Teachers’ Challenges and Strategies in Sexual and Reproductive Health Education for Children with Intellectual Disabilities
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Abstract
Children with intellectual disabilities require additional support in understanding sexual and reproductive health due to decision-making challenges and limited educational and socio-cultural support. This study explored teachers’ challenges and strategies in delivering such education. A qualitative descriptive design was conducted in a special school involving five teachers selected through purposive sampling. Data were collected through focus group discussions (FGDs) and analyzed using inductive content analysis. Five themes revealed challenges in managing sexual behaviors that were not aligned with cognitive development. Teachers implemented habituation, experience-based learning, and counseling to support understanding of bodily changes, social norms, and self-regulation during puberty, supported by collaboration among schools, parents, and health professionals. These findings highlight the importance of adaptive and collaborative approaches. Schools should integrate experience-based learning and strengthen partnerships with families and health professionals.
Anak dengan disabilitas intelektual membutuhkan dukungan tambahan dalam memahami kesehatan seksual dan reproduksi akibat keterbatasan dalam pengambilan keputusan serta dukungan sistem pendidikan dan sosial-budaya yang masih terbatas. Penelitian ini mengeksplorasi tantangan dan strategi guru dalam memberikan edukasi tersebut. Penelitian menggunakan desain deskriptif kualitatif di Sekolah Luar Biasa dengan lima guru yang dipilih secara purposive. Data dikumpulkan melalui diskusi kelompok terarah (FGD) dan dianalisis menggunakan inductive content analysis. Hasil penelitian mengidentifikasi lima tema yang menunjukkan tantangan dalam mengelola perilaku seksual yang tidak sejalan dengan perkembangan kognitif. Guru menerapkan strategi berupa pembiasaan, pembelajaran berbasis pengalaman, dan konseling untuk mendukung pemahaman perubahan tubuh, norma sosial, serta pengaturan diri selama pubertas, melalui kolaborasi antara sekolah, orang tua, dan tenaga kesehatan. Temuan ini menegaskan pentingnya pendekatan yang adaptif dan kolaboratif. Sekolah perlu mengintegrasikan pembelajaran berbasis pengalaman serta memperkuat kemitraan dengan keluarga dan tenaga kesehatan.
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Abfalter, D., Mueller-Seeger, J., & Raich, M. (2021). Translation decisions in qualitative research: A systematic framework. International Journal of Social Research Methodology, 24(4), 469–486. https://doi.org/10.1080/13645579.2020.1805549
Andrikos, G. P., Smith, C. A., & Ciccarelli, M. (2024). Supporting co-regulation and development of self-regulation skills in students with intellectual disabilities: A scoping review. Australasian Journal of Special and Inclusive Education, 48, 1–17. https://doi.org/10.1017/jsi.2024.3
Casale-Giannola, D., Delisio, L., Sardo, L., & Kline, K. (2023). Research and reality: A survey of educators’ perceptions about evidence-based practices in inclusive settings for students with intellectual disabilities. Education Sciences, 13(6), 1–8. https://doi.org/10.3390/educsci13060558
Davies, A., O’Leary, S., Prioletta, J., Shay, B., Bryan, M., & Neustifter, O. (2026). Sexuality education for disabled children and youth in Ontario, Canada: Addressing epistemic injustice through school-based sexuality education. Children and Society, 40(1), 165–182. https://doi.org/10.1111/chso.12843
Doyle, L., McCabe, C., Keogh, B., Brady, A., & McCann, M. (2020). An overview of the qualitative descriptive design within nursing research. Journal of Research in Nursing, 25(5), 443–455. https://doi.org/10.1177/1744987119880234
França, T. F. A., Segura, I. A., Dias, N. M., Miranda, M. C., & Pompeia, S. (2025). The effect of pubertal status on self-regulation of behavior and executive functions—A systematic review. Developmental Psychobiology, 67(5), 1–48. https://doi.org/10.1002/dev.70069
Goli, S., Rahimi, F., & Goli, M. (2022). Experiences of teachers, educators, and school counselors about the sexual and reproductive health of educable intellectually disabled adolescent girls: A qualitative study. Reproductive Health, 19(1), 1–10. https://doi.org/10.1186/s12978-022-01397-8
Greene, A., Simić Stanojević, I., Sherwood-Laughlin, C., Sangmo, D., Baugh, M., Greathouse, L., Chow, A., Myers, N., & Galyan, J. (2025). Teachers’ perceptions of barriers to implementing school-based sexual health education for students with intellectual and developmental disabilities. American Journal of Sexuality Education, 20(4), 536–558. https://doi.org/10.1080/15546128.2024.2429432
