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. 2020 Dec 22;13(4):611–619. doi: 10.3233/PRM-200743

Table 2.

Sexual Health and Education guidelines for providers

Age group Guideline Evidence
0–11 months
  • 1.
    Educate parents and caregivers about the anticipated neurologic sequelae of spina bifida including how sexual functioning may be impacted and that sexuality is a part of life for everyone including individuals with disabilities.
 Clinical consensus
1–2 years 11 months
  • 1.
    Educate parents and caregivers about the anticipated neurologic sequelae of spina bifida including how sexual functioning may be impacted.
  • 2.
    Educate parents and caregivers that sexuality is a part of life for everyone including individuals with disabilities.
  • 3.
    Provide factual information to parents and caregivers and encourage them to provide developmentally appropriate sexual education to their children.
  • 4.
    Explore the parent’s expectations regarding their child’s sexual development.
  • 5.
    Explain that sexual exploration is a normal and healthy part of early childhood development.
  • 6.
    Explain the importance of minimizing the child’s risk of sexual abuse through teaching children about their body parts, privacy, who may touch their bodies and what to do if inappropriate touching occurs.
 Clinical consensus as well as [10, 44, 50, 51]
3–5 years 11 months
  • 1.
    Provide factual information to parents and caregivers and encourage them to provide developmentally appropriate sexual education including appropriate versus inappropriate touching to their children.
  • 2.
    Explore the parent’s expectations regarding their child’s sexual development.
  • 3.
    Explain that sexual exploration is a normal and healthy part of early childhood development.
  • 4.
    Underscore goal of continence (see Bowel Function and Care and Urology guidelines) for optimal sexual relationships in the future.
  • 5.
    Review relevant literature that addresses this topic, such as “Bright Futures” and other reports prepared by the American Academy of Pediatrics.
  • 6.
    Provide education about pubertal development, evaluate concerns or abnormal physical findings and explain the risks of precocious puberty (see puberty guidelines)
 Clinical consensus as well as [10, 44, 50, 51]
6–12 years 11 months
  • 1.
    Provide factual information to parents and caregivers and encourage them to provide developmentally appropriate sexual education to their children.
  • 2.
    Review relevant literature that addresses this topic, such as “Bright Futures” and other reports prepared by the American Academy of Pediatrics.
  • 3.
    Allow the child to ask questions about sexual development and sexuality.
  • 4.
    Serve as a resource to schools to ensure that children with spina bifida participate in sexual education.
  • 5.
    Encourage parents to discuss information that their children are receiving about healthy relationships from school, their peers, the media, and social media.
  • 6.
    Promote skill-building to identify dangerous situations, refuse or break off an attack and summon help.
  • 7.
    Promote socially appropriate behaviors and social skills.
  • 8.
    Underscore goal of continence (see Bowel Function and Care and Urology guidelines) for optimal sexual relationships in the future
  • 9.
    Provide education about sexuality, pubertal development, evaluate concerns or abnormal physical findings and explain the risks of precocious puberty (see puberty guidelines)
Clinical consensus as well as [10, 44, 50, 51, 52]. Also see: National Guidelines Task Force. Guidelines for comprehensive sexuality education: kindergarten through 12th grade. Reviewers: Gelperin N, Goldfarb ES, Hemich J, Kelly MA, Schoeder E. 2004;

http://sexedu.org. tw/guideline.pdf: 1-109.
13–17 years 11 months
  • 1.
    Acknowledge that sexual health is an important part of life.
  • 2.
    Discuss healthy relationships in gender-neutral language as the teen years are the time when many achieve self-awareness about sexual orientation.
  • 3.
    Educate teens about intimate partner violence and sexual assault.
  • 4.
    Discuss safe-sex practices including non-latex condoms to prevent sexually transmitted infections and unwanted pregnancies.
  • 5.
    Refer to a women’s health provider (i.e., gynecologist, adolescent medicine specialist or family medicine practitioner), if the young woman with spina bifida intends to become sexually active. Refer men to a sexual function clinic if desired. (See Women’s and Men’s Health guidelines).
  • 6.
    Ensure that the Guidelines for Adolescent Preventive Services are implemented.
  • 7.
    Create an environment in which the teen feels comfortable and safe discussing sexual health including being able to speak to the adolescent alone and confidentially.
 Clinical consensus as well as [10, 20, 44, 50, 51]. Also see: National Guidelines Task Force. Guidelines for comprehensive sexuality education: