Skip to main content
Log in

Sexuality and sex education for children with developmental disabilities: Attitudes and concerns of parents in the Accra Metropolis of Ghana

  • Published:
Current Psychology Aims and scope Submit manuscript

Abstract

Sexuality and sex education are basic human rights. However, individuals with developmental disabilities (DD) often lack the knowledge and skills regarding their sexuality due to negative attitudes of significant others around them. This study explored the attitudes and concerns of parents regarding sexuality and sex education of their children with DD. Eleven (11) parents living in Accra participated in in-depth interviews utilized for this qualitative investigation. The children of these participants were aged 10–18 years. Thematic analysis of the data revealed five main themes: (1) Hinderances to sex education; (2) Parental Concerns; (3) Child agency in sexuality; (4) Proper sex education needs; and (5) Hopes for future love relationships. Results indicated that in general, parents did not provide sex education for their children due to the perceived cognitive ability of their children to comprehend issues of sexuality. Secondly, access to resources that match their children’s cognitive ability are not available to parents. Nonetheless, parents were concerned about their children being sexually abused and hoped for a better family life for them in the future. Findings are further discussed in the context of implications to inform policy, guidance, and appropriate sexual education for parents, society, and schools working with children with DD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Data availability

Data will be available to be shared upon request.

References

  • Aunos, M., & Feldman, M. A. (2002). Attitudes towards Sexuality, Sterilization and Parenting Rights of Persons with Intellectual Disabilities. Journal of Applied Research in Intellectual Disabilities, 15(4), 285–296. https://doi.org/10.1046/j.1468-3148.2002.00135.x

    Article  Google Scholar 

  • Attafuah, K. G. (2000). Enhancing disability rights in Africa: The Ghanaian experience. Social Policy, 1(2), 34–44.

    Google Scholar 

  • Ballan, M. S. (2012). Parental perspectives of communication about sexuality in families of children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(5), 676–684. https://doi.org/10.1007/s10803-011-1293-y

    Article  PubMed  Google Scholar 

  • Baines, S., Emerson, E., Robertson, J., & Hatton, C. (2018). Sexual activity and sexual health among young adults with and without mild/moderate intellectual disability. BMC Public Health, 18(1). https://doi.org/10.1186/s12889-018-5572-9

  • Bane, G., Deely, M., Donohoe, B., Dooher, M., Flaherty, J., Iriarte, E. G., Hopkins, R., Mahon, A., Minogue, G., Donagh, P. M., Doherty, S. O., Curry, M., Shannon, S., Tierney, E., & Wolfe, M. (2012). Relationships of people with learning disabilities in Ireland. British Journal of Learning Disabilities, 40(2), 109–122. https://doi.org/10.1111/j.1468-3156.2012.00741.x

    Article  Google Scholar 

  • Bates, C., Terry, L., & Popple, K. (2017). Partner selection for people with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 30, 602–611.

    Article  PubMed  Google Scholar 

  • Brown-Lavoie, S. M., Viecili, M. A., & Weiss, J. A. (2014). Sexual knowledge and victimization in adults with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44, 2185–2196.

    Article  PubMed  PubMed Central  Google Scholar 

  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.

    Article  Google Scholar 

  • Campbell, S. M., Löfgren-Mårtenson, C., & Santinele Martino, A. (2020). “Cripping” sex education. Sex Education, 20(4), 361–365.

    Article  Google Scholar 

  • Carter, A., Strnadová, I., Watfern, C., Pebdani, R., Bateson, D., Loblinzk, J., & Newman, C. (2021). The sexual and reproductive health and rights of young people with intellectual disability: A scoping review. Sexuality Research and Social Policy, 1–19. https://doi.org/10.1007/s13178-021-00549-y

  • Cheak-Zamora, N. C., Teti, M., Maurer-Batjer, A., O’Conner, K. V., & Randolph, J. K. (2019). Sexual and relationship interest, knowledge, and experiences among adolescents and young adults with autism spectrum disorder. Archives of Sexual Behavior, 48, 2605–2615.

    Article  PubMed  Google Scholar 

  • Clatos, K., & Asare, M. (2016). Sexuality Education Intervention for Parents of Children with Disabilities: A Pilot Training Program. American Journal of Health Studies, 31(3), 151–162.

