Behavioural Skills Training (BST) for Teaching Sexual Abuse Prevention Skills for Children with Intellectual Disabilities

NCT06732479 | Completed

• 2 other identifiers: NIMHANS/DO/101ST IEC/2015NIMH:A&E/C:Ph.D(Nsg):2014-16:N
• Study Type: interventional
• Target: 120
• Locations: 0 countries
• Sites: N/A

Brief Summary

The main goal of the study was to see if Behavioural Skills Training (BST) could improve knowledge about sexual abuse and the ability to resist it among children with intellectual disabilities. This study also evaluated any negative effects of the programme on children with intellectual disabilities. There were two groups, one group received a training programme which was delivered as three one-hour sessions in a week over 12 weeks. The Behavioral Skills Training (BST) module was structured into ten lessons, each conveyed through engaging stories and corresponding illustrations. The training commenced with teaching children general safety topics such as poison, fire, pedestrian, and vehicle safety. This served as an initial step to establish comfort. Subsequently, the module transitioned to imparting knowledge on body safety rules. This included educating children on stranger safety and private parts, understanding appropriate and inappropriate touches, and teaching them self-protection skills. Videos were used to show appropriate and inappropriate situations effectively, and training sessions involved role-playing scenarios. Another group received the usual sex education offered by teachers at school. After completing training students were assessed for their knowledge regarding sexual abuse and their self-protection skills (ability to say no, remove themselves from the situation, identify a person to whom the incident can be reported and report the incident and identify the offender. This was assessed based on the situations presented in a video. Children were tested one week after the training, at one-month, three-month and six-month intervals to see whether they could retain the information and skill. Their knowledge and self-protection skills improved after attending the programme and it was retained for six months. Participation in the programme did not cause any negative effects among children with intellectual disabilities.

Conditions

Intellectual Disability, Mild to Moderate; Sexual Abuse

Keywords

Behavioural Skills Training; children with intellectual disabilities; Sexual abuse prevention; sexual abuse and resistance ability

Outcome Measures

Primary Outcomes (2)

• Personal Safety Questionnaire

  Designed to evaluate knowledge regarding sexual abuse, this questionnaire consists of 11 items related to personal safety. Participants respond with "yes," "no," or "I do not know" to these items, and scores can range from 0 to 11; a higher score indicates a more comprehensive understanding of sexual abuse. The score range spans from 0 to 11, with an average score of 5.5. Personal Safety Questionnaire (PSQ) demonstrates strong test-retest reliability (r = 0.77) and internal consistency (Cronbach's α = 0.78).

  pre intervention and one week, one month, 3 month and 6 months after the intervention

• Video supplemented 'what if' situation test

  This test assesses the participant's ability to differentiate appropriate from inappropriate sexual advances and their understanding of hypothetical abusive situations. It includes two practice trials and six brief vignettes. Three vignettes describe appropriate requests for touch, while the other three depict inappropriate requests. The 'What If Situation Test' generates three scale scores: 1) Appropriate request recognition (score range: 0-3), 2) Inappropriate request recognition (score range: 0-3), 3) Total score, which measures knowledge of self-protection skills (score range: 0-24). The total score comprises four specific skill scores that represent the participant's verbal reports on their ability to 1) Refuse advances using appropriate, assertive, and persistent verbal responses (say), 2) Remove themselves from the situation (do), 3) Identify a person to whom the incident can be reported (tell) 4) Report the incident and identify the offender.

  pre intervention and one week, one month, 3 month and 6 months after the intervention

Secondary Outcomes (1)

• Side effects measure

  pre intervention and one week, one month, 3 month and 6 months after the intervention

Study Arms (2)

Control group: Treatment as usual (TAU)

NO INTERVENTION

These included general safety tips, and the detailed instructions taught to children by teachers in special school during academic programme. As part of the curriculum, teachers taught children about safe touch and unsafe touch and instructed children to say "No" to unsafe touches. Teachers mainly focused on inappropriate touches and the main mode of instruction was lecturing.