Hill, J., Meyer, J., Stokes, L., Ausmus, J. C., Worthey, B., & Carney, J. (2024). Sexuality, sex education, and intellectual disability: Guidance for counselors. Journal of Counseling Sexology and Sexual Wellness, 5(1), 1–12. https://doi.org/10.34296/05012004
Hole, R., Schnellert, L., & Cantle, G. (2022). Sex: What is the big deal? Exploring individuals’ with intellectual disabilities experiences with sex education. Qualitative Health Research, 32(3), 453–464. https://doi.org/10.1177/10497323211057090
Hunt, G. R., Higgins, D. J., Willis, M. L., & Harris, L. (2024). Scoping review of the definitions used to describe and understand harmful sexual behaviors in children and young people. Trauma, Violence, and Abuse, 25(4), 2569–2583. https://doi.org/10.1177/15248380231218294
Ismail, N. A., Sukeri, S., Rahman, A. A., Ghazali, A. K., Rahim, M. Z. A., & Hashim, N. (2025). Exploring health issues of adolescents with intellectual disabilities: A qualitative study. Malaysian Journal of Medicine and Health Sciences, 21(3), 318–327. https://doi.org/10.47836/mjmhs.21.3.37
James, M. H., Porter, J. E., Kattel, S., Prokopiv, V., & Hopwood, P. (2022). Peer educators in the facilitation of sexuality and respectful relationship education for people with an intellectual disability: A scoping review and narrative synthesis. Sexuality and Disability, 40(3), 487–502. https://doi.org/10.1007/s11195-022-09740-4
Janighorban, M., Boroumandfar, Z., Pourkazemi, R., & Mostafavi, F. (2022). Barriers to vulnerable adolescent girls’ access to sexual and reproductive health. BMC Public Health, 22(1), 1–16. https://doi.org/10.1186/s12889-022-14687-4
Kamaludin, N. N., Muhamad, R., Yudin, Z. M., & Zakaria, R. (2022). Barriers and concerns in providing sex education among children with intellectual disabilities: Experiences from Malay mothers. International Journal of Environmental Research and Public Health, 19(3), 1–14. https://doi.org/10.3390/ijerph19031070
Khalesi, Z. B., Adib, M., & Sigaroudi, A. E. (2022). Exploring the structure of a school-based sexual and reproductive health education program: A qualitative study. Jornal Brasileiro de Reproducao Assistida, 26(2), 299–304. https://doi.org/10.5935/1518-0557.20210072
Maggio, M. G., Calatozzo, P., Cerasa, A., Pioggia, G., Quartarone, A., & Calabrò, R. S. (2022). Sex and sexuality in autism spectrum disorders: A scoping review on a neglected but fundamental issue. Brain Sciences, 12(11), 1–14. https://doi.org/10.3390/brainsci12111427
Matin, B. K., Ballan, M., Darabi, F., Karyani, A. K., Soofi, M., & Soltani, S. (2021). Sexual health concerns in women with intellectual disabilities: A systematic review in qualitative studies. BMC Public Health, 21(1), 1. https://doi.org/10.1186/s12889-021-12027-6
Mouna, H., N’djoli, J., & Maria, H. (2025). Role of health education and reproductive health education in schools and higher education institutions. Indonesian Journal of Innovation and Applied Sciences (IJIAS), 5(1), 33–48. https://doi.org/10.47540/ijias.v5i1.1764
Munea, A. M., Alene, G. D., Debelew, G. T., & Sibhat, K. A. (2022). Socio-cultural context of adolescent sexuality and youth friendly service intervention in West Gojjam Zone, Northwest Ethiopia: A qualitative study. BMC Public Health, 22(1), 1–11. https://doi.org/10.1186/s12889-022-12699-8
Oranga, J., & Matere, A. (2023). Qualitative research: Essence, types and advantages. OALib, 10(12), 1–9. https://doi.org/10.4236/oalib.1111001
Outhwaite, L. A., Early, E., Herodotou, C., & Van Herwegen, J. (2023). Understanding how educational maths apps can enhance learning: A content analysis and qualitative comparative analysis. British Journal of Educational Technology, 54(5), 1292–1313. https://doi.org/10.1111/bjet.13339
Pandia, W. S. S., Widyawati, Y., Handayani, P., & Sutamto, E. (2024). The reproductive health education to adolescents with intellectual disabilities: Perspectives of parents, teachers, and caregivers. AMCA Journal of Education and Behavioral Change, 4(1), 17–24. https://doi.org/10.51773/ajeb.v4i1.328
Pérez-Curiel, P., Vicente, E., Morán, M. L., & Gómez, L. E. (2023). The right to sexuality, Reproductive health, and found a family for people with intellectual disability: A systematic review. International Journal of Environmental Research and Public Health, 20(2), 1–29. https://doi.org/10.3390/ijerph20021587
