Pupil Services and Pupil Services and

the Mental Health the Mental Health Needs Needs

of Students who are of Students who are Deaf Deaf

or Hard of Hearingor Hard of Hearing

Today’s First PresenterToday’s First Presenter

Marcy DickerMarcy Dicker Outreach DirectorOutreach Director Wisconsin Educational Services Wisconsin Educational Services

Program for the Deaf and Hard of Program for the Deaf and Hard of Hearing (WESPDHH)Hearing (WESPDHH)

262-787-9540 voice262-787-9540 voice 866-552-7792 vp866-552-7792 vp marcy.dicker@wesp-dhh.wi.govmarcy.dicker@wesp-dhh.wi.gov

Today’s Second Today’s Second PresenterPresenter

John Humphries, NCSPJohn Humphries, NCSP School PsychologistSchool Psychologist Student Services/Prevention & Student Services/Prevention &

Wellness TeamWellness Team WI Department of Public InstructionWI Department of Public Instruction 608-266-7189608-266-7189 john.humphries@dpi.wi.govjohn.humphries@dpi.wi.gov

ResourcesResources

To obtain the resources we discuss, To obtain the resources we discuss, go to:go to:

dpi.wi.gov/sped/hi_deaf.htmdpi.wi.gov/sped/hi_deaf.htm

Look for links to DHH and mental Look for links to DHH and mental healthhealth This PowerPointThis PowerPoint The Protocol for ScreeningThe Protocol for Screening A Screening Tool (NEW)A Screening Tool (NEW)

Hearing Loss 101Hearing Loss 101

2,200 students, ages 3-21, identified 2,200 students, ages 3-21, identified with hearing loss in the public with hearing loss in the public schools in the state of Wisconsin. schools in the state of Wisconsin.

2/3 of these students are thought to 2/3 of these students are thought to be “hard of hearing” and 1/3 are be “hard of hearing” and 1/3 are considered “deaf”considered “deaf”

Hearing Loss Simulation – What Hearing Loss Simulation – What would a hearing loss “look like”? would a hearing loss “look like”? What would it sound like?What would it sound like?

Hearing Loss SimulationHearing Loss Simulation

Normal 0-25 dBNormal 0-25 dB Mild 25-40 dBMild 25-40 dB Moderate 40-70 Moderate 40-70

dBdB Severe 70-90 dBSevere 70-90 dB Profound 90-110 Profound 90-110

dBdB Cochlear Cochlear

Implant Implant

Knock, knock – who’s there?

Time for bed.

Pick up your toys.

Would you like more juice?

The wife helped her husband

Visual Representation of Visual Representation of Hearing Loss and aided Hearing Loss and aided

hearinghearing

What are the issues?What are the issues?

Impact of severe and profound hearing Impact of severe and profound hearing loss, when the child uses ASL on social loss, when the child uses ASL on social emotional developmentemotional development Parents may not have the language skills to Parents may not have the language skills to

communicate effectively around the abstract communicate effectively around the abstract concepts of emotional and interpersonal issues.concepts of emotional and interpersonal issues.

Students face challenges in building close social Students face challenges in building close social relationships with peers and staff because of the relationships with peers and staff because of the inability to communicate in a common languageinability to communicate in a common language..

Students cannot communicate directly with their Students cannot communicate directly with their hearing peers – most must use an interpreterhearing peers – most must use an interpreter

All these factors lead to ISOLATIONAll these factors lead to ISOLATION

What are the issues?What are the issues? Impact of mild and moderate hearing Impact of mild and moderate hearing

loss – more subtle, yet equally loss – more subtle, yet equally important…important… Students miss out on conversations between Students miss out on conversations between

others (containing important social information)others (containing important social information) Students miss social language cues – how to Students miss social language cues – how to

initiate a conversation, turn taking, etc.initiate a conversation, turn taking, etc. Misunderstandings are commonMisunderstandings are common Assumptions that hearing aids “fix” the problem Assumptions that hearing aids “fix” the problem

and students “smile and nod” responseand students “smile and nod” response These students will also cope with ISOLATIONThese students will also cope with ISOLATION

Mental Health Challenges Mental Health Challenges begin with a sense of begin with a sense of

isolationisolationand result in a lack of:and result in a lack of:

Success in building meaningful Success in building meaningful friendshipsfriendships

Opportunities to build a healthy self-Opportunities to build a healthy self-conceptconcept

Ability to understand and manage Ability to understand and manage conflictconflict

Opportunities to develop appropriate Opportunities to develop appropriate coping and problem-solving skillscoping and problem-solving skills

Proactive support for Proactive support for Mental WellnessMental Wellness

Identify Environments that foster positive self esteem in Deaf and Hard of Hearing

Provide access to deaf and hard of hearing role models

Recognize the value of direct access to communication and interaction

Ensure and support the student’s access and participate in school events, community events and society-at-large

Increase awareness of mental health issues for these students (protocol) and provide appropriate supports

End of Hearing End of Hearing 101101

Now, what can Pupil Services Now, what can Pupil Services providers do for DHH providers do for DHH

students?students?

