1 Sexual Health Education Elementary TrainingKK 3 intro slides, 15 minutes 11-11:15 Welcome participants to the training. Introduce ourselves. Use ice-breaker to do participants introductions. Gather the group into a circle. Introduce self to the group with a motion. For example, “Hi, I’m Andrea. I teach 5th grade in Kent.” The rest of the group says hello while repeating the motion. For example, “Hi, Andrea!” while making the same motion. Go around the circle so everyone has a turn. AG: Set the tone for the morning. When we do these trainings, participants typically come with a wide range of experience teaching sexual health. Our plan is to create a learning environment that really supports and encourages each other in taking a big step forward in our own learning, wherever we may be on our individual paths. By the end of the day, we hope to see everyone feeling a lot more skilled and more prepared than when they came in. Review logistics. Location of bathrooms Sign-in sheet and materials, if you didn’t already pick them up Clock hours Kari Kesler, MA Andrea Gerber, M.S.Ed. October 2014

2 Training Objectives Participants will…Understand the goals of comprehensive sexual health education Improve skills in delivering sexual health education Have sufficient medically-accurate knowledge of puberty to deliver the curriculum with confidence Explain how to assess students’ needs through the use of an anonymous question process Understand and demonstrate FLASH Values Question Protocol Feel more confident in the sensitive handling of difficult student questions KK Briefly review objectives and explain as necessary. Check for buy-in.

3 Agenda Introduction Curriculum overview Key conceptsTeaching about puberty Answering students’ questions Evaluation and clock hours KK Here is our agenda for today, as you can see it is pretty packed. We do have some “working” breaks scheduled in here as well. Lunch will be 1 hour. Any questions about the agenda?

4 FLASH Overview Comprehensive elementary, middle, high school and special education sexual health education curriculum Focus on abstinence, prevention of pregnancy and STDs, and prevention of sexual violence Lessons are available: Online scroll down and look for FLASH Hard Copy—each school has 3 binders that have all the FLASH lessons in them KK (4 mins) FLASH is a comprehensive sexual health education program developed by Public Health of Seattle & King County. In addition to HIV and STD-prevention information, it also covers pregnancy prevention, abstinence, and the prevention of sexual violence. Has anyone used FLASH? In elementary years, FLASH lays the groundwork by teaching about reproductive system, puberty, friendship, decision-making, self-esteem. FLASH is approved for use as a comprehensive program in Washington State, and is currently considered a “promising program” nationally, meaning that although it has not undergone a rigorous evaluation, it has been shown to be based on effective practices and principles. FLASH is approved in Highline and can be used in elementary – all the lessons are available free online. You can use them, supplement with them, or even just read them as teacher prep. The teacher’s notes are very helpful, and GBS doesn’t really have much in the way of teacher's notes.

5 Outcomes of Sexual Health EducationComprehensive sexual health education can reduce the likelihood that teens are involved in a pregnancy or acquire an STD or HIV. It may also be able to reduce sexual violence These outcomes are achieved by focusing on beliefs, attitudes, and skills at all ages. AG, Outcomes and Key Concepts, 30 mins (4 mins) 11: Let’s talk briefly about what we’re trying to achieve overall in sexual health education. We know with confidence that comprehensive sexual health education can reduce the likelihood that teens are involved in a pregnancy or acquire an STD or HIV. These outcomes are achieved by focusing on specific sexual beliefs, attitudes and skills that research tells us (1) have the most impact, and (2) are the most amenable to change. I think this point is especially relevant for elementary school teachers. We all know, even personally, how hard it is to change an attitude or belief once we have it. Helping younger student form attitudes and beliefs from the get-go that support healthy behavior is exactly what we should be doing. Similarly, helping them acquire skills and integrate them into their daily practice before the stakes are so high will absolutely improve their ability to use those skills later.

