Robert Crown Center for Health Education

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1 Robert Crown Center for Health Education PUBERTY EDUCATION PROGRAM ADAPTED FOR GIRLS WITH ASD/SPECIAL NEEDS-SCRIPT Barb Barrett. Senior Health Educator September 29, 2014 Materials PowerPoint: Slide Activity/Content/Teaching Point This script is specifically intended for children with autism spectrum disorder or other special needs. The level of comprehension is starting at that of a 3-4 year old level. Instructors may modify the presentation to accommodate a higher level of learning. If students come to the Center, places for them to sit will be marked with a X. This structure/order provides a sense of comfort and safety to students. Hand fidgets may be available to help students with any restlessness or anxiety they may experience during the program. Instructor should call the school about a week ahead of a scheduled program to establish a relationship with teacher(s) and aides and address any special concerns or needs they may have. At that time, schools coming to the Center will be sent the social story explaining the field trip experience to the Robert Crown Center to allow teachers to present it to students. Schools should also be sent vocabulary list at this time to allow students to become familiar with words that will be sued during program and put into their devices if needed. INTRODUCTION: Welcome to the Robert Crown Center for Health Education. I am happy you re here today. My name is. Do you know why you came to the Robert Crown Center for Health Education today? This will provide feedback of their knowledge of the subject as well as their expectations about the program. I don t want to do all the talking today. I hope to hear from you, too. Please let me know if you have any questions about anything we discuss today, at any time. This is a safe time and place to ask questions about what we will be talking about and I will try my best to answer your questions. Let s try to talk one at a time and raise our hands like this (demonstrate raising hand) when we have something to ask or say.

2 Age ranges are difficult to understand. The pictures of girls with ages above will help students understand this concept. Today we are going to talk about puberty. Puberty means the changes your body goes through as you get bigger, grow taller and grow up. Girls start puberty changes between the ages of 8 and 16. These are changes you may SEE or may have already SEEN in you and your friends. The word see is simple and easy for students to understand vs. the word notice which is too abstract. What these students can see and experience is imperative to their understanding so the goal is to use language that allows that. One of the changes you will experience during puberty is you will grow taller and bigger. Bigger is also a word that is easier for students to understand and comes early in students development. What things should we do to grow bigger and be healthy? It is often a challenge for a child with ASD/special needs to eat a healthy diet consisting of a variety of foods. Briefly discuss healthy food choices and good portion sizes. List specific examples. Explain that everyone needs to eat good foods for their body to be healthy. You may not like all healthy foods but you should try different ones to decide which ones you like the best. Reinforce that healthy foods can taste good. These students will often associate healthy foods with doing without the things they love. Also be sensitive to the fact that many of the students may be on special diets. Some are very picky. Qualify this by saying Not everyone will need the same foods for their bodies.

3 Briefly discuss the benefits of exercise and ask if there s any type of exercises students like. Adapt this segment to discuss exercise appropriate for the group. Reinforce that exercise is fun and discuss with students different ways in which it can be fun--swimming, biking etc. Depending on the group, students may even run in place, do push-ups, etc. * Encourage a brief discussion of these health topics with positive reinforcement. Establishing a positive relationship early in the program with easier topics will enhance trust as you discuss more challenging topics later.* Another thing that is very important to keeping us healthy and growing is sleep. Briefly discuss the need for sleep, again adapting the level of discussion to the group s comprehension level. Bedtime and recognizing the need for sleep can be a challenge for students with ASD/special needs. Reinforce that when we sleep well at night, we feel awake, happy, and our bodies feel ready to do things the next day. If we don t get enough sleep we will feel tired, unhappy and won t feel ready to do things the next day. Another change you will SEE is you will grow hair under your arms and SOMETIMES the hair on your arms and legs will get thicker and darker. This can be confusing because students already have hair on their arms and legs--that s why the word sometimes is necessary to avoid confusion. Make sure to point out these changes in these pictures otherwise students may focus on something else.