    PubMed  PubMed Central  Google Scholar 

  • Cornwell, A., & Welbourn, A. (2000). From reproduction to rights: Participatory approaches to sexual and reproductive health. PLA Notes, 37, 14–21.

    Google Scholar 

  • Cotter, A. (2018). Violent victimization of women with disabilities, 2014. Juristat, Statistics Canada, catalogue no. 85-002-X. Statistics Canada. https://www150.statcan.gc.ca/n1/daily-quotidien/180315/dq180315b-eng.htm

  • de Carvalho, A. N. L., & da Silva, J. P. (2018). Sexuality of People with Disabilities: A Systematic Review. Arquivos Brasileros De Psicologia, 70(3), 289–304.

    Google Scholar 

  • Esmail, S., Darry, K., Walter, A., & Knupp, H. (2010). Attitudes and Perceptions Towards Disability and Sexuality. Disability and Rehabilitation, 32(14), 1148–1155. https://doi.org/10.3109/09638280903419277

    Article  PubMed  Google Scholar 

  • Frawley, P, Wilson, N. J, David, J., O'Shea, A., & Areskoug, J. K. (2022). Access to Sexual Health Services and Support for People with Intellectual and Developmental Disabilities: an Australian Cross-sector Survey. Sex Res Social Policy, 1935–1943. https://doi.org/10.1007/s13178-022-00734-7

  • Friedman, C., Arnold, C. K., Owen, A. L., & Sandman, L. (2014). Remember our voices are our tools: Sexual self-advocacy as defined by people with intellectual and developmental disabilities. Sexuality & Disability, 32(4), 515–532. https://doi.org/10.1007/s11195-014-9377-1

    Article  Google Scholar 

  • Friedman, C. (2019). Intimate Relationships of People With Disabilities. Inclusion, 7(1), 41–56. https://doi.org/10.1352/2326-6988-7.1.411

  • Fulford, C., & Cobigo, V. (2016). Friendships and intimate relationships among people with intellectual disabilities: A thematic synthesis. Journal of Applied Research in Intellectual Disabilities. https://doi.org/10.1111/jar.12312

  • Ghana Statistical Service (GSS). (May, 2012). Population and Housing Census. Summary Report of Final Results. Sakoa Press Limited. Retrieved from http://www.statsghana.gov.gh/docfiles/2010phc/Census2010_Summary_report_of_final_results.pdf

  • Goli, S., Noroozi, M., & Salehi, M. (2018). A comprehensive sexual health care program for educable intellectually disabled adolescent girls: Protocol for a mixed methods study. Reproductive Health, 15(1), 141. https://doi.org/10.1186/s12978-018-0587-3

    Article  PubMed  PubMed Central  Google Scholar 

  • Gürol, A., Polat, S., & Oran, T. (2014). Views of mothers having children with intellectual disability regarding sexual education: A qualitative study. Sexuality and Disability, 32(2), 123–133. https://doi.org/10.1007/s11195-014-9338-8

    Article  Google Scholar 

  • Heifetz, M., Lake, J., Weiss, J., Isaacs, B., & Connolly, J. (2020). Dating and romantic relationships of adolescents with intellectual and developmental disabilities. Journal of Adolescence, 79, 39–48. https://doi.org/10.1016/j.adolescence.2019.12.011

    Article  PubMed  Google Scholar 

  • Hellemans, H., Colson, K., Verbracken, C., Vermeiren, R., & Deboutte, D. (2007). Sexual behavior in high-functioning male adolescents and young adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 37, 260–269. https://doi.org/10.1007/s10803-006-0159-1

    Article  PubMed  Google Scholar 

  • Holland-Hall, C., & Quint, E. H. (2017). Sexuality and Disability in Adolescents. Pediatric Clinics of North America, 64(2), 435–449. https://doi.org/10.1016/j.pcl.2016.11.011

    Article  PubMed  Google Scholar 

  • Hollomotz, A. (2011). Learning Difficulties and Sexual Vulnerability. A Social Approach. Jessica Kingsley Publishers.

    Google Scholar 

  • Holmes, L. G., & Himle, M. B. (2014). Brief Report: Parent-Child Sexuality Communication and Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 44(11), 2946–2970.