6 Key Concepts Key concepts are the main ideas you’re trying to convey in the lesson. Returning to your key concepts helps you stay focused and achieve the goals of the lesson. AG (4 mins) In sexual health education, we are trying to achieve learning that is deep and long-lasting. Of course, sexual health education is by no means the first field to think about how to achieve more lasting learning. There is a sea of academic literature on this topic, and much of it advocates for teaching bigger ideas. We’re calling these bigger ideas “key concepts.” By keeping them in the forefront, we stay connected to the skills, behaviors and attitudes that we’re after, and of course, we have a much better chance of achieving the goals of the lesson and the curriculum. This focus on key concepts is a pedagogical shift that has taken place within sexuality education. In the past, there has been a tendency to focus on the many medical facts in sexual health, about HIV or puberty, for example. The risk is that we lose track of the larger goals of the lesson – the very reasons we do sexual health education in the first place. Of course, this happens at some point with all of us, for very good reasons. It may be that this was how we were taught to teach sexuality, or it’s in the lesson plans we’re using. It may be that we worry that students aren’t going to get the information anywhere else so I need to cram it all in right now. Its certainly understandable how we can lose track of our guideposts. Today, we’ll be using key concepts as a way to stay focused on the bigger pictures in our lessons, and on the broad goals of sexual health education.

7 Instructional ApproachFocus on key concepts Teach fewer sexual health facts Use key concepts to frame sexual health information AG (3 mins) Here is the instructional approach we’ll be using… Focus the lesson on our key concepts. Share a reasonably small number of carefully selected sexual health facts, And frame them with key concepts. (Repeat, with emphasis on sharing less facts.) We know that students will walk away remembering only a few things from the lesson. We don’t want it to be random. We want them to be tied to the key concepts that can really impact their learning. Teachers tell us that this is extremely helpful to them. It doesn’t just provide guideposts to their lesson, but helps them tie in all the seemingly random stuff that their students bring up too. It also frees you from having to become sexual health experts, which is not what your students need from you.

8 Key Concept Guide Derived from research on the behavioral goals of sexual health education Organized by topic and grade level AG FLASH has a key concept guide to assist you in implementing the curriculum, so you know exactly what key concepts to focus on. These key concepts align with the research I spoke about earlier. The guide is set up by topic and by age level. You’ll notice that some of the elementary topics are subjects you routinely teach about, like puberty. Others, like birth control, for example, are topics that you don’t have any lessons about at the elementary level, but it’s helpful to have key concepts to assist you during the times that students bring up questions outside the scope of your lesson. In these cases, the key concepts are developmentally appropriate stepping stones for future concepts.

9 Key Concept Exercise Key concepts are posted around the roomEveryone will receive 2 or 3 different strips of paper Walk around the room reviewing the key concepts. Tape your slip of paper beneath the key concept that you could use when teaching the sexual health information on your strip of paper. AG Use talking points on following two slides to debrief the HIV, Puberty and Abstinence key concepts.

10 Puberty Key Concepts Puberty key concepts are related to sexual violence prevention determinants Gender equality and fairness KK Review key concepts for puberty. These are the main messages you want to convey. Make sure to go through the puberty key concepts thoroughly FLASH puberty lesson is a pretty good match with these key concepts. The SV prevention research came out after the lesson was written, but the concept of gender fairness had always been a part of the philosophical fabric of FLASH. If we were to re-write it today, we would probably even strengthen it up a bit in this regard, but it is a very good starting point.

11 HIV Key Concepts Laying the groundwork for lifelong prevention of HIVImportant attitudes to foster in upper elementary grades Belief that HIV isn’t inevitable for anyone Motivation to avoid HIV Belief in ability to prevent HIV in the future HIV knowledge alone is not a protective factor in the literature AG Now we’re going to focus on HIV key concepts. HIV is an insidious disease AND it’s preventable. The fact that HIV is the only illness that Washington State requires us to teach to children every single year, starting in 5th grade, says something about the critical role of education in curbing the epidemic. Fortunately, there’s excellent research telling us what students need to learn. As we discussed earlier, right now, in elementary school, we can begin teaching concepts that can have a major impact on HIV prevention down the road. At the upper elementary level, students aren’t typically engaging in behaviors that cause them to get HIV. They’re not currently at risk. But we CAN start forming critical attitudes that HIV isn’t inevitable. We can motivate students to avoid HIV, and we can help them believe in their ability to prevent or avoid HIV in their future. These things are huge. These things translate into relatively straightforward key concepts – with a big emphasis on HIV being preventable. Significantly, being knowledgeable about HIV doesn’t appear as a protective factor in the literature. You don’t actually need a ton of information about HIV to protect oneself from getting it.

