the rest of his day he was calm and really enjoyed, loved being in school.

I observed, of course, this changing routine from the side to afford him some privacy, and I felt that it was just we needed to add another TA to support.

So we put a second TA to help with the changing routine.

And then the TA that was at his head she was singing to him, she was being bit.

So we added some Kevlar sleeves so the adults wouldn't be harmed.

We put in a little heater so it would be warmer.

We added in music.

We changed the lighting.

Nothing was changing the violence that was occurring during his changing routine.

So I was really watching during my last observation.

I took note about when did the exact violence, what was the moment when the violence began?

So it started as soon as the TA mentioned that she would be taking down his pants.

You'll not that she didn't say may I take down his pants.

Although he was nonverbal he was able to understand, his receptive language was sufficient enough for him to understand someone asking a question.

So then I said, well let's try a receiving blanket on top of him before the procedure started so that he wouldn't feel vulnerable on the table.

So, that's what we did.

I went to Walmart, bought a package of the receiving blankets.

We washed them and we started trying that.

It's not perfect, but the violence to the point where we're now down to one teacher assistant managing his toileting routine.

So we keep the receiving blankets there.

We do everything else that we put in place.

The heat is still going.

The music is still going.

And the other thing that we added was that she asks before she does everything.

Okay, I'm going to now, I'm gonna take your pants down now.

Let me know when you're ready.

And he can do that.

He has, he uses an app on his iPad called Proloquo2go, and he's able to say I'm ready.

And now that he has some ability to feel part of the routine, we've covered him, so there's the modesty piece is there.

We're now able to manage the toileting routine.

Remember our students can't change, but we can.

We can do a whole bunch of things to make their lives easier.

So I love this little picture that I put here.

When a flower doesn't bloom you fix the environment it in which it grows, not a flower.

And we must remember that with our students.

They can't change so we need to change.

So, I have a whole bunch of stories to show you.

And I don't know how I'm gonna try to make this work.

I have to, I want to show these.

I want to show the generic sample and then the sorting game first.

And then I have how I adapted these public versus private social stories for specific cases.

- [Susan] If I could Annamarie just before you go into those there are a couple of questions.

So, one of the questions is what do you recommend regarding teaching sexual health curriculum for a student who has sexual trauma, ASD, and ID?

- So as we would teach anything, any topics with a student with sexual trauma we would do slow and be careful.

I would also involve the team members that are involved, it most be a psychologist they've been diagnosed with trauma.

And there must be a psychologist that's been working with the student, some sort of health professionals I would get involved.

I would have a team sit together and figure out what's the best way to teach.

Because they have autism I believe in scripts and routine teaching.

I would also be sure that the family was involved to help with that.

We would go slow.

I think the generic piece about that I'm going to show you, the public versus private social story is where to start, it's where I start pretty much with everything I do.

But again, I don't know the student well enough to go into details.

But I think you need to start at a very low level and see what they're comfortable with so that we're not re traumatizing them.

But we want them to have the knowledge that they will not be victimized again.

- [Susan] Okay, thank you for that.

There are a couple of others if you don't mind.

- No, no problem.

- [Susan] Would it be better to use real pictures to teach anatomy versus the line drawing pictures, or that type of thing.

- It depends on your student.

So that's one example.

Everyone is different and what they prefer.

I really prefer real picture myself.

And sometimes I will also use models.

And one of the health nurses I worked with had a lovely model that she used and that was very successful as well.

So, I think whatever is best suited to your student and be the best option.

- [Susan] Great, thank you.

And there is one more.

There is a video that explains consent to a cup of coffee.

Are you familiar with that video and what are your thoughts on it.

- Yes, I'm very familiar.

There are a lot of videos on consent.

I've looked at them.

I think the Consent is Like a Cup of Tea, that's the one I've looked at.

I do, I love looking at it.

I think for many of our older students they might get that, the understanding from consent.

Although my student with an intellectual disability when I use that video he didn't understand the topic, you know, he kept focusing on how it was funny when they were poring the coffee down their throat.

So, it's an awesome video that I think we could use for our neuro typical learners.

I think our ASD learners need a very clear script, and they need modeling.