4 Some girls will shave the hair on their legs and under their arms. You ll need help from a parent or trusted adult when you begin shaving. Make sure and ask them. Some girls will not shave. What kinds of things will you need to have to shave the hair on your legs and under your arms? Many of these students will use an electric razor to shave while others will use a razor with a blade. It is very important for them to understand that they should always have an adult help them when shaving. Some girls use a sharp razor and shaving cream to shave their legs and under their arms. Some will use an electric razor. Never use an electric razor in the bath. Mom or another adult will need to help you shave. You may accidentally cut your skin with the razor because the razor is sharp. You will need to tell an adult and put a little tissue on the cut until it stops bleeding. Sometimes girls and women cut themselves when they shave. That s normal. It s even happened to me. Here s a picture of different razors. Have any of you seen these? With students input, point out the difference between razors with a blade and electric razors. Again emphasize that razors are very sharp and you should never touch the razor with your finger. Instruct students to only shave areas on their legs and under their arms where they have hair and when it is covered by shaving cream/gel. Reinforce that they need to talk to mom or a trusted adult about which areas to shave. Interaction is very important to make this program a success. It is important not to expect the right answer -- or any answer at all -- but asking will encourage interaction. These students will benefit from answering questions and receiving positive reinforcement for that, even if the answers are not correct. Try to guide students to answer some questions correctly when they re able. Pass around boxes with different shaving creams and gels in it for students to see, or have students come down in front where containers of different types of shaving cream/gels are available. Discuss how shaving cream feels and that it is like soap and will feel cool and creamy. Remind students that they can only shave when the shaving cream or soap is on their skin unless they are using an electric razor. Do not allow students to touch personal hygiene products due to concern of allergies.

5 After playing the video, explain steps emphasizing the following information: 1. You need to be careful when shaving and have a parent or another trusted adult help you. 2. The razor is sharp and you shouldn t touch the blade. 3. You can only shave your skin when you have shaving cream, shaving gel or soap on it. 4. Move softly over your skin with the razor. 5. The shaving cream and hair will come off on the razor. 6. You will need to rinse the shaving cream and hair off the razor sometimes. 7. You should only shave the hair under the shaving cream. 8. When you are done shaving, wash off shaving cream and then dry your skin. 9. Your skin will feel smooth and soft. You may want to put a moisturizer on your legs. 10. If you accidentally get a small cut when you shave, tell an adult and dab the blood with a tissue until it stops bleeding. This is normal and sometimes happens when people shave. Review: 1. Hold up items needed-razor, shaving lotion, and moisturizer asking students to define them. 2. Discuss, with students input, why we shave (some people don t like hair under their arms or on their legs), how often and when to do it (in the shower or bath or on the side of the bathtub or sink). 3. Verbally review steps. Ask questions like, Where should you shave your legs or under your arms? Guide students along, When you re in the shower, what should you do next? 4. Act out steps. This will serve as a review. Ask questions like Now that we have the shaving cream on our hands, what do we do next? and physically walk through the motions. Repetition is the key to helping students understand these concepts. Emphasize to students that it is important not to share razors with anybody else. Everyday your body gets dirty. Most people take a bath or shower every day. As you get bigger, you are also going to sweat more. Ask students if they know what you mean by sweat and remind them sometimes we feel sweat on our face or neck and other places when we get hot. We feel WET. We will feel WET on different places on our body, especially under our arms and not just when we are hot. That will smell really bad and that s not good. What should we do every day so that we don t smell bad to our teachers, friends and family? Shower or take a bath. These are the things that you will need to shower. Can you name one of them? As students provide answers instructor provides positive affirmations for any response provided.

