Sexual Health Services

Everyone has the right to have healthy, consensual relationships. Historically, resources for sexual health and education for individuals with intellectual and developmental delays (I/DD) have been limited and censored. However, we know that individuals with developmental disabilities have sexual encounters at a rate commensurate to their peers without disabilities and experience sexual assault and rape at a rate seven times higher than their peers without disabilities. In Nebraska, only 37% of adult females with I/DD have received a pap smear in the past three years, a routine preventative care recommendation, compared to 70% of adult females without I/DD nationally. Therefore, education and resources related to sexual health are vital to the health, safety and happiness of our community.

Munroe-Meyer Institute has developed a multidisciplinary team consisting of occupational therapists, psychologists, physical therapists, and recreational therapists to address this critical area of need. Clinicians have assembled a resource library for individuals and families, fostered relationships with local organizations and explored national networks to provide resources for individuals with I/DD, their families and caregivers.

Plain language: We have sexual health services for people with disabilities and can connect you with other resources too.

What services do I need?  

Few people with I/DD have been provided with developmentally appropriate, comprehensive sex education, so this is an area of need for almost everyone and a great place to start. Families and staff may feel comfortable tackling this on their own, and MMI also holds workshops that provide tips for successfully communicating about sexuality with your children and clients. If individuals with I/DD or families have one specific question, Munroe-Meyer has many professionals who have completed the Askable Adults Matter Training (PDF) and would be happy to try to answer your question and direct you to any appropriate related resources.

If you think you may benefit from a specific discipline, read more about them below and contact the appropriate provider. If you’re unsure, our staff will be happy to help you decide. Please direct general inquiries and Askable Adult questions to Barb Glover at 402-559-6483 or email.

Plain language: Call Barb at 402-559-6483 or e-mail her at bglover@unmc.edu if you want to figure out what services you need.

What is community-based education?  

Carly De Bruin, MPA, CTRS, has been trained in the ELEVATUS curriculum specifically for people with I/DD, their families and staff members working with them. This evidence-based, comprehensive and trauma-informed curriculum will be offered for people with I/DD at Munroe-Meyer at certain times during the year. It covers tough topics such as: puberty in males and females, consent, gender identity, social media safety, pornography, masturbation, STI prevention, pregnancy, healthy friendships/relationships and appropriate expression of sexuality through public and private behaviors. The information will be age-appropriate but is provided using developmentally appropriate techniques.

Education should begin in the home. The curriculum also includes workshops for families on how to talk to their kids about topics related to sexuality. These workshops will be offered intermittently throughout the course of the year. It is the responsibility of clinicians to provide medically accurate, fact-based education on sexuality, NOT to express personal values related to sexuality. This workshop gives parents the tools to open honest lines of communication with their children about sexuality and share their personal opinions and values about the topic.

Adults with I/DD are often served by residential and employment programs. These new settings provide novel challenges related to sexuality as adults are introduced to a new group of people and relationships develop. Support staff and administration are often left to handle these challenges alone, which is why the ELEVATUS curriculum also provides workshops for service providers. These workshops will be offered on a request basis.

Plain language: Carly can provide sex education for people with disabilities, their families, and service provider support staff.

What does occupational therapy do?  

Samantha “Sam” Montemarano, MOT, OTR/L, is an occupational therapist who can serve adolescents and adults in an outpatient capacity to address activities of daily living related to sexuality and relationships including: personal hygiene, adaptive equipment for intimacy, health care management, home and bedroom management and money management. She can assess current functional status and help determine needs. A prescription for occupational therapy can be obtained from your primary care physician.

Plain language: Sam can help you with activities related to healthy sexuality and living.

What does psychology do?  

Lisa Neitzke, PhD, LMHP, PLP, is an adult provider at MMI who has treated behavioral sexual health issues at Beatrice State Developmental Center and for Nebraska’s Department of Health and Human Services. Lisa can administer an assessment called the Socio-Sexual Knowledge and Attitudes Test-Revised (SSKAAT-R) to determine an individual’s current understanding of relationships and sex. She also is able to treat expressions of inappropriate sexual behavior.

Plain language: Lisa can help people find out what they understand about sex, and with behavior problems.

What does physical therapy do?  

Anne Woodruff Jameson, PT, DPT, is a pediatric physical therapist who has completed specialized training in pelvic floor physical therapy and pediatric incontinence. She can treat youth, adolescents and adults with I/DD who are experiencing urinary and/or fecal incontinence, pelvic pain and physical barriers to engaging in sex. Many individuals with I/DD would benefit from extra education regarding their genitalia and how to keep it healthy and with additional training in contracting and relaxing pelvic floor muscles in preparation for insertion of tampons, routine gynecological exams or sexual activity. Annie can provide this extra support. She also can consult on pregnancy and postpartum care. A prescription is needed from your primary care physician for pelvic floor physical therapy. Please see the flyers below for additional information:

Plain language: Annie can help people who are having problems peeing, pooping, with sex, or pain in their private parts.

