Submission 118 — True Relationships & Reproductive Health — Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability

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relati.onships & reproductive health true

Submission

to the

Royal Commission

into

Violence, Abuse, Neglect and Exploitation of People

with Disability

True Relationships & Reproductive Health

November 2019

True Relationships & Reproductive Health

230 Lutwyche Rd Windsor Q 4030 Phone: 07 3250 0240 Email: info@true.org.au Web: www.true.org.au

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About True Relationships and Reproductive Health

True Relationships and Reproductive Health (True), formerly known as Family Planning Queensland (FPQ), is the leading provider of sexual and reproductive health services and relationships and sexuality education (RSE) in Queensland. True offers a comprehensive range of clinical, counselling, education and training services in 7 metropolitan and regional locations throughout Queensland.

True’s services include:

• Education and Community Services

• Child and Family Services (Cairns)

• Cairns Sexual Assault Service

• Reproductive and sexual health clinical and education services. True has gained practice knowledge through service provision to a broad cross section of the community, including people at intersections of Aboriginality, ethnicity, migration status, age, ability, sexual diversity, gender and gender diversity. Our education and community service provision includes resource development and professional development for staff who work in settings such as:

• government and non-government organisations working in child protection and child safety, including foster and kinship carers, Community Visitors, Child Safety Officers and other OOHC professionals

• child and youth support and empowerment services

• domestic, family and sexual violence prevention and response services

• disability and sexual violence

• ability and disability services

• domestic and family violence prevention

• multi-cultural wellbeing and health

• education materials for same sex attracted, gender diverse and intersex people

• social workers and case managers, psychologists and mental health services

• educators, early learning teachers, primary, secondary and tertiary teachers • judicial and enforcement professionals such as lawyers and police in correctional

facilities and detention centres

• family support services, parent and carer community groups

• Aboriginal and Torres Strait Islander agencies and organisations

• faith-based organisations and groups

• aged care service and support agencies

• medical professionals including doctors and nurses Through our extensive practice, True have provided a broad range of sexual and reproductive health services to community and professional groups and individuals. True have outstanding expertise in developing and delivering education and resources to support healthy sexual

  development, respond to sexual behaviours, address sexual abuse and respond to

reproductive and sexual health needs. True has been working with children and young people with disability in the area of sexual and reproductive health and education since 1972. On average, 20 000 plus education participants and 20 000 plus professional participants attend True’s training and professional development sessions each year. True have also developed over 45 resources and publications on relationships, sexuality and reproductive health, many of them award winning.

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Our submission

True welcomes the opportunity to provide this submission to: Royal Commission into Violence, Abuse, Neglect and Exploitation ofPeople with Disability. The primary focus of this submission is focused on: Prevention of sexual abuse and equal opportunity to access relationship and sexuality education, information and reproductive health care. True responds to the sexuality and relationships needs of children, young people and adults with disability as well as our unique experience of more than 45 years’ working within school and community settings for the health and well-being of people with disability.

The UN Convention on the Rights of Persons with Disabilities clearly outlines the right of people with disabilities to comprehensive sexuality education, and reproductive and sexual health services, that is customised to meet individual needs, during all life stages.

In preparation for this submission True also reviewed the Final Report of Royal Commission into Institutional Responses into Child Sexual Abuse. There were several recommendations

made  in relation to access to prevention education  - of child sexual abuse that increase

children’s knowledge of sexual abuse - integrated into school curricula and linked with related areas such as respectful relationships and sexuality education. These recommendations state that this “should be mandatory for all preschools and schools”. It should also include parents, community members, and staff.

Despite these recommendations being widely accepted, many children, young people and adults with disability in Australia do not have ease of access to education or support that enables them to develop healthy relationships or express their sexuality safely.

As specified in the submission document, only the relevant questions from the submission document template have been included, with responses below commencing at Question 6.

6. Best practice and innovation: Have you been a part of a process that designed or implemented best practice or innovative models for the prevention, reporting and investigation of, or responding to violence against and abuse, neglect or exploitation of, people with disability? If yes:

a. Where and when did this occur? b. What led to this process? c. How has it been implemented? d. Has there been any evaluation or independent assessment of this model? e. What was the outcome of the independent assessment or evaluation? True has extensive experience in developing and delivering RSE in schools and community groups throughout Queensland. True is across the national curriculum requirements, best practice delivery methods, including creating a safe and engaging environment, policies for responding to disclosures of abuse and the developmental needs of children, young people and adults with disability.