    Article  Google Scholar 

  • Kanwetuu, V. P., Mokulogo, R. K., & Azumah, F. D. (2018). Understanding Adolescents’ Sexual Behaviour in Ghana: Information Sources and Their Effects. Sexuality and Culture, 22, 942–961. https://doi.org/10.1007/s12119-018-9509-3

    Article  Google Scholar 

  • Katz, G., & Lazcano-Ponce, E. (2008). Sexuality in subjects with intellectual disability: An educational intervention proposal for parents and counselors in developing countries. Salud Publica Mex, 50, 239–254. https://doi.org/10.1590/S0036-36342008000800018

  • Kramers-Olen, A. (2016). Sexuality, intellectual disability, and human rights legislation. South African Journal of Psychology. https://doi.org/10.1177/0081246316678154

  • Lam, A., Yau, M., Franklin, R. C., & Leggat, P. A. (2020). Public opinion on the sexuality of people with intellectual disabilities: A review of the literature. Sexuality and Disability, 39(2), 395–419. https://doi.org/10.1007/s11195-020-09674-9

    Article  Google Scholar 

  • Lam, A., Yau, M., Franklin, R. C., & Leggat, P. A. (2022). Voices from parents on the sexuality of their child with intellectual disabilities: A socio-emotional perspective in a Chinese context. British Journal of Learning Disabilities, 12448. https://doi.org/10.1111/bld.12448

  • Leutar, Z., & Mihokovic, M. (2007). Level of Knowledge About Sexuality of People with Mental Disabilities. Sexuality and Disability, 25, 93–109. https://doi.org/10.1007/s11195-007-9046-8

    Article  Google Scholar 

  • Lesseliers, J., & Van Hove, G. (2002). Barriers to the Development of Intimate Relationships and the Expression of Sexuality among People with Developmental Disabilities: Their perceptions. Research and Practice for Persons with Severe Disabilities, 27, 69–81.

    Article  Google Scholar 

  • Lightfoot E, & DeZelar S. (2020). Parent centered planning: A new model for working with parents with intellectual and developmental disabilities. Children and Youth Services Review. https://doi.org/10.1016/j.childyouth.2020.105047

  • Löfgren-Mårtenson, L. (2012). “‘I Want to Do It Right!’: A Pilot Study of Swedish Sex Educationand Young People with Intellectual Disabilities.” Sexuality and Disability, 30(2), 209–225. https://doi.org/10.1007/s11195-011-9239-z

  • Makatjane, T. (2002). Pre-marital Sex and Child Bearing in Lesotho. African Population Studies, 17(2), 99–112.

    Google Scholar 

  • Mays, N., & Pope, C. (2000). Quality in qualitative health research. In N. Mays & C. Pope (Eds.), Qualitative Research in Health Care (2nd edition) (pp. 89–102). BMJ Books.

    Google Scholar 

  • McCann, E., Marsh, L., & Brown, M. (2019). People with Intellectual Disabilities, Relationship and Sex Education Programmes: A Systematic Review. Health Education Journal, 78(8), 885–900. https://doi.org/10.1177/0017896919856047

    Article  Google Scholar 

  • Menon, P., & Sivakami, M. (2019). Exploring Parental Perceptions and Concerns About Sexuality and Reproductive Health of Their Child With Intellectual and Developmental Disability (IDD) in Mumbai. Frontiers in Sociology, 4(58), 1–13. https://doi.org/10.3389/fsoc.2019.00058

    Article  Google Scholar 

  • Mehzabin, P., & Stokes, M. (2011). Self-assessed sexuality in young adults with High-Functioning Autism. Research in Autism Spectrum Disorders, 5(1), 614–621.

    Article  Google Scholar 

  • Michielsen, K., & Brockschmidt, L. (2021). Barriers to Sexuality Education for Children and Young People with D in the WHO European Region: A Scoping Review. Sex Education, 21(6), 674–692. https://doi.org/10.1080/14681811.2020.1851181

    Article  Google Scholar 

  • Motalenyane, A. M. (2019). Parent sex education beliefs in a rural South African setting. Journal of Psychology in Africa, 29(1), 84–86. https://doi.org/10.1080/14330237.2019.1568047

    Article  Google Scholar 

  • Murphy, N. A., & Elias, E. R. (2006). Sexuality of Children and Adolescents with Developmental Disabilities. Pediatrics, 118(1), 398–403. https://doi.org/10.1542/peds.2006-1115

