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ORIGINAL ARTICLE |
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Year : 2022 | Volume
: 38
| Issue : 4 | Page : 357-361 |
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Knowledge, attitude, and practice among parents about sex education of their children with intellectual disability
Wasim Ahmad1, Nazli1, BS Chavan2
1 Departments of Special Education (Intellectual Disability), Government Rehabilitation Institute for Intellectual Disabilities, Chandigarh, India 2 Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India
Date of Submission | 30-Aug-2020 |
Date of Decision | 26-Feb-2021 |
Date of Acceptance | 25-Mar-2021 |
Date of Web Publication | 04-Aug-2021 |
Correspondence Address: Dr. Nazli Assistant Professor, Department of Special Education (Intellectual Disability) Govt. Rehabilitation Institute for Intellectual Disabilities (GRIID), Sector-31-C, Chandigarh-160030 India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ijsp.ijsp_297_20
Background: Awareness among parents having children with intellectual disabilities has been a major concern for the last many decades. Despite several policies and plans of the government somehow, the desired awareness among the parents has not yet been created. Objective: The objective of this study was conducted to find out the knowledge, attitude, and practice (KAP) toward sex education among parents having children with intellectual disability. Materials and Methods: One hundred and thirty parents of children with intellectual disability (irrespective of severity) using a random sampling technique were selected. To assess the KAP of parents scale named Awareness on Sexual Education for Parents of Intellectually Challenged Children developed by Lakshmi and Navya (2014) and published by National Psychological Corporation, Agra, India, was used. Results: The result reveals no significant difference in the KAP, respectively, among parents w.r.t. their gender. Significant difference in the knowledge (t = 3.58) and attitude (t = 2.82) was noticed w.r.t. education. In the KAP, respectively, a significant difference (t = 2.95; t = 2.22 and t = 3.06) was found among parents toward sex education w.r.t. their income. The overall awareness (KAP) w.r.t. education (t = 3.62) and income (t = 3.82) reveals significant difference but not w.r.t. gender. The analysis reveals a significant positive correlation of knowledge with attitude (r = 0.453), knowledge with practice (r = 0.233), and attitude with practice (r = 0.252). Conclusion: Based on the findings, the study concludes that gender has no role to play in imparting sex education to children with intellectual disability. However, education and income may contribute significantly to the awareness among parents of children with intellectual disability.
Keywords: Attitude, awareness, intellectual disability, knowledge, parents, practice, sex education
How to cite this article: Ahmad W, Nazli, Chavan B S. Knowledge, attitude, and practice among parents about sex education of their children with intellectual disability. Indian J Soc Psychiatry 2022;38:357-61 |
How to cite this URL: Ahmad W, Nazli, Chavan B S. Knowledge, attitude, and practice among parents about sex education of their children with intellectual disability. Indian J Soc Psychiatry [serial online] 2022 [cited 2023 Feb 6];38:357-61. Available from: https://www.indjsp.org/text.asp?2022/38/4/357/323116 |
Introduction | |  |
Parents must arrange to impart sex education to protect their children from sexual abuse. The role of parents, particularly the mother is significant in imparting sex education to the children than that of father.[1] The present study suggests that mothers of persons with intellectual disability are more careful about contraception, readiness to learn about sex, and decisions about intimate relationships.[2] The authors argued to offer a better understanding and awareness of perspectives that can apprise persons with and without disability's sexuality and empower them so that they can make their own choices as per the social and sexual context.[3] Developmentally appropriate and evidence-based sex education provided by schools, professionals, and parents is important to help children in making informed, positive, and safe choices about healthy and responsible relationships and sexual activity.[4] To prevent sexual abuse, it is important to create the awareness in the families of children with special needs. Families must acquire necessary skills and raise awareness in the community about the sexual abuse in children with disabilities.[5],[6] It has been expressed by the teachers that families must be trained on the issue related to sexual abuse of children with disabilities.[7],[8]
Research indicates that children with disabilities are more than twice as frequently sexually abused than children without disabilities[9] and within the disabilities, intellectual disability can be considered as one of the most challenging disabilities due to its nature, severity, and complexity.[10] There is a dire need for educational programs which can focus on development of sexuality for persons with disabilities. Irrespective of severity, challenges, and limitations persons with disabilities have the rights to access all the information about their bodies and about how to interact in society.[11] Persons with intellectual disabilities are not given training about sex education just because of their disability, although it is well-known reality that they are more prone to be subjected to sexual exploitation.[12] The findings of a study suggest that 51.7% of adolescents with intellectual disability have not been educated professionally about sexuality. Nearly 47% of them have never even talked about sex with their parents suggesting adolescents with intellectual disabilities have low levels of appropriate information about sex and the stages of development during adolescence.[13]
Materials and Methods | |  |
Participants
One hundred and thirty parents whose children with intellectual disability (irrespective of severity) studying at Government Rehabilitation Institute for Intellectual Disabilities, Chandigarh, India, were selected randomly as sample. Following were the inclusion criteria: willingness to participate followed by a written consent, male and female having minimum education of 10th standard. Parents who attended any workshop/seminar regarding awareness on sex education in the last 3 years and parents having individuals with other than intellectual disability were excluded.