Qi, W., Li, H., Lian, Q., Zuo, X., Yu, C., Lou, C., & Tu, X. (2023). Knowledge level and access barriers related to sexual and reproductive health information among youth with disabilities in China: A cross-sectional study. Reproductive Health, 20(1), 1–11. https://doi.org/10.1186/s12978-023-01625-9
Read, J. E., Vasile-Tudorache, A., Newsome, A., Lorente, M. J., Agustín-Pavón, C., & Howard, S. R. (2024). Disorders of puberty and neurodevelopment: A shared etiology? Annals of the New York Academy of Sciences, 1541(1), 83–99. https://doi.org/10.1111/nyas.15246
Rungsattatharm, L., Tasingha, P., Trairatvorakul, P., & Chonchaiya, W. (2025). Longitudinal associations between executive function and positive parenting during early childhood and resilience, self-regulation, and behavioral problems in school-age children. Child and Adolescent Psychiatry and Mental Health, 19(1), 1–12. https://doi.org/10.1186/s13034-025-00875-8
Saleh, A., & Dillenburger, K. (2025). Sexual health education for children and young people with autism and/or intellectual/development disabilities in the Arab World: A systematic literature review of the attitudes and experiences of parents and professionals. Sexuality and Disability, 43(3), 1–18. https://doi.org/10.1007/s11195-025-09901-1
Shibuya, F., Estrada, C. A., Sari, D. P., Takeuchi, R., Sasaki, H., Warnaini, C., Kawamitsu, S., Kadriyan, H., & Kobayashi, J. (2023). Teachers’ conflicts in implementing comprehensive sexuality education: A qualitative systematic review and meta-synthesis. Tropical Medicine and Health, 51(1), 1–22. https://doi.org/10.1186/s41182-023-00508-w
Shukla, S., Ezebuihe, J. A., & Steinert, J. I. (2023). Association between public health emergencies and sexual and reproductive health, gender-based violence, and early marriage among adolescent girls: A rapid review. BMC Public Health, 23(1), 1–14. https://doi.org/10.1186/s12889-023-15054-7
Strnadová, I., Danker, J., & Carter, A. (2022). Scoping review on sex education for high school-aged students with intellectual disability and/or on the autism spectrum: Parents’, teachers’ and students’ perspectives, attitudes and experiences. Sex Education, 22(3), 361–378. https://doi.org/10.1080/14681811.2021.1941842
Svae, G. B., Blixt, L., & Søndenaa, E. (2022). Personal and sexual boundaries: The experiences of people with intellectual disabilities. BMC Public Health, 22(1), 1. https://doi.org/10.1186/s12889-022-14181-x
Tohit, N. F. Mohd., Rashid, S. A. Z. Abd., Fakuradzi, W. F. S. W. A., Zaidi, N. ‘Adnin A., & Haque, M. (2024). Exploring pathways from community involvement to empowerment in sexual and reproductive health: A public health perspective. Advances in Human Biology, 14(4), 296–307. https://doi.org/10.4103/aihb.aihb_112_24
Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357.
Truong, H.-H. M., Amboka, S., Kadede, K., Otieno, B., Odhiambo, H., Odeny, D., Agot, I., Miller, L. E., Bushman, D., Obunge, D., Auerswald, C., & Zamudio-Haas, S. (2025). Harmonizing voices: A collaborative, cross-cultural approach for adolescent sexual and reproductive health research. Adv Glob Health, 4(1), 1. https://doi.org/10.1525/agh.2025.2469788
Vears, D. F., Gillam, L., & Vears, D. (2022). Inductive content analysis: A guide for beginning qualitative researchers. 23(1), 2022. https://doi.org/10.3316/informit.455663644555599
Vincent, R., & Krishnakumar, K. (2022). School-based interventions for promoting sexual and reproductive health of adolescents in India: A review. Journal of Psychosexual Health, 4(2), 102–110. https://doi.org/10.1177/26318318221089621
Vincent, R., Nalini, R., & Athira, V. H. (2025). Primary Carer’s Experiences on the Emerging Sexuality of Adolescents with Intellectual and Developmental Disabilities: A Qualitative Meta-synthesis. In Journal of Psychosexual Health, 7(3), 235–242. https://doi.org/10.1177/26318318241276987
Wakjira, D. B., & Habedi, D. (2022). Barriers to access and utilisation of sexual and reproductive health services among adolescents in Ethiopia: A sequential mixed-methods study. BMJ Open, 12(11), 1–8. https://doi.org/10.1136/bmjopen-2022-063294
Warschburger, P., Gmeiner, M. S., Bondü, R., Klein, A. M., Busching, R., & Elsner, B. (2023). Self-regulation as a resource for coping with developmental challenges during middle childhood and adolescence: The prospective longitudinal PIERYOUTH-study. BMC Psychology, 11(1), 1–21. https://doi.org/10.1186/s40359-023-01140-3
Zinda, A. R. P., Riskiyani, S., & Nasir, S. (2024). Menstrual hygiene: Barriers and support for adolescents with intellectual disability. International Journal of Chemical and Biochemical Sciences, 25(19), 1–5. https://doi.org/10.62877/96-ijcbs-24-25-19-96