Pupil Services ProtocolPupil Services Protocol

Follow basic screening protocol as Follow basic screening protocol as with any area of concernwith any area of concern Prepare to screenPrepare to screen Identify studentsIdentify students Get consentGet consent ScreenScreen Follow upFollow up

Step 1: Identify DHH Step 1: Identify DHH studentsstudents

Contact your DHH teacherContact your DHH teacher Talk about cues for mental health and Talk about cues for mental health and

illnessillness How do they perceive student’s mental How do they perceive student’s mental

health needs?health needs? Also contact general education staff to Also contact general education staff to

identify students who are not in special identify students who are not in special education or who do not have a 504 education or who do not have a 504 Plan who have a mild hearing lossPlan who have a mild hearing loss

Step 2: Obtain Consent for Step 2: Obtain Consent for ScreeningScreening

Talk with parents about your Talk with parents about your school’s efforts to prevent mental school’s efforts to prevent mental illness and promote mental healthillness and promote mental health

Explain procedures Explain procedures Use a standard consent for pupil Use a standard consent for pupil

services formservices form

Step 3: Identify Step 3: Identify Communication NeedsCommunication Needs

Talk with the DHH teacher to Talk with the DHH teacher to identify how the student effectively identify how the student effectively communicatescommunicates

Discuss supports to meet Discuss supports to meet communication needscommunication needs

Consider hearing technology and Consider hearing technology and visual supportsvisual supports

If you don’t need an If you don’t need an interpreterinterpreter

Note the needs for lighting in the room. Note the needs for lighting in the room. Allow the student to sit with their back Allow the student to sit with their back to the window.to the window.

Always face the student when speakingAlways face the student when speaking Be aware of background noiseBe aware of background noise You may need to define or explain termsYou may need to define or explain terms Ask the student to repeat back some of Ask the student to repeat back some of

your questions to check for your questions to check for understandingunderstanding

If you do need an If you do need an interpreterinterpreter

Using the educational interpreter is a last Using the educational interpreter is a last resortresort

Recognize limitations of the teacher of Recognize limitations of the teacher of the deafthe deaf

Consider a mental health interpreterConsider a mental health interpreter Clarify the limits of confidentialityClarify the limits of confidentiality Interpreters are NOT mandated reportersInterpreters are NOT mandated reporters The role of the interpreter is solely to The role of the interpreter is solely to

interpretinterpret

Step 4: Meet with the Step 4: Meet with the StudentStudent

Establish rapportEstablish rapport Share the limits of confidentiality Share the limits of confidentiality Ensure that any other person in the Ensure that any other person in the

room (interpreter), also agrees to uphold room (interpreter), also agrees to uphold the confidentiality of the meetingthe confidentiality of the meeting

Be aware of state law and follow any Be aware of state law and follow any local policies and procedures in this local policies and procedures in this regardregard

NEW: Use Screening Tool from DPI NEW: Use Screening Tool from DPI or other sourceor other source

Step 5: PrioritizeStep 5: Prioritize

Read the protocol for specific Read the protocol for specific suggestionssuggestions

Low Level of Mental Health NeedLow Level of Mental Health Need Moderate LevelModerate Level High LevelHigh Level

Note crisis reponseNote crisis reponse

Step 5: PlanStep 5: Plan

Share the results with parentsShare the results with parents Consider Consider

ThoughtsThoughts MoodsMoods BehaviorsBehaviors

And And SeveritySeverity ChronicityChronicity Frequency of symptomsFrequency of symptoms

Planning DomainsPlanning Domains Case managementCase management Home-school coordination/communicationHome-school coordination/communication Extending or strengthening the social Extending or strengthening the social

networks networks Get the help of the DHH teacherGet the help of the DHH teacher Group or individual services at schoolGroup or individual services at school Document in IEP and possibly reconveneDocument in IEP and possibly reconvene Mental health services in the communityMental health services in the community Follow up on crisis issues as with any Follow up on crisis issues as with any

studentstudent

ConclusionConclusion

Students who are DHH have high Students who are DHH have high liklihood of mental health needliklihood of mental health need

Use a screening protocol to identify needsUse a screening protocol to identify needs Follow through with help in multiple Follow through with help in multiple

domains and consistent with the level of domains and consistent with the level of needneed

For more information, go to:For more information, go to: dpi.wi.gov/sped/hi_deaf.htmdpi.wi.gov/sped/hi_deaf.htm Look for links to DHH and mental healthLook for links to DHH and mental health