Design
It was a descriptive research study.
Tool
Awareness (knowledge, attitude, and practice [KAP]) on sex education for parents of intellectually challenged children was used. This tool is developed by Lakshmi and Navya (2014) and published by National Psychological Corporation, Agra, India.[14] There are 71 items in the tool and responses are to be given as “Strongly Agree, Agree, Uncertain, Disagree, and Strongly Disagree.”
Procedure
The administration of the tool was scheduled as per the convenience of the sample. Written informed consent was obtained from the participants. The aims and objectives of the study were made clear to the participants. Participants were informed that the collected data will be used only for research purpose, and their identity will remain confidential. Instructions written on the tool were given verbally by the researcher to the participants and enough time was provided to the samples to complete the tool. Researchers were available to look for their query if they have regarding understanding the item while filling up the tool. The tool was administered to parents of individuals with intellectual disability. The study was approved by the Departmental Research and Ethics Committee of Institute. The data collected were analyzed using the Statistical Package for the Social Sciences (SPSS) (Released 2008. SPSS for Windows, Version 17.0. Chicago: SPSS Inc.).
Results | |  |
[Table 1] depicts the awareness among parents of children with intellectual disability toward sex education. The awareness ranges from extremely high, high, above average, average, below average, low, and extremely low. It is interesting to know that only 0.76% (n = 1) were extremely aware, whereas 2.3% (n = 3), 8.46% (11), 31.54% (41), 36.15% (47), 16.15% (n = 21), and 4.6% (6) were high, above average, average, below average, low, and extremely low, respectively. The majority of the participants (36.15%, n = 47) had below average awareness, whereas an average 41 (31.54%) was the second most scored awareness by the participants. The extremely low was 4.6% (n = 6) while extremely high was 0.76% (n = 1).
