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Section 2:

A S∙T∙A∙R∙S Model

The S∙T∙A∙R∙S model originated through our efforts to design a training program for teaching basic personal safety skills to avoid sexual abuse. As we began working with individuals, we quickly learned that the issues of sexual abuse were connected to other issues, such as the person’s self-esteem, assertiveness, understanding of sexuality, and opportunities to develop healthy relationships.

We recognized the need to teach and support positive expression of sexuality in addition to facilitating the learning of skills to prevent sexual abuse. Equally important were the environments in which people spent their time and the attitudes and values of family, teachers, caregivers, and the community at large. The realization of the complexity of the issues people were facing led us to develop our S∙T∙A∙R∙S model as a more comprehensive or holistic training model.

In our S∙T∙A∙R∙S model, we present a “building blocks” approach to training about the complex areas of sexuality and abuse prevention. Each content area offers concepts that are built upon in the next content area. For example, many of the activities in the “Assertiveness” section build upon content and behaviors that are acquired in all three of the previous content areas. The S∙T∙A∙R∙S model has four areas, with specific content areas in each:

Understanding Relationships

Building a positive self-image.

Identifying people in one’s life as family, friends, acquaintances, community helpers, and strangers.

Learning behaviors that are appropriate for each type of relationship.

Social Interaction

Approaching, responding, and conversing with people in different settings and situations, including social media.

Expressing preferences and making choices.

Building friendships.

Engaging in more mature relationships.

Recognizing options for relationships into adulthood.

Building a strong foundation for adult relationships.

Understanding the responsibilities of parenthood and the pros and cons of having children.

Sexual Awareness

Building a positive self-image and sexual identity.

Identifying as male or female.

Identifying body parts and understanding their functions.

Understanding the difference between public and private behaviors.

Differentiating between inappropriate and appropriate touching.

Understanding the emotional and physical changes of puberty.

Understanding sexual feelings and behaviors.

Understanding reproduction.

Examining societal norms and values regarding sexuality.

Learning about sexually transmitted diseases.

Discussing other health issues related to sexual awareness.

Assertiveness

Increasing self-empowerment through words and actions, including responding to bullying.

Recognizing a situation as potentially dangerous.

Learning to say no and to use basic self-protection skills.

Knowing how and where to get help at home, at school, and in the community.

Reporting sexual exploitation or abuse.

Assessing the Needs of Children or “Figuring out What to Teach”

Parents and teachers often wonder when, what, and how they can teach a child with a disability about sexuality.While we believe it is essential to take the time to figure out what each youth needs to learn, we have not developed a specific “assessment tool” for children and youths in S∙T∙A∙R∙S 2. (Refer to the original S∙T∙A∙R∙S guidebook for two assessment tools—“The Sexual Attitudes and Knowledge Assessment” and the “Sexual Abuse Risks Assessment”—that are useful for older adolescents and adults with disabilities.)

We suggest that parents and teachers begin to approach the topic of sexuality for children with disabilities in a similar way it is approached for children without disabilities. One helpful resource is How to Talk with Your Child About Sex: Help Your Children Develop a Positive Healthy Attitude Toward Sex and Relationships by John Chirban, PhD, and published by Thomas Nelson, Inc. (2007). This book is a helpful resource regarding how and when to discuss sexuality, and it helps parents clarify their own thoughts and learn how to guide their children in developing the confidence, integrity, and honesty necessary for understanding sexuality.

Some pointers:

Support from others. Parents may want to get support from others when thinking about approaching sexuality with their child. Other parents of children with disabilities are often supportive. Asking the child’s school teacher to become involved is helpful for many parents. The teacher and parents can share information on how the child best learns and ways of teaching that are successful. Making a plan together and reinforcing information between the two settings is very helpful. We encourage parents to advocate for the integration of goals in their child’s individualized educational plan (IEP) regarding learning sexuality information, as well as social skills and assertiveness training.