They need role plays and modeling with adults to understand consent.

And they need to learn consent from a no perspective as well, and kind of part two of this webinar would go into how we teach no through consent and that sort of think.

But I love those videos.

I think they're awesome, and I certainly have used them with some of our higher functioning students.

Our students with autism, with intellectual disabilities combines I feel need something more explicit.

It's too abstract for them to understand.

- [Susan] Great.

Thank you so much for sharing your perspective on that.

I think that's all of the questions for now.

But I'll keep an eye on the chat box.

- Okay, I'm gonna try to show this.

So, it's the generic story I was talking about.

So what is the difference between public and private?

Now these are what I would call board maker pictures, not my favorite, but it's a starting place at least.

So then the understanding of private and public, and public is different from private, so you can all read that.

Well, is it gonna let me go?

There we go.

So, it goes into public places, and then it goes into private places.

And again, I like the bathroom picture is a little better because it's more real than the board maker picture.

And then it talks about public bathroom and a private stall.

Again, I would never, ever in my opinion not use the stall as a private place.

Again, in public in a bathroom, I mean that's where you go to use the bathroom, but I would never talk about masturbation in a stall at a school.

And when we're in public places we wear clothing that covers our bodies.

As I mentioned earlier all the body is private, some parts are special is my preferred.

But this is an example and you can edit it as you like.

Sometimes in private places like the bathroom or when changing clothes these parts of the body are not covered, but then we're private.

So, we call the parts of our bodies that would be covered by a bathing suit or private parts, we do not show our private parts in public.

It's inappropriate behavior and unacceptable.

So public behaviors and language are used when you are with other people.

If you behave in public in an inappropriate way people will think you are strange and may laugh at you.

I often use the word creepy when I'm writing social stories as well.

They need to know when they're creepy.

And I know that may be uncomfortable for some of you but I think just being frank with out students and saying that's creepy behavior is better for them.

Just tell it like it is.

Other behaviors are considered to be private, things like going to the bathroom, brushing your teeth, adjusting your underwear, burping, or picking your nose are private behaviors.

If you do these private things in public places people may think you're acting inappropriately.

Change that to say people may think you are creepy.

That is not okay.

People will want to be with you when you do, will not want to be with you when you do private things in public places.

They will feel embarrassed.

Again, for many of our students with autism they do not under, it's hard for them to understand their own feelings, let alone the perspective of others.

So they to be taught.

So there is a game that goes along with this.

And I'm gonna try to show you that now, and okay.

So these are just board maker pictures.

I prefer to use real pictures.

So as often as you can do that.

So there's just these activities.

You print and laminate the pages.

You just make your little pictures that you would.

It's a simple sorting activity.

But you can see that they behaviors are here, what is public versus private.

So we have pictures here, and we sort public versus private.

This could be a very simple teach task and you would control the pictures that you would create.

If there was issues that they were having you would want to put that in right away.

Maybe they were adjusting their underwear all the time, you would want to put a picture of that.

And you could certainly put real pictures of them.

Okay, so I'm gonna show you now a specific story that I've written around public versus private to support student in understanding.

So, after they would have completed the public versus private social story and been working on the sorting tasks as their teach activities I would then go to this.

So this is one that I just call it public versus private.

I put their name on it.

So again I use the same diagram here for public, but then these are specific to the student to the student.

Where is it that they consider public.

So they would have been sitting with me when I was creating these.

Public behaviors, they would be doing, the student was doing jobs around the school, singing in church, recycling, playing sports, that sort of thing.

And then we named some private places.

We did name in this case the bathroom at home.

Fortunately for this young man he has his own bathroom and his parents have their own bathroom, and he has his.

So I did say in this case that the bathroom at home was a private place.

I wanted to use, I always use doctors office or nurses office.

I want them to be able to go to the nurse at school and know that it's a private place and they can say what they need to say.

And/or the doctor's office, because that's important as well.

We need to teach that.

This is a safe place to say what's happening.

We name, this was some activities that we talked about, of course, with this particular student you'll notice down at the third from the bottom is touching your penis, because he was touching his penis a lot.

And we needed to tell him that that was a private activity.

