Sexual Knowledge, Experience, Feelings, and Needs Scale

Sexual Knowledge, Experience, Feelings, and Needs Scale‌‌‌‌

MARITA P. MCCABE,1 Deakin University

The Sexual Knowledge, Experience, Feelings and Needs Scale (SexKen) is designed to evaluate the knowledge, experience, feelings, and needs of respondents in a range of sexual areas. There are four parallel versions of the scale: for people from the general population (SexKen), for people with mild intellectual disability (SexKen-ID), for people with physical disability (SexKen-PD), and for care- givers of people with disabilities (SexKen-C). The development of these parallel forms allows the similarities and differences in the sexuality of different groups of respondents to be evaluated and also the report of people with dis- abilities to be contrasted with the report of their caregivers. The measures may be completed as either a questionnaire or interview.

Description

Each of the versions of SexKen consists of 13 subscales. Within each subscale there are questions on the knowledge, experience, feelings, and needs of respondents as they relate to that area of sexuality. The number of items within each of these areas is different for each subscale, as the need for questions in each of these areas is different for the vari- ous aspects of sexuality. The subscales, with the number of questions in each area, are summarized in Table 1.

The first version of the scale to be developed was SexKen-ID. The reason for its development was the lack of an instrument which adequately evaluated the sexuality of people with mild intellectual disability across a broad range of areas. The scale was designed to focus on sexual knowl- edge, experience, feelings and needs. SexKen-ID was gen- erally intended to be administered as an interview. The areas covered by the scale and the original questions included in the scale came from a review of the sexuality literature and other sexuality scales, mainly those developed for the general population. The original scale was tested with five people with mild intellectual disability, and feedback was obtained from professionals working in the sexuality area, carestaff working with people with intellectual disability, and academics who specialised in psychometrics.

The revised scale and the parallel SexKen and SexKen- C versions of the scale, which were designed for the gen- eral population and caregiver assessment of the sexuality of people with intellectual disability, were administered to 25 people with mild intellectual disability, 39 volun- teer students, and 10 carestaff working with people with

intellectual disability (Szollos & McCabe, 1995). SexKen and SexKen-C were completed as questionnaire measures and SexKen-ID was administered as an interview. From this study, it was clear that some items in the scale were not readily understood by people with mild intellectual disabil- ity. Items in the scale were altered or removed to address the problems of relevance and comprehension that were evident from this study.

Modified versions of SexKen-ID and SexKen were used to evaluate the sexuality of people with mild intellectual disability and a student population in two further studies (McCabe & Cummins, 1996; McCabe, Cummins, & Reid, 1994). Analysis of responses and discussions with respondents led to further modification of the scales. SexKen-ID was restructured so that it comprised three separate inter- views. The subscales were organised so that they ranged from the least intrusive to the most intrusive subscales in successive interviews. Interview 1 comprised the sub- scales of Friendship, Dating and Intimacy, Marriage, and Body Part Identification; Interview 2 comprised Sex and Sex Education, Menstruation, Sexual Interaction, Contraception, and Pregnancy, Abortion and Childbirth; and Interview 3 comprised Sexually Transmitted Diseases, Masturbation, and Homosexuality. There were knowledge questions at the end of each interview to determine whether respondents had sufficient knowledge to proceed to the next interview. SexKen and SexKen-C were also reorganised, but remained as questionnaire measures, with the subscales in the same order as for SexKen-ID. A further parallel ques- tionnaire measure was developed for people with physical disability (SexKen-PD).

SexKen, SexKen-ID, and SexKen-PD have been used to gather data among people from the general population (n = 100), people with mild intellectual disability (n = 60), and people with physical disability (n = 60). Test-retest data have been collected on 30 people in each group. These data are available from the author.

Response Mode and Timing

Each of the SexKen measures may be completed as either an interview or questionnaire measure. However, SexKen- ID is designed to be completed as an interview, and SexKen, SexKen-C, and SexKen-PD are designed as questionnaire measures. If completed as a questionnaire, the measure takes about 1 hour to complete. SexKen-ID is divided into three interviews, with each interview taking about 1 hour to complete.