Individualize for each child. Consider the child’s chronologic age and figure out what information would be appropriate for any child of that age. Remember, the basics of sexuality begin at an early age (e.g., body parts and private and public concepts) and lay the groundwork for teaching throughout childhood and into adolescence. Materials and teaching methods must be individualized for the child’s learning needs and abilities. Recognize that incongruities between the child’s chronologic age, social maturity, and physical development may exist; this means that a youth who is 12 years old and going through puberty but whose cognitive abilities are more like those of a first grader will need the important information about body changes in puberty given in a manner that he or she will understand.

Consider:

What information and skills in the areas of sexual awareness, social skills, relationships, and assertiveness does the child already have?

What is the child’s chronologic age? Social maturity? Cognitive ability?

What is the child’s learning style?

What specific augmentative technologies (e.g., an iPad or voice output device) does the child use to communicate and learn?

What additional information and skills do you think the child needs to acquire?

Are there any specific concerns relating to sexuality that need to be addressed? Think about this in a comprehensive way; these are just a few concerns.

For example:

Does the child often get teased or bullied?

Has the child been prompted or exploited to do sexually inappropriate things?

Does the child tend to masturbate in inappropriate places (e.g., in front of people at home or at school)?

Has the child been sexually assaulted? Note that for this situation, specific counseling from a mental health counselor may be necessary in addition to teaching about sexuality.

Guidelines for Parents and Support Providers

Parents are generally considered the primary sexuality educators for their children. From the beginning, a child’s sexuality is influenced by early family experiences, and guidance is received from caregivers. A family environment that supports the sexuality of the child in positive ways—such as through appropriate touching while bathing, dressing, and playing—leads to pleasure and pride in the child’s body and an established sense of well-being. Positive early experiences provide the adolescent with a good basis for responding to changes during puberty.

In contrast, healthy sexual development may be impeded by discomfort with the subject of sex, negative comments about the child’s body, uncertainty in the presentation of information, and fear regarding the adolescent’s expression and control of sexual behavior. Children learn what they live. If they experience love and affection from caregivers who share it, then the sexuality they learn will be in the context of that love and affection. The experience of sexuality educators has shown that, when all is said and done, in general, the family still has the most powerful influence on the child.

Parents may not feel comfortable or knowledgeable in educating or responding to the child with respect to sexuality. Professionals, along with parents, may need to become more sensitive and participate in educational experiences that will increase comfort and knowledge about sexuality. Together, health professionals, educators, and parents can help youth build social competence and provide appropriate sexuality education that is respectful of family values.

When preparing to address sexuality with youth, these are things to do:

Examine your own attitudes about sexuality in general and about sexuality and disability in particular. Foster a positive attitude about sexuality. The goal is to promote healthy sexuality and safety, not to eliminate sexual responses.

Work toward becoming an “askable” adult regarding sexuality. This means that you listen carefully to everything a child says and avoid being overly judgmental. Children need to feel that they can ask questions without fear or punishment. At the same time, parents can seize these moments to reinforce and transmit their own family’s values in a positive manner.

Provide accurate information about sexuality. Even if a child never asks questions about sexuality, realize that the child has likely already acquired some information from other sources and needs to know that you will be there to clear up misconceptions, distortions, and fantasies. Provide straightforward, correct information, and check the child’s understanding in a supportive manner.

Recognize that telling your child about sex will not lead him or her to act out sexually. Instead, providing accurate information about sexual feelings and physical changes in clear-cut terms will reduce confusion and minimize the risk for inappropriate behavior.

Be aware of the wide variety of behaviors, attitudes, values, and feelings related to sexuality, and deal with them in a sensitive manner.

Guidelines for Training

Group or Individual Learning

Most of the material in this book was developed from our work with groups, but we find that many of the activities and ideas are suited or easily adapted for individual training, as well. Individual training may be preferred for any youth who doesn’t learn well in a group or doesn’t want a group experience or when there are insufficient resources to support a group. For most youths, though, the advantages of participating in a group are great. The group provides opportunities for practicing social skills, peer modeling, and peer coaching, as well as meeting new people and making new friends.

