Healthy Sexual Growth Phenomenon in Children with Mild
Retardation and the Role of Parents in Providing Sex Education
Arbania Fitriani
Faculty of Psychology, Universitas Esa Unggul, Jl Arjuna Utara No. 9, Jakarta, Indonesia
Keywords: Retardation, Mild Retardation, Sex Education, Parents.
Abstract: This Study aims to investigates what is the role of parents with mild retardation children in efforts to provide
sex education. The researcher also wants to see the health of sexual development as well as the problems that
arise in connection with these aspects. The method used in this research is a qualitative method. The technique
used in collecting data is interview and observation techniques. Data collection tools in this study were
interview guidelines, observation sheets, and tape recorders. The number of subjects is 4 people, 3 of them
are mothers and 1 subject is significant others/aunts. From the results of the study, it was found that all subjects
had implemented sex education within the guidelines of the American Association of Pediatrics without them
knowing it. The average subject applies democratic parenting and sometimes is overprotected. All subject
children experienced healthy and normal sexual development. In the sexual aspect, the support needed for
children who are female is greater than men. The party most involved in providing sex education is the mother.
The factor that makes the subject willing to apply sex education is fear if the child experiences something
unpleasant in the aspect of his sexuality.
1 INTRODUCTION
Basically, mentally retarded children can have
characteristics that are not much different from
normal individuals. Today, many experts use the term
educated mentally retarded individuals who do not
receive stimulation from the environment due to
inadequate parenting or due to genetic factors
(Hallahan & Kauffman, 1994). Education can be said
as one form of stimulus that becomes an important
and meaningful thing for mentally retarded persons.
The provision of education for individuals with
mental disabilities / mental retardation in Indonesia
has a strong legal foundation since 1945
(Mangunsong & Dkk, 1998).
One form of education needed by mentally
retarded persons who are able to educate is sex
education. According to Grossman (Payne & Patton,
1981) mentally retarded people also have a sex drive,
can fall in love, and desire to get married. What
Grossman has mentioned is consistent with what is
written in the American Academy of Pediatrics in the
Sexually Education of Children and Adolescents with
Developmental Disabilities (With & Policies, 2019),
"persons with disabilities have similar curiosities,
drives, and interests in their own bodies and in the
bodies of the bodies of the bodies of others". This
makes it clear that people with intellectual disabilities
especially those who are able to educate apparently
also have sexual needs as normal individuals. The
existence of sexual needs automatically gives right
birth to the need for sufficient information about
fulfilling those needs in accordance with the values
that can be accepted by the surrounding community.
Sex education during the formation of children is
very important. This education needs to avoid the
occurrence of hidden experiments that can cause
guilt, shame, fear, or other difficulties in adulthood
later (Marisa, 2019). The attitude of parents who are
ashamed to provide sex education will make children
afraid to ask. Whereas for mentally retarded people
who are able to educate, lack of information is a
dangerous condition because they might carry out
sexual experiments so as to have a negative impact on
the child. This sex education then becomes very
important to be given to mentally retarded persons
because as revealed by (Thompson & Grabowski,
1978), one of their characteristics is sexually
promiscuous or having sexual relations with anyone
(freesex). This is certainly not healthy for the
individual.
108
Fitriani, A.
Healthy Sexual Growth Phenomenon in Children with Mild Retardation and the Role of Parents in Providing Sex Education.
DOI: 10.5220/0009567401080120
In Proceedings of the 1st Inter national Conference on Health (ICOH 2019), pages 108-120
ISBN: 978-989-758-454-1
Copyright
c
 2020 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved

Van Dyke (Dyke, McBrien, & Sherbondy, 1995)
states that as humans, individuals with disabilities
have the same rights as normal individuals in
expressing their sexual needs so as to get satisfaction.
A similar thing was also expressed by Fegan & Rauch
(Fegan & Rauch, 1993) that the right to express
sexual needs in individuals with disabilities is a
fundamental right. Like normal individuals, mentally
retarded people also need to get sex education to
avoid hidden experiments that can cause difficulties
in the future.
Providing sex education to persons with
intellectual disabilities - especially those who are
capable of educating - is important for developing
intellectual levels, helping to achieve healthy
sexuality, preventing unwanted pregnancies and
sexually transmitted diseases, and overcoming other
problems relating to their sexual functions (Schwab,
1992). Cognitive and cultural limitations in the
adaptive function of people with intellectual
disabilities make them often experience sexual
problems that are quite alarming. Van Dyke (Dyke et
al., 1995) state that the cognitive and language
barriers they experience can predispose to unwanted
pregnancy, sexually transmitted diseases, and sexual
exploitation.
Much research has been done relating to the
existence of sexual exploitation and sexual abuse
experienced by people with intellectual disabilities.
Schwab (Schwab, 1992) states that:
Numerous expect in physical and sexual abuse
acknowledge that mentally disabled individual is
particularly vulnerable to sexual exploitation and
abuse.
Ridington in The Disabled Women's Network of
Canada (Nosek & Howland, 1998) examined 245
women with disabilities and found 40% of them were
exploited, and 12% were ‘molested’. Another study
conducted by Sobsey & Doe (Nosek & Howland,
1998) found that of 166 cases of exploitation, 70% of
them were individuals who experienced impairment
in cognitive aspects. In a survey of 62 women by The
Ontario Ministry of Community and Social Services
(Nosek & Howland, 1998), it was found that the ratio
between women with disabilities and normal women
who experienced violence was 33% vs. 22%. While
those who experience sexual abuse the comparison is
40% vs. 37%. It was also reported from the recorded
history of sexual abuse, it was found that 25% of
adolescent women with mental retardation
experienced unhealthy sex treatment.
In addition to the possibility of experiencing
sexual exploitation, persons with intellectual
disabilities who have cognitive limitations that have
implications for understanding the sexual aspects
they have are also very at risk for contracting sexually
transmitted diseases. In a study conducted by Stone
(Van Dyke et al 1995), it was found that individuals
with disabilities have an increased risk of contracting
sexually transmitted diseases (STDs) 50–90% of
which are the risk of contracting gonorrhea. Jacobs et
al (Jacobs & Et al, 1989) stated that the presence of
special characteristics such as impairment in the
intellectual aspect of people with intellectual
disabilities causes the risk of becoming infected with
the HIV virus to be as high as the normal population.