    Article  PubMed  Google Scholar 

  • Nichols, S., & Blakeley-Smith, A. (2009). “I’m not sure we’re ready for this…”: Working with families toward facilitating healthy sexuality for individuals with autism spectrum disorders. Social Work in Mental Health, 8(1), 72–91. https://doi.org/10.1080/15332980902932383

    Article  Google Scholar 

  • Nosek, M. A., Foley, C. C., Hughes, R. B. et al. (2001). Vulnerabilities for Abuse Among Women with Disabilities. Sexuality and Disability 19, 177–189. https://doi.org/10.1023/A:1013152530758

  • Oti-Boadi, M., Dankyi, E., & Kwakye-Nuako, C. O. (2020). Stigma and forgiveness in Ghanaian mothers of children with autism spectrum disorders (ASD). Journal of Autism and Developmental Disorders, 50, 1391–1400. https://doi.org/10.1007/s10803-020-04366-x

    Article  PubMed  Google Scholar 

  • Oti-Boadi, M., Malm, E. K., Dey, N. Y. E., & Oppong, O. (2023). Parental Knowledge and Attitudes Towards Sexuality and Sex-Education of Their Children with Developmental Disabilities. Sexuality and Disability. https://doi.org/10.1007/s11195-023-09797-9

    Article  Google Scholar 

  • Pownall, J.D., Jahoda, A., & Hastings, R.P. (2012). Sexuality and Sex Education of Adolescents with Intellectual Disability: Mothers’ Attitudes, Experiences, and Support Needs. Intellectual and Developmental Disabilities, 50, 140–154. https://doi.org/10.1352/1934-9556-50.2.140

  • Pryde, R., & Jahoda, A. (2018). A qualitative study of mothers’ experiences of supporting the sexual development of their sons with autism and an accompanying intellectual disability. International Journal of Developmental Disabilities, 64(3), 166–174. https://doi.org/10.1080/20473869.2018.1446704

  • Ramarumo, M., Mudhovozi, P., & Sodi, T. (2011). Safe sex education for adolescent daughters: VhaVenda mothers views. Journal of Psychology in Africa, 21(1), 103–111. https://doi.org/10.1080/14330237.2011.10820434

    Article  Google Scholar 

  • Rottenberg, R. (2012). Caught inside a paradox: how cultural representations perpetuate disability stigma. Disability and Representation. Available online at: http://www.disabilityandrepresentation.com/caught-inside-a-paradox-howcultural-representations-perpetuate-disability-stigma/. Accessed  16 Sep 2021

  • Rushbrooke, E., Murray, C., & Townsend, S. (2014). The experiences of intimate relationships by people with intellectual disabilities: A qualitative study. Journal of Applied Research in Intellectual Disabilities, 27, 531–541.

    Article  PubMed  Google Scholar 

  • Schaafsma, Dilana, Kok, Gerjo, Stoffelen, Joke M. T., & Curfs, Leopold M. G. (2014). Identifying Effective Methods for Teaching Sex Education to Individuals With Intellectual Disabilities: A Systematic Review. The Journal of Sex Research, 52(4), 412–32.

    Article  PubMed  Google Scholar 

  • Shah, S. (2017). Disabled People Are Sexual Citizens Too: Supporting Sexual Identity, Well-Being, and Safety for Disabled Young People. Frontiers in Education, 2. https://doi.org/10.3389/feduc.2017.00046

  • Simpson, A., Lafferty, A., & McConkey, R. (2006). Out of the Shadows: A Report on the Sexual Health and Wellbeing of People with Learning Disabilities in Northern Ireland. Family Planning Association, 112.

  • Sinclair, J., Unruh, D., Lindstrom, L., & Scanlon, D. (2015). Barriers to Sexuality for Individuals with Intellectual and Developmental Disabilities: A Literature Review. Education and training in autism and developmental disabilities, 3–16.

  • Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretative phenomenological analysis: Theory, method and research. Los Angeles, CA: SAGE

  • Stein, S., Kohut, T., & Dillenburger, K. (2017). The Importance of Sexuality Education for Children With and Without Intellectual Disabilities : What Parents Think. Sexuality and Disability. https://doi.org/10.1007/s11195-017-9513-9

    Article  Google Scholar 

  • Sullivan, F., Bowden, K., McKenzie, K., & Quayle, E. (2016). The Close Relationships of People with Intellectual Disabilities: A Qualitative Study. Journal of Applied Research in Intellectual Disabilities, 29(2), 172–184. https://doi.org/10.1111/jar.12168

    Article  PubMed  Google Scholar 

  • Swango-Wilson, A. (2008). Caregiver perceptions and implications for Sex Education for individuals with intellectual and developmental disabilities. Sexuality and Disability, 26, 167–174.

