Raising and Educating a Deaf Child

International experts answer your questions about the choices, controversies, and decisions faced by the parents and educators of deaf and hard-of-hearing children.

Social, Emotional and Behavioral Development

I have a 5 yr old son who was born deaf; he has a serve/profound hearing loss. He has limited sign language and no speech. His behavioral is the problem. I just can’t seem to control him – he is so active. Is there anything i can do to help him so he can be able to focus more and be able to learn?

Question from R.A., Florida. Posted April 22, 2014.
Response from Patrick Brice - Gallaudet University

Language is crucial to children learning how to regulate their emotions and their behavior.   In children with very limited language, great patience is required from adults, as these children are missing an important tool.  There is no simple solution, but Ross Greene has argued that all children want to be good and would be good if they could.  Behavior that is not cooperative or compliant is not because children want to misbehave, but because they cannot organize to do what is asked.  The adult’s job is to remember this point (easier said than done!) and help them learn to organize.  The area of psychology that has had the greatest success dealing with behavior difficulties in children with low levels of communication has been Applied Behavior Analysis.  This approach, though, requires effort from the adult who is practicing it, reinforcing children for approximations of cooperative behavior and not allowing and certainly not reinforcing uncooperative behavior.   There are specialists in most urban areas who provide ABA services, both in schools and in home; you might ask about that.

Additionally, use pictures, drawings, or photos of the child doing the desired activity and keep them handy (laminating them helps) to point out to the child what is desired of him along with rewards that will be given immediately upon cooperation.  Start with very low expectations so that children are rewarded quickly, easily, and frequently and then gradually make the expectations greater.  Remember also that children often have much more energy than adults, so finding ways for a child to expend his or her energy before asking them to do more quiet activities (e.g., household chores, homework, coming to the dinner table) will be important.  Rewards should be things that the child truly enjoys and that can be given easily and cheaply.  No need for trips to Disney World, but play time with particular games, favorite foods, or other enjoyable activities should be used.  Rewards may need to change as well since children will tire of things.

This approach does not always work quickly and in fact when first employed, behavior tends to get worse as children believe they must be more uncooperative to get what they got before.  But, with time and patience, it can make a difference.

My 8-year-old son is profoundly deaf and uses ASL for communication. About 1 1/2 years ago he was removed from the deaf/HOH program offered by our city public school due to behavior problems and issues. The school told me his only option for placement was a local alternative school where he would use an interpreter. I expressed concern regarding this placement, as it does not seem like the LRE. There is only one other deaf student, there are no trained teachers of the deaf, and none of the school staff or administration knows ASL. I am concerned for my son’s social and cultural development as well as his education and ability to work on his emotional and behavioral challenges in this setting. I tried to have him enrolled at the deaf school in our state, but they will not take him because they are not able to deal with his behavioral and emotional needs. I am willing to have my son attend an appropriate program, such as PACES at ASD, but the local school insists he is in the LRE and that he is making progress. Since he has been in the alternative school he has made no significant progress, has had many critical incidents as well as sustained minor injuries, and has been hospitalized for his behavior twice. I do not feel my son is in the LRE, although I have expressed this to the school many times I feel my concerns about his placement are ignored. What is the best way for me to advocate for my son to be educated in the LRE?

Question from K.G., Virginia. Posted May 7, 2013.

Given what you have been through thus far, the best advice is for you to seek help from an Advocate, either in your community or through the State. Contact your State Department of Education; they will tell you how to obtain one. [You also might see if there is a local chapter of Hands & Voices; other parents of deaf children in your area might have had the same experience.] In addition, you might take a look at the website of the Conference of Educational Administrators Serving the Deaf (www.ceasd.org)and review the Child First information. There is a clear need to define “progress” as you and the LEA differ on this critical factor. Again, an Advocate with prior experience with deaf children and assessment likely would be a great place to start. You also might look into having an objective school psychologist (also with having experience with deaf children) involved in the IEP meeting.

The issue of LRE is always challenging, but you and the LEA need to remember the law requires a review of the “unique communication needs of deaf children.”  The LRE is not the sole criterion for services, although it is one of the many criteria that IEP teams have to consider. The PACEs program* at the American School for the Deaf is considered the LRE for the 30 youngsters currently served in the program. That placement was determined by each child’s PPT (Planning and Placement Team) – IEP (Individualized Education Program) team.