Another form that may be experienced by persons
with intellectual disabilities as a result of their
inheritance is child neglect. One form of child neglect
according to Ann (Welfare & Gateway, 2019) is
Educational neglect which is an error in providing
education in special needs. One of those special needs
is sex education.
Parents have the right to demand the best service
for their children who experience obstacles in every
aspect of a child's life, especially difficult aspects
such as sexual aspects (Fegan & Rauch, 1993). Along
with these rights, the obligation to provide education
to children, which must be fulfilled by parents, where
parents have the biggest responsibility in fulfilling
children's education (Pohan, 2011). The education
referred here is not only formal education but
includes informal education which includes sex
education. According to Brock & Jenning (Aini,
2001) parents are an element that is often missing in
sex education. It has been mentioned before that
underdeveloped children including mentally retarded
people who are also able to educate also need sex
education. The consequence of these needs is the
emergence of demands that must be met by parents of
mentally retarded persons.
It should be recognized that the provision of sex
education to people with intellectual disabilities
especially those who are capable of educating is still
a matter of controversy. Talks about sex education are
often rejected by parents of people with intellectual
disabilities. Rejection is caused by several things as
mentioned in the Journal of Pediatrics vol. 97, no.2
(1996). The first refusal was due to the parent's focus
on the inability of the child rather than the child itself.
Furthermore, it is caused by the fear that if the talk
about sexuality will encourage unwanted sexual
behavior and fear of pregnancy or exploitation.
Another reason is the difficulty in deciding what to
say and how. The final reason is the parents'
uncertainty about the extent to which the child will
understand what has been said.
Healthy Sexual Growth Phenomenon in Children with Mild Retardation and the Role of Parents in Providing Sex Education
109

During this time many misunderstandings about
people with intellectual disabilities associated with
efforts to provide education to them. One of the
biggest misconceptions according to Thompson
(Thompson & Grabowski, 1978)is "it is not
appropriate and / or not worthwhile to attempt to
educate and train the retarded resident". Mangunsong
et al. (Mangunsong & Dkk, 1998)says that,
The consequence of a negative view of mentally
retarded children is that they are not only
prevented from doing what they can do but also
to develop the skills they are actually able to do.
... Only because of his intelligence, mentally
retarded children are distinguished, exploited
and deprived.
This assumption that mental retardation is not
suitable for education or training has a negative
implication on the effort to provide information in the
form of sex education to persons with intellectual
disabilities.
Moving on from the aforementioned phenomena
along with the lack of research on the importance of
sex education for mentally retarded persons
especially those who are capable of educating in
Indonesia, the problem arises to be investigated. The
problem to be investigated is how the role of mentally
retarded children's parents can be educated in efforts
to provide sex education. Another problem to be
investigated is how the description of the sexual
development aspects of mentally retarded people can
be educated and the forms of support needed in order
to achieve sexual development that is physically and
psychologically healthy.
The subjects in this study were parents of mentally
retarded children who are able to educate. However,
the researcher will only interview one parent or
significant others. The reason of the subject chosen
because based on Thornburg's research (Aini, 2001)
it was found that 17% of sex education comes from
mothers and approximately 2% comes from fathers.
In addition, according to Hassiotis and Heller et al.
(Porter & McKenzie, 2000) mothers are more active
in the care of children. Mothers are also those who
pay more attention to emotional stress in the family
in relation to child obstacles and also demands for
care and other support needed by children with
disabilities (Koegel et al. In Porter & McKenzie,
2000). And most importantly the mother who is often
more involved in providing therapy or providing
education to children with disabilities (Padeliadu in
Porter & McKenzie, 2000). Another consideration is
the stage of development of children in general, as
seen in everyday life and in literature such as Papalia,
Olds, & Feldman (Papalia, Olds, & Feldman, 2001),
it is the mother who follows the stages of the child's
development more than the father. Therefore,
researchers assume that the mother will be better in
order to answer the research questions, especially for
things that are still very sensitive, namely the aspects
of child sexuality. The method used by researchers is a
qualitative method using interviews and observation
methods. The choice of this method was based on
consideration of the sensitivity of the problem, namely
the aspect of child sexuality which is still classified as
a taboo in Indonesia (Pohan). In addition, by using
qualitative methods it is expected that in-depth
information can be explored even more broadly.
2 METHOD
2.1 Subject Research
Sample in this study is one of the parents of
individuals with mild retardation or significant others.
Characteristics of mentally retarded people who are
classified as able to educate that can be known
through a child's IQ that is 55-69 (Wechsler) or 55-68
(Stanford-Binet). Another characteristic that must be
possessed by persons with intellectual disabilities to
be subjected to this study is adolescents aged at least
15 years with the consideration that the most late age
for mentally retarded children is experiencing puberty
is 14 years (Elkins et al. In Van Dyke et al, 1995).
While parents are one of the subjects' parents and
mothers are preferred because based on research the
mother is the biggest contributor in providing sex
education to children so that the information obtained
can be richer and more in-depth. But it is also possible
to interview fathers or other significant others if it
turns out that in the field it is difficult to meet these
standards. Parents or significant others to be
interviewed have a minimum high school education
background. This limitation because the subject's
education level will affect the subject's ability to
understand and answer the researcher's questions.
2.2 Data Collection Technique
In general, a qualitative approach uses a purposive
approach in which samples are not taken randomly
but are instead chosen according to criteria
(Poerwandari, 1998). Based on this fact, the
researcher will use a purposive technique in selecting
research subjects as the main technique, namely
sampling based on a particular theory, or based on
operational constructs (theory-based operational
ICOH 2019 - 1st International Conference on Health
110

construct sampling). This respondent is chosen based
on willingness and availability.
According to Sarantakos (in Poerwandari, 1998),
sampling techniques in qualitative research generally
display characteristics (1) directed not at large sample
sizes, but in typical cases according to the specificity
of the research problem; (2) not determined rigidly
from the start, but can change both in terms of the
number and characteristics of the sample, according
to the conceptual characteristics developed in the
study; and (3) it is not directed at representativeness
(in the sense of a random number/event) but rather on
a context match.