12 Abstinence Key ConceptsSets positive attitudes and positive peer norms about abstinence for future. Behaviorally specific Related to pregnancy and STD prevention AG End at 12:00 Just like HIV risk, abstinence is really a concept that is useful to students in their future, not right now. Elementary aged students don’t need to be convinced that waiting to have sex is a good idea – most of them are still wondering why anyone would even want to have sex! However, that will change as they get older, and we want to have already fostered both positive attitudes and positive peer norms about abstinence for them to fall back on at that point. That is why our elementary key concepts let students know that everyone abstains at some points on their life, and that there are real benefits to choosing abstinence – not having to worry about pregnancy and STDs. Finally, in order for abstinence education to be effective, it has to be behaviorally specific, focusing on the specific behaviors that place people at risk for pregnancy and STDs. For this reason, we define oral, vaginal and anal sex so we are clear what people will need to abstain from.

13 Teaching About PubertyFLASH lesson 9 Define puberty Brainstorm puberty changes and explain Highlight gender similarity KK 12 – 12:40 (40 mins)

14 BREAK Break, 15 mins 12:40-12:55

15 Student Questions Fundamental to student learning Teacher anxietyStudent anxiety Many effective strategies AG, 10 mins, intro and generating anon questions 12:55 – 1:05 We’re going to spend the afternoon together working on the skill of answering student questions. The reason we’re spending so much time on this is that student questions are the cornerstone of sexual health education. Not only are they fundamental to student learning, but they give you an opportunity to build trust in your classroom, and to build your own credibility as a trusted and reliable source of accurate information – amidst a sea of myths and confusion. It also seems that the unpredictability of student questions can make educators feel a little anxious about teaching sex ed. We’re all able to follow a lesson plan, but who knows what our students – or particular students -- will bring up and ask! And as anxious as some of us may feel at times, our students feel it tenfold. They are taking a huge risk by asking questions. Surveys tell us that their questions about sexuality are extremely important to them, and they desperately want trusted adults that they can ask. (Check in with the group to see if this reflects their experience and observations…) Fortunately, there are many effective strategies to responding to students’ questions. Past participants have told us that this part of the training has helped them move forward in answering student questions, whether you are new to this subject area, or you want to refine and advance your skills.

16 Agenda Strategies for generating student questionsStrategies for answering different types of questions Question exercise AG

17 Anonymous Questions Why do them? How to set it upExplain what you’re doing Pass out slips of paper, same size and color No names Post big list of possible topics Post sentence stems (e.g. “Is it true that…”) Everyone writes AG Most questions are asked out loud during class, and that’s great. But many educators also give students an opportunity to ask anonymous questions. Whether or not you’ve done this in your own classroom, why do you think it might be valuable? Confidential, less embarrassing Best possible assessment of what students need to know Gives teacher time to think about their answers ahead of time! Let’s talk through how to set this up. Has anyone used this strategy before? Pass out handout and talk through it. In just a minute, we’ll work with some real anonymous questions!

18 Questions about Value-laden TopicsStudent questions may be about values Student questions may be about topics which people hold strong values about AG, 20 minutes 1:05 – 1:25 We are going to talk now about students questions. We’re going to start with the ones that can sometimes be the most unnerving for teachers – questions that are about value-laden topics. These questions may be directly about values, or may be about topics which people have strong values about. For instance, a student may ask directly about a value, such as “Why do people have sex when they are not married?” Or they may ask a question about a value-laden topic, such as “Can girls masturbate?” We’re going to talk now about how you handle these types of questions. You want to give an answer that is honest and helpful, and that is respectful of the broad range of values and beliefs held by your students and their families. We have some strategies to help you do that. 18

19 The Role of Values Universal ValuesLarge majority of our society holds these values. We are obligated to teach these values. AG First of all, value questions might be about values that are universal, that is values are those that 95% or more of the community agrees on. We are obligated to teach these values. 19