[Table 2] shows the difference between mean and standard deviation parents with respect to their gender. The result reveals that there was no significant difference in the knowledge (t = 0.917, NS), attitude (t = 0.090, NS), and practice (t = 0.153, NS) among parents with respect to their gender. However, a significant difference in the knowledge (t = 3.58**) and attitude (t = 2.82**) was noticed with regard to education except practice (t = 1.453, NS). Furthermore, a significant difference in the knowledge (t = 2.95**), attitude (t = 2.22**), and practice (t = 3.06**) was found among parents toward sex education with regard to their income. The overall awareness (KAP) with respect to gender (t = 0.318, NS) was not found significant. However, the other two demographic variables, i.e. education (t = 3.62**) and income (t = 3.82**) reveal a significant difference in the level of awareness (KAP) among parents. | Table 2: Mean and standard deviation of awareness knowledge, attitude, and practice on sex education
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[Table 3] shows the Pearson correlational analysis which reveals that there was a significant positive correlation of knowledge with attitude (r = 0.453**), practice (r = 0.233**), and practice has a positive relationship. A significant correlation was found between attitude and practice (r = 0.252**). Thus, it can be concluded that KAP had a significant positive correlation depicting that parents who have good knowledge help to develop the right attitude and enables them to practice both in a given situation. | Table 3: Correlation between knowledge, attitude, and practice (awareness) on sex education
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Discussion | |  |
The findings of the study show no significant difference with respect to the gender on KAP among the parents of individuals with intellectual disability. The result highlight that gender has no role to play in having awareness of sex education. No significant difference was seen in the domains of sex education, i.e. KAP as well as overall awareness. The study conducted by Nagpal and Fernandes came up with similar findings which recommend that parents are supporting to have sex education for their children. No significant difference was found in the attitude of mother and father about educating their children which suggests that the responsibility of imparting sex education can't be left on mothers' or fathers' alone.[15] A critical review of the literature suggests that parents are keen to have interaction with their children about sex education provided they are equipped with appropriate skills to establish a healthy dialogue.[16] A study carried out by Mercier et al. (1994) viewed that parents have positive attitudes toward imparting sex education to their children with intellectual disability as they assume it will help them in safeguarding against any sexual abuse.[17] The findings of research suggest that parents are in favor of educating their children about sex education by the teachers while school is in the opinion that the foundational sex education must be imparted by the parents and family.[18] There are researches which recommend having appropriate orientation and sensitization program for the parents to make them enable to understand about importance and skills to teach sex education for their children with intellectual disability. The sex education training program can influence the knowledge and attitude of mothers.[2],[19] Therefore, mothers must be educated and empowered about children's sex education.[20] However, the result of the study conducted by Walker (2001) found that the awareness of mothers has a major role in providing sex education to their children.[21] There are mothers, particularly those with sons, who agree to provide sex education.[22]
A significant difference in the knowledge and attitude was noticed with regard to education. However, no significant difference in practice was seen. The majority (95.6%) of parents had high knowledge, while (98.7%) had positive attitudes, however, only about a quarter (27.3%) had good practices on protection and prevention of child sexual abuse.[23] Education could be one of the possible factors which may influence the attitude of parents. The finding of the study reveals a significant difference with regard to education.[18] Adequate education and training of parents can equip them to impart informal sex education which could be inexpensive and affordable also. Such training will help in preventing sexual harm and trauma of sexual abuse in rural communities.[11],[23]
A significant difference in the KAP was found among parents toward sexual health education with regard to their income. There are several other factors such as socioeconomic status, locality of residence, and family structure, which can also play a great role in the awareness of parents toward sex education.[18] Parents must be involved not only in sex education for their children but also must be a part of other related programs which can help their children. Making aware the parents is important for providing training regarding sex education.[24] Although there are studies which suggest better understanding of sexuality among persons with intellectual disability, role and involvement of parents cannot be ignored.[25],[26]