Furthermore, Patton (in Poerwandari 1998) said
that a qualitative study could conduct in-depth
research on a single case (n = 1) that were chosen
purposively. Therefore, the number of subjects in this
study was set at 4 (four) people, parents or significant
others who are considered to understand the child's
history of growth and development broadly,
especially all matters relating to aspects of child
sexuality. The reason for choosing the sample size of
4 people is because with this amount it is expected to
be able to dig up all the information needed to answer
this research question. It is also possible that the
number of samples selected will increase or decrease
according to the availability of subjects to be studied,
as well as the developing conceptual understanding.
In qualitative research, there are several methods
that can be used to collect data including interviewing
techniques, observation, focus group discussions,
analysis of documents or relics (film works, written
works, or other works of art), or analysis of audio-
visual material (Poerwandari, 1998). In this study, the
author will use in-depth interviews with mentally
retarded children's parents. The author will also use
the method of observation of the subjects being
interviewed as additional data to understand the
answers given by the subject to the researcher's
questions.
In this study, variations that will be used are
interviews with standardized guidelines. The use of
this variation is intended so that the discussion does
not extend to things that are not relevant to the
research objectives. In addition, this technique is
expected to facilitate the classification of information.
The researcher must also pay attention to the
guidelines in the formulation of the interview.
According to Smith et al. (in Poerwandari, 1998)
questions must be neutral, avoiding using
sophisticated, official, or too high terms, especially in
interviewing individuals who do not represent the
scientific or professional circles. Finally, researchers
should also use open-ended questions.
2.3 Data Collection Tools
2.3.1 Interview Guidance
This interview guide is useful so that the interview
does not widen from the predetermined themes. This
interview guide is made based on the problem to be
examined and adjusted to the existing theory. The
following is a list of the questions in the interview
guide.
2.3.2 Observation Sheet
This sheet will be used to record important things that
happened during the interview situation and also
during the research. What will be done by researcher
in accordance with Banister et al (in Poerwandari,
1998), namely: (a) description of the context
(including date, time, and place of observation); (b) a
description of the characteristics of the people
observed; (c) a description of who made the
observation; (d) a description of the behavior of the
person being observed; (e) the interim researcher's
interpretation of the observed event; (f) consideration
of alternative interpretations; (g) exploration of
feelings and appreciation of the researcher towards
the observed event.
2.3.3 Recorder Device
A recording device is used to record the dialogue that
occurs during the interview process so that it can
facilitate researchers in the processing. This recording
device is in the form of a tape recorder that is used if
the respondent agrees to use the device during the
interview process.
2.4 Research Procedure
2.4.1 Research Preparation
a. Making research instruments. Before the
research is carried out, the researcher first prepares a
research instrument in the form of interview
guidelines and observation guidelines. Interview
guidelines are made based on the problems in this
study and adjusted to the theory. While the
observation guidelines are based on guidance in
qualitative research theory. After getting feedback
from the supervisor, the researchers then tested the
research instruments that were made on the mothers
of mentally retarded individuals. This trial aims to
find out how far the instrument is able to dig up the
data needed to answer the research problem.
Healthy Sexual Growth Phenomenon in Children with Mild Retardation and the Role of Parents in Providing Sex Education
111

Table 1: Interview Guidance.
Dimension
Items
Child Growth and
Development
1. What is the condition of the mother and
the environment around the mother when
she is pregnant? 2. What is the condition of
the child while still in the womb? 3. What
are the child's birth history and health? 4.
What is the child's growth and development
history before schooling? 5. What are the
child's overall growth and development
history? 6. What form of parenting is given
to children to stimulate their growth and
development? 7. Since when did you know
that your child is different from a normal
child?
8. How did you react when you first found
out and what were the next actions? 9. What
kind of support does your child need for you
in relation to the obstacles experienced by
the child?
Factors Affecting
Parenting
1. Are there different forms of parenting
form before and after learning that the child
is experiencing obstacles? 2. Are there
different forms of parenting form in
childhood and in adolescence? 3. Do
siblings, childhood friends, neighbors,
office friends (if you have one) give support
to you in caring for children in order to help
children to adjust to their environment? 4. In
general what form of parenting do you apply
to children (specifically for the subject)?
Child Problems
Related to the
Aspects of Child
Sexuality and the
Roles of Parents
1. What age does the child experience
menstruation and what is the child's
menstrual cycle? 2. How does the child
adjust to the menstruation he experiences
and how is your role in helping the child to
adjust? 3. Does the child's secondary organs
(eg breast growth, hair growth, etc.) develop
normally? 4. How does the child adjust to
the changes he/she experiences in the
secondary organs and your role in helping
the child to adjust? 5. Does the child ever
date or have the intention of dating or have
shown interest in the opposite sex? 6. If yes,
what is your role in providing understanding
to children about dating/attraction with the
opposite sex and how do you provide this
understanding? 7. If not, have you or others
ever talked about dating or feeling attracted
to the opposite sex? 8. Does the child ever
express the desire to get married? 9. If so,
what is your role in providing understanding
to children about marriage and its
consequences and how do you provide this
understanding? 10. If not, have you or others
ever talked about marriage to children? 11.
What do you think sexual harassment is? 12.
Has the child ever been sexually abused? 13.
If so, what impact did this have on the child
after being sexually abused? 14. If not, what
are your efforts to protect your child to avoid
sexual harassment? 15. Have you ever told
your children about husband and wife
relationships (sexual intercourse) and the
impact if done outside of marriage and with
just anyone? 16. If yes, how do you convey
it and if not do you have a plan to deliver it?
17. Have you ever told your child that your
child can one day conceive and have a baby
and then teach your child how to care for
and raise the baby? 18. If yes, how do you
convey it and if not do you have a plan to
deliver it? 19. Do you know about sexually
transmitted diseases and how they are
transmitted? 20. Have you ever talked about
sexually transmitted diseases to children and
how sexually transmitted diseases can infect
children? 21. If yes, how do you convey it
and if not do you have a plan to deliver it?
