Thursday, June 13, 2013

Applying Disability-Related Considerations to Program Planning

Safe sex education is a necessary program for hearing-impaired adolescents so that they can be informed and comfortable with their sexuality (Getch, Branca, Fitz-Gerald, & Fitz-Gerald, 2001). The goal of this paper is to describe a proposed safe sex program for hearing-impaired adolescents in the community, the resources necessary to implement the program, and challenges that might be faced for the hearing-impaired population, and how they could be resolved.

                                                                   Program Goals

An abundance of research has found hearing-impaired children do not know as much about sexual issues than their hearing counterparts (Jones & Badger, 1991; Sawyer, Desmond, & Joseph, 1996). Hearing-impaired children know less about birth control, emotion in relationships, human anatomy, and sexually transmitted diseases (Getch et al., 2001). At college age, hearing-impaired students know less about preventing the transmission of HIV/AIDS than hearing college students (Jones & Badger, 1991). Considering college students are more educated than the average hearing-impaired individual, this lack of knowledge is troublesome. This deficiency may speak to the paucity of effective safe sex education programs for hearing-impaired adolescents.

Safe sex programs should be designed for in-school implementation, with consideration to the challenges faced by hearing-impaired individuals (Moinester, Gulley, & Watson, 2008). Hearing-impaired adolescents, like hearing adolescents need to be provided accurate working knowledge of sexually transmitted diseases and infections, pregnancy prevention, and safe sex (Moinester, Gulley, & Watson, 2008). A program designed for hearing-impaired students would be similar, in many ways, to a program for hearing students. Hearing-impaired adolescents are exposed to the same advertising and role models as hearing students and they associate being sexually active with being cool and attractive. Hearing-impaired adolescents are experimenting with their sexuality, and exploring all other aspects of their life including fashion trends, their interests and goals, friendships and peers, and how to garner the attention of the opposite sex (Laitmon, 1979).

Although there are many similarities between hearing and hearing-impaired adolescents, research suggests that hearing-impaired adolescents benefit from a program on safe sex practices designed specifically for them (Laitmon, 1979). These programs can be especially beneficial when the teens have the opportunity to express their attitudes, feelings, and experiences without judgment. In a group of hearing students, they might not have the same opportunities (Laitmon, 1979). A separation exists between the hearing and hearing-impaired world, and prevention initiatives for this population are sometimes missed because of barriers that result from discrimination, and inaccurate social attitudes (Moinester, Gulley, & Watson, 2008).

Additionally important to creating a program specifically for this population is the need for this young population to belong to a group. For hearing-impaired adolescents, this membership serves as a reference for normal behavior and provides emotional support for hearing-impaired adolescents. They also gain a sense of belonging, which is exceedingly important for all adolescents, whether hearing or hearing-impaired (Gardner & Steinberg, 2005; Laitmon, 1979). Laitmon (1979) explained that in a program for safe sex education, students are not being graded or judged so there is no need to try and earn group recognition like they might in a combined hearing and hearing-impaired group.

One of the goals of the program would be to establish an alternative perspective of norms in adolescent sexual behavior, specifically adapted to this population. Because this population of teens is diverse because of their hearing impairment, the program must represent views and attitudes consistent and of consequence to this population. Card (1999) claimed that effective sex education programs for adolescents must present information in a way that is palatable, yet consequential and at their level of understanding. Adolescents are keenly aware of the normative behavior of their teen culture, whether they are hearing, or hearing-impaired. Therefore, it seems appropriate to establish an alternative perception of normal, expected, and acceptable sexual behavior, as well as to develop an increased knowledge of the practice of safe sex.

                                                               Program Format

Generally, hearing-impaired adolescents do not like being separated from hearing adolescents, but many times, by virtue of their hearing impairment, they feel separate, self-conscious, and lonely. For these reasons, it is important to design a specific sex education program for hearing-impaired adolescents. In this atmosphere, the hearing-impaired teen is more apt to feel a sense of belonging in a social group consisting only of hearing-impaired teens. The need for adolescents to have a sense of belonging is well-established (Gardner & Steinberg, 2005). Research suggests hearing-impaired adolescents have this same need to be a part of a group (Hauser and Marschark, 2008). Further, hearing-impaired individuals form distinct communities similar to other racial groups or ethnicities (Gannon, 1998).

This program will take place during the school day. Since there are 50 adolescents that will be attending this program, the students will be divided into two groups; the first will be comprised of freshman and sophomore students; the second of junior and senior students. The smaller groups will be more intimate for discussions and may be an advantage because of the differences in experience between the age groups, with the older adolescents having an increased exposure to sexual activity.

                                                                  Resources Needed

This program needs one teacher who knows American Sign Language (ASL), and three or more young hearing-impaired adults from the community who would like to speak, provide discussion, and work in smaller groups with the students. They must know ASL as well. Additionally, other hearing-impaired individuals will be invited to speak and share experiences.


Adequate space exists within the school and arrangements will be made with faculty to utilize the space for an hour, one day per week for six weeks.