    Article  Google Scholar 

  • Thompson, V. R., Stancliffe, R. J., Broom, A., & Wilson, N. J. (2014). Barriers to sexual health provision for people with intellectual disability: A disability service provider and clinician perspective. Journal of Intellectual & Developmental Disability, 39(2), 137–146. https://doi.org/10.3109/13668250.2014.898742

    Article  Google Scholar 

  • Tomsa, R., Gutu, S., Cojocaru, D., Gutiérrez-Bermejo, B., Flores, N., & Jenaro, C. (2021). Prevalence of Sexual Abuse in Adults with Intellectual Disability: Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 18(4), 1980. https://doi.org/10.3390/ijerph18041980

    Article  PubMed  PubMed Central  Google Scholar 

  • UNFPA. (2018). Young Persons with Disabilities. Global Study on Ending Gender-based Violence and Realizing Sexual and Reproductive Health and Rights. UNFPA.

  • United Nations. (2006). Convention for the Rights of Persons with Disability (UNCRPD). https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities/convention-on-the-rights-of-persons-with-disabilities-2.html. Accessed 21 Jan 2021

  • Volkmar, F. R., & Wiesner, L. A. (2004). Healthcare for children on the autism spectrum: A guide to medical, nutritional, and behavioral issues. Bethesda, MD: Woodbine House Inc.

  • Walker-Hirsch L. (2007). The Facts of Life and More: Sexuality and Intimacy for People with Intellectual Disabilities. Paul H. Brooks.

  • Wigham, S., & Emerson, E. (2015). Trauma and Life Events in Adults with Intellectual Disability. Current Developmental Disorders Reports, 2(2), 93–99. https://doi.org/10.1007/s40474-015-0041-y

    Article  Google Scholar 

  • Wilkinson, V. J., Theodore, K., & Raczka, R. (2015). ‘As normal as possible’: Sexual identity development in people with intellectual disabilities transitioning to adulthood. Sexuality and Disability, 33, 93–105.

    Article  Google Scholar 

  • Wilson, E. K., Dalberth, B. T., Koo, H. P., & Gard, J. C. (2010). Parents’ perspectives on talking to preteenage children about sex. Perspectives on Sexual and Reproductive Health, 42(1), 56–63.

    Article  PubMed  Google Scholar 

  • Wilson, N., & Frawley, P. (2016). Transition staff discuss sex education and support for young men and women with intellectual and developmental disability. Journal of Intellectual & Developmental Disability, 41(3), 209–221. https://doi.org/10.3109/13668250.2016.1162771

    Article  Google Scholar 

  • World Health Organisation (WHO, 2011). World Report on Disability. http://www.who.int/disabilities/world_report/2011/report.pdf. Accessed 21 Jan 2021

  • World Health Organization. (2021). Sexual and Reproductive Health and Research. https://www.who.int/teams/sexual-and-reproductive-health-and-research-(srh)/about-us. Accessed 05 April 2022

Download references

Acknowledgements

We thank all parents who participated in the interviews for this study. We further thank Special mothers and fathers project (Support group) for their assistance.

Author information

Authors and Affiliations

Authors

Contributions

M.O. conceptualized the study. MO. E.M., N.E.Y.D., & S.O were involved in the design of the study. All authors analysed and interpreted the data and were involved in drafting the manuscript and revising it critically. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Mabel Oti-Boadi.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed Consent Informed consent was obtained from all individual participants included in the study.

Competing interests

The authors declare that they have no competing interests

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix A

Appendix A

Table

Table 2 Demographic characteristics of participants

2

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Oti-Boadi, M., Malm, E., Dey, N.E.Y. et al. Sexuality and sex education for children with developmental disabilities: Attitudes and concerns of parents in the Accra Metropolis of Ghana. Curr Psychol 43, 8173–8185 (2024). https://doi.org/10.1007/s12144-023-05006-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12144-023-05006-0

Keywords

Navigation