Creating Awareness of Sexual Abuse in Children with Special Education Needs : Depending on the Opinions of Teachers of the Mentally Handicapped

The purpose of this research is to determine what students and families should do in order to prevent sexual abuse in students who need special education, depending on the opinions of teachers of mentally handicapped students. The qualitative research technique was used in this research. The study population of the research consisted of the teachers of mentally handicapped individuals working in Turkey/Konya province. The study population included 35 teachers. Semi-structure interview method was used as data collection method in collecting data in the research. According to the results, it is evident that individuals ought to be taught about their private parts, private parts in their bodies, and they ought to be made conscious about the fact that no one can touch these private parts in order to raise awareness about sexual abuse in individuals with special education needs. In order to stop sexual abuse by raising awareness in families of individuals with special education needs, it is necessary for families to acquire skills in terms of knowing their children, determining their needs and consulting an expert periodically. In order to raise awareness in the community about the sexual abuse in individuals with special education needs, the teachers express that all families should be trained, seminars should be organized on the issue and media ought to do its part to create awareness.


Introduction
Sexual abuse towards a child is an action which is done for sexual satisfaction or for a sexual purpose and in which a child is used or it is attempted to use a child (Fowler, 2008;Walsh, Zwi, Woolfenden & Shlonsky, 2015;WHO, 1999).When a child feels that s/he is sexually abused, it is a sexual abuse, even if s/he cannot identify whether the behavior is sexual abuse it specifically because of lack of understanding and his/her age.Misuse might happen once or it might be a continual sexual abuse which extends over a long period (Fowler, 2008:17).It is possible to characterize sexual abuse in children in different ways which determine whether an incident is accepted to be a sexual abuse or not.The first condition is lack of consent.Children do not have the maturity to give permission sexual activity.Another condition is misuse.Children might be manipulated or forced into sexual behaviors by stronger, more skillful or more knowledgeable adults (Kinnear, 2007:3).So emerging adulthood's period is not appear these children (Özteke-Kozan & Hamarta, 2017).
When it comes to disability, children with disabilities are more vulnerable to sexual abuse since they experience deficiencies in understanding and interpreting events; additionally, they cannot control their sexual drive and they need special interest about sexuality (Yıldırım-Doğru, 2006).Sexual harassment and assault of children with physical and developmental disabilities is quite common (Krohn, 2014).In a research conducted by Baladerian, Colemand and Stream (2013) on 1300 people with disabilities, it has been revealed that 41.6% of individuals with disabilities are sexually abused.In addition, in another study which was conducted on how individuals with abilities were victimized, it is stated that the possibility of being sexually abused for children with disabilities is 2.9 times higher in comparison with children without disabilities (Stalker & McArthur, 2012;Smith & Harrell, 2013).The risk of sexual abuse for mentally handicapped children is 4.6 times more than their peers with disabilities (Smith & Harrell, 2013).Besides, as the severity of an individual's disability increases, the possibility of being exposed to sexual abuse also increases (Bensy, 2011).This issue has not caught the attention of politicians, experts, advocates or members of the public because of various factors such as: children with disabilities experience difficulties in expressing situations related to abuse; it is easier to get them take advantage of them by comparison with other sufferers; and, the possibility of receiving support is low for them (Smith & Harrell, 2013).Nevertheless, there has been an increasing interest in the risk of abuse of individuals with disabilities for the last 20 years.The society has begun to accept that abuse is a serious problem (Thornberry & Olson, 2005).Amendatory services and criminal justice systems are generally unsuccessful in meeting the needs of children with disabilities.There have been limited numbers of studies concerning abuse and protection of children with disabilities (Stalker & McArthur, 2012).
It is thought that teachers are an important factor in preventing child sexual abuse (Claudia & Martine, 2014).At this point, special education teachers believe that students with disabilities are at the risk of sexual abuse (Kliethermes, 2003;Konuk Er, Büyükbayraktar, Kesici, 2016).With reference to this opinion, sexual abuse of children who spend most of their time at school inevitably happens at school (Krohn, 2014).It is stated that most of the students with disabilities who are exposed to sexual abuse experience severe abuse once at least in a school environment and sexual abuse continues to happen in different environments (Bensy, 2011).Zemp (2002) believes that lack of sexual knowledge also poses a risk factor for sexual abuse.In addition, Davis (2011) believes that in order to prevent abuse, individuals such as those with disabilities themselves, families, lawyers, judges, public prosecutors and police officers should be encouraged to receive training on abuse.Further, children with disabilities should receive education at an early age in order to understand abuse and avoid it.In addition, family assistance schemes should be established to prevent the abuse of the disabled person by taking a break from the day-to-day care responsibility, which directly affects disabled families such as day care and becomes more difficult.There is a need for developing a more successful, integrated approach in order to prevent sexual abuse.Such an approach must consider individual needs of children, a balance between a healthy sexual development and protection from sexual abuse (Krohn, 2014).From this point of view, the purpose of this study is to determine what students and their families must do in order to prevent sexual abuse that students with special education needs are exposed to, depending on the opinions of teachers of the mentally handicapped.In order to achieve this goal, this qualitative research attempted to respond to the following questions: 1-What skills do you think must be developed in children with special education needs in order to create the awareness of sexual abuse?
2-What skills do you think families of children with special education needs must gain in order to raise awareness in terms of preventing child sexual abuse?
3-What points do you think must be considered in order to create awareness in the society of sexual abuse of children with special education needs?