TABLE 1
A Description of the Subscales, Areas, and Range of Scores for the Sexual Knowledge, Experience, Feelings, and Needs Scale (SexKen, SexKen-ID, SexKen-PD, SexKen-C)
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Number Range
Subscale Area of Items of Scores
Friendship (23 items)
Knowledge:
1
0–2
Experience:
13
5–22
Feelings:
4
4–20
Needs:
5
5–25
Dating and Intimacy (16 items)
Knowledge:
2
0–4
Experience:
4
3–9
Feelings:
6
4–11
Needs:
4
4–20
Marriage (16 items)
Knowledge:
2
0–4
Experience:
0
Feelings:
13
6–10
Needs:
1
1–5
Body Part Identification (21 items)
Knowledge:
21
0–42
Experience:
0
Feelings:
0
Needs:
0
Sex and Sex Education (16 items)
Knowledge:
1
0–2
Experience:
7
6–27
Feelings:
5
5–25
Needs:
3
3–15
Menstruation (16 items)
Knowledge:
11
0–22
Experience:
2
2–4
Feelings:
2
2–10
Needs:
1
1–5
Sexual Interaction (52 items)
Knowledge:
21
0–42
Experience:
15
8–31
Feelings:
14
8–31
Needs:
2
2–10
Contraception (19 items)
Knowledge:
9
0–18
Experience:
8
4–11
Feelings:
1
1–5
Needs:
1
1–5
Pregnancy, Abortion and
Knowledge:
15
0–30
Childbirth (24 items)
Experience:
3
Feelings:
4
4–20
Needs:
2
2–10
Sexually Transmitted Diseases
Knowledge:
11
0–22
(19 items)
Experience:
2
1–2
Feelings:
4
4–20
Needs:
2
2–10
Masturbation (16 items)
Knowledge:
3
0–6
Experience:
6
4–20
Feelings:
6
5–25
Needs:
1
1–5
Homosexuality (10 items)
Knowledge:
1
0–2
Experience:
1
1–5
Feelings:
6
4–20
Needs:
2
2–10

Scoring

Whether completed as an interview or questionnaire, the experience, feelings and needs items are either yes/no (scored as 1 or 2) responses or are scored on a 5-point Likert scale (ranging from 1 to 5). The knowledge questions are open-ended, with responses scored 0, 1, or 2 depend- ing upon the accuracy of the responses. The nature of the acceptable responses for each question was determined through pilot work. Some items are categorical (e.g., What do you do with your friends?) and do not contribute to the total score. All other items are scored in the same direction. A total score is obtained for each area within each subscale. The range of scores for each subarea and each subscale is listed in Table 1.

Reliability and Validity

Data have been gathered on people with mild intellectual disability, physical disability, and the general population, which will allow the internal consistency of each of the scales and the test-retest reliability of the scales to be evaluated.

The validity of the scale has been ensured through the initial development of the scale with close attention being paid to the wording of items (Sigelman, Budd, Winer, Schoenrock, & Martin, 1982). Subsequent modification of the scale has been based on feedback from professionals working with people with intellectual disability, psycho- metricians, and subjects from each group who completed the various versions of the scale. There have been three revisions of the scale. It was not possible to assess the validity of the scale using another measure of sexuality because at the time of the original publication, no other psycho- metrically sound measure of sexuality had been developed for people with disabilities or carestaff working with these people.

Other Information

The scale, along with the scoring code, may be obtained from the author for use with clinical or research subjects.

Address correspondence to Marita P. McCabe, School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Victoria, Australia 3125; e-mail: [email protected]

References

McCabe, M. P., & Cummins, R. A. (1996). The sexual knowledge, experience, feelings and needs of people with mild intellectual disability. Education and Training in Mental Retardation and Development Disabilities, 31, 13–22.

McCabe, M. P., Cummins, R. A., & Reid, S. B. (1994). An empirical study of the sexual abuse of people with intellectual disability. Journal of Sexuality and Disability, 12, 297–306.

Sigelman, C., Budd, E. C., Winer, J. L., Schoenrock, C. J., & Martin, P. W. (1982). Evaluating alternative techniques of questioning men- tally retarded persons. American Journal of Mental Deficiency, 86, 511–518.

Szollos, A., & McCabe, M. P. (1995). The sexuality of people with mild intellectual disabilities: Perceptions of clients and caregivers. Australia and New Zealand Journal of Developmental Disabilities, 20, 205–222.