Research indicates that effective sexual abuse prevention education programs are enhanced when they are taught alongside a broader RSE program. Our relationship and sexuality education resources and programs are inclusive and promote sexual abuse prevention. Studies have shown that children who receive comprehensive RSE (inclusive of sexual abuse prevention and respectful relationships education) from an early age are more likely to:

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• feel good about themselves

• understand and accept changes

• appreciate and accept individual differences

• are more likely to make informed and responsible sexual decisions later in life

• are less vulnerable to sexual abuse

• understand appropriate and inappropriate behaviours

• talk about their feelings and experiences. There is clear evidence for supporting the need for access to comprehensive sexuality education and sexual health services to meet the holistic needs of all children and young

  people. Compared to other young people, children and young people with disability

experience:

• higher rates of Sexually Transmitted Infections (STl’s), and unplanned pregnancy
• higher rates of sexual violence, abuse and exploitation • higher rates of domestic violence and are likely to remain in domestic violence

relationships for longer (than non-disabled people)

• More frequently experience problem sexual behaviours and sexual behaviours that cause concern.

For 20 years True has been funded to deliver RSE to students with disability (of all year levels) in Queensland schools. This funding is provided by Specialist Disability Support in Schools (SDSS, previously NSO) to assist students with disability to access the national curriculum in relation to RSE topics. As a result of this program, some student’s make disclosures of sexual or relationship abuse, as these topics can be a catalyst for disclosure and help-seeking. A limited number of students participate in this program each year. Many teachers/schools advise that they prefer True educators deliver these subjects as they are not comfortable, or trained, in delivering this topic area. True educators adapt the program for students with a range of disabilities such as intellectual disability, ASD, hearing or visual impairment.

8. Do you believe that a person with disability missed out on any services, care or communication that has resulted in or increased the risk of violence, abuse, neglect or exploitation because of:

a. gender, gender identity, sexual orientation or intersex status, b. age, c. being born outside Australia d. not speaking English as a first language e. any other personal attribute, reason or circumstance (please specify which) If yes, please tell us what happened.

All students should have access to RSE at school between Prep - Year 10 as these topics sit predominantly within the subject area HPE (Health and Physical Education). However, in reality most students with disability do not receive adequate RSE despite the risks and poor outcomes of not getting this information. Not all teachers, (particularly in primary school or special education settings) are trained or comfortable in delivering this subject area. Not all special school education settings prioritise this subject being taught comprehensively as it should be. Some schools believe that certain year levels are “too young” for RSE, or that students with ID are too “cognitively young” for RSE. True educators are frequently requested not to broach content around LGBTIQA+ in special education contexts. True facilitates RSE sessions that are inclusive to all sexual and gender identities and varied make-ups of families,

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and positively acknowledges the diversity that exists within society. These circumstances show a clear need for further community education about LGBTIQA+ in regards to the

inclusion  of people  with  disability  to  experiencing  diversity, and  education  about  the

importance of commencing prevention education at an early age.

Comprehensive RSE and sexual abuse prevention education helps to reduce barriers to disclosing abuse by providing:

• awareness raising of rights and responsibilities in relation to bodies and relationships

• providing communication tools such as terminology for private body parts, symbols, images and signs relating to bodies and relationships so that communication is clear and understood

• modelling of communication around these topics

• skills practice • an awareness that it is “OK” to talk to identified safe adults about bodies and

relationships

• improved skills and confidence building of carers and professionals to identify and respond indicators of harm and respond to disclosures appropriately

• increased in health literacy and the ability to seek information about sexual health from reputable and trusted services.

Evidence shows that children and young people who have received ongoing and effective personal safety, relationships and sexuality education are less vulnerable to commercial sexual exploitation and sexual abuse. They are less likely to feel guilty or shameful about their bodies and feelings. Children are more likely to disclose instances of abuse, when they have participated in a program which provides guidance for them on how to do so.

9. What  could  be done  to promote a more  inclusive  society  that supports  the

independence of people with disability and their right to live free from violence, abuse, neglect and exploitation?