22. Have you ever told your child about
contraception and its uses, why it is used,
and when it can / should be used? 23. If yes,
how do you convey it and if not do you have
a plan to deliver it? 24. Has the child ever
played his own genitals? 25. If so, what are
your actions and if not, have you taken any
anticipative actions to prevent the child
from doing this? 26. In general, what kind of
support do children need for their parents in
adjusting to the development of child
sexuality?
Sex Education
1. What do you think about sex education?
2. Do you apply sex education to children in
the home? 3. If so, what factors made you
willing to apply it, what form did it take, and
since when was it given? 4. If not, will you
apply it, what factors make you willing to
apply it, and when will you start to give it?
5. According to you, who has the most role
in giving effort sex education to children? 6.
What are your hopes for providing sex
education to children?
Another aim is to find out how far this instrument can
be understood by the subject. After that, the
researcher re-consulted the research instrument to the
supervisor and then made improvements until it was
ready to be used in field research.
b. Selection of research subjects. The subjects
chosen in this study were subjects who had criteria
previously determined by the researcher.
c. Contact Dr. Soemiarti Patmonodewo to ask
permission to conduct research at the foundation that
she manages namely SLB-C Swakarya.
d. Contacting the head of SLB-C Swakarya to ask for
help to provide subjects in accordance with the
criteria needed by researchers.
e. Contact one by one of the subjects who have been
willing to participate in this study to make an
interview appointment.
f. Conduct interviews at the home of each subject in
accordance with the agreement that has been made.
2.4.2 Research Implementation
Interviews were carried out in some time. For the first
subject, interviews were conducted three times,
ICOH 2019 - 1st International Conference on Health
112

namely on 17 March, 24 May and 9 June 2019. For
the second subject, interviews were carried out twice,
on 7 March and 9 June 2019. For the third subject,
interviews were conducted twice, on March 17 and
June 14, 2019. While for the fourth subject,
interviews were conducted on April 3 and June 14,
2019. The interview process was carried out for
approximately 45 minutes. Interviews were
conducted using a tape recorder. When one side of the
tape runs out the researcher hears the recording again
to ensure that the dialogue is recorded properly. At
the time of the interview, the child who was the focus
of the study was not far from where the interview took
place so that sometimes the researcher or subject
interviewed asked the child something to confirm the
answer given. After completing the interview
process, the researcher then typed the results of the
interview verbatim to be further analyzed.
2.4.3 Data Analysis Technique
In analyzing the data that has been obtained, the
researcher tries to follow the steps in the analysis of
data put forward by Patton (in Poerwandari, 2001: 85),
1. Change the raw data in the form of sound
recordings into written form verbatim, through
the transcription process of recorded
discussions and interviews.
2. Read the data over and over to find out the
topics that emerge and get an overview of the
overall data.
3. Coding and grouping data on each subject into
categories according to the research problem.
4. Arrange chronological data summaries.
Analyzing data that has been coded and
categorized. The analysis was carried out
individually for each subject in the interview
to find out their dynamics and experience.
5. Make a comparison of the images and analysis
results and all subjects in the interview to get
the general analysis results.
6. Trying to explain the results of the analysis
based on the theory that has been compiled.
3 RESULT
3.1 Overview of Subject Demographics
The following table provides a general description of
the personal data of the interviewees.
Table 2: Subject Overview.
I
II
III
IV
Age
46
51
33
38
Religion
Moslem
Moslem
Christian
Moslem
Ethnic
Java
Java
Java
Betawi
Education
High School
Academy
High School
High
School
Occupatio
n
Housewive
Housewive
Housewive
Housewive
Age of
children
22
20
18
19
Relation
Mother of
Subject
Mother of
Subject
Sister of
subject
Mother of
Subject
3.2 Subject I (S)
3.2.1 Form of Support
In general, S gets all the forms of support he needs.
Subjects have also provided adequate stimulation to
S. The greatest support was obtained from the
parents, especially from the subjects themselves. In
the aspect of emotional support, the subject tried to
support S by paying attention in the form of empathy
to the activities he was doing so S felt that he was
noticed by his parents.
Through the emotional support obtained by S
from the subject of the activity that S is doing, the
subject indirectly has fostered in him the feeling of
being able and valued. In addition to information
support and appreciation, subjects also provide
instrumental support both short-term such as S daily
needs and long-term needs such as assets for the
future of S.
The subject also always gives S direction, advice,
and information about important things in life that
need to know both personal and social.
Socially, S gets meaningful support from where S
usually moves. The most significant support from the
social environment S is praise for the activities that S
is doing so that it indirectly fosters confidence and
feelings of respect. In addition, according to the
subject, S also gained a lot of understanding about the
aspects of sexuality from the surrounding
environment ie from the S study site.
Among all the support S received from both the
subject and S social environment, the most significant
support related to his inheritance was love and
Healthy Sexual Growth Phenomenon in Children with Mild Retardation and the Role of Parents in Providing Sex Education
113

understanding. In addition, another support is
assistance that the subjects provide in terms of
meeting their personal needs.
For the aspect of sexuality, S needs support,
especially in terms of understanding and assistance if
S experiences problems in terms of sexuality such as
the venereal disease that he is experiencing.
3.2.2 Sex Education
In general, aspects of sexuality of S develop like
normal individuals. S secondary organs such as voice
changes and secondary hairs grow normally. S is
quite able to adapt well to the changes that he
experiences in relation to changes in secondary
organs even though he still needs some help from the
subject.
Like men in general, S also has wet dreams. Based
on information from the subject, S also knew the
concept of shame related to aspects of sexuality since
S was a child.
Regarding the desire to date and get married,
according to the subject, S has not thought too much.
However, subjects still hope that someday S will get
married.
Until now, the subject and husband have not
provided yet an understanding of the concept of
marriage because they think S is still too small now.
Subjects plan to provide an understanding of marriage
after S is considered to be mature enough. The subject
also sometimes gives advice or informs about norms
in dating or marriage matters. Giving an
understanding of aspects of marriage or dating is
usually done by S parents when relaxed and as a joke.