Research Model
Semi-structured interview method of qualitative research was used in this research.Providing sensitivity to the natural environment, researchers' roles as participants, having an integrated approach, revealing perceptions, flexibility in research design and having an inductive analysis are significant characteristics of qualitative research techniques (Yıldırım & Şimşek, 2005).Qualitative research emphasizes the interpretation of meanings, experiences and descriptions.Comprehensive and detailed data consisting of words which are completely described and observed by individuals formed the primary part of this research (Coolican, 1992).

Research Group
In this research, purposive sampling method was used.Obtaining extensive and detailed information about what sexual problems people with special education needs experience and how sexual education for these students must be provided depending on the opinions of teachers of mentally handicapped individuals is the reason why this sampling method is preferred (Yıldırım & Şimşek, 2005).Criteria for the selection of teachers for the working group were determined and these criteria are those who work in special education institutions and volunteer to participate in the research..The research was conducted using information provided by teachers of the mentally handicapped who have been working in Special Education Schools and Counseling and Guidance Centers which belong to the central districts of Konya province.The research group consists of 35 teachers: 22 of these teachers are female, 13 of them are male.Considering the ages of these teachers, it is seen that 11 of them are in 25-30 age range, 8 of them are in 31-35 age range, 7 of them are in 36-40 age range, 9 of them are in 46 and over age range.When years of working experience of the teachers are considered, it is seen that 2 people have 1-year working experience, 1 person has 2-year working experience, 8 people have 3-year working experience, 3 people have 4-year working experience, 3 people have 5-year working experience, 2 people have 6-year working experience, 1 person has 7-year working experience, 7 people have 8-year working experience, 1 person has 9-year working experience, 3 people have 10-year working experience, 1 person has 11-year working experience, 1 person has 13-year working experience and 2 people have 15-year working experience.

Semi-structured Interview Technique
In the research, semi-structured interview method was used as the data collection method in collecting data and the related literature was reviewed.In the literature, emphasis was put on sexual abuse of students with special education needs and with particular attention to how it can be prevented.Children with disabilities are more vulnerable to sexual abuse because they experience deficiencies in understanding and interpreting incidents; moreover, they cannot control their sexual drives and they need special care in learning about sexuality (Kvam, 2004).Starting from this point, the related themes are: which skills must be acquired by individuals with special education needs in order to create awareness of sexual abuse; which skills must be gained by families in order to prevent sexual abuse of their children; and, the which interventions must take place in order to create awareness in society about sexual abuse of individuals with disabilities were determined and a semi-structured interview form was developed using questions which might measure these themes.
In order to ensure the validity of the interview form, interview form was given to five faculty members working at the Faculty Education of Necmettin Erbakan University.The semi-structured form was constructed in the direction of the opinions offered by the faculty members.After that, pilot practices were conducted and the interview forms became ready for use in consequence of corrections which were made according to the results obtained.Practices were collected from the teachers in writing.It is significant for validity to include quotations from individuals and explain the results with these quotes for this purpose, some of the data obtained from the research were presented as they are in order to provide the credibility (Wolcott, 1990).

