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Strategies for Effective Lifelong Health Education for Learners of All Ages with Visual Impairments

by Drs. Stacy Kelly and Gaylen Kapperman, Northern Illinois University, College of Education

Taking a Look at the Research: Meaningful Sex Education Can Provide Requisite Knowledge for Lifelong Safety and Wellbeing

High quality, comprehensive health-education instruction is something every student should have access to in their general education curriculum; this includes students who are blind or have low vision. In reviewing the literature, the authors found that the positive effects of well-designed sex-education instruction far outweigh the supposed disadvantages. Researchers have consistently found numerous benefits for students who have undergone well-designed sex-education instruction. For example, students who participated in well-designed sex-education instruction were less likely to participate in early sexual intercourse, and they were less likely to cause teenage pregnancies or to become pregnant. They were also less likely to be infected with a sexually transmitted infection (STI) because of their increased use of protection. They had fewer sex partners and had improved academic performance. All of these advantages occured because the students possessed the requisite knowledge to maintain their safety and health as they matured (Fox, Himmelstein, Khalid, & Howell, 2019; Kirby, 2011; Unis, 2020). These advantages are supported by the Centers for Disease Control and Prevention (CDC) (2020) and the Society for Adolescent Health and Medicine (2017).

Another major advantage of students’ participation in sex education is that they accumulate a well-developed array of accurate information. For example, the vast majority of parents who have not been trained in the methods for providing sex-education instruction, are not prepared to give their children the most accurate information regarding this very important aspect of growing up. Most parents feel ill-prepared or understand that they are not equipped to provide this information in an age-appropriate way, as well as in a manner that will enable their children to fully grasp the concepts in the sexual arena. This may be one of the reasons why many parents feel extremely uncomfortable playing the role of sex-education instructors for their children. Thus, the vast majority of parents want their children to participate in school-sponsored sex education programs (Ito et al., 2006). 

Providing blind or visually impaired students with sexually-oriented knowledge requires much more skill and sophistication than the provision of sexually-oriented knowledge for students who are sighted. Much more skill is required of teachers responsible for the education of blind or visually impaired students than of those who can provide the same requisite information in pictures and drawings to sighted students. This is because the former must translate the information shown in pictures into a form that is comprehensible by a student who cannot see. Thus, parents of children who cannot see are less capable of providing them with accurate information, and potentially are even less qualified than the parents of sighted children.

Another well-documented point in the literature is that the social milieu is replete with sexually-oriented information that can be gleaned only by sight, which makes for another argument for well-designed sex education for students who are blind or visually impaired (Kapperman & Kelly, 2013, 2014; Kelly & Kapperman, 2012, 2019). Students who cannot use their eyesight to gather that information are at a distinct disadvantage compared to students who can, both from an early age and on a daily basis. There are major disadvantages for children who cannot see that are a result of their inability to comprehend the all-pervasive information that is available to everyone else in society. One of the major advantages that sighted children have is the knowledge they gain by simply living, which adds to their ability to maintain their personal safety. Students who are blind, of course, do not have that advantage without having undergone well-designed instruction.

Incidental learning among sighted children means that exposure to the all-pervasive sexually oriented information in society provides them with knowledge, which they absorb simply by living and watching. Teens who are blind should not be left behind in such a “knowledge desert” because of the absence of well-developed, meaningful instruction as it pertains to sexuality. In simple terms, it is not fair to purposefully withhold that information from them!

Through support from the research, the reader can easily discern that there are only pros in judging the effects of sex education. Thus, there is reason to believe that there are no cons, and the CDC seems to indicate the same (2020). On the other hand, though, there is a very small, vocal minority of parents who believe that sex education, as practiced in our country, is inappropriate. They believe that if youth are exposed to sex-education instruction through school, it will lead them to have premarital sexual intercourse and will lead to the decay of their morals. Given this, it is our belief that parents should have the option to decline to let their child participate in sex education. We believe that the parents’ decision in this vital area should be honored, even though, in our estimation, that decision could have negative consequences.

Recommended Resources to Support Meaningful Sex Education for Students with Visual Impairments

As we define it, pre-teaching consists of providing students with visual impairments instruction using materials and methods which will enhance the meaningfulness of the lessons that will occur in the regular classroom with sighted peers. We strongly recommend that pre-teaching take place before the instruction with sighted peers in the regular classroom begins. Use of the special materials and methods before the beginning of regular instruction can be highly effective.

But there is a need for broader range of sex education content, more accommodating pedagogical approaches for students with visual impairments, and more appropriate resources from which they can draw. Students with visual impairments cannot use vision to discern important details and decode vague descriptions. The recommended resources outlined here are ways to help parents and educators make various sex education programs accessible to and meaningful for students with visual impairments.

Recommendation:  Obtain the American Printing House for the Blind (APH) Guidebook of Record on this Topic

In response to the need for effective instruction in the area of health education, the American Printing House for the Blind developed the guidebook on this topic, “Health Education for Students with Visual Impairments: A Guidebook for Teachers,” and is available for purchase on the APH website for $75.

It is recommended that parents be certain that those who have the responsibility for providing instruction to their children with visual impairments have acquired and are using the guidebook. The guidance found in the guidebook provides methods for making specific aspects of health education meaningful and fully accessible to students with visual impairments.

Recommendation: Use Assistive Technology to View Described and Caption Educational Videos on the Topic

Described and captioned videos available through the Described and Captioned Media Program (DCMP) can be used for the pre-teaching of a wide range of topics addressed by school-based sex education programs. The purpose of DCMP is to provide students with sensory disabilities, along with their parents and teachers, with major network-produced educational content carefully customized to serve the needs of K-12 students. DCMP is a resource fully funded through the U.S. Department of Education. Parents and school professionals of students with visual impairments are encouraged to create a free account.

Once an account is established, the user can search for “sex education” videos available on DCMP as an accessible source of high-quality information. There are many videos available—all DCMP videos are produced by major networks and only include educationally based content.

Parents, caregivers, and teachers can determine which videos are appropriate for a teen’s developmental stage and present those videos to them. The student can then view the selected videos independently with their own computer and/or with parents or caregivers. This is an alternative to the commonly found recommendation for watching the Emmy Award winning “Miracle of Life” DVD in audio described format.

Recommendation: Use Assistive Technology to Read Accessible Electronic Educational Books on the Topic

It is recommended that students who are blind or visually impaired have access to appropriate reading material to accompany their instruction in sex education. Accessible reading material can be found through Bookshare, the most prominent digital library for individuals with reading challenges in the U.S. The use of assistive technology used by students with visual impairments can enable them to access Bookshare’s content. Several books that focus on the changes that boys and girls experience as they progress through puberty are available from Bookshare’s library. To become familiar with the services that this organization offers, we recommend that the reader visit their website, where more details can be obtained regarding the process by which students can access the library and the types of assistive technology that can be used.

We recommend one or more of the following books:

  • The Boy’s Body Book most recent edition published in 2019

5th Edition

ISBN: 978160433824

Author: Kelli Dunham

  • The Girl’s Body Book (the most recent edition published in 2019)

5th Edition

ISBN: 9781604338331

Author: Kelli Dunham

  • It’s Perfectly Normal: Changing Bodies, Growing Up, Sex, and Sexual Health (the New Edition 20th Anniversary Edition which is the 4th edition published in 2014)

ISBN: 9780763668723

Author: Robie H. Harris and Michael Emberley

  • What’s Going on Down There? A Boy’s Guide to Growing Up (the most recent edition published in 2017)

ISBN: 9781681193618

Author: Karen Gravelle

  • The Period Book (the updated edition published in 2017)

ISBN: 9781619636620

Author: Karen Gravelle

In our opinion, these books are very appropriate for students who are about to begin the various stages of puberty or who are currently experiencing the many changes that take place when adolescents find themselves on the developmental journey to adulthood.

*Note: The library has the older editions of the books listed above. We would not recommend them. The older editions tend to possess outdated information regarding HIV; at the time of the writing of those books, there was no treatment for that infection. Reading outdated books would result in some misinformation. A second point along these lines is that the older editions make no mention of HPV. We highly recommend that only the newer editions of the books should be provided. When searching for books, one can easily determine the copyright date of the book. Any book which has the same title as listed above but has an older copyright date should not be read by the student because of the outdated information that it may contain.

Recommendation: Use Low-Cost Materials to Make Anatomically Correct Models that Support Meaningful Instruction on this Topic

  • Anatomically Correct Models of the External Male and Female Anatomy

Modeling clay can be used in the production of three-dimensional models used in pre-teaching of the concepts regarding male and female reproductive anatomies including genitalia involved in school-based sex education programming. For example, the Crayola Model Magic Modeling Compound ranges in cost from $5 for a four-ounce bag, to $25 for a two-pound container available from Michaels, Wal-Mart, and Amazon. Another alternative substitute for the modeling clay can be Play-Doh.

