Touch and Personal Boundaries
Issue - Violating personal boundaries and touching for
more information.
Things to Try
* Use teachable moments to calmly model the right way to get information using
good social skills.
* Provide adequate support in social situations: be an ambassador and orient
and redirect the child.
* Provide more information to the child in a neutral manner through the use
of units.
Issue - Aggressive touching.
Things to Try
* Develop a behavior plan that is both proactive and reactive.
Issue - Inappropriate hugging or kissing.
Things to Try
* Teach appropriate greeting rituals.
* If the student understands rules, make lists of those people he may and
may not hug or kiss.
* Use appropriate greetings and displays of affections with the child.
Issue - Preservation that results in inappropriate touch.
Things to Try
* Develop a behavior plan.
* Schedule times during the day for the behavior.
* If the student understands rules, develop rules about the particular behavior.
* Avoid and plan for trigger situations.
Issue - Stripping in public places.
Things to Try
* Determine why the behavior is occurring and develop a behavior plan to insure
a consistent approach to resolving the problem:
* He/she is uncomfortable,
* His/her behavior is triggered by something in the en vironment,
* He/she is using his clothing to self-stimulate, or
* He/she is tearing his clothes because he is upset.
* Be calm and acknowledge the child's need to remove the clothing (e.g., "I
know that shirt is hot" communicated by fanning the shirt away from his
body), then redirect inappropriate behaviors by signing "wait" or
"later" and move the child to a more appropriate location for removing
his clothes. Avoid saying "no" and "stop."
* Try to distract him from the pursuit (e.g., fanning the child with a paper
or taking him to the restroom where he can sponge his face and neck to cool
down).
* Find more complicated clothing that is more difficult for the child to strip
off before you can intervene and redirect (e.g., a shirt with buttons as opposed
to a pullover).
* Redirect the behavior by signing "wait" and "private" and distract by providing something else for him/her to do.
Issue - Obvious and prolonged adjusting of undergarments in public.
Things to Try
* Determine if there is a physical reason for the behavior, such as clothes
that are poorly designed, are too tight or loose, or have tags or stitching
that might be irritating.
* Determine if the child is using the clothing for self-stimulation, and provide
more appropriate items for him to use in public settings such as keys on a
key chain, a purse with a shoulder strap, or a wristband or bracelet.
* Acknowledge the child's concerns and redirect the behavior by signing "wait"
and "private" and helping him/her move to a better location for
adjusting the clothing.
Issue - Responding sexually to touch that was not meant sexually.
Things to Try
* Determine who or what is triggering the response.
* Consider switching staff/caregivers during this particular activity.
* Reevaluate the amount of touch needed to assist the child and reduce touch
or increase distance if possible.
Issue - The child masturbates in public places.
Things to Try
* Identify possible triggers such as position, clothing, objects, etc.
* Make sure there are not medical issues contributing to the behavior.
Issue - The child uses an unwilling peer as part of his/her masturbation
strategy.
Things to Try
* Develop appropriate intervention strategies such as changing the position,
removing the trigger object, and dressing the child in more complicated clothing
to reduce the behavior.
* Increase the supervision and be prepared to redirect the child.
* Give the child a symbol to represent masturbation and tell him to "wait
home" to "wait bedroom."
Issue - The child uses an unwilling peer as part of his/her masturbation
strategy.
Things to Try
* Intervene and stop the behavior immediately.
* Share the incident with the team immediately, follow established policy
related to reporting, and develop a plan to prevent a future occurrence of
the event.
* Increase supervision.
Issue - The child masturbates in a way that may be dangerous.
Things to Try
* Remove any object that is dangerous and make sure it is completely unavailable
to him/her.
* Increase supervision.
Menstration
Issue - Pulling off sanitary pad
Things to Try
* Try other pads.
* Redirect her to the restroom and allow her to change pad.
* Consider other type of pad.
Issue - Playing with soiled pad.
Things to Try
* Allow her time to examine clean pad.
* Provide more assistance removing and disposing of pad.
Issue - Smearing menses.
Things to Try
* Provide more opportunities to go to the toilet and supervise closely.
* Assist her with removing the pad and disposing of it.
Issue - Constantly requesting the restroom.
Things to Try
* Let her go as often as she needs and practice changing pads.
* Work on concepts “wet,” “dry,” “blood,” “feces,”
“urine,” “red.”
* Praise her efforts to keep the pad changed.
Issue - Flushing stained underwear or soiled pad.
Things to Try
* Provide a bag for carrying home soiled underwear or for storing it until
she can help wash them out.
* Provide a trash receptacle next to the toilet and guide her to throw soiled
pad in it.
* Praise her efforts to appropriately dispose items.
Issue - Excessive physical discomfort.
Things to Try
* See doctor about health issues such as yeast infection, endometriosis, constipation,
etc.
* Request prescription or over-the-counter PMS medication.
* Increase or start a regular exercise program that works on relaxation such
as yoga, swimming, or walking.
* Allow frequent breaks and provide a place for her to lie down.
* Use relaxation techniques such as deep breathing, massage, heating pads,
etc.
Issue - Excessive emotions
Things to Try
* Reduce demands.
* Practice relaxation techniques such as deep breathing, massage, resting.
* Increase or start a regular exercise program that works on relaxation such
as yoga, swimming, or walking.
Sexual Health
Issue - The student becomes agitated the minute he/she
enters a doctor's office.
Things to Try
* Using a routine or unit approach, practice the steps that will take place
for an examination.
* Have a symbol representing the examination and a favorite activity, and
discuss the sequence of events using a daily calendar.
* Plan a field trip to the doctor's office just to meet the doctor, see the
room, and if possible do some of the preliminary examination tasks such as
checking blood pressure. You may want to make several trips, adding a few
new and more stressful items each visit. Go immediately to the reward activity.
Take home mementos of the field trip and then make them into a storybook or
story bag to review regularly with the student.
Issue - The student resists during an examination.
Things to Try
* Have familiar trusted people go with the student to the exam.
* Select a doctor who will work with you and allow for such extras as a "field
trip," having an educational support person in the examination room,
and so forth.
* Take along favorite objects to distract the child during the exam.
* Schedule the appointment for a time of day when the student is typically
most calm and cooperative (e.g., after lunch).
* Stand near the student during the entire exam, talk with him or her reassuringly,
and try to engage him or her with a favorite toy or object. As part of the
conversation, remind the child of the next (favorite) activity after the exam
using symbols or signs.
* Have the doctor or nurse be prepared to stop the procedure if necessary,
to allow you to calm the student and review the picture sequence. Then, try
again.
Source: Moss, K. and Blaha, R. (2001). Introduction to Sexuality Education
for Individuals Who Are Deaf-Blind and Significantly Develpmentally Delayed.
DB-Link, Monmouth, OR. DB-Link is supported by funding from the U.S. Department
of Eudcation, Office of Special Education Programs.
to table of contents for
Spring 2002 issue