Values Clarification

When teaching about human sexuality, it is important to discuss various family values or attitudes related to specific topics (e.g., masturbation, birth control, homosexuality, and abortion). It is important to give parents an opportunity to review instructional content and suggest at-home activities or discussions to teach their family’s values. With youth, acknowledge the range of opinions and beliefs that exist, encouraging them to learn how their parents feel about such issues.

Inclusion of Sexuality Education Content in IEP

We encourage families to work with the school IEP team to incorporate appropriate goals and activities for promoting positive sexuality and preventing abuse in the school setting.

Working with a Group

Selecting Participants

Who?

S.T.A.R.S 2 activities were developed for youth with autism or other developmental disabilities. Children, from preschool age to adolescents in high school, can benefit from its content. We also believe that the information presented here is valuable to all children and could be effectively used in settings in which children both with and without disabilities are learning together.

Co-ed or not?

Groups can be co-educational or organized separately for girls and boys. We have found that co-ed groups emulate the “real world.” Such groups enhance role-playing and other activities and foster an appreciation for human development and sexuality issues in both sexes. The content area and/or the comfort level of the instructor may influence whether the instruction is done for a co-ed group or not. If the adult facilitator is comfortable, even gender-sensitive issues, such as menstruation and condom use, can be taught and discussed in a co-ed group. Sometimes, girls and boys may feel more comfortable learning some content separately. For example, we believe that both girls and boys can benefit from learning about and seeing menstrual hygiene products; however, some of the more explicit discussion and demonstration about their use may best be done with girls only. For each area, use your judgment about what will work best for you and your participants.

Number of Youths in the Group

We recommend that the size of the group be small (four to eight youths). Size will depend on the individual needs of the participants, participants’ learning styles, and the capacity of group leaders.

Number and Frequency of Teaching Sessions

Information should be shared at a pace that is comfortable for the group or individual. The pace will vary with the age and learning style of the youths. For children, having sessions at least two times per week usually works well for continuity of content.

Involvement of Parents

Whenever there is instruction on human sexuality for minor children and youths, it is best to involve parents or guardians at the outset. If you are offering sexuality education as part of a school human growth and development curriculum, become familiar with the guidelines, which were established by the school board for your school district regarding parent or guardian involvement. A sample parent letter is included in the Appendix (page A-3).

Some instructors offer to meet with parents individually or as a group to review content. This not only informs parents about the content of the training but can promote continuity and reinforcement of the training at home. Sometimes, a parent group meets concurrently with the youth group to clarify and discuss content and concerns that are pertinent to sexuality.

Instructional Methods

In general, information that will be presented to youth with disabilities will be the same as that for other youth, except it is presented in simpler words, at a slower pace, and with much repetition. Any information that you share with an individual child must be presented with methods that are best for teaching that child. For example, it may be helpful to break the content down into the simplest concepts; use simple language; or use visual aids, such as pictures, drawings, or a Social Stories™ format.

We suggest that a variety of instructional methods be used, such as individual and group instruction, simple workbook activities, art, songs and games, puppets, “Social Stories™,” and role-playing. Anatomic dolls, photographs, and line drawings are the most effective methods for identifying reproductive body parts. Group discussion and question and answer sessions are the most effective techniques for problem solving. Social skills are best taught through “real life practice,” role-playing, and group discussion. Lecturing is the least effective method because participants may lose interest if they are not actively engaged.

For some activities, we may refer to specific resources (e.g., slides). Effective teaching can happen even if you don’t have access to the latest technology. Some of the best teaching tools are creatively made with common materials and are tailored to the individual child.

Me and My World Scrapbook

Pages of this scrapbook are located in the Appendix and can be copied for each child. The materials can be adapted for a child of any age with age-appropriate stickers or artwork. There are specific suggestions for using the scrapbook in the “Activities” sections. When completed, youth can keep it as a scrapbook about themselves. The scrapbook can be periodically reviewed with youth, either formally or informally, to reinforce concepts that were learned in the group format.

Role-playing

Role-playing is a particularly effective technique because it involves the active participation of children, giving them an opportunity to try out and rehearse new behaviors and identify and change inappropriate behaviors. Peer feedback and coaching give the youth who observe the role-play exercise an opportunity to learn the concepts by asking them to judge and identify the strengths and needs of the role players.

A potential drawback of role-playing is that, at times, it can become too “real” for some children. For example, when someone is acting out a situation in which he or she is angry, a participant may believe that the person really is angry. And when role-playing a threatening situation, a participant may become truly frightened. It is important to keep reminding role players that it is only make-believe. Another drawback is that role players may get too caught up in the fun of role-playing and work at being good actors rather than focus on learning the concepts being taught.

Activities in the Natural Setting

Children and youth benefit most from this program when time is spent reviewing content and practicing skills related to the sexuality education training program in their natural settings. If trainers are not available for this individual work, other persons in the participant’s support network could carry out this training activity. This time can be used to practice and reinforce skills and knowledge covered in the group meeting and focus on issues identified for each child. At the end of the “Activities” section for each of the four content areas, an “Informal Activities” section is included.

Circle of Friends

All children benefit from having friends and being part of a social group. Children with disabilities often need the same level of direction and support in making friends as they do in other areas of their lives. We are learning more about individuals with autism spectrum disorder and their common human desire for friendships; that is, even though they may not appear interested in others, they have a desire for social connections. “Circles of Friends” is one way of expanding and enhancing friendships for children.

How it works:

1. Make a list of peers without disabilities with whom the focus child has contact during the day. Contact may occur in mainstreamed classes, peer tutoring, recreation or sports, passing from class to class, recess, or lunch. Peers can be identified through observation; by asking the focus child; and by talking with teachers, classroom aids, or other school personnel.

2. Note the quality of interactions, and identify a shorter list of potential friends. Try to include one or two peers with whom the focus child may have shared interests, such as music, art, computers, video games, and sports. Social media, when used with safeguards, can be a useful tool for organizing a Circle of Friends.

3. Talk to each of the potential peers about Circle of Friends. Explain that its purpose is to help the focus child make friends and feel more connected with school.

4. Select the peer or peers who demonstrate the greatest interest in being involved for inclusion in the Circle.

5. Ask the peer or peers to identify three to five of their friends who might know the focus child or who might be interested in joining the group.

6. Invite four to six peers to an introductory meeting. Collect more information about the youths’ schedules, daily routines, and interests. Brainstorm possible activities and outings.

7. Circles usually meet about once a week for about an hour, but the frequency and length of the meetings depend on the age of the kids, the setting, the kids’ schedules, etc. Kids initially meet for group activities, but as the focus child develops friendships with the other peers, encourage one-on-one or smaller group experiences. Think of times during the day when pairing is possible. At first, the group may want to make a schedule or calendar mapping out interaction times. See samples below.

8. Over time, the adult should fade from the social group as much as possible to allow typical interactions and friendships to more naturally occur. It is important to remain available for problem solving, conflict resolution, and other kinds of support as needed.

9. If Circle of Friends activities are to take place in settings other than school, which we highly recommend, parents will also need to be involved (e.g., for transportation). It is a good idea to notify parents that their child is participating in Circle of Friends, invite their encouragement and support, and respond to any concerns.

Excerpted and revised from “Setting Up and Managing Peer Support Networks: Social Context Research Project- Methods for Facilitating the Inclusion of Students with Disabilities,” In Integrated School and Community Context, edited by C. Green, C. Kennedy, and T. Haring, University of California, Santa Barbara.