sign here. deafness variables communication and culture dysfluency deprivation implications for...
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• Deafness• Variables• Communication and Culture• Dysfluency• Deprivation• Implications for Treatment
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DEAFNESS
a) Degree of Deafness
b) Onset of Deafness
c) Presence of Disabilities
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COMMUNICATION
• Deaf population have linguistic diversity:– age of onset/cause of deafness – organic/neurological dysfunction – intellectual ability– language deprivation – age that language acquisition began – educational background – involvement in Deaf community
(Miller & Vernon, 2001)
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SOME IMPORTANT FIGURES(U.K.)
• 1/1000 born with profound bilateral Deafness
• 2.6 /1000 under 10 year olds – deaf (40+dbHL)
• 90% of Deaf children born to hearing parents
• 40% deaf people 25% hearing people experience mental health problems (Ridgeway)
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Pre-verbal Post Verbal
Onset at birth/early age After acquisition of speech/language
Communication based on Sign Language Speech/written word/lipreading
Difficulties - parents and Deaf children Early communication in same language
Impact on emotional/social/psychological/linguistic development
No impact on social, psychological, linguistic, educational development
Identify with Deaf community Often do not identify with Deaf community
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DEAF: IMPACT OF DEPRIVATION
• Linguistic/Social/Emotional/Psychological Lack of language, expressive/receptive skills Concrete/literal understanding Social interactions/understanding Recognition/regulation own and others emotions Minimal language Echopraxia
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COMMUNICATION MYTHS
• Speak loudly/Shout
• Written word – average Literacy 8.5 (Conrad)
• Lipreading
• Nodding syndrome
• Understand Interpreters
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• Parent/Child interaction - hearing parents of deaf children are more directive and discuss less
• Language development: speech v sign
• Implications for social and emotional development
• Major decisions about education
• Complex needs
CHILDHOOD
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• Issues of identity – Deaf/Hearing
• Leaving school – HELP!! Poor Access to FE
• Poor understanding - Social, Moral, Legal, Emotional
• Poor access to training/employment
• Discrimination
• Relationships - How do these work?/Peer Groups
• Mental Health issues
ADOLESCENCE
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• Maturational delays• Gaps in knowledge – Poorly equipped• Access: Health, Education, Employment - limited• Attitudes and discrimination• Additional stressors - MH matters• ‘Low key’ support systems: Family/Friends/primary care services ? Access• Psychosexual Issue
YOUNG ADULTHOOD
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• Dinner Table Syndrome– Family talking: laughing, serious, discussions
• Validating experiences– Lack of communication with siblings/peers
• Lack of access to media/written/TV– Miss opportunity to understand contemporary views
• Misunderstanding information on social media
SOCIAL INTERACTIONS
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• Mainstreaming
• PHU’s- issues of bullying, mixing all ages
• Deaf schools - Residential – Separation/Abuse - Positives – Deaf Community/Role Models
• Further Education/Higher Education problematic
EDUCATION
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• Damaging stigma and discrimination• Impoverished social networks which are associated with
mental health problems• Life in deprived communities which leads to:
• Feeling lonely and life is not worth living• Having lower sense of control over their lives• Problems with rowdy behaviour and harassment
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Deaf people are more likely to experience
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• Be excluded from local decision making about services
• Not have fair access to mainstream services and resources
• Not be able to access mainstream services
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Deaf people may
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CULTURAL MODEL
• Cultural / linguistic minority
• Use BSL (UK)
• Share social, interpersonal experiences
• Humour, Clubs, Rallies
DEAF PEOPLE
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THE UNIQUENESS OF THE DEAF COMMUNITY
The term “Deaf Community” has demographic, linguistic, political, psychological and sociological dimensions. The Deaf community shares characteristics born from common experiences, beliefs, values and norms. Most importantly the Deaf community bonds through a common language and a shared culture.
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DYSFLUENCY
• A small but significant section of the Deaf community has minimal language skills in verbal and sign language
- co-existing organic, neurological dysfunction- early language deprivation, learning disability
• Pervasive developmental Disorder• Gaps in information, poor awareness of social norms• Deprivation psychological, social, emotional development• Involvement in Deaf Community - Limited
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EEC STUDY – CHILDHOOD DEAFNESS(T MARTIN ET AL)
3000 – Children – 9 countries
• 29% – Disability – Physical/Visual
• 9.9% - Learning Disability
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Dysfluency Compared
DeafHearing
Incoherent MLS Compre- Proficient Fluent Eloquent hensible
Professor Robert Pollard – University of Rochester
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SOME DEAF PEOPLE …
• Learning Disabled/ASC• Deafened• Cochlea Implants• Use spoken and written language• Cannot access Deaf Community without support• Ethnic minorities
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Do not identify themselves as part of the Deaf Community
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• Fill in the gaps• Identify the impact of deprivation • MDT assessment and treatment• Develop skill areas/opportunities to practice skills• Target weaknesses
– Compensate for the lack of skills• The team provide Nurturing
HABILITATION
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Shared PathwayM
oral
Val
ues
Recovery&
Relapse
Offence Related• SOTP• Arson• Violence
Anger Trauma Substance
Mental Disorder
Psycho education
Assessment & Risk Assessment
Rehabilitation Model
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• Communication – Emotional vocabulary• Education – Sex Education, Feelings, Interaction• Social Skills – Understanding others needs• Psychological - Coping skills/stress management• Relationships – Therapeutic/Non therapeutic relationship• motivation/encourage appropriate behaviour• New experiences
Pyramid: Targeting an Immediate Priority
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• Age Line• Understanding Emotions Group Programme• Understanding Social Skills Group Programme• Basic Relationship Education Programme• Sexual Education / Relationship Intervention • Substance Misuse• Anger Management
PYRAMID: DEPRIVATION AREAS
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Anger
Emotion Big. You want shout, hit, punch, kick, threaten.
Emotion Posters: Definition
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Lowe, Gahir, MacDonald, IAFMHS April 2012
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Anger Thermometer: Intensity
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Trigger / Start Build up DangerBuild up Angry stay
Anger less Angry / Upset
Anger Small/ Upset Big
UpsetCalmer Calm
big
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THINK
GO
STOPDON’T DO IT. DON’T HIT OUT OR REACT
WHATS WRONG?WHAT CAN I DO? WHAT ARE THE OR COSTS?
MAKE A PLAN & TRY IT THINK POSITIVE BE CALM
ANGER MANAGEMENT
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Habilitation Treatment Approaches
H O P E
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HEARING CARE PATHWAY
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“What matters deafness of the ear when the mind hears? The true
deafness, the incurable deafness, is deafness of the mind.”
Victor Hugo, 1845
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Any Questions? ? ?
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