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On Teaching Children About AIDS

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Two months into the fall school term, I conducted a forum on AIDS for school-age children in Brooklyn, N.Y. One question during the hourlong session came from an 8-year-old boy: ''If a friend falls down and cuts himself, can I help him? Or should I leave him alone?" A 7-year-old girl whose mother was working in a dialysis lab in a local hospital wondered if it was safe to kiss her when she got home. A practical 13-year-old needed information about the recommended disposal of used syringes, because, he said, a clinic at the end of his block tossed needles, in unsealed plastic bags, onto the street. These same needles were later transformed into water pistols by neighborhood youngsters. "Should I tell someone?" he asked.

Especially since last September, when parents demonstrated their concerns about the schooling of children with acquired immune deficiency syndrome in locations as diverse as Kokomo, Ind., and Queens, N. Y., millions of healthy youngsters have become subject to the fear, prejudice, and misinformation surrounding the disease.

Nationwide, pockets of students--predominantly in high schools--have received factual instruction on the definition and transmission of the AIDS virus. But when the Philadelphia public schools launched an ambitious effort in February to distribute booklets on the disease to parents, the program soon became mired in controversy over the terminologies and information the booklets contained.

Although the U.S. Public Health Service has stressed the value of education as a principal means of preventing the spread of the disease, most educators have remained guarded in their approach. Presexual children in particular continue to be deprived of opportunities to discuss the epidemic and their fears about it. Dr. Myron Belfer of the American Academy of Child Psychiatry recently warned of the psychological dangers AIDS poses even to healthy children, and urged schools to provide students with facts on the disease, without overdramatizing it.

I pose that, in the absence of objective, age-appropriate discussion, early-childhood fears related to AIDS present a much greater threat to children's present emotional health than the likelihood of contracting the disease threatens their long-term physical health.

Children have often been publicized of late as victims, through widespread media attention to kidnappings, sexual abuse, and other violence. It is vital in this environment that educators not victimize them further by assuming that, because they are children, they should remain uninformed about a disease most have already heard of, and many have reasoned could kill either themselves or their parents. Without reassurance and information about what AIDS really is, children will conjure their own perceptions about the disease and its dangers to them.

Teachers concerned about the spread of the AIDS virus through typical classroom exposure--such as contact with desks and other inanimate objects--or social interaction can better spend their energies learning more about the disease and then discussing its known means of transmission with their students. In an appropriate fashion, teachers can touch on causes and preventive measures. Adolescents who are sexually active, and those experimenting with intravenous drugs, are already at risk; they have an immediate need for accurate information. It should also be kept in mind that younger children will no longer be so young in 1990 or 1995, when the first vaccines may appear. These children are exposed to the epidemic of fear now, but in 5 to 10 years, their social habits may expose them to the virus itself.

O.K., you say. Convinced of the need to dispel children's fears and assist them in understanding AIDS, you wonder how to address these issues in the classroom. For the most commonly asked questions about the disease, a brief but useful source for teachers, parents, and older students is "What Everyone Should Know About AIDS," the 16-page booklet prepared for the Philadelphia schools by the Channing L. Bete Company of South Deerfield, Mass. A videocassette, “AIDS: Profile of an Epidemic"--recommended for 11th and 12th graders--is available for rental or purchase from the Indiana University Audio-Visual Center in Bloomington, Ind. Schools should, of course, consult public-health officials to be sure of having the most up-to-date information.

I suggest social-sciences classes as an appropriate forum for AIDS education. Beyond being prepared to provide the basic facts, teachers should, naturally, tailor their approach to the subject to their students' age and developmental levels. Here I can offer some brief "how to" guidelines--based on developmental theory--that take into account the ways children acquire intellectual and moral judgment. A number of theorists have explored children's ability at different ages to grasp concepts affecting their lives. Interested teachers and parents might consult the writings of Erik Erikson (Childhood and Society, Norton) and Jean Piaget (Theory of Intellectual Development, Prentice Hall) for examples of psychosocial and intellectual approaches to child development. Such works offer useful background for adults who want to discuss sensitive subjects with youngsters in appropriate ways.

My general guidelines:

• If fears about AIDS exist among younger children, such as 5- and 6-year-olds, they are likely to surface during informal times--for instance, when children are working with blocks or paints or engaging in "dramatic play." At such times, children employ concepts learned during their more "formal" exposure to social structure and other people. Teachers who observe indications of fear about the disease should broach the subject with the children. If the youngsters seem to need additional information, teachers could supply it through stories read aloud to the group. A discussion time after the story would offer an excellent opportunity for children to voice emotion.

• Teachers can consult The Bookfinder: A Guide to Children's Literature About the Needs and Problems of Youth Aged 2 and Up (American Guidance Service, Circle Pines, Minn.) for sources of fiction that can be adapted to discussions of AIDS and related issues. For example, subjects indexed include death, illness, homosexuality, and empathy, and are identified by age category (through age 14).

• Teachers of children in the middle grades are well aware that adult opinion is very important to this group. While their consciences have begun to operate, these children are most affected by any prejudices of their immediate families and any lessons drawn from their social experiences. In addition, though they may possess sophisticated verbal skills and an openness to discussion of sexual issues, they generally lack the ability to grasp concepts outside their experience. I suggest that, in addition to introducing students to age-appropriate literature, teachers consult Emotional Care of Hospitalized Children by Madeline Petrillo and Sirgay Sanger (Lippincott). This book offers an analytical approach to discussions of illness with hospitalized children, but teachers can easily adapt its ideas to classroom discussions of AIDS.

• For children age 12 and older, the possibilities for educational programs on AIDS and the issues it raises are, of course, much greater. Children who have developed deductive- reasoning skills are open to the world of possibility in their approach to social mores. So, while recognizing that this idea is bound to be controversial in many schools, I suggest that teachers consider inviting speakers from the National Gay Task Force, the Gay Men's Health Crisis, or a comparable local group to discuss AIDS issues with older students.

Effective dialogue on the disease, regardless of students' grade levels, must involve one other aspect: communication of values that respect the "human condition"--values that tease empathy with other people's joys, sorrows, and losses. Teachers have a responsibility to communicate to children a human perspective regarding disease in general, and incurable disease in particular.

While we must be careful that children do not themselves feel victimized by AIDS--that they understand that the disease is not waiting to take their lives--we must teach them further that those suffering from AIDS are people like themselves, people who want to be well and live fruitful lives. For children mature enough to understand, we must communicate objectively that the homosexuals and intravenous-drug users who make up the majority of AIDS victims do not "deserve" to be ill. The sharing of such age-old values might help displace the epidemic of fear for all of us.

Vol. 5, Issue 30, Page 52

Published in Print: April 16, 1986, as On Teaching Children About AIDS
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