For a life partner, S don’t want a girlfriend or a
wife, those who experience disabilities like him. S
prefers a woman who is normal and can give full
affection. Related to the sexual aspect, S encountered
venereal disease.
For the issue of sexual harassment itself, subjects
said that S had never experienced it. To prevent
sexual harassment, the subject reminds S to always be
careful and also monitor to whom and to where S
went. Based on the subject's knowledge, S seems to
understand the concepts of reproduction, parenting,
sex and their effects if done freely. This
understanding is obtained from every day’s
observations or from the subjects themselves. Usually
the subject gives an understanding to S about sex
when S asks.
Apart from his parents, S also gained an
understanding of sexual relations from religious
lectures he used to attend at the mosque and also from
TV or from pictures in magazines. For sexually
transmitted diseases, subjects often remind S of the
dangers of the disease and also explain how it is
transmitted. The subject gives understanding to S
usually if it happens to be being broadcast on TV. S
already understands the rules in the religion that he
adheres to the Shari'a which he must follow if he
releases sperm after he has masturbated or after a wet
dream. The subject also often gives an understanding
of the risks that would be experienced if he frequently
masturbates.
An understanding of contraception has not been
given to S because the subjects consider that S is still
too small and that one day S will understand himself
after marriage. In addition, the subject also considers
that even if she explain to S, he will not understand
due to the lack of intellectual function of S.
An understanding of contraception has not been
given to S because the subjects consider that S is still
too small and that one day S will understand himself
after marriage. In addition, subjects also assume that
even if explained S will not understand the lack of
intellectual functions due to lack of S.
A form of sex education that is preferred by the
subject to be given to S is the provision of
understanding of hygiene care. As for other
understanding such as understanding about dating,
marriage, reproduction, care, sexually transmitted
diseases, and contraceptives, subjects said that S will
know for themselves over time. The most important
role in providing sex education is the subject itself.
Subject’s expectation in implementing sex education
is S does not fall into undesirable things and be a good
person.
3.3 Subyek II (N)
3.3.1 Form of Support
With the disabilities that N has, the form of support
needed by N from other parties, especially parents, is
even greater. In general, subjects have provided
enormous support in every phase of N's life, such as
love, appreciation, material, or information support.
The subject give more emotional support as part of
parenting to N more intensive than normal children.
Even though N was different from other normal
children, he was still involved in environmental
activities. In addition, the subject's actions that do not
differentiate between her and her sister can be a
particular tribute to N.
As for instrumental support for N, subjects call
therapists and teachers to the house. In addition, to
give N independence, all N requests, for example,
wanting to buy and choose their own clothes, are
ICOH 2019 - 1st International Conference on Health
114

always fulfilled by both the subject and husband,
although they are still accompanied. The subject also
continues to support and assist in various daily needs
of N.
From the subject's explanation, it was found that
the form of support needed by N in childhood and
adolescence had several differences. When N was a
child, support of daily necessity had to be given
intensely. Whereas when N was a teenager, the most
needed support was greater in the emotional aspects
and occasionally still had to be assisted in a number
of daily needs.
In the form of providing information, the subject
always provides information, advice, and main advice
in terms of knowledge about aspects of sexuality N.
3.3.2 Sex Education
Aspects sexuality of N develops as teenagers
generally. N secondary organs such as breasts or
secondary hairs grow as other teenagers. In adapting
to the physical changes that experienced by N, she
must still be assisted by the subject especially in terms
of cleaning care.
According to the subject's explanation, N had a
menstruation at the age of 11 years with a regular
cycle. There was a time when N menstrual cycle was
interrupted but could be resolved quickly after being
taken to the doctor and given hormone therapy and
reflexology.
In adjusting to the changes experienced by N
related to aspects of menstruation she experienced,
the most important role came from the subject itself.
The role of the subject, in this case, is not only in the
form of giving an understanding of N but also in
technical terms. In addition to the technical
assistance, the subject also explained how N should
behave in accordance with N's developmental tasks
after N got a period.
Like teenage girls in general, N also once dated
fellow SLB children. They related for about a year
until then N partners decided to separate. The
difference that was seen in the form of a dating
relationship between N with normal teenagers that is
they are never talked specifically about each other's
feelings. In addition, according to the subject, N also
expects to be able to date normal men like teenagers
in general.
The subject also teaches and provides
understanding to N about the norms in dating that are
healthy and acceptable to the community. Although
the subject is quite open in accepting N's desire to
date, but sometimes the subject feels worried if N
asks to date seriously with a normal man.
Regarding marriage, N once expressed his desire
to get married to the subject. But N did not want to
accept the consequences of marriage such as living
apart from parents because N is still dependent on her
parents. For the concept of reproduction and
parenting, subject also provides an understanding that
can be understood by N. For the concept of sex and
contraception, until now the subject has never
discussed it to N despite having plans to convey
things about it.
As for the provision of information about sexually
transmitted diseases, the subject does not have plans
to submit information regarding this matter. The
reason for the subject to postpone the provision of
information about the concept of sex, contraception,
and sexually transmitted diseases because the subject
considers N will not understand due to her
disabilities.
Regarding cases of sexual harassment, the subject
also had never conveyed this to N in an effort to
protect N. Until now, the subject still feels quite safe
by always asking someone to accompany N wherever
N goes.
The problem with N is not from sexual
harassment, but from venereal disease. According to
the subject's explanation, one of the causes was N's
dirty hands during N's masturbation. After suffering
from the disease and based on a subject closely watch
to N intimate activity, N finally stopped masturbating.
For the understanding of sex education itself, the
subject understands it as an explanation of free sex.
The party most involved in providing sex education
to N at home is the subject itself.
The form of sex education that is mostly offered
by subjects to be given to N is how to care for bodily
hygiene with a very intense frequency. In addition,
the subject will occasionally provide information
regarding the ethics of courtship to N. Apart from the
subject, N also obtained information about aspects of
sexuality from TV and magazines and from his
friends.
Subject implement sex education in the home
because of concerns if their children have a
pregnancy out of wedlock. The subjects' expectations
in providing sex education to N is her daughter be
able to know the norms about things that should not
be done before N was married.
3.4 Subject III (D)
3.4.1 Form of Support
The biggest support that D got came from his family.