Data Collection
Interviews were conducted on a voluntary basis.An explanation was prepared for the interviews was offered, the purpose of the research and how the research would be done was stated in it.It was also emphasized that the identities of the participant would remain hidden.Written interview forms were used during the interviews.The interviews lasted for 20-25 minutes.

Data Analysis and Interpretation
The collected data were analyzed using the content analysis technique.The main purpose in the content analysis was to get concepts and relationships which might explain the collected data and respond to the research questions.
What is done in the content analysis is clearly organizing similar data by gathering them within the frame of certain concepts and themes and interpreting them.For this purpose, first of all, the data were conceptualized, and then they were arranged logically according to the obtained concepts and the themes describing the data were determined (Tavşancıl & Aslan, 2001;Yıldırım & Şimşek, 2005).
The opinions of the participants were recorded into the semi-structure forms in writing.Each interview was numbered, starting with number 1.While reading the data, words, sentences and paragraphs, information was coded by conceptualizing in order to determine the intended idea (Brott & Myers, 2002).Coding was carried out within the frame of the research purpose and interview questions.During coding, "computer assisted qualitative data analysis program Nvivo7" was used.The categories are used to analyze and compare various meanings in a category which is formed at the lowest level.The unique richness of the items in this category exhibits qualitative analyses as they are (Coolican, 1992).The themes concerning: the skills which must be acquired by individuals with special education needs in order to create awareness about sexual abuse; the skills which must be gained by families in order to prevent sexual abuse of their children; and the things which must be done in order to create awareness in the society of sexual abuse of individuals with disabilities were determined according to the related the literature for this research.The themes were categorized into subcategories.Opinions of teachers associated with each category were included.

Results
The things to be done by children and families in order to prevent sexual abuse of children with special education needs were analyzed as to the opinions expressed by the teachers in accordance with the three themes mentioned (awareness of sexual abuse of children with disabilities, awareness in families of sexual abuse of children with disabilities, awareness in the society of sexual abuse of children with disabilities) and were determined in the direction of these opinions.Afterwards, these three themes were categorized.Opinions related to each category were included.Findings, themes, themes related to the categories, number of teachers expressing their opinions related the categories and sample opinions of teachers are given in Table 1.

The Theme of Awareness of Sexual Abuse in Children with Disabilities
The theme of awareness of sexual abuse in children with disabilities consists of 5 categories.These categories are: teaching privacy regions in human body (privacy), avoiding physical contact, informing about sexual abuse, informing families, informing about sexuality and gender differences.Among 35 teachers who participated in the research: 11 of them expressed their opinions on "avoiding physical contact", 8 of them delivered opinions on "teaching privacy regions in human body", 6 of them presented their opinions on "sexual abuse", 5 of them expressed opinions on "informing families", 5 of them expressed opinions on "sexuality and gender differences".Sample opinions of teachers concerning these categories are given in Table 1.

The Theme of Awareness in the Family of Sexual Abuse of Children with Disabilities
The theme of awareness in the family of sexual abuse of children with disabilities consists of 5 categories.These categories are: teaching a child privacy regions in his/her body, family training/awareness, knowing a child well, observation/following skills, and awareness of sexual needs.Among 35 teachers who participated in the research, 12 of them expressed opinions on "family training/awareness", 7 of them delivered opinions on "knowing a child well", 6 of them presented opinions on "observation/following skills", 5 of them expressed opinions on "teaching a child privacy regions in his/her body", 5 of them expressed opinions on "awareness of sexual needs".Sample opinions of teachers concerning these categories are shown in Table 1.