He would also like to kiss students, and we did put that there as a private activity.

And we made a separate story for that one as well.

So, activities to avoid, people will think you are creepy when you touch your penis in public.

So, all we did was we took this board maker picture, particular an x through it, added it to the story, very clear.

He didn't have to wonder what he wasn't supposed to do with that picture.

So, john will always keep his hands away from his penis in public.

John will only touch his penis in the bathroom or in the bedroom with the door closed.

So keep calm and please don't touch.

So this is taught to him every day.

He does his public versus private generic story.

He has his sorting teach task in his teach bins.

He's in grade nine.

And he also has all these stories are done on an iPad, they're videotaped.

And he goes through them independently every morning, that's his morning routine.

And then one time during the week the teacher will sit and read them to him to do the explicit teaching, and to get some feedback from him.

So this is about social media.

Many of our students are doing inappropriate sexual behaviors on social media.

So this is an example that I created.

We know that John loves his iPhone and using apps like Snapchat and Instagram.

Again, these are real pictures and real picture of a phone so that he gets the idea.

Using your phone to text your friends can be fun.

Sending pictures to our friends is also fun.

We only send public pictures to our friends.

Remember the difference between public and private behaviors.

Now, he would have had the generic public versus private story, and he would have had a specific public versus private story that was created for him.

And then he would have this story that would talk to him about private and public pictures.

So John Doe takes his phone to school to be able to call or text him mom.

He puts his phone in a basket at the office and he can use his phone to make a call at the office only.

What was happening we wanted to make sure when he was at school there was no access to internet because of the behaviors that he was exhibiting online in terms of Snapchat and sending naked pictures of himself.

So, he is not to be on the internet at school.

He can use technology for school work only, and we want john to be happy and safe at school.

So, again, just the very specific things.

And we wanted him to know what he can do.

So, that was helpful.

And the last one.

So this was rules about girls, a story that I created to help a student with how he was engaging with girls.

Again he would have the generic social story around public versus private.

He would have a specific social story that talked about public versus private in relation to his activities, and this would be a third story.

So as most young me he was very interested and he liked to look at girls.

He liked to look at their breasts and bellies.

So I was very clear, he actually helped me pick out these picture sitting next to me on my laptop because I wanted him to say, oh, I like that picture.

I wanted him to know what it was he liked because I wanted him to be very clear about what the next step was, which was, this is what I do instead.

I need to look at their face.

Looking at their breasts and bellies makes them uncomfortable and scared.

They think I am creepy and do not want to talk to me.

This is called how sexual harassment, the police can charge me and I can go to jail.

It is against the law.

So, what he can do, fortunately his parents felt that they really wanted him to be safe in public.

And they felt that magazines in the bedroom with the door closed of breasts and bellies was the best way to go.

They took him and bought some magazines and he could do that in his bedroom.

They were excellent to help teach these stories at home.

I haven't mentioned that.

But when we do these stories I also send them all home.

And we hope that parents will support by teaching them.

Some parents are not comfortable, so we do it at school, and that's the best we can do.

It's the best.

We have to do what we can.

So again, this is a private activity.

I'm not hurting or scaring the girls, and he gets to look at that.

And you know, there's no problem with that.

Okay, moving right along.

So, I guess I'm getting, getting close to the end here.

My, I'm not an expert at any rate.

I want to say that this, my experience comes out of necessity.

A case would be presented and I supported the school in creating the programming to match.

The topic of sexuality or sexual behaviors can scare people away and they don't know where to start.

So I feel that where I start is I start with public and private and I go from there.

I also want to add that Emily Martinello's work through Sexual Health Nova Scotia that was made possible to me in 2017 from the funding through the province of Sexual Violence Strategy, which supports innovative efforts to reduce sexual violence Nova Scotia was very helpful for training teachers.

Their train the trainer model with the activities and the research is the model that works and is working for me well.

I was fortunate enough to be part of that advisory committee and many of, much of the work has come from mine as well.

So I feel that this is, it's a work in progress.

I'm always trying to find resources to support teachers that are struggling with situations that are outside their knowledge base.

I don't ever have all the answers.