All people have the right to:

• the highest attainable standard of sexual health, including access to sexual and reproductive health care services

• seek, receive and impart information related to sexuality

• sexuality education

• respect for bodily integrity

• choose their partner

• decide to be sexually active or not

• consensual sexual relations

• consensual marriage

• decide whether or not, and when, to have children

• pursue a satisfying, safe and pleasurable sexual life (World Health Organisation 2006)

Children and young people with disability often miss out on sexuality education and support that assists in the development of personal safety skills, healthy sexual development, safe and healthy decision making and a safe learning environment. Due to their vulnerabilities and specific needs, some children and young people have fewer opportunities to engage in

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‘learning moments’ and formal education about healthy sexuality and relationships and being safe. Some examples of this include:

• less opportunity to engage spontaneously with peers and limited social opportunities
• challenges in accessing and processing information independently
• negative attitudes from the community about sexuality and sexual identity
• low self-esteem, impacting on learning or willingness to learn • learned compliance resulting in reduced assertiveness and decision-making

opportunities

• less consistency in schooling and home environments. True’s programs and resources are designed to be inclusive and to meet the needs of groups or individuals. However not all people with disabilities can afford to access these services privately if they are not offered in school. Some examples include:

• Every body needs to know - A sexuality and relationships education resource for teaching people with a disability (True, 2001 - revised 2018), is an example of how information can be modified to assist with individual learning needs by using illustrated flash-cards, activity sheets and modified lesson plans for children, young people and adults with intellectual disability.

• The Every body needs to know special education project True has worked across Queensland to support students with a disability to receive sexuality and relationships education (RSE) thanks to funding provided by the Specialist Disability Support in Schools (SDSS) program, Department of Education, Training and Employment. The Every body needs to know special education project implements a whole school approach to RSE through curriculum-based resources, teacher training and student engagement.

• Looking after me program (LAMP) uses visual resources and interactive activities to support individuals with disability to access information and education in order to

understand bodies, enjoy healthy relationships and be safe.

• I have the right to be safe booklet

• Feel Safe app

• Happy & Healthy Relationships book While many different strategies are required to increase children’s safety, sexual abuse

  prevention programs play an important role in teaching children foundation skills that are

protective against sexual abuse. Prevention lessons and professional development training around this issue also builds the capacity of trusted adults to help prevent and respond to disclosures and indicators of child sexual abuse. Ultimately it is an adult’s responsibility to

keep  children  and  young  people  safe  and  educational  institutions  have  legislative

requirements and duty of care to ensure this imperative.

True supports all student’s right to this valuable and protective information such as education

about relationships,  sexuality, and reproductive health.  Including information about body

changes, consent, pleasure and where to get factual age-appropriate information about sex, bodies, and personal safety/well-being.

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10. What is already working well to encourage reporting, investigation and/or prevention of violence, abuse, neglect or exploitation towards people with disability?

Knowing how to identify and respond to sexual behaviours in children and young people helps adults to support the development of healthy sexuality and protect young people from harm or abuse.

True recommend  that RSE education and  services  delivered  to people  with  disability

commencing from early childhood in order to provide:

•  improved  skills and confidence  building  of carers and  professionals  to  identify,

understand and respond to indicators of harm and respond to disclosures appropriately

• health literacy skills development

• support for children, young people and adults to seek information about sexual health from reputable and trusted services

• comprehensive, safe, correct and age appropriate RSE

• customised services and education to meet the needs of the person with disability . Section 2: Is there anything else that you would like to share with the Royal Commission that comes within the terms of reference?

Recommendations:

1. All students with disability should have easy access to comprehensive RSE that sits within the Australian National Curriculum. Whether this education is facilitated by external professionals who work within an evidence-based framework, or appropriately trained and supported teachers/staff within the school (doing the same), access and priority to this information/education is vital.

2. Ensuring the safety and wellbeing of all in regards to the sexuality and sexual health of children and young people through protective behaviours prevention education, and comprehensive RSE education to be provided as mandatory at all year levels of schooling. While there is a compulsory curriculum for this content, currently many schools do not deliver this content adequately, inclusively, or at all.

   3. Pre-service teachers to receive training during University/Teachers College on

protective behaviours, prevention of abuse, including sexual abuse and appropriate responses to indicators of abuse and reporting abuse. As well as the importance of RSE topics for students.

4. School staff to also receive comprehensive training as well as having an understanding of the importance of relationship and sexuality education in the prevention of abuse and poor outcomes for students/people with disability.

5. Parents and carers to be included in social campaigns that help to keep children, young people and adults safer and help them to understand the importance of early

conversations about personal safety, and relationship and sexuality information and education.

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Conclusion

There is clear evidence supporting the need for access to comprehensive sexuality education and sexual health services to meet the sexuality needs of all children, young people and adults with disability. There is extensive indication that people with disability, have additional needs and are consistently represented throughout the literature as having heightened risk.

There is a substantial evidence base that reinforces the implementation of effective strategies to meet the sexuality and relationships education and information needs of children, young people and adults with disability. Specifically, an effective response requires the development and implementation of policy and guidelines, training and RSE programs for children, young

people  and  adults  with  disability and  the  people who  support them  whether   it be

parents/carers, teachers or support workers.

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