As long as the mother is still alive, the mother plays
Healthy Sexual Growth Phenomenon in Children with Mild Retardation and the Role of Parents in Providing Sex Education
115

the most role in providing support. But after his
mother died, the role was taken over by the subject
(sister of D). Among the forms of emotional support,
appreciation, instrumental, direction, and social
network support, the biggest form of support obtained
by D is emotional support in the form of excessive
affection.
In addition to emotional support, the direction that
is often given both from parents and from the subject
is very useful for D especially in the form of concepts
relating to aspects of sexuality D. Oftenly, the subject
consulted and asked for D's opinions. This indirectly
became a separate appreciation for D, for the
emergence of feeling respect by hearing D.'s
opinions.
The instrumental support given to D is in the form
of parents' efforts to choose the best school for D
where he can adjust well in it. Neighbors or teachers
often provide support for D. This becomes a form of
support from social networks where is very useful for
D especially in the aspect of adaptation.
According to the subject, the form of support that
D needed when he was a child and when he was a
teenager had some differences. When D was a child,
support was most needed, especially in general
matters. Meanwhile, when a teenager, the most
needed support is mainly in aspects of sexuality. The
subject said that the mother always advised the
subject that in providing support to D required
considerable patience because of the characteristics
of D which is very slow.
3.4.2 Sex Education
Sexuality Growth and development of D shows
normal even though the growth of secondary organs
such as breast and secondary hair only grows at the
age of 17 years. This age can be said to be late for the
size of adolescents. According to the subject, D is
quite familiar with the changes that occur in his
physical form because all his sisters and D can
understand through observation of his brother,
especially when bathing.
D experiencing menstruation at the age of 13
years with a regular cycle. For the first time, D was
shocked by the change that she experienced. This
happens because previously there has been no
notification either from the parent or from the subject
of D about the possibility that D will experience
menstruation when D is a teenager.
The subject said that in adjusting to the menstrual
period experienced by D, the role for assisting D was
taken by the mother. Mother not only helps in giving
understanding to D until D can adjust but also helps
D for the technical aspect. However, this assistance is
not given forever because after the first two months,
D has begun to be able to do everything herself even
though some times she still assisted by mothers or
subjects in certain matters.
Regarding the concepts of courtship and marriage,
subjects said that D was able to understand clearly.
However, until now D still does not have the desire to
date or get married even though most of D's friends
are men and have been recommended by the subjects.
The reason of the subject encouraged D to date was
because the subject was afraid that D did not want to
date because of trauma after seeing the subject's
experience of being broken-hearted. D's
understanding of the concept of dating, norms in
courtship, the concept of marriage and the
consequences of marriage are mostly obtained from
the subject and part of D.'s observation.
According to the subject, D also has a well
understanding of the consequences of marriage, sex,
reproductive concepts and childcare. As with the
concepts of courtship and marriage, an understanding
of this concept is also largely derived from the
information of the mother and subject. The subject
began to give an understanding of various aspects of
sexuality to D since D sat in junior high school.
The subject said that D had been sexually abused
once on the bus. To avoid this from happening again,
the subject always gives an understanding of D about
how to avoid it.
Until now, parents or subject have not provided an
understanding of sexually transmitted diseases and
contraceptives. This is because there has been no
notification to D about it. Specifically for AIDS,
subjects had told D about the dangers of the disease and
how it could be transmitted. As for contraception,
although it has not been submitted to D, there are plans
to provide understanding to D about the concept later.
In providing sex education to D, the parties most
involved in it are the mother and the subject. For
subjects, sex education is understood as teaching how
to have sex. Subject strongly agree on the application
of sex education both at school and at home.
The most preferred form of sex education by
subject for D is the provision of a correct
understanding of how healthy sex should be to
prevent unwanted pregnancy. The provision of
material on these aspects is given at leisure. Apart
from the subject, D also obtained the information
needed about aspects of sexuality from TV. The
subject's expectation in the application of sex
education is so that D can understand the concept of
marriage, sex, and the consequences of that
relationship.
ICOH 2019 - 1st International Conference on Health
116

3.5 Subject IV (A)
3.5.1 Form of Support
In connection disabilities of A, he needs more support
from both the subject and the environment. The
greatest support obtained by A came from the subject.
The form of emotional support given by subject to A
is more in the form of attention and accompaniment
to A.
Other forms of support provided by subjects to A
are support in the form of providing information and
supervision to A both in general and more specific
terms such as information on aspects of sexuality.
Another support given by the subject to A is
instrumental support in the form of meeting basic and
secondary needs. In this case, there is a significant
difference between the form of support needed when
A was a child and when he was a teenager until now.
An also received social support from the
environment, especially from the teacher.
3.5.2 Sex Education
In terms of growth and development aspects of
sexuality, A does not find too many difficulties,
especially for aspects of adjustment to changes that
occur in him. Secondary organs grow like other
normal individuals. After experiences physical
changes, he recognizes the concept of shame.
In adjusting to changes in secondary organs that
occur in A, the subject has a large role. The role is in
the form of giving directions to A about what he
should do and what he should not do regarding his
age.
A also had a wet dream once. Once upon a time,
subjects had found A had a porn book. This is an
indication that A also has a desire and has a curiosity
in the aspect of sexuality. The reaction of the subject
who is not immediately angry with A after finding the
pornographic book, because it will have a positive
effect on fostering trust and openness of A to the
subject.
A once dated a classmate in SLB. At that time, A
did not admit that he was dating, so the subject did
not feel the need to give direction regarding social
norms in dating.
In addition, the subject also considers that A is
able to judge for himself which are good and which
are bad. However, the subject still has plans to inform
A about the norm in courtship.
For the problem of marriage, until now A has no
desire to go there. According to the subject, A was
quite understanding about the concept through the
explanation given by the subject regarding the
concept of marriage and the consequences of
marriage itself as well as about the concept of
reproduction. In terms of sexual harassment, so far A
has never experienced that. The subject often gives
understanding and control A to prevent this situation
from happening to A.