I just try to start from public versus private and create something specific to the child and do the explicit teaching that needs to be done.

Emily's work has made a huge difference in our province.

And as a trainer of this program I feel that it's really helping my teachers as well.

I have added a bit of a bibliography there.

Isabelle Haunalt is someone that I truly respect and has been very helpful for me.

I do wanna bring to your attention the book that was written by Isabelle Henault, Nick Dubin, and Tony Atwood.

It's called the Autism Spectrum Sexuality and the Law.

It certainly opened my eyes around the laws in regards to students with intellectual disabilities and disabilities of any kind.

So that's, you would find that at Amazon.

And I did actually go and see Isabelle last year and after the Nick Dubin story and it is very helpful.

I do have the diversity.

com website there for you.

That's where I get my, oh, so the diversity.

com is where I order the materials for the videos that I have shared with families around masturbating and how to have safe boundaries, and that sort of thing.

So you'll see all of that on that website.

So, are there any other questions?

- [Susan] There are a couple of other questions.

One of our participants is wondering at what age should we start teaching all of this?

- I think for our students they need to start very early.

When we think about when they start learning about their body parts I think it's like 18 months of age.

So when they come to us our students with intellectual disabilities with autism, whatever their diagnosis may be they need to, we need to start teaching the anatomy piece as soon as it becomes appropriate.

So if you're doing a toileting routine, if you see the toileting routine is being done and the teacher assistant is going to wipe them we need say what, where they're wiping.

We're not gonna say we're gonna wipe your flower now.

We're gonna say I'm gonna wipe your vagina now.

I'm gonna pull down your pants.

You know, that sort of thing.

We need on the use the proper language right from the beginning.

- [Susan] Great, thank you for that.

Are there any other questions among the group?

I did see that a couple of folks are wondering about having the additional resources that Annamarie has shared.

If you receive the PowerPoint in PDF format you'll notice that the links don't work.

We will be sharing all of the resources that we have consent from Annamarie to share.

When the recording of this webinar is ready, which will be a couple or three weeks we'll make sure that all of the resources are also available there on the Autism and Education website, along with the recording.

Some of them as you can imagine are fairly large files so they're a little bit big to try to email.

Most of them won't get through the firewalls either here at APSEA or out in most of the schools.

So, we'll make sure you can access them on the Autism and Education website along with the recording.

And there's a question Annamarie about what topic, so we're already getting questions about what's coming up in part two.

(Annamarie laughing) As I mentioned at the beginning and some of you weren't able to get on right at the beginning of the webinar.

We are planning for a follow up to this webinar probably some time in January, mid to late January, but we'll be confirming the date as soon as we have a definite date.

But as a bit of a teaser, what topics do you anticipate being covered in part two?

- So, consent of course will be a big one as well as well as sexuality and the law.

Sexuality and the law is a big one because there's been a lot I didn't know.

So that would be something I would like to talk about as well, and then relationships.

So those would be kind of the three next topics that I would talk about in relation to sexuality education.

And I have a variety of social stories and excerpts from real things that have happened to explain.

That will be helpful, and a bit of a tease.

- [Susan] Great, thank you.

And then there's also a comment slash question about getting parents on board with using the proper terminology.

- So that's really hard I find to get parents on board.

I had a, sitting in a parent meeting beginning of the, I guess it was, maybe it was close to the end of last year and the mom casually said, oh, my son is gonna be out he has to be circumcised.

I said, oh, I said, was he harming himself while he was masturbating?

And economy at the table kind of was agassed and I said, she said, how did you know.

And I said well, he's 18.

It's not typical that students at 18 get circumcised.

And she said well, I'm really struggling.

He's masturbating in public.

And he wasn't doing it at school, so we really had no idea.

Unfortunately I find that with get parents on board when they're in crisis mode, and there's a behavior that comes about.

I do try with transition and with life skills goals to put that in place.

So everybody that I've trained in the straight region so far we talk about how we can incorporate this into our life skills goals, and we start slow.

So, public versus private, I would start there.

There's no reason that everybody can't learn that.

And all of our students with any type of disability need that specific training.

So, I think if you can get parents on board to see that that's okay.

We can do public versus private because we want them not to be creepy.