6 Let s talk about what to do when we take a shower. 1. Turn water on and take off clothes. Either one first is fine. 2. Get in the shower. 3. Get body and soap wet with water or use body wash. 4. Rub on all parts of your body. You can use a washcloth or your hands. 5. Rinse with water. 6. Turn shower or bath off. 7. Dry body with towel. 8. Put on clean clothes. Instructor may act out steps as she lists them, using props. Washing hair can be a challenge because of soap/shampoo getting into eyes. Many students don t like to have soap or water on their heads. Reinforce how important and necessary it is to wash hair. Your hair can get dirty, greasy, and smell bad too, so sometimes you will need to wash your hair. You may do this when you are taking a shower. What do you need to wash your hair? Again thank students for answers even if not correct. This positive reinforcement will encourage continued interaction. That s right: shampoo. Shampoo will clean your hair and make it smell nice. 1. Squeeze a small amount of shampoo into your hand. 2. Rub hands together. 3. Rub shampoo into your hair. The shampoo will smell nice and feel soapy. 4. Sometimes the shampoo may get into your eyes. That s okay. Sometimes that happens to people when they wash their hair. Try to keep your eyes shut and, if the shampoo gets into your eyes, you can wipe your eyes with a wash cloth. 5. Get under the water and get all of the shampoo out of your hair. You will need to feel your hair to make sure all the shampoo is out. 6. Repeat.

7 Again, instructor should act out steps as she lists them, using props. Not everybody conditions their hair, but if you do, you will condition your hair after you wash your hair so it feels smooth and isn t knotty. That will make it easier for you to brush your hair. What should you use to condition your hair? Again always thank students for any response provided. That s right: conditioner. 1. Squeeze a small amount of conditioner into your hand. 2. Rub your hands together. 3. Rub conditioner into your hair. The conditioner will smell nice and feel smooth. 4. WAIT. Sing a song. 5. Get under the water and get all of the conditioner out. What can you do after you shower that will help you smell nice and feel less wet and sweaty? Use deodorant, right? We need to talk about deodorant with an adult we trust before we do it ourselves, though. What does deodorant look like and how do we use it? Pass deodorants around. Instructor will demonstrate the process of applying deodorant. After you ve done such a good job cleaning your body, you want to make sure you put on clean clothes; not the clothes on the floor or in the laundry basket, right? Make sure not to use teaching methods that involve humor. Humor and jokes can be difficult for autistic and special needs children to understand and may cause stress for them. Simple, clear concise information in a friendly manner is effective.

8 REVIEW: Social Story As previously mentioned, repetition is very important for students. This activity is done using a white board with pictures individually laminated and using magnets. Depending on the students levels of abilities, they may come up to arrange pictures, one line at a time, in order (pictures are in a container from which they may choose). Other students may explain the steps, or the instructor can put pictures in order and explain the steps with or without student input, based on level of interest and ability. Once the story is complete, the social story image should be returned to the screen and briefly explained again. Show three squares at a time to allow students to process the information without being overwhelmed. If you shower in the morning, how should you clean your body at the end of the day, before you go to bed at night? Allow answers and again, any answer is a positive answer. The more interactive the program for students, the more effective it is. You need to wash your face and brush your teeth. You will get some red spots on your face and maybe even your back and chest. They are called pimples. They look like this. These red bumps are okay and they do not mean you are sick. Many of these students think that pimples mean they are sick and need a doctor. They will need reassurance. You need to wash your face with a washcloth or clean hands, soap and water. Sometimes you may put some medicine on your pimples or red bumps. A parent or trusted adult can show you how. These are some of the things you will need to wash your face. Can you name any of them? Instructor explains how each item is used.

9 Instructor again briefly explains that some students may need acne ointment (use the word ointment vs. medication for many students are on medication and this could be confusing or upsetting) and the need to get help with this from a trusted adult. BEFORE SHOWING SLIDE SAY: Everyone needs to brush their teeth 2-3 times a day to keep them clean and healthy. What are the times you should brush your teeth? Allow answers and provide positive feedback. Brushing your teeth will also prevent cavities which are bad for your teeth and can make them hurt. Show slide. You should brush your teeth in the morning, after you eat and before you go to bed. Here are some things you need to brush your teeth. Can you name one of these things? Rather than asking them to name any of these things, asking a student to name one is easier for them to understand. Demonstrate the correct way to put toothpaste on the toothbrush and show an appropriate amount.

10 You will brush your teeth at the sink. The toothpaste may taste like mint or cinnamon or even bubblegum, but you don t eat it. When you re done brushing your teeth, make sure not to swallow the toothpaste. Spit it all out into the sink. Then you rinse your mouth with water and spit again. Demonstrate and explain proper brushing and flossing of teeth using RCC model and toothbrush. Instruct students to brush teeth while singing the ABC song. After we brush our teeth is a good time to remember to brush our hair. People brush their hair so it looks nice and is not tangled. You should brush or comb your hair when your hair is wet, after you wash it, and every morning before you go to school. Sometimes you will need to comb or brush your hair during the day to keep it looking nice. You should brush or comb your hair in the bathroom or bedroom and not around food. Make sure not to share your hairbrush or any of your personal items, like your razor or toothbrush.

11 At this time a pink blank slide will appear on the screen indicating an interactive component of the program. This will not have a title so that it will not be distracting to the students. At the end of this section, the instructor should place all of the items discussed on a table and call on different students to pick out one thing they would need to complete one of the activities. (i.e. Show the group one thing you would need to wash your face. Show the group one thing you could use to help you smell good. ) Choose students who appear to need some movement. Depending on the size of the group you could have the whole group come down and explore items and then ask volunteers to show one thing you would use to wash your face, hair, etc. Again, depending on the group s ability level, students could walk through steps with props for each hygiene activity previously described in the lesson. We just talked about a lot of changes that have happened, or are now happening quickly to your bodies. We ve talked about things you need to do to take care of your bodies. Your feelings can also change quickly. Sometimes these changes don t feel good so you need to talk to mom or dad or another trusted adult and they will be able to help you. Feelings are some of the hardest things for these students to understand or explain. It is difficult and abstract. Change is also a difficult concept, so by showing a clear representation, students will be better able to grasp the concept. Depending on the group, you can discuss healthy ways to handle emotions (i.e. talking, exercise, deep breathing).the instructor will need to be very aware of the audience because, for some ASD/special needs students, this can be an overwhelming topic. Just talking about it can cause anxiety. It may be enough just to let them know their emotions will change quickly and to talk with a trusted adult when needed. SLIDES CHANGE FROM HAPPY IMAGES TO ANGRY AND SAD It can be difficult for ASD/special needs students to understand what s appropriate to talk about with others. ASD/special needs students often have difficulties reading the reactions of others and find it difficult to determine if what they say is appropriate or not. Who they can talk to about these topics will need to be reinforced. You may need to talk to mom, dad or other adults you trust about the things you are talking about today. Here are some people you can talk to about these things. Are there other adults you can talk to about these things? Be aware that most of these students have severe and negative reactions to the word doctor. They would not necessarily consider a doctor to be a safe person in whom to confide. Explain that a doctor is a safe person because their job is to understand the things that happen during puberty and to help. As you go through each picture, ask students to show a thumbs up or a thumbs down to demonstrate that they understand with whom they can discuss these changes. Then, show whether their response was correct and discuss. Animation will show thumbs up or thumbs down

12 after each picture. Here are some people who we should not talk with about these things. Go through slide using demonstration done with previous slide. These students are receptive to guided language. It provides clarity to the topic. BEFORE SHOWING SLIDE OF PRIVATE CHANGES: During puberty you will also go through changes that no one else will be able to see. These are changes you share with only a few other people. These are called private or personal changes. What does it mean if something is personal or private? It means that it is not shared with everyone. Review thumbs up/thumbs down slides. Is anyone excited to learn about these private changes? Does anybody know a private change that happens during puberty? SHOW SLIDE OF PRIVATE CHANGES: Some personal or private changes you will see are your breasts will grow bigger and hair will grow in your pubic area. Your period also begins. You can talk about these changes with a few people. You can share things that are personal and private with certain people who you feel safe with and trust. These things we will be talking about today may make you feel silly or make you want to laugh or giggle, but every girl goes through these changes. Avoid words like embarrassing and normal. These are complex languages terms that are difficult to understand. Your breasts will slowly start to get bigger. When you are a child you do not have breasts. As you grow and get bigger, breasts get bigger. Show with your hands. Sometimes your breasts will feel sore or hurt a little bit. That can happen when they get bigger and doesn t not mean anything is wrong. That is okay and will not last long. As they get bigger, you will need to start wearing a bra. A bra will hold and cover your breasts and help your breasts feel comfortable. Grown women and older girls wear bras to hold and cover their breasts too.

13 This is a topic that can cause worry for students. Many are sensory challenged and the transition to wearing a bra is difficult. Students will need to understand that wearing one is very important. Reinforce that developing breasts are part of personal/private changes. If you don t wear a bra, people can see your breasts. These are private and we don t show them to others. Your bra should feel comfortable. Say okay if comfortable is too difficult a word for students to understand. It should not leave red marks on your body, like something does when it is too tight and doesn t feel good. If it does feel too tight, tell mom or another trusted adult. Mom or another adult, like your Grandma, can help you go to buy bras. You will need to put a bra on each morning when you get dressed. Your bra and panties are your underwear. People should not see you wearing your bra and panties. You wear your clothes on top of your bra. You don t need to wear a bra with your pajamas and when you wear a swimsuit. Discuss different types of bras. Examples of bras for girls to see will be passed around. Demonstrate how they should fit evenly around and again not cause red marks or hurt at all. You will also grow hair in the pubic area. This will happen slowly too. You do not have hair on your pubic area when you are a child. As you get bigger, you grow hair in your pubic area.

14 Reinforce slow process of hair growth to students. At this time a pink blank slide will appear on the screen indicating an interactive component of the program. This will not have a title so that it will not be distracting to the students. Have students squat down like they are little children. Ask a few students to say what their body was like as a little girl (At 4 years old I was short, little, and had no breasts or pubic hair.). Then have them stand up a bit and call on a few students to talk about what their body is like when they are a little older (At 7 years old, I was a little taller but still didn t have breasts or pubic hair.). Then have them stand up and tell about changes that would be happening to a 14 year old body (I get taller, I get breasts and pubic hair, hair under my arms. I may get pimples. I sweat more and have stronger odors.). Then have them stand with hands way above their heads and tell what their bodies are like after puberty is over, around 21 years old. This activity represents the idea more fully to the students of the growth they will be experiencing during puberty. Before showing this slide, introduce the topic. During puberty you will also get your period or menstrual cycle. This means you are growing up. Other girls your age are starting their periods too. Mention menstrual cycle once for those higher functioning students that may understand or be familiar with it. After this use the term period only. Ask students, What is it? What will it look like? Some students may have already started having their periods and this will inform you of their knowledge and experience level. SHOW SLIDE. When you get your period, blood will come from your private area (vagina). That is okay, you are not hurt! You period will come every month. Blood will come out of your private area (vagina) for 3-7 days and then stop. This may be scary at first but it is okay and happens to all girls when they grow bigger. Has anyone ever seen blood? We can bleed when we fall down or when we get cut. When you get your period, it will be like that but much slower and you are NOT hurt. Some girls may fear bleeding to death. Compare bleeding during your period to other body fluids like, tears, sweat and urine (pee). This reinforces that the period will end and, when compared to some other body fluid loss, normalizes it. To talk about menstruation by age range can be very difficult for students to understand. Listing ages will provide clarity. If you are 9, 10, 11, 12, 13, (etc.) you can get your period. Use whatever ages are appropriate for the group. What will you see when you get your period?

15 We talked about blood coming from the private area between your legs. When you get your period you will see brown or red colored blood on your underwear or on the toilet paper after you wipe yourself. Reinforce red and brown color on slide. This blood does not mean you are hurt. This happens to all girls when they get bigger and grow taller. Discuss who girls can go to for help (mom, school nurse, health aide, etc.). Periods are messy and can get on underwear and pants. You will use a pad in your underwear so the blood won t get on your pants. The pad may feel weird when you first use it, but it will help keep your pants clean from the blood. Soon, wearing a pad will feel fine. You will need to keep the pad on when you are having your period. When you get your period you will bleed like this and it will last for about 3-7 days. Go through days of the week: Monday, Tuesday, Wednesday... This is a difficult concept for students to understand. You will get your period every month. This happens when you get bigger and grow taller. Show calendar/month slides. Explain that these slides mean that this will happen again and again. This is one of the hardest things for the students to understand. If it has not yet occurred for them, they have difficulty understanding that it happens over and over. They will see the first time as a single event rather than a recurring event. The following slides are reviewed very quickly to reinforce this is a recurring event.

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18 Show actual pad and pass it around for students to feel. When you get your period, you will use pads to keep your underwear and clothes clean. This is what a pad looks like. The pad helps us. The blood stays on the pad and your clothes stay clean. Remember that getting your period is personal. Pads are private. You don t show them to other people. You take them to the bathroom without showing others. You can use a purse or put them in your pocket. Explain to students that you will be showing them how to put a pad in their underwear. Wash your hands first. This is very important when you put on your pad. Demonstrate proper hand washing technique. Then, discuss going into a bathroom stall and making sure door is closed because this is private, unless you have somebody helping you.

19 As you walk through the pad placement demonstration, reference the same steps as in the picture. Put pad on. Show how to take off the adhesive strip and place the pad on underwear. Make sure you discuss and demonstrate placement of wings on pads because many girls will have pads that have wings. Emphasize that the adhesive side faces down. Wash hands when done. Ask students to volunteer to explain steps of placing a pad in underwear. Depending on the group, a student may even provide a demonstration of placing a pad in underwear. Have supplies available for student(s) to demonstrate.

20 You will need to change your pad when it is dirty. Demonstrate changing a pad while going through pictures: 1. Review proper washing of hands. 2. Place some red food coloring on a pad to represent blood. Do this prior to the program. If students recognize what menstrual blood looks like on a pad, they will become accustomed to it and be less fearful when they have the real experience. 3. Remove pad and show how to wrap it in toilet paper. Emphasize not to touch the blood. Throw away dirty pad in trash. Don t flush it down the toilet. Explain that if you put the pad in the toilet, the toilet won t be able to flush. The pad is too big to go down the toilet. 4. Place new pad in underwear. 5. Wash hands. The instructor again reinforces proper technique. Show Video demonstrating changing of pad. Ask students to explain steps of changing a pad. Depending on group, a student(s) can even demonstrate changing a pad (make sure to have a pretend soiled pad available). Many girls need frequent reminders to change their pad. Suggest to students that they may use a timer to remind them when to change their pads. They may need some help doing this. Some school settings will allow it. You will need to change your pad when it becomes dirty or every 3-4 hours. You may feel wet at times, which means it s time to change your pad. Pads should be changed at least at these times (on the

21 slide) or even more often. If not, there may be leaking which is when the blood gets on your underpants and clothes. Discuss what to do if you leak through a pad. Describe actions using clear and observable instructions. Be careful when using the word embarrassing. This is a difficult concept. If the group brings it up and understands the word then you can talk about it with them. When a pad leaks, we want to clean it up because it is messy. Periods are private/personal. If blood gets on your clothes, other people may see it. Go to the bathroom with a new pad and new underwear and pants/skirts/shorts. Take the pad off. Wrap it in toilet paper and throw it in the trash. Take off the clothes that got blood on them. Put clothes in a plastic bag. Put on a new pad. Put on new clothes. Take dirty clothes and wash them in the washing machine to clean them. Emphasize that this is normal and happens to all girls but it can get messy so we want to take care of it properly. Reinforce again to ask for help from a parent, teacher, school nurse or trusted adult. Discuss signs your period is coming. Sometimes when you re going to get your period, your stomach may hurt. Your stomach may look or feel bigger. Your breasts may hurt when you touch them. You may see red or brown on the toilet paper after you wipe. Sometimes when you have your period, you may get cramps. Cramps feel like pain low down in your tummy. Cramps can be uncomfortable and can hurt. If you get cramps you need to tell a parent or trusted adult and they will help you feel better. Many girls and women get cramps when they have their period. It is normal. Reinforce again that these are private changes that happen to every girl. Who can you talk to about these changes?