20 Universal Values Forcing someone to have sex with you is wrong. Knowingly spreading disease is wrong.  Elementary school age children should not have sex.  Sex between children and adults is wrong.  Taking care of your reproductive health is important.  AG Anyone have any questions, or disagree that these are universal values? 20

21 The Role of Values Non-Universal ValuesThere is no large consensus on these issues Examples include . . . AG Non-Universal values are everything else - those that 95% or more of the community does not agree on. There is not a consensus in the larger community about these issues. Can you all think of some topics that people hold varying values about? 21

22 Non-Universal Values on Many TopicsSex outside of marriage  Same-sex relationships Birth control  Masturbation Cohabitation  Abortion   What age/under what circumstances it's ok to start having sex  Using tampons Girls shaving AG Great. Why include using tampons as a non-universal value? While medically, there is no harm in tampon use - there IS a range of beliefs among families and cultures about when, or if, girls should use tampons. 22

23 Non-Universal Values in the ClassroomIt is not helpful or educational to express our own personal beliefs on non-universal issues at school. Families have the role of teaching values on non-universal issues, not schools. Schools must teach about these topics in a way that respects the diversity of values. AG We DO NOT have the right to express our own beliefs about non-universal values. It is the role of the family to teach values about these issues. However, we can, and should, answer our students questions about these topics, and even teach about them. This must be done with respect for the diversity of opinion within our communities. For example, you can discuss tampons- what they are and how they’re used, the fact that many women and girls use them, etc., but it is not appropriate to share your opinion about whether or not tampons are a good choice.  We have developed a protocol to help you answer your students questions about non-universal values. 23

24 Values Question ProtocolAG Has anyone here ever used this values question protocol before? Great! You can help out the others as they are learning it. Like I alluded to earlier, the VQP is a way to acknowledge and respect the full range of beliefs on an issue, while still answering any factual parts of the question. It’s respectful to students and their families., and it helps the teacher avoid accidentally sharing their own beliefs. Let’s go through it together. Validate the student: "I am glad someone asked this one.“ "That's an interesting question.“ "People ask me this one every year.“ "This one is really  thoughtful/compassionate/imaginative/respectful. This will encourage your students to keep asking even as it discourages snide remarks about whomever asked that particular question. 2.Identify it as a belief or value question:  "Most of the questions you've been asking have been "fact questions" where I could look up an answer that all the experts agree upon. This one is more of a "value question" where every person, every family, every religion has a different belief."Teaching your students to distinguish facts from opinions (and from feelings) is at least as important as any content you will convey. 3. Answer the factual part, if there is one. For instance, if the question is about the rightness or wrongness of masturbation, you need to make sure that your class understands that -- values notwithstanding -- no physical harm results from masturbating:  Even questions that are fact questions on their face may need a discussion of the underlying values, but always start by answering them: "Can you get birth control without your boyfriend or husband's knowing? Yes, legally in our state, you can. Now let's talk about the different beliefs people might have about couple's communicating about birth control.“ 4.Help the class describe the community's range of beliefs, not their own.; On sensitive issues such as sex and religion, it can be really unfair (and, in Washington State, illegal) to ask individual students their own beliefs. But it is very appropriate to generalize:  "Tell me some of the things you've heard that people believe about that.“ Prompt the group with a stem sentence: "Some people believe ___?"  "Um, hmm, and some people believe ___?"In a class that is used to thinking about the range of community values, you will be able to draw a full assortment of answers from the students. In other groups, especially younger ones, you may draw only a dichotomy ("Some people believe abortion is wrong." and "Some people believe it is right.") In any case, your role is two-fold: (1) to make sure that every belief gets expressed -- or paraphrased -- respectfully, hopefully just as the person who believed it might express it and (2) to make sure that a complete a range of beliefs gets expressed, even if you have to supplement the few values the group can think of 5. State your belief only if it is a Universal Value. For instance, if a student asks you if it is illegal for someone who knows that they have HIV to have sex with other people and not tell them, it is perfectly fine for you to answer the factual part (it’s a grey area, some people have been prosecuted for this behavior), and then state that it is not right for someone to knowingly spread disease, that it hurts people and is not a fair way to treat each other. 6.Refer to family, clergy and other trusted adults.  "Because people have such different beliefs about this, I really want to encourage you to talk with your families, or with somebody at your community of worship, if you attend a church or mosque or synagogue or temple. Or talk with some other adult you trust and whose opinions matter to you. Notice that this encouragement didn't assume that every child has a parent they can talk with. Also, notice that we shouldn't assume that every child goes to church. What if the family is likely to convey values that the child will feel hurt by (a teen who has come out to you as gay, for instance, but whose family is strongly opposed to homosexuality)? Still, knowing one's family's beliefs is developmentally important for young people. But help them think of other trusted adults, as well. 7.Check to see if you answered the question, and 8.Leave the door open.  " Validate the student for asking the question. Identify the question as a belief or value question. Answer the factual part of the question. Describe the range of beliefs. State your belief only if it is a universal value. Refer the student to family, clergy, or other trusted adult. 24