For other aspects are also not too problematic such
as masturbation. According to the observations of
subjects, A had never done that. But the subject also
did not dare to guarantee because A was not fully
open to the subject. Even though A has never seen A
doing masturbation, the subject still gives A direction
to not do that.
For an understanding of contraception and sex, the
subject has been briefly explained. The subject has
not planned to give a clear explanation about this for
now, unless A has questions about it.
In terms of understanding of sexually transmitted
diseases, the subject has given an understanding of A
about the disease and how it is transmitted. The
subject also always gives concrete examples of the
material explained to A.
Regarding the notion of sex education, the subject
understands it as a relationship between men and
women which then leads to sex. The subject himself
felt that she had implemented sex education even
though she did not really agree with sex education
based on what she understood.
The aspect of sex education that is most
emphasized by the subject to be given to A is the
aspect of hygiene care. In addition to getting
information from the subject directly, A also gained a
lot of understanding about aspects of sexuality from
TV. Subject’s expectation in applying sex education
is A can understand the concept of sexuality correctly
so that he does not explore himself which will
negatively impact for A.
4 DISCUSSION
4.1 Form of Parenting
The form of parenting provided by the four subjects
is almost similar. Average of them give attention,
privilege, or give full affection to the subjects related
to their disability. They tend to be more controlling
and directing almost all children's activities. In
general, they try to care for children democratically,
such as the merging of positive things from
permissive and authoritarian forms of care
(Baumrind, 1997 in Aini, 2001). But among the
subjects such as subjects II and IV, they sometimes
Healthy Sexual Growth Phenomenon in Children with Mild Retardation and the Role of Parents in Providing Sex Education
117

tend to be authoritarian in certain matters such as in
the case of letters not posted by subject II or
restrictions on space as did subject IV.
There is no difference in the form of care between
childhood and adolescence of subjects I and III, This
is because they are not too demanding of various
kinds of care. As for subjects II and IV, the provision
of care between childhood and adolescence shows
differences. This difference is more to the form of
technically care when they had menstruation. For
subject II, the difference that arises is when the child
become a teenager, the care and support from the
subject are not as great as when they were still a child
who could not do everything alone. But the subjects
still have to accompany them constantly after they
become a teenager. In contrast to subject II, the
difference in subject IV is that when the child of the
subject is a teenager, the subject is even more stringent
in looking after his child and his worries are also
greater. The difference in parenting is related to the
special characteristics of mentally retarded
adolescents, including those who are able to educate
such as the emergence of a desire to socialize broadly
(Porter & McKenzie, 2000). Changes in the character
of individuals with mild retardation during adolescence
causes a different response from each subject.
4.2 Characteristics of Parents
In dealing with the reality of their son's disability, the
four subjects reacted the same, which were shocked
and sad. This is consistent with what was expressed
by Porter & McKenzie (2000) that the reactions that
often arise in the parents of individuals with mental
retardation are sadness, loss, and chronic sorrow. For
subjects II and IV, they were stressed but did not last
long. For the subject, I, coping with stress was
obtained from a religious approach. In subjects II and
IV, all of them managed to overcome the sadness
after seeing the fact that not only their children
experienced the same thing, there were even many
other children whose problems were even worse. As
for subject III, parents successfully overcome it after
getting advice from other children.
Except for subject III, all three subjects checked
the truth of the claim given by the subject's teacher
that their child was unable to attend public school to
a psychologist. Among the four subjects, those who
were overprotected against children were subjects II
and IV. Cases in subjects II and IV correspond to what
Jhonson stated (in Thompson & Grabowsky, 1978)
that usually parents tend to be overprotected and will
usually be stressed and shocked when they find out the
fact that their child is not normal like others.
4.3 Form of Support
In general, four subjects provide support in all aspects
as expressed by Sarafino (1998, in Aini 2001) such as
emotional support, appreciation, instrumental,
information and networking. The biggest support that
is most needed and received by the 4 children of the
subjects is emotional support where each subject,
pays more attention to and privileges their child in
connection with the child's disability. All subjects
provide full understanding and patience in dealing
with children so that children are greatly helped by
this support.
In addition to the form of affection and attention,
another support of providing information and
direction from the subject is very helpful for children
to be able to behave adequately. The provision of
such information also includes matters regarding
child sexuality. With this information, children are
able to adapt to the changes that occur in themselves
both at the personal level and at the social level.
For subjects who have male children (I and IV),
the support that still needs to be provided in the aspect
of sexuality is not as great as the support needed by
subjects who have daughters (II and III). The support
needed most for the aspect of sexuality is more in the
form of providing correct information. For the child
of the subject I the support that he needs from other
parties, especially from the subject is greater than the
child of subject III, both support for daily needs and
support for technical aspects of sexuality. This is
caused by a child's disability.
In subjects II and III, support is needed by them
when they are menstruating. The support needed
includes providing information about menstruation
issues including maintaining hygiene and providing
technical assistance to them. Compared to subject III,
the daughter of subject II needs greater support during
menstruation. This is most likely due to secondary
impairment in the form of cerebral palsy which
causes weak motor coordination. In addition, stricter
subject attitudes in looking after children also
contribute to the child's independence in terms of
menstruation. Whereas for subject III, the greatest
support that she needs related to menstruation is only
needed in the first two months when she gets a period.
Furthermore, they can do everything themselves even
though sometimes they still need help from parents or
from the subject.
Among the four subjects studied, the ones who
needed the most support especially from the parents
were children of subject II. Almost all the needs of
children must still be assisted by the subject. While
other subjects only need support in certain aspects.
ICOH 2019 - 1st International Conference on Health
118

For children of subject I, even though almost all their
needs still need support, but this is more due to the
spoiled nature of the child and also because the child
has a physical disability at hand.
4.4 Sex Education
According to Van Dyke et al (1995) issues regarding
child, sexuality includes sexual development and
behavior including hormonal and physical changes.
Other issues include dating and marriage,
reproduction and care, sexual relations and
contraception, and sexually transmitted diseases.
In the aspect of sexuality, the four individuals
with mental retardation can be said to be normal. The
secondary organs of each individual develop like
normal teenagers. This is consistent with what was
expressed by Schwab (1992) that children with
mental retardation have a series of physical and
hormonal changes like other normal children. For
subjects who have male children (I and IV), they
experience wet dreams while for subjects who have
female children (II and III) experience menstruation.