  • Anatomically Correct Models of the Internal Male and Female Reproductive Systems

For the teaching of the complex internal male and female reproductive anatomy studied in school-based sex education programming, there are low-cost anatomically correct models available for purchase. These can be used as accurate models of the more complex internal human reproductive anatomy. The male model can be found on Amazon, Famemaster 4D-Vision Human Male Reproductive Anatomy Model, for $25. The female model, Famemaster 4D-Vision Human Female Reproductive Anatomy Model can also be found on Amazon for $26.

Recommendation: Review the Additional FamilyConnect Webinar to learn more about how Parents of Students with Visual Impairments and School Personnel Working Together  Ensuring Students with Visual Impairment Receive Meaningful Sex Education

The FamilyConnect postings below can be widely shared by parents and caregivers of students with visual impairments with each other and with the school personnel who provide direct instruction to their students.

The webinars below are recommended for parents of students with visual impairments and those who provide direct instruction to students with visual impairments.

Sex Education as An Ongoing Conversation to Be Revisited Regularly throughout the Formative and Developmental Years

Specific methods include the use of realistic, anatomically correct, three-dimensional models, in combination with frank, direct, and explicit language. The models and instructional tools are not to be used by themselves, but instead in combination with direct instruction that includes ongoing, age-appropriate conversations. Giving students with visual impairments the opportunity to explore recommended, meaningful, and age-appropriate sex education resources—both before and after such conversations—can deepen their understanding and bring forward new questions that can be explored with their parent or instructor throughout their developmental milestones.

It is important that parents and educational teams work together to regularly revisit this topic overtime with visually impaired students. SIECUS’ National Sexuality Education Standards has clear, consistent, and straightforward guidance on sex education, beginning in kindergarten and continuing each year after that through twelfth grade. Thus, sex education can be addressed in age-appropriate ways that enhance learner understanding about themselves and those around them as they grow up. It is a lifelong process to learn about the best ways to keep oneself safe and healthy with decisions based on educationally sound information.

Learn More: To learn more about this topic, watch Working Together to Provide Meaningful Sex Education for Students with Visual Impairment a FamilyConnect webinar presented by Dr. Stacy Kelly and Dr. Gaylen Kapperman.

References

Centers for Disease Control and Prevention (CDC). (2020). Adolescent health: What works in schools. U.S. Department of Health and Human Services. Retrieved from https://www.cdc.gov/healthyyouth/whatworks/index.htm

Fox, A. M., Himmelstein, G., Khalid, H., & Howell, E. (2019, March). Funding for abstinence-only education and adolescent pregnancy prevention: Does state ideology affect outcomes?. American Journal of Public Health, 109 (3), 497–504.

Future of Sex Education Initiative (2012). National sexuality education standards: Core content and skills, K-12 [a special publication of the Journal of School Health]. Retrieved from https://siecus.org/resources/national-sexuality-education-standards/

Huebner, K. M., Merk-Adam, B., Stryker, D., & Wolffe, K. (2004). The national agenda for the education of children and youths with visual impairments, including those with multiple disabilities (rev. ed.). New York, NY: AFB Press.

Kapperman, G., & Kelly, S. M. (2013). Sex education instruction for students who are visually impaired: Recommendations to guide practitioners. Journal of Visual Impairment & Blindness, 107(3), 226-230.

Kapperman, G., & Kelly, S. M. (2014). Accessible sex education resources for students who are visually impaired: Assistive technology is required. Division on Visual Impairments Quarterly, 59(2), 59-64.

Kelly, S. M., & Kapperman, G. (2012). Sexual activity of young adults who are visually impaired and the need for effective sex education. Journal of Visual Impairment & Blindness, 106(9), 519-526.

Kelly, S. M., & Kapperman, G. (2019). Sex education. In Health Education for Students with Visual Impairments: A Guidebook for Teachers. Louisville, KY: American Printing House for the Blind.

Ito, K. E., Gizlice, Z., Owen-O’Dowd, J., Foust, E., Leone, P., & Miller, W. C. (2006). Parent opinion of sexuality education in a state with mandated abstinence education: Does policy match parental preference?. Journal of Adolescent Health, 39(5), 634–641.

Kirby, D. (2011). The impact of sex education on the sexual behaviour of young people. Population Division Expert Paper No. 2011(12). United Nations Department of Economic and Social Affairs: New York.

Society for Adolescent Health and Medicine. (2017, September). Abstinence-Only-Until-Marriage Policies and Programs: An updated position paper of the Society for Adolescent Health and Medicine. Journal of Adolescent Health, 61(3), 400–403.

Unis, B. D., & Sallstrom, C. (2020). Adolescents’ conceptions of learning and education and sex and relationships. American Journal of Sexuality Education, 15(1), 25–52.