“They Go Away and Hook up On Campus”: A Qualitative Analysis of School Social Workers' Needs in Serving Adolescents with Disabilities

Background and Purpose. Many assume that adolescents with disabilities experience an asexual identity (Murphy & Elias, 2006); to the contrary, studies have found that they engage in sexual activity at similar levels to their peers (Gordon et al., 2004). Moreover, youth with learning disabilities may be at greater risk of contracting sexually transmitted infections (STIs) and experiencing teen pregnancy (Mandell et al., 2008). Sex education is often not offered to adolescents with disabilities in special education, however, and may not be appropriately designed for adolescents with mild disabilities within regular curricula (Murphy & Elias).  Social workers serve a crucial role in assisting adolescents with disabilities to understand sexual risk, and to support them in developing healthy sexual relationships. The present study sought to understand adolescents with disabilities’ sexual experiences from the perspectives of school social workers, and to explore social workers’ needs in working with these youth.

Methods. Purposeful and theoretical sampling methods were used to recruit school social workers with an MSW degree, at least two years of practice experience (M=10.44), and that work primarily with adolescents with disabilities. All were from an urban setting of a Southwest state (N=12; 9 females). Semi-structured interviews were digitally-recorded and transcribed verbatim. An open codebook was developed via a form of inductive content analysis where weight was given to repetition, specificity, similarities and differences, linguistic connectors, emotionality and extensiveness. Codes (themes) emerged from the data itself rather than from a pre-existing theoretical framework in line with a phenomenological study design and in order to give voice to school social workers’ perceptions and experiences.

Results.  A prominent theme discussed by school social workers was the need to provide appropriately-tailored pregnancy education and support for adolescents with intellectual disabilities, a population they felt was particularly at risk for misinformation and confusion. Social workers often provided individualized sexual education to such youth, given that cognitive impairments required support in knowing how to become pregnant (e.g., “They think it’s from French kissing.”), how to seek resources, signs of pregnancy (e.g., “We have a girl who…went across the street to the neighbor’s house and had the baby. She didn’t know she was pregnant.”), and the consequences of pregnancy. Despite abstinence-only policies, which many felt limited their ability to effectively work with adolescents with disabilities, some had created services and programs for sexual education. Social workers felt there was a need to better prepare them for direct practice serving adolescents with disabilities towards sexual health (e.g., “I think most social workers are just floundering…because it is so complicated and having to address each case.”).  

Conclusion and Implications. Findings indicate that school social workers often address pregnancy concerns (i.e., both prevention and intervention) among adolescents with disabilities. Social work education should include preparation for working with these youth towards sexual and dating health, especially in school settings where abstinence-only education is commonplace and adolescents with disabilities are often not offered appropriately-tailored sexual health curricula. Perspectives from school social workers provide avenues for future research concerning social work practice.