25 Validate the student for asking the question. AG Let’s work on this one together… (Go through steps, eliciting suggestions.) Validate: I’m glad you asked that question. Often when we hear about masturbation, it seems like they’re talking about boys. So it makes sense to wonder if girls can masturbate as well. About values: This question is asking about a fact, whether girls can masturbate. But masturbation is also a topic that people have different beliefs about. Factual part: Masturbation is when someone touches or strokes their own genitals in order to feel pleasure. Girls and women, as well as boys and men, can masturbate. There is no physical harm caused by masturbation. (Be sure terms are defined for students. Here, I’m assuming the word “genitals” was defined in a recent lesson .) Give range: However, there area lot of different beliefs or values about masturbation. If you’re going to put it back on the students. Don’t ask them what the personally believe, but ask what different beliefs are out there. Remember, you’re trying to get the full range of community beliefs. Some people believe that masturbation is natural and healthy. Other people think it’s wrong and that people shouldn’t do it. Some think it’s OK as long as someone doesn’t do it a lot. Are there other beliefs you’ve heard? Refer to family: Because families have different values about masturbation, I encourage you to talk with an adult in your family that you trust about your family’s views on this. Check and keep door open: I hope this answer was clear. Let me know if there’s still questions. Validate the student for asking the question. Identify the question as a belief or value question. Answer the factual part of the question, if there is one. Describe the range of beliefs. Refer the student to family, clergy, or other trusted adult. Check to see if you answered the question. Leave the door open. 25

26 Additional Strategies for Answering QuestionsFactual questions Slang questions Personal questions KK, 40 mins 1:25 – 2:05 We’ve just discussed the strategy we use when answering questions with value-laden topics. Questions about value-laden topics are just one of the types of questions we encounter. There are some other broad categories that each have their own challenges and strategies. Most of the questions we get are factual questions. Questions also sometimes involve slang terms or are personal questions. Of course, questions don’t usually fall neatly into one category. But by discussing strategies for each of these different types of questions, it gives us a lot of useful tools to select from our toolkit.

27 Small Group Question PracticeBreak into 3 small groups Each group will receive a student question and a strategy sheet In your small group, come up with an answer to the student’s question using some of the strategies on your sheet In the large group, we’ll hear each group’s answer and discuss the strategies you employed KK Technique: How do you French kiss? Slang: What do they mean when they say someone is horny? Personal: Were you married when you had sex the first time? Give each small group their question and several tips for them to utilize in answering their question. Give 10 minutes. Debrief each answer in the large group, focusing on the strategies used.

28 Question Practice Move around the room while the music plays.When the music stops, FREEZE! Partner up with the person standing nearest you. In each pair, pick a “teacher” and an “asker”. “Teacher” answers the question on the screen. We’ll discuss as a group. Then switch roles, “asker” becomes the “teacher”. KK starts, KK/AG debrief , 40 mins, for question exercise 2:05 – 2:45 Explain the exercise. In the past, participants have sometimes been concerned about their eloquence. Everyone is probably much more eloquent in front of their class than their peers. For now, concentrate on the words, not on smoothness of delivery. In fact, don’t even worry about smoothness – it doesn’t count here! Also, remember that we show our students respect by sticking with it and struggling to get the right words out. It shows we value them and their questions.

