Deaf Children and Mental Health Dr. Cathy Chovaz
Blindness cuts one off from things, Deafness cuts one off from people. Helen Keller
Two Perspectives Medical d a wrong to be made right broken ear with a person attached model Cultural D birthright heritage shared language and traditions way of being in the world
Two Views of Deafness - Chris Wixtrom 1st View: DEAFNESS AS PATHOLOGY With this perspective, a person might: Define deafness as a pathological condition (a defect, or a handicap) which distinguishes abnormal deaf persons from normal hearing persons. Deny, downplay, or hide evidence of deafness. Seek a "cure" for deafness: focus on ameliorating the effects of the "auditory disability" or "impairment." Give much attention to the use of hearing aids and other devices that enhance auditory perception and/or focus on speech. Examples: amplifiers, tactile and computeraided speech devices, cue systems... Place much emphasis on speech and speechreading ("oral skills"); avoid sign and other communication methods which are deemed "inferior." 2nd View: DEAFNESS AS A DIFFERENCE With this perspective, a person might: Define deafness as merely a difference, a characteristic which distinguishes normal deaf persons from normal hearing persons. Recognize that deaf people are a linguistic and cultural minority. Openly acknowledge deafness. Emphasize the abilities of deaf persons. Give much attention to issues of communication access for deaf persons through visual devices and services. Examples: telecommunication devices, captioning devices, light signal devices, interpreters... Encourage the development of all communication modes including - but not limited to - speech.
Promote the use of auditory-based communication modes; frown upon the use of modes which are primarily visual. Describe sign language as inferior to spoken language. View spoken language as the most natural language for all persons, including the deaf. Make mastery of spoken language a central educational aim. Support socialization of deaf persons with hearing persons. Frown upon deaf/deaf interaction and deaf/deaf marriages. Regard "the normal hearing person" as the best role model. Regard professional involvement with the deaf as "helping the deaf" to "overcome their handicap" and to "live in the hearing world." Neither accept nor support a separate "deaf culture." Strongly emphasize the use of vision as a positive, efficient alternative to the auditory channel. View sign language as equal to spoken language. View sign language as the most natural language for the deaf. In education, focus on subject matter, rather than a method of communication. Work to expand all communication skills. Support socialization within the deaf community as well as within the larger community. Regard successful deaf adults as positive role models for deaf children. Regard professional involvement with the deaf as "working with the deaf" to "provide access to the same rights and privileges that hearing people enjoy." Respect, value and support the language and culture of deaf people.
Children and Mental Health 8 million of our Canadian population is under 19 years of age Childhood and adolescence are marked by dramatic changes in physical, cognitive, and socialemotional skills and capacities Mental health is defined by the achievement of expecteddevelopmental cognitive, social and emotional milestones, and by secure attachments, satisfying social relationships, and effective coping skills.
Mentally healthy children and adolescents enjoy: a positive quality of life function well at home in school and in their communities and are free of symptoms of psychopathology
Mental Health Disorders One in 5 Canadians experience a mental disorder of sometype over the course of their life A number of these disorders will occur in childhood Children are not little adults Even more than is true for adults, children must be seenin the context of their social environments, that is, family,peer group, and. their larger physical and cultural surroundings
Mental Disorders with Onset in Childhood and Adolescence From the DSM - I V: Anxiety Disorders Attention-Deficit and Disruptive Behaviour Disorders Autism and Other Pervasive Developmental Disorders Eating Disorders Elimination Disorders Learning and Communication Disorders Mood Disorders (e.g. Depressive disorders) Schizophrenia Tic Disorders
Assessment 3 goals 1) Case formulation - helps the clinician understand the child within his/her context 2) Diagnosis - helps identify children who have a mental disorder with an expected pattern of distress, limitations, course, & recovery 3) Recommendations and support - to the child, the parents, the school
Mental Health and Deafness The Child expression of clinical symptoms will differ prevalence of certain disorders will be higher higher rate of comorbidity The Service serious lack of trained professionals assessment must be contextually sensitive treatment must be sensitive and appropriate
The Deaf or Hard of Hearing Child 90% are born to hearing parents (only 2/10 families learn to communicate well) Language may be different (ASL) from language of parents May be language deprived or delayed Cultural perspective may be different from that of parents May do better with different teaching methods and strategies Higher vulnerability of abuse and neglect Higher prevalence of mental health issues related to risk factors May be lack of family support related to communication, behavioural difficulties, and lack of awareness
Assessment of a Deaf Child Requires specialized training with a solid understanding of the process and context Few appropriate assessment tools Theoretical and applied clinical experience Diagnosis needs to tease deafness out from psychopathology Recommendations need to be appropriate
What can Clinicians do?? Adopt a developmental contextual perspective Advocate for deaf children for appropriate services Strive for sensitive and appropriate environments Work collaboratively with mental health professionals Provide direct support to the child