Information packets for the students, will include the information covered in the program, as well as a list of resources for birth control and TTY telephone resources for the adolescents' questions. The information packets will provide written explanations as well as images along with ASL-structured word phrases (Moinester, Gulley, & Watson, 2008). Because of the cultural cohesion among hearing-impaired individuals, it is important to use materials that have been designed by hearing-impaired individuals. This will provide the greatest level of appropriateness and subsequently, will affect the overall impact of the program. Video presentations should include actors using ASL rather than spoken language, and the video portions will be supported by subtitles.

                                             Challenges for this Population

Cognitive Differences

Hauser and Marschark (2008) found the coding for short-term memory is more complex for sign language used by hearing-impaired individuals than the coding for language used by hearing individuals, so hearing-impaired individuals may have what may seem as a deficiency in memory capability. This can be resolved in this program by introducing concepts in a structured, iterative manner, perhaps with pauses for discussion so the material will be fully digested and stored in long-term memory. Other cognitive differences were found in hearing impaired individuals as well. Learning disabilities are an issue for at least 25% of hearing impaired individuals, and this may further affect their ability to socialize normally. This, of course, has implications for teaching them how to respond to sexual advances and resolving the normal adolescent intrigue with the opposite sex, both of which can lead to premature sexual activity. Because a paucity of research exists on the social and sexual experiences of hearing-impaired adolescents, the program will underline the significance of employing hearing-impaired young adults share their experiences of exploring their sexuality safely.

Role Modeling

The deaf community's needs are, for the most part not considered by "the hearing, white, middle-class sexuality curricula" (p. 284) that is often used in sex education (Gannon, 1998). Specifically, other than their teachers, hearing-impaired adolescents may not have hearing-impaired role models with whom to relate. Gannon (1998) advises that in sex education programs, deaf role models should be invited to speak or employed to be the primary instructor for the program. Hearing-impaired adolescents need relatable role models, and access to the stories and personal experiences of hearing-impaired role models to help reduce the typical adolescent attitude that it cannot or will not happen to them (Gannon, 1998).

Hearing-impaired individuals are often isolated from their families and society in general. It is important for them to witness a variety of relationships, including platonic and romantic, as well as to have exposure to other aspects of sexual relationships, such as how to make decisions and resolve conflict with a sexual partner (Laitmon, 1979). Further, role models expose hearing-impaired adolescents to the idea that they can have normal sexual relationships in which they can decide when and with whom they want to have sex (Gannon, 1998). This and other socialization skills must be developed along with one's sexuality. All of these reasons support the need for hearing-impaired role models in this program.


The need for sex education for hearing-impaired children is great. Research suggests there is a paucity of programs designed for the specific needs and considerations of the hearing-impaired population (Gannon, 1998; Getch et al., 2001; Laitmon, 1979; Jones & Badger, 1991). This paper has identified the basic parameters of such a program. The challenges of implementing this program should not be understated (Suter, McCracken, & Calam, 2009). However, if the program designers and facilitators are culturally and contextually competent (meaning they understand, respect, and consider the complexities of the hearing-impaired population), the challenges will be navigable. The benefits of an effective sex education program are critical to the sexual health and well-being of hearing-impaired adolescents and young adults.


Card, J. (1999). Teen pregnancy prevention: do any programs work?. Annual Review Of Public Health, 20257-285.
Gannon, C. L. (1998). The deaf community and sexuality education. Sexuality & Disability, 16(4), 283–293.

Gardner, M., & Steinberg, L. (2005). Peer influence on risk-taking, risk preference, and risky decision making in adolescence and adulthood: An experimental study. Developmental Psychology, 41(4), 625–635.
Getch, Y., Branca, D., Fitz-Gerald, D., & Fitz-Gerald, M. (2001). A rationale and recommendations for sexuality education in schools for students who are deaf. American Annals Of The Deaf, 146(5), 401-408.

Hauser, P. C., & Marschark, M. (2008). What we know and what we don’t know about cognition and deaf learners. In M. Marschark, & P. C. Hauser (Eds.), Deaf cognition: Foundations and outcomes (pp. 439–457). New York, NY: Oxford Press.

Laitmon, E. (1979). Group counseling: Sexuality and the hearing impaired adolescent. Sexuality and Disability, 2(3), 169-177. doi: 10.1007/BF01100788

Jones, E., & Badger, T. (1991). Deaf children's knowledge of internal human anatomy. Journal of Special Education, 25(2), 252-260.
Moinester, M., Gulley, S., & Watson, S. (2008). The Nature of Risk: HIV/AIDS and the Deaf Community in the United States. Disability Studies Quarterly, 28(4), 12.

Sawyer, R. G., Desmond, S. M., & Joseph, J. M. (1996). A comparison of sexual knowledge, behavior, and sources of health information between deaf and hearing university students. Journal of Health Education, 27(3), 144-152.

Suter, S., McCracken, W., & Calam, R. (2009). Sex and Relationships Education: Potential and Challenges Perceived by Teachers of the Deaf. Deafness And Education International, 11(4), 211-220.

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