And I try to use that language and find out what's going on.

You will see ques if you start to bring out the topics, very gently around consent, about violation of boundaries, about all their body is private, you will start, you will be surprised about what will come out at those program planning team meetings.

And unfortunately we do see a lot, I find a lot of times with my teacher assistants, or educational assistants when they're working with students, a lot of it can come out at that point as well because we notice things that just aren't quite right.

And so you just have to be aware and go from there.

I hope that helps, but public versus private is where I start with everything.

- [Susan] Great that's really helpful.

There are a few more questions coming in.

Are there any resources to teach consensual sexual activity in a sex positive way to let students know that they shouldn't feel shameful about their sexuality, and are there any resources about gender and sexuality?

- There aren't a lot of resources that I can point to.

What I'm doing is reason I'm doing the social stories is that what I find is the best to use.

I'm using Isabelle Henault's work.

And I, that's what I've been finding the most helpful.

There are some, there's a variety of books out there I could, the next time, the next webinar I could get you more of a list.

But again, I find for my students in particular that I need to create something that's individualized for them more so than I can't use something from a book.

It needs, they're so unique.

So I haven't, I just need to use the sex positive language in my own social stories that is addressing the need of the moment for that child.

- [Susan] Great, thank you.

And how do you curb masturbation so that it's only happening at home, not at school.

So if it's happening at school how do you work with that so that it's only happening at home, especially if it's a young child.

So, thinking about age appropriateness as well.

- So again, much like the social story I used I also encourage clothing needs to be appropriate.

We don't want them to have easy access to their vagina or their penis to do the masturbation.

So for boys this means jeans and briefs.

For girls this means the appropriate clothing that they don't have, you know, little tights on, or something that it's easy to get to.

I also encourage a full physical activity routine during the day.

Keep them busy, get them tired.

That sort of thing.

We really just teach.

We do not masturbate at school.

We masturbate at home with the door closed.

I had an instance a few years back now where we were doing a lot of activity with a young girl because we were doing some self regulation strategies, and so yoga was part of her day.

And when she go into shavasana and had the blanket on top of her she felt that she was covered.

She had autism and she said well, the lights are dim, I'm under a blanket, no one can see me, I can masturbate now.

And so we, I took the blanket away of course, and we of course we did not stop the yoga because that was certainly appropriate.

But we made sure that she learned.

And she was so quick.

I have been checking now.

She's now in grade 11.

That happened when she was in grade three.

I check every year, we don't have any masturbation at school, and they look at me and they say, no, there's no masturbation.

She learned really quickly where to masturbate.

So when you teach that explicitly every day and the video modeling as I explained they get it.

So that's what I've had success with.

- Oh, I was going to give you a thank you, but there's one more question.

Actually it's a comment from Yvonne at Autism Nova Scotia.

So Autism Nova Scotia has compiled a curriculum that covered sexuality education for adults with autism from a sex positive lens as well, discussing pleasure and sexual activities.

The program has a module on fender identity and expression.

So there's another resource as well if folks are looking for a place that they can find more information.

- Great, if you do have additional questions after the webinar, if you want to email them to me I'll gather up any questions that you may have and I'll send them along to Annamarie.

And I know that she's always so generous with her time and her resources that we'll be able to share additional answers with you if you have questions after the fact.

But I just wanna thank Annamarie so much for being here with us and I say live from the APSEA studio.

It's so nice.

I actually have the Autism and Education advisory committee with me today and we have Annamarie here too, so it's so nice to, to have friends to do these with for a change.

But thanks so much Annamarie for joining us and for sharing your experience and your expertise in this area.

I know that you say that it's a journey and you're always learning more as well.

But for many of us we're starting far earlier on that journey than where you are.

And so we appreciate you helping to bring us along further on our journey and learning some of these skills as well.

And as I mentioned the recording will be available on the Autism and education website and also the resources that Annamarie shared will be available there as well within the next couple of weeks.

So, kep an eye out there for more information.

And thanks so much Annamarie.

Thanks so much everyone, and we will sere you back probably sometime in January, but we'll let you know as soon as we have more information about the date of the next webinar.

Have a great week everyone.