What does recreational therapy do?  

Currently, recreational therapy is providing all of our community-based sex education. Future goals for expanding this program include offering 1:1 and group services in community accessibility related to skills obtaining and maintaining relationships, including friendships and romantic relationships. Additionally, we hope to offer 1:1 a la carte sex education classes for individuals who may need extra reinforcement on certain topics.

Plain language: Learn about sex and more services will be offered in the future.

What do you have in your resource library?  

Munroe-Meyer Institute offers a resource library for individuals and families to come explore books and equipment to see if it is something they would like to purchase for use at home. Families also are welcome to schedule a time to come read the books together at MMI. Contact Barb Glover at 402-559-6483 or email to schedule an appointment.

Unfortunately, in order to ensure resources always continue to remain available for families, check-out is not an option. However, many of these resources are available for check-out through the Omaha Public Library.

Plain Language: You can schedule an appointment to come look at our sex education books and equipment listed below. Call Barb at 402-559-6483 or e-mail her at bglover@unmc.edu.

Books

The Tom and Ellie Series [link]

Girls Growing Up on the Autism Spectrum [link]

Girls Growing Up on the Autism Spectrum: What Parents and Professionals Should Know About the Pre-Teen and Teenage Years [link]

The Growing Up Book for Boys: What Boys on the Autism Spectrum Need to Know! [link]

The Growing Up Guide for Girls: What Girls on the Autism Spectrum Need to Know! [link]

The Autism-Friendly Guide to Periods [link]

Sexuality and Relationship Education for Children and Adolescents With Autism Spectrum Disorders [link]

Teaching Children with Down Syndrome about Their Bodies, Boundaries, and Sexuality [link]

Boyfriends & Girlfriends: A Guide to Dating for People with Disabilities [link]

Doing What Comes Naturally [link]

Asperger's Syndrome and Sexuality: From Adolescence through Adulthood [link]

Guide to Getting It On! [link]

What Makes a Baby [link]

Sex Is a Funny Word: A Book about Bodies, Feelings, and YOU [link]

Equipment

Pleasure Able Sexual Device Manual for Persons with Disabilities [link]

Intimate Rider [link]

MJ Weightless Multifunctional Position Bouncer Bedroom Chair [link]

WETPIA Adjustable Padded Thigh & Neck Restraints Bondage - Thigh Spreader Restraints for Therapeutic Support [link]

What other local resources are available?  
  • Women’s Center for Advancement provides free, high-quality legal, counseling and educational services to victims of domestic violence, assault and trafficking. MMI has a parent resource coordinator embedded in the WCA to make sure victims with I/DD are getting comprehensive care and all the help they need.
  • Planned Parenthood of the Heartland provides free, 1:1 evidence-based sex education. They currently have an educator, Sam Carwyn, who is a former special education teacher. Appointments can be made to work specifically with Sam to address sex education needs.
  • The Women’s Fund of Omaha runs the Adolescent Health Project and Askable Adults Matter Training program. They are engaged in many efforts throughout the region to increase sexual literacy and are working closely with MMI to make sure these efforts are inclusive of and accessible to people with I/DD
  • Ollie Webb Center, Inc. and the Down Syndrome Alliance of the Midlands offer intermittent classes on healthy relationships and boundaries. Please contact those agencies for current class offerings.
  • There are two local sex therapists who have worked with people with I/DD:
  • People First of Nebraska Self-Advocate Group is the only statewide advocacy organization in Nebraska run BY and FOR people with any disability. They have partnered with MMI to develop and disseminate sexual health information.
What online resources are available?  

ACOG (The American College of Obstetricians and Gynecologists) Guidelines
Guidelines for your OBGYNs on working with women with I/DD [link].

Amaze
Animated videos for school-aged youth about sex, your body, and relationships [link].

National Council on Independent Living (NCIL)
A sex education video and guidebook series by and for people with I/DD [link]

Organization for Autism Research
A sexuality and sex education resource specifically written for people on the Autism spectrum ages 15+ [link].

Resource Binder for Disability and Reproductive Justice [link]

Universities of Oregon [link] and University of Wyoming [link]
Both universities have staff dedicated to keeping their websites updated with national resources for sexual and reproductive health for people with I/DD and their families.

Vanderbilt Kennedy Center
A parental guide on puberty for boys and girls [link].

Women Enabled International
Provides practical and concrete guidelines for making gender-based violence and sexual and reproductive health rights services more inclusive of and accessible to women and young persons with disabilities [link].