29 Why do girls shave their legs?Question Practice AG Type of question? Fact and values What are some of the values a person might hold? Shaving legs is a personal choice, depending on whether you like the feeling of hair on your legs or not, or how you want them to look. It’s something a woman must do, but a girl doesn’t have to. It’s best not to shave, especially for a girl. Different cultures have different beliefs about shaving. What’s the factual part of the question? Both boys and girls both start getting more hair on their legs during puberty. Not everyone shaves their legs. People who do shave their legs do it for different reasons. Some possible reasons are: they like how it feels, like how it looks, don’t like it but feels pressured to, culture says they should. No health reasons for or against shaving. People’s bodies can look very different from each, but are still healthy and normal -- including the amount of hair on their legs and whether or not they shave it off. If it doesn’t come up in answers, ask: what key concepts would help you frame the answer? Did anyone ask the class… What are some of the reasons you’ve heard of? Why do girls shave their legs?

30 Question Practice Do we have to have sex? KKWhat kind of question is this? How did you feel when you first read this question? Any affirmations that felt genuine? Do we have to have sex?

31 Question Practice Whats a orgazime? AGWhat kind of question is this? Fact, maybe question you don’t understand. Who remembered to do an affirmation? Any new ones? How did you answer? Sample: I think this question is asking about orgasms. An orgasm is a good feeling a person sometimes get in their body when they have sex or masturbate. (VQP, if first time these topics have come up.) Whats a orgazime?

32 Question Practice What are nuts? KKWhat kind of question? Factual, slang. How did you respond? Affirmation Nuts are a slang word for testicles. In class, let’s use the word testicles. Does anyone remember what testicles do? (Make sperm.) And where they are in the body? (In scrotum, the sack that hangs behind the penis.) Remember how we said men’s and women’s bodies were mostly similar. Women have body parts that do the same basic thing as testicles. Does anyone know what organs I’m talking about? (Ovaries) Great! What do testicles and ovaries have in common? (You can decide what kind of teaching you want to do about testicles, depending on where you are in your unit and what you’ve covered.) If they framed around key concept, point it out. If not, ask if they could answer by framing it with key concept. If it didn’t come up, what did you say about it being slang? Point out that it’s not an offensive word to most people. What are nuts?

33 Question Practice What are condoms for? KKType of question? Fact and values Possible answer could include… Validate: I’m glad someone asked this because this is very important. Identify: This is a factual question about how condoms work. Answer factual part: Condoms can be worn during sex to help prevent pregnancy and the spread of sexually transmitted diseases, also called STDs. HIV, which causes AIDS, is one type of STD. Male condoms are worn over the penis so that the semen goes only into the condom and not into their partner’s body. Female condoms can be worn inside the vagina so that the man’s semen does not touch the women’s body. Condoms work very well when used correctly. The best way to avoid catching an STD or becoming pregnant is to not have sex, which some people call abstinence. Describe range of values: Condoms are a form of birth control, and people have different thoughts about when or if it is a good idea to use birth control. What are some things you have heard? Important to use birth control if you are not planning on becoming pregnant Important to use birth control so you don’t have more children than you can care for Good to use birth control if you are single but not if you are married The purpose of sex is to create a pregnancy, so someone shouldn’t need birth control Pregnancy is up to god and people shouldn’t interfere with it. What are condoms for? 33

34 How do you know when you need a small, large, wide, or sinny?Question Practice AG What kind of question is this? Answer depends on what you want to teach. What can you use it as a springboard for? How do you know when you need a small, large, wide, or sinny?

35 Now, I… Understand the goals of comprehensive sexual health educationHave improved my skills in delivering sexual health education Have sufficient medically-accurate knowledge of puberty to deliver the curriculum with confidence Can explain how to assess students’ needs through the use of an anonymous question process Understand and can demonstrate FLASH Values Question Protocol Feel more confident in the sensitive handling of difficult student questions KK, 10 mins, for all remaining slides 2:45 – 2:55 Please share with the group one of the following training objectives or something else you learned from today that you feel more confident in.

36 Evaluation and Clock HoursOnce we receive your evaluation we can give you your clock hours. THANK YOU!! KK Do evals and fill out clock hour forms.