*From the ASD website: The PACES Program is a special educational/residential unit for emotionally/behaviorally disordered students, who because of intensity of these disorders need educational, social, and psychological services beyond those offered in traditional school settings. The program’s goals are to maximize students’ potential and return them to the least restrictive educational environment. The PACES Program has two components: Upper PACES (ages 13 to 21) and Junior PACES (ages 6 to 13). [the program accepts out-of-state students]

My boyfriend has a 3 year old son who was late on his speech, so we decided to take him to see a doctor. He has seen a neurologist and taken a BAER test which indicated that he had profound hearing loss in the left ear and severe in the right. He is very smart and his motor skills have always seemed high for his age. Were just confused on what are all the options it could be… we have been referred to the children’s hospital, but it wont be for a while. If any one has dealt with this or has any advice we would appreciate it. We’re just kind of lost on where do we go from here. (When he was born he passed his hearing test.) Also he seems to have behavior problems, and the docs say its just his age, but we feel it could be more. He has really bad anger problems and is very moody. Could that be because he can’t hear or should we look into other things like ADHD or bipolar syndrome?

Question from A.H., California. Posted April 5, 2013.

Based on the basic information provided, my thoughts are that your 3 year old boy’s anger and moodiness  is related more to his hearing loss and communication frustrations.   His behaviors may look like he has attention difficulties (i.e.,  easily distracted, impulsive, daydreaming). However, these behavior may because he cannot hear and uses his vision for information.  Sometimes parents have a difficult time differentiating whether the child’s hearing loss is contributing to disobedient behavior, or, whether the child’s attention and willfulness is creating communication difficulties.

In most cases, parents need to address communication issues before assuming defiant behavior. For example, parents must make eye contact  instead of talking to the child from a location where the child does not see the parent. There are many more communication strategies and tips for parents.  At this time, seeking out professionals who work with children who have  ommunication disorders is a suggestion, especially if your community does not have psychologists who have expertise in working with families who have deaf members. You also might check to see if there is a local chapter of Hands & Voices or contact the American Society for Deaf Children for advice.

Why is it that some schools include socialization in the IEP and some do not ? Shouldn’t it be included?

Question from D.L., Massachussetts. Posted February 12, 2013.

Well, I think so. But, IEPs are not solely determined by the school, and many of them may not be aware of the socialization challenges of deaf and hard-of-hearing children. If a parent thinks that there are socialization issues that might influence their child’s academic functioning, they definitely should have it included in the IEP. Some schools may not see socialization as an academic issue (after all, they may point out, it is an Individualized Education Program). Parents and/or the school psychologist may need to education them!

I am looking for a curriculum or program for teaching social communication and beginning advocacy skills to elementary students. All I find are either checklists and assessments for D/HH, or programs written for kids on the Spectrum.

Question from K.B., Vermont. Posted January 14, 2013.

Iowa’s Expanded Core Curriculum for Students Who Are Deaf or Hard of Hearing covers eight content areas, including Self-Determination and Advocacy and Social-Emotional Skills. Examples of skill areas under Self-Determination and Advocacy are community advocacy and using interpreters and transliterators. The Social-Emotional Skills area includes self-management, personal responsibility, and social interaction including conversational skills. However, I am not aware of any instructional programs in these areas.

It sounds as though you are familiar with some of the checklists/inventories available, but for others who may be interested, the Hands & Voices website has an Advocacy section on the Topics webpage. Among articles and personal stories, click on Deaf/Hard of Hearing Self Advocacy Inventory to find the Informal Inventory of Independence and Self-Advocacy Skills for Deaf/Hard of Hearing Students. Also available is the Minnesota Social Skills Checklist for Students who are Deaf/Hard of Hearing at www.successforkidswithhearingloss.com.

My sister is deaf and she needs a job. How can we help her and other deaf boys and girls get jobs?

Question from M.A., Kenya. Posted January 10, 2013.

There are many areas to address, such as getting training or education in the field you are interested in, developing a resume, practicing interview skills, and so forth. “Networking”  is also one of the best way to find a job.  Networking is making contact with people you know and letting people know what your skills, experience, and strengths are.   Research has shown that 75-80% of people find jobs through networking.

Job-seekers can network with everyone, everywhere, and all the time.  It is important for job seekers to network with friends, relatives, businesspeople, doctors, clergy, clubs, teachers…etc.  It can be scary and a challenge for deaf individuals to know what to say.  Here are some suggestions, “I’m looking for a job, do you know anyone whom I could contact?, can you think of 5 companies where I should apply?, do you know other people who could be helpful?”.

Networking can help you grow in your  area of interest and as a person.  Every time you go up to a stranger, talk to them, and get through that little wall of fear, you’re boosting your self-confidence.  That confidence is what people see in you even before you communicate.

I have a son who is 3 1/2 years old. We found out this year that he is profoundly deaf in his right ear and has a moderate to severe loss in his left. He has a hearing aid in his left ear. He has hardly got any speech, his balance is very poor, and I’ve been told he’s a year behind for his age. Since he has got older, he has started to get very angry – kicking, biting, hitting, and throwing things at me; sometimes he hits his head on the floor. I’m getting worried. Do you think he could be autistic as well as being deaf? It really is starting to