The Theme of Awareness in the Society of Sexual Abuse of Children with Disabilities
The theme of awareness in society of sexual abuse of children with disabilities includes 4 categories.These categories are: by the government, through seminars and informative meetings, through media and through families.Among 35 teachers, 14 of them expressed their opinions on "through seminars and informative meetings", 9 of them delivered opinions on "through media", 7 of them expressed opinions about "through families", 5 of them presented their opinions about the category of "by the government".Sample opinions of teachers related to these categories are given in Table 1."Children should be informed about to which regions in their bodies they must not let others touch" "The feeling that their body is theirs must be taught to children and it must be told them that other people cannot touch to their specific regions" (Ö35).Informing about sexual abuse 6 people "They should gain skills such as sensitivity to sexual abuse, empathy"(Ö4 "Social media must be more active about this issue and it must play a part in creating awareness"(Ö28).Through Families 7 people "Colorful picture posters can be prepared and handed to families.Families become more careful, so awareness might be created in this way"(Ö15)."The awareness must be raised, first of all, in the families of these children, then in these children, and finally in the society"(Ö29).
More preventive study needs to be done than crisis intervention studies on sexual abuse that children are exposed to.This is because children with disabilities who have been exposed to unsupported sexual abuse are exposed to long-term effects such as post-traumatic stress disorder, anxiety, and depression, which increases the risk of bedeviled in adulthood (Smith & Harrell, 2013;Kesici & Baloğlu, 2017).In this research, therefore, findings and suggestions will be provided by discussing skills which will be taught by teachers of mentally handicapped individuals including skills of expression, especially inappropriate behaviors, and avoidance-protection. Awareness fields related to sexual abuse which will be taught by parents of mentally handicapped individuals to their children and each theme which occurs in order to raise awareness in the society of sexual abuse of the mentally handicapped and categories related to these themes.
The teachers of mentally handicapped children expressed their opinions on acquiring some awareness skills in order to protect mentally handicapped children from sexual abuse as to degree of disability.It is possible to conduct preventive research on their opinions which emphasize that especially mentally handicapped students should gain skills in order to protect themselves from sexual abuse by avoiding physical contact.The reason for this is if a student gains skills about to which physical regions of his/her body s/he should not allow toughing, it can be an important step in prevention of sexual abuse.According to the research conducted by Baladerian, Colemand & Stream (2013), 92% of special education teachers state that sexual abuse and sexual drive behaviors are observed between students-students and the most common behaviors are physical jokes.
Within the theme of awareness in the family of sexual abuse of children with disabilities, most of the teachers of the mentally handicapped children delivered opinions in the category of family training and awareness in the family.Parents fear to be obliged to take their children out and force them to live in another place because the mentioned reasons indicate that there is social pressure over families.In this situation, families are generally abusive (Davis, 2011).
In addition, if a family fails in terms of knowledge, skills, resources or supporting a child's special needs and provides insufficient care and guidance, it is likely for a child to be at risk of abuse (Fisher, Hodapp & Dykens, 2008).Sexual abuse of children has become a quite significant issue for families having special children who are very sensitive.When it is taken into consideration that the stage of accepting their children may be quite difficult for many families, this topic ought to be sensitively approached.From this point of view, it is possible to say that providing information for families and raising their awareness of sexual abuse may be significant factors.
In the theme of raising awareness in the society of sexual abuse of children with disabilities, most of the teachers of mentally handicapped individuals express that it is possible to raise awareness in the society of sexual abuse of children with disabilities through seminars and informative meetings.Since abuse is considered as a taboo that must not be mentioned, people avoid talking about sexual abuse of children (Al-Zboon & Ahmad, 2016).
Both because of this reason and the necessity to specify (report) sexual abuse of individuals with disabilities clearly (Liou & Chen, 2016), educators must be careful, they need to receive training related to the legal protection rights and appropriate health interventions (Tharinger, Horton, & Millea, 1990).Seminars and informative meetings may be crucial in this regard.

Table 1 .
Opinions of Teachers of the Mentally Handicapped about the Things To Be Done by Students and Their Families in order to Prevent Sexual Abuse of Children with Education Needs