22 Have students do thumbs up, thumbs down as you go through the pictures again listing examples of things they can discuss with these people and things they can t. Again remind girls that these puberty changes can start at any of the ages displayed and that they now know what to do when these changes happen. Remind students that this a time to ask mom, dad or another trusted adult for help (Students can list who those adults might be.). Reinforce that everybody has questions and will need help from a trusted adult. Have a brief discussion asking girls to list changes that were discussed during class and maybe ideas of how to take care of those changes. Guide them with answers if needed. 1. Get taller/bigger. 2. Hair on legs/arms may get thicker and darker. Hair will grow under arms (armpits) and in pubic area. May shave under arms and legs. 3. Sweat more and be stinky so need to shower every day and use deodorant. 4. Pimples, so keep face and other areas clean and maybe put on medicine with a trusted adult s help. 5. Can t forget to brush our teeth 2-3 times a day. 6. There will also be private changes. Breasts will get bigger so will need to wear a bra. 7. Get period so wear pads and change them often so you don t get messy (Have girls name times to change pads.)

23 *** These two following topics can be extremely uncomfortable to students and discussing them in 1st person plural(we) will help them be less threatening to students.*** Discuss private parts: Public places are where other people can see us (school, store, etc.). Private means away from other people, like in our bedroom or bathroom with the door closed. Everybody has private parts of their body. We can tell which parts of our body are private because we cover them with underwear. We don t touch our private parts in public where other people can see us. We don t ever put our hands inside our pants in public. Sometimes we need to remember not to touch ourselves in public so we can put our hands by our sides, cross our arms, or fold our hands. Demonstrate these motions while showing slide. Sometimes we need to touch our private parts, like when our underwear is uncomfortable or when we itch. We can ask to go to the bathroom. When we are alone in our bedroom or bathroom, we can touch our private parts.. Discuss Safe Touch: When we are with friends and family, it s usually okay to touch them and for them to touch us on the arm, back, shoulders, or hands. Point to these areas as you list them. These are go areas of the body. For example, we can give high-fives, pat them on the back, or touch them on the arm to get their attention. It s not okay to touch other people on parts of their body covered by underwear, such as their behind, breasts, penis, or vagina. It s not okay for anyone (but a doctor/ parent/ )* to touch us on parts of our body covered by underwear either. These are private parts of our body and are stop areas. If someone touches us in our private areas, we should say STOP or NO and tell mom, dad, or teachers. Sometimes mom, dad, another adult we trust, and our doctor will need to see our private areas to help us stay clean and healthy. Have students give examples. We need to remember that some people don t like to be touched on their arms, hands or heads and that s fine. May need to alter to include caregivers or medical professionals who need to assist with daily living skills or perform needed medical procedures. Discuss examples: 1. Should a Dentist touch your mouth? Should a Dentist touch your breasts or pubic area? 2. Should a cashier touch your breasts or pubic area? 3. Can you shake hands with a good friend? Pat them on the back? High five? Touch their shoulder to get attention. Should a good friend touch your breasts or pubic area? 4. Can an Aunt or Uncle touch your shoulder to get your attention? Pat you on the back? High five you? Touch you on your breasts or pubic area?

24 At this time a pink blank slide will appear on the screen indicating an interactive component of the program. This will not have a title so that it will not be distracting to the students. Instructor will have students come up and place green or red stickers on large male/female body silhouettes demonstrating safe/unsafe touch areas they can be touched as well as safe/unsafe areas they can touch others. Use the terms OK and Stop to distinguish safe/unsafe areas. Thank students and teachers for coming and doing such a great job. Address any other questions at this time. Provide booklets to teachers to distribute to students and/or parents. Explain to students that the booklet is for them to use with a parent or trusted adult. It will have information on the things we talked about today to help remind them how to take care of their bodies during puberty and to answer questions they may have.

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