This is an indication that within them there has been
a series of hormonal changes and also shows that they
are all fertile (Elkins et al, 1987 in Van Dyke et al,
1995).
Regarding the desire to date, there are children
who have already dated their fellow at SLB as in
children of subjects II and IV. Whereas the children
of other subjects do not yet have the desire to date.
For the child of the subject I, he does not want a
mentally retarded couple either to be his girlfriend or
wife. He prefers relationships with normal women.
While the children of subject III, so far do not have
the desire to date or get married. In the child of subject
II, he already has a desire large enough to be able to
get a partner like a normal teenager. This can be seen
from his efforts to find a partner through teen
magazines. Children have also expressed their desire
to get married but do not want to bear one of the
consequences of being separated from parents.
Whereas in children of subject IV, even though they
have dated once but the subjects have not considered
about marriage yet.
In terms of providing an understanding of
sexuality, the four subjects have provided their
children with sufficiently clear information. The
concept includes norms in courtship, marriage and its
consequences, reproduction and parenting. Except for
subject II, all three subjects have also provided
information about sexual harassment and ways to
protect themselves from the possibility of this
occurring. Subject II did not provide this information
because the subjects considered that the assistance he
had done was sufficient to protect their children from
possible sexual harassment.
Regarding the concept of sex, the four subjects
have provided information to the child quite clearly.
However, for contraception, all subjects have not
provided adequate explanations except for subject IV,
she once giving brief information because at that time
the child had ask the subject. One reason that arises
in accordance with what was revealed in the journal
pediatrics vol.97 no.2 which states that parents are
reluctant to discuss issues of sexuality, especially sex
with children because of fears of parents if the
discussion about sexuality will encourage the
emergence of unwanted sexual behavior and fear of
pregnancy or exploitation. In addition, parents also
admit that there are difficulties in deciding what to
say and how. Another reason is parents' uncertainty
about the extent to which children will understand
what has been conveyed. But there are also subjects
like those in subjects I who assume that one day the
subject will understand itself. Except for subject II,
the most subject has explained several types of
sexually transmitted diseases and how they are
transmitted to children.
In general, subjects understand sex education as a
lesson about sex between men and women. All
subjects felt that they had applied sex education to the
children. For subjects I, II, and III, all agreed with the
provision of sex education at home. Whereas the
subject IV did not really agree with sex education
based on what he understood, such as teaching
children to have sex by watching pornographic
VCDs. In the aspect of child sexuality, the greatest
role of the subject is in the form of providing
information and direction on concepts relating to
aspects of child sexuality. For subjects I, II, and IV,
the most important role in sex education in the home
is the mother's side. As for subject III, the role of sex
education at the time the mother was still alive was
held by the mother. But after the mother dies, the role
is completely taken over by the subject (sister).
For subjects I, II, and IV, the most emphasized
aspect of sex education is regarding aspects of body
hygiene care. In contrast to other parties, the aspect of
sex education most emphasized by subject III is a
correct understanding of sex to prevent unwanted
pregnancy before marriage. Regarding expectations
to the provision of sex education, all subjects have
almost the same expecation, children do not
experience problems in aspects of sexuality that will
have a negative impact on them.
Healthy Sexual Growth Phenomenon in Children with Mild Retardation and the Role of Parents in Providing Sex Education
119

REFERENCES
Aini, I. N. (2001). Peran Orang Tua dalam Memberikan
Pendidikan Seks pada Anak Usia Remaja. University of
Indonesia.
Dyke, D. Van, McBrien, D., & Sherbondy, A. (1995).
Issues of sexuality in Down syndrome. Down Syndrome
Research and Practice, 3(2), 65–69.
https://doi.org/10.3104
Fegan, L., & Rauch, A. (1993). Sexuality and People With
Intellectual Disabilty (2nd ed.). Sidney:
Maclennan+Petty.
Hallahan, D. P., & Kauffman, J. M. (1994). Exceptional
Children ; Introduction to Special Education (6th ed).
USA: Allyn & Bacon.
Jacobs, R., & Et al. (1989). Developing an AIDS Prevention
Education Program for Persons with Developmental
Disabilities. Mental Retardation, 27(4), 233–237.
Retrieved from
https://www.ncbi.nlm.nih.gov/pubmed/2586313
Mangunsong, F., & Dkk. (1998). Psikologi dan Pendidikan
Luar Biasa. Depok: LPSP3 UI.
Marisa. (2019, September). Nasib Malang Giyono 11
Anaknya Cacat Mental. Majalah Kartini Online.
Retrieved from https://majalahkartini.co.id/?s=giyono
Nosek, M. A., & Howland, C. A. (1998). Abuse and Women
with Disabilities. Minnesota: MINCAVA.
Papalia, D. E., Olds, S. W., & Feldman, R. D. (2001).
Human Development (8th ed.). Boston: McGraw Hill.
Payne, J. S., & Patton, J. R. (1981). Mental Retardation.
Columbus: A Bell and Howel Company.
Poerwandari, K. E. (1998). Pendekatan Kualitatif dalam
Penelitian Psikologi. Jakarta: LPSPS3 F.Psikologi UI.
Pohan, M. I. (2011). Seks dan Kehidupan Anak Sebuah
Buku Pedoman untuk orang Tua. Jakarta: PT. Asri
Media Pustaka.
Porter, L., & McKenzie, S. (2000). Proffesional
Collaboration with Parents of Children with
Disabilities. Sidney: Maclennan+Petty.
Schwab, W. (1992). Clinical Info: Sexuality in Down
Syndrome. Wisconsin: SESA.
Thompson, T., & Grabowski, J. (1978). Behavior
Modification of the Mentally Retarded. London: Oxford
University Press.
Welfare, C., & Gateway, I. (2019). Definitions of Child
Abuse and Neglect, 2010(March), 1–98.
With, C., & Policies, D. (2019). American Academy OF
Sexuality Education of Children and Disabilities
Adolescents With Developmental, 97(2).
ICOH 2019 - 1st International Conference on Health
120