Behavioral skill Training (BST)

EXPERIMENTAL

The Behavioural Skill Training (BST) was developed by modifying the Body Safety Training programme developed by Dr.Sandy.K.Wurtele.The Module was organized under 10 lessons. Each lesson was taught through stories, and each story had a picture that goes along with it. Children were taught first about the general safety (poison safety, fire safety, pedestrian safety, and vehicle safety) as a way of establishing rapport, and then moved to body safety rules (stranger safety, concept of private parts, appropriate and inappropriate touches, self-protection skills). Appropriate and inappropriate situations were presented using video and training was given to children on how to respond appropriately to each situation using role play. The Module was delivered over a period of one month, three sessions per week.

Behavioral: Behavioural Skill Training Programme

Interventions

Behavioural Skill Training Programme BEHAVIORAL

BST was administered in 3 sessions in a week on alternate days, each session lasting for an hour. Training was given in small groups consisting of 4-6 members. Parents were involved as co-therapists, and observed the training given by the researcher and practiced it at home with their children. The training was carried out through the following steps: 1. Instruction- Involved teaching the location of private parts, difference between appropriate and inappropriate touch, safe and unsafe secrets, sexuality, self-protection skills (saying NO, move from situation, tell trusted person, report the person and situation. 2. Modelling- researcher, modelled, correct responses, and instructed to act in the unsafe situation using role play. Situations were presented using video. 3. Rehearsal-researcher presented situations using video and instructed to rehearse the skills until able to demonstrate the skill independently

Behavioral skill Training (BST)

Eligibility Criteria

• Age: 10 Years - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Children with mild and moderate Intellectual Disability as per Diagnostic and Statistical manual (DSM) V, and as determined by the assessment of qualified educational psychologists prior to the admission to the special schools.
• Age 10-18 years
• Those children whose parents are available during the period of study
• Children with verbal ability which would allow them to participate in the study

You may not qualify if:

• Children who cannot speak Malayalam/English
• Presence of active symptoms of co morbid psychiatric illness
• Parent
• Parents (either mother or father) who are willing to participate as co therapists.
• Parents who cannot speak Malayalam/ English
• Parents who are not willing to participate in the one month,3 month and 6 month follow ups.

Sponsors & Collaborators

• University of Canberra: lead
• National Institute of Mental Health and Neuro Sciences, India: collaborator

Related Publications (2)

• Schaafsma D, Kok G, Stoffelen JM, Curfs LM. Identifying effective methods for teaching sex education to individuals with intellectual disabilities: a systematic review. J Sex Res. 2015;52(4):412-32. doi: 10.1080/00224499.2014.919373. Epub 2014 Aug 1.

  PMID: 25085114 BACKGROUND

• Jojo N, Nattala P, Seshadri S, Krishnakumar P, Thomas S. Knowledge of sexual abuse and resistance ability among children with intellectual disability. Child Abuse Negl. 2023 Feb;136:105985. doi: 10.1016/j.chiabu.2022.105985. Epub 2023 Jan 3.

  PMID: 36603444 BACKGROUND

MeSH Terms

Conditions

Intellectual Disability

Condition Hierarchy (Ancestors)

Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Neurodevelopmental Disorders; Mental Disorders

Study Officials

• Dr.Natasha Jojo, PhD

  University of Canberra

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Model Details: Participants were systematically selected using a stratified random sampling approach. The schools were first categorised into three strata based on the number of enrolled children: those with more than 100 children, those between 25 and 100 children, and those with fewer than 25 children. Schools were randomly chosen from each stratum. Two schools with more than 100 children were randomly selected, one designated as the experimental group and the other as the control group. Six schools in the 25 to 100 children were randomly chosen and equally divided into experimental and control groups. Similarly, in the stratum of schools with less than 25 children, four schools were randomly selected and equally split into experimental and control groups. It is important to note that all participants who met the predetermined selection criteria within each selected school for specific purposes were invited to participate in the study, ensuring a comprehensive and representative sample.

Study Record Dates

• First Submitted: December 8, 2024
• First Posted: December 13, 2024
• Study Start: August 8, 2016
• Primary Completion: March 11, 2017
• Study Completion: March 11, 2017
• Last Updated: December 17, 2024

Record last verified: 2024-12

Data Sharing

• IPD Sharing: Will not share