Conclusion | |  |
The findings highlight that mothers are more aware than the father toward sex education of their children with disabilities. However, statistically, no significant difference in the awareness was noticed among the parents with regards to gender. A significant difference with regard to education and income was seen which suggest that the higher the education and income higher the awareness toward sex education among the parents. The findings of the study also suggest to have extensive parents' empowerment programs to deal with sex education of their children with disabilities. The teacher from the special education and mental health professionals can play a great role in empowering parents of children with disabilities towards sex education. The educators must pay attention to develop individualized education program focussing the sexual health needs of persons with developmental disabilities. The active involvement of parents must be ensured for its effective implementation.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References | |  |
1. | Addlakha R, Price J, Heidari S. Disability and sexuality: Claiming sexual and reproductive rights. Reprod Health Matters 2017;25:4-9. |
2. | Ariadni DK, Prabandari Y, Sumarni DW. Parents' perception having children with intellectual disability providing sex education: A qualitative study in Yogyakarta. Galore Inter J Heal Sci Res 2017;2:1-6. |
3. | Bastien S, Kajula LJ, Muhwezi WW. A review of studies of parent-child communication about sexuality and HIV/AIDS in sub-Saharan Africa. Reprod Health 2011;8:25. |
4. | Breuner CC, Mattson G. AAP Committee on Adolescence, AAP Committee on Psychosocial Aspects of Child and Family Health. Sexuality education for children and adolescents. Pediatrics 2016;138:e20161348. |
5. | Büyükbayraktar CG, KonukEr R, Kesici S. Creating awareness of sexual abuse in children with special education needs: Depending on the opinions of teachers of the mentally handicapped. Educ Train Stud 2018;6:151-8. |
6. | Clatos K, Asare M. Sexuality education intervention for parents of children with disabilities: A pilot training program. Am J Health Stud 2016;31:151-62. |
7. | Gurol A, Polat S, Oran T. Views of mothers having children with intellectual disability regarding sexual education: A qualitative study. Sex Disabil 2014;32:123-33. |
8. | Güven ST, Işler A. Sex education and its importance in children with intellectual disabilities. J Psy Nurs 2015;6:143-8. |
9. | Harader DL, Fullwood H, Hawthorne M. Sexuality among adolescents with moderate disabilities: Promoting positive sexual development. Prev Res 2009;6:17-20. |
10. | Isler A, Tas F, Beytut D, Conk Z. Sexuality in adolescents with intellectual disabilities. Sex Disabil 2009;27:27-34. |
11. | Lakshmi VH, Navya S. Awareness on Sexual Education for Parents of Intellectually Challenged Children. Agra (UP), India: National Psychological Corporation; 2014. |
12. | Lakshmi VH, Navya S. Influence of independent variables on knowledge, attitude and practices of the parents towards imparting sexual health education. Asian J Res Soc Sci Hum 2015;5:142-54. |
13. | Mercier M, Delville J, Collignon JL. Sexuality and mental disability. Eur J Men Dis 1994;1:24-30. |
14. | |
15. | Mlekwa FM, Nyamhanga T, Chalya PL, Urassa D. Knowledge, attitudes and practices of parents on child sexual abuse and its prevention in Shinyanga district, Tanzania. Tanzania J Health Res 2016;18:1-9. |
16. | Mobredi K, Hasanpoor-Azghady SB, Azin SA, Haghani H, Farahani LA. Effect of the sexual education program on the knowledge and attitude of Preschoolers' mothers. J Clin Diag Res 2018;2:JC06-9. |
17. | Murphy N. Sexuality in children and adolescents with disabilities. Dev Med Child Neurol 2005;47:640-4. |
18. | Nagpal AN, Fernandes C. Attitude of parents towards sex education. Inter J Indian Psychol 2015;2:38-43. |
19. | Nazli, Ahmad W, Chavan BS. Attitude towards sexual health education among parents of adolescents with intellectual disability. Indian J Soc Psychiatry 2017;33:S25. |
20. | Pownall JD, Jahoda A, Hastings RP. Sexuality and sex education of adolescents with intellectual disability: Mothers' attitudes, experiences, and support needs. Intellect Dev Disabil 2012;50:140-54. |
21. | Vashistha KC, Rajshree. A study of attitude towards sex-education as perceived by parents and teachers. Samwaad 2012;1:63-74. |
22. | Walker JL. A qualitative study of parents' experiences of providing sex education for their children: The implications for health education. Health Edu J 2001;60:132-46. |
23. | Moshin NM, Khan TM, Doger AH, Awan AS. Role of parents in training of children with intellectual disability. Int J Hum Soc Sci 2011;1:78-88. |
24. | Nair S, Indiramma V, Girimaji SC, Pillai RR. Sexuality in adolescents with intellectual disability: Felt needs of parents. Ind J Psy Soc Work 2017;8:28-38. |
25. | Chavan BS, Ahmad W, Arun P, Mehta S, Nazli, Ratnam V, et al. Sexuality among adolescents and young adults with intellectual disability: Knowledge, attitude, and practices. J Psychosexual Health 2021;3:1-6. |
26. | Gupta RK. Understanding issues of sexuality and marriage among persons with disabilities. J Disabil Manage Rehab 2017; 2:61-67. |
[Table 1], [Table 2], [Table 3]
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