Sexual Health and Safeguarding Communication Displays

Introduction

We believe that people who use Augmentative and Alternative Communication (AAC) should have the same rights and freedoms as people who do not have disabilities. They have the right to make their own lifestyle and relationship choices. In order to do this, they need access to information, opportunity and the means to communicate about their sexuality and safety. The communication displays presented here evolved from Speak Up's educational programs for adults who use AAC.

What is Augmentative and Alternative Communication (AAC) and who uses it?

Why do people who use AAC need vocabulary about sexuality and abuse?

About the Vocabulary.

Who might use this vocabulary?

Selecting vocabulary for a communication display or device.

What is Augmentative and Alternative Communication (AAC) and who uses it?   [Top]

Some people have complex communication needs associated with a wide range of physical, sensory and environmental causes which restrict/limit their ability to participate independently in society. They and their communication partners may benefit from using AAC methods (ISAAC 2002).

People have difficulty speaking due to disabilities such as cerebral palsy, traumatic brain injury, developmental delay, autism etc. Having a severe speech problem affects many aspects of a person's life. It may affect one's ability to live in the community, direct one's care, find employment, discuss sexual matters and report or prevent abuse.

AAC refers to ways other than speech that are used to communicate. Most people who use AAC have a variety of communication systems. Depending on their needs and skills they usually include a number of aided and unaided communication systems.

Unaided AAC systems might include:
Voice; nodding and shaking one's head; facial expression; pointing or looking at desired objects; gestures; sign languages.

Aided AAC systems might include:
Communication displays (comprised of written words, letters or phrases, pictures or symbols); devices which speak or print out messages; call bells etc.

There are specialized AAC Services available to assist people in determining the AAC systems which best meet their needs and skills.

List of AAC services in Ontario.

Why do people who use AAC need vocabulary about sexuality and abuse?   [Top]

People with disabilities experience two to more than five times greater risk of sexual assault than people without disabilities. Abusers are most often known to their victims and are in positions of trust and authority. Abusers may be caregivers, attendants, family members, drivers, teachers (Sobsey, 1994).

People who use AAC are vulnerable to sexual assault because they may have limited communication skills and limited experience in exercising their personal rights and assertive behavior. Many AAC users who have physical disabilities require assistance with daily living tasks that brings them into contact with many different service providers throughout the day and thus increases their vulnerability for abuse.

Traditionally, AAC systems have not included vocabulary on healthy sexuality or abuse. A person who cannot communicate what has happened cannot report a crime, access the judicial system or get help. The abuser may see AAC users as the best victims as the abuse may believe that he/she will get away with the assault (Farrar, 1996).

People who use AAC and who cannot point to letters of the alphabet to spell out the words they need, can often use pictures, whole printed words or symbols to communicate. Most people who use AAC need to rely on another person to put these pictures and symbols on their displays or into their devices (although some of the newer devices give AAC users this option). People who use AAC often find that they do not have the vocabulary they need in order to communicate. This is especially the case about sexually related vocabulary and words to do with sexual abuse.

Vocabulary about healthy sexuality allows a person who is an AAC user to communicate about, question, and understand healthy sexuality. Knowing about healthy sexuality helps to identify and stop sexual assault (Farrar 1996).

The vocabulary pages developed by Speak Up are intended for people who have their AAC systems (communication displays or devices) in place, who want to learn about, and communicate about sexuality and /or sexual abuse.

The vocabulary can be used to:

• Complement a sexual health education program for children, youth and adults. It is important that people who use AAC have the vocabulary in order to ask questions and discuss these issues.
• Communicate about sex and sexual matters within the context of the person's life.
• Negotiate safer sex with a partner.
• Report and disclose incidents of sexual abuse.
• Discuss and learn about legal procedures.
• Participate in counseling sessions about sexual abuse.

About the Vocabulary   [Top]

It is important to acknowledge that people have very different attitudes and beliefs relating to sexuality. These attitudes are based on one's life experiences, knowledge, access to information, culture, sexual orientation and/or religious beliefs. Speak Up has made no attempt to censor the vocabulary presented on its communication displays. We strongly recommend that AAC users participate in selecting the vocabulary that they want on their individual displays.

Some of the pictures on the displays are explicit and have been designed for youth and adults who use AAC as a means of learning as well as communicating about sexuality and abuse. If you are using these pictures with children, we suggest that you carefully select the items that you want or check out resources that have been specifically developed for children.

The expression of sexuality has been widely acknowledged by disability advocates as a basic human right, with the censoring of sexual information and expression recognized as a form of abuse. However, for many people with disabilities, this problem of censorship persists. Speak Up believes that people who use AAC should have the same rights and freedoms as people who do not have disabilities. They have the right to make their own lifestyle and relationship choices. In order to do this, they need access to information and communication about sexuality and safety. It is for this reason that sexual health vocabulary is included on this website as an essential component of safeguarding.

People who are not fully literate may need to use the picture version and people who can read and spell may find it faster to use the printed words along with their spelling.

Not all words are represented here. It is important to use this vocabulary in conjunction with an existing communication vocabulary, which should contain frequently used nouns, action words, descriptives etc. If the person does not have an established AAC system, he/she may want to go to an AAC service. Click here for a list of Services in Ontario.

The Speak Up vocabulary can be customized for each individual by changing the pictures for other pictures that make more sense to the person using AAC; adding new words and pictures and/or moving the location of vocabulary items. To do this you must have access to the software program Boardmaker and the Sexuality PCS Library. For more information on Boardmaker and the Sexuality PCS Library visit Mayer-Johnson's web site.

An AAC clinician may also be able to assist you in making these changes.

Who might use this vocabulary?   [Top]

The vocabulary and displays presented here are intended to supplement a person's existing communication system.

In order to use this vocabulary a person must be able to recognize pictures or read words. Many people cannot do this and they require other AAC systems that meet their needs and skills.

If the person does not have an established way of communicating he or she should be referred to an AAC service or a Speech Language Pathologist.

Information about AAC services in Ontario.

Information about AAC in general. (Coming Soon!)

Selecting vocabulary for a communication display or device.   [Top]

The Speak Up displays are intended as samples.

Some people who use AAC may want to use a sample display, however most people will want to select and organize the vocabulary to suit their own individual needs.

We have used the sample displays in educational sessions as they provide a broad spectrum of vocabulary. Following these sessions, AAC users may want to program selected items into their devices, add them to their displays or have a separate private display developed to contain items about sexuality and abuse.

To support people in selecting the items that they want, we suggest that you:

• Laminate all the pages or place them in sheet protectors.
• Put the pages in a binder.
• Ask the person if he/she wants to add any needed vocabulary to their existing display or device or whether they want you to assist in developing a private communication binder.
• Spend time reviewing each vocabulary item and its meaning.
• Ask the person is he/she wants that item or something close to the meaning of that item.
• If the person is using pictures, find out is he /she likes the way it is represented or wants to use another picture.
• Mark each requested item with an adhesive dot.
• When the vocabulary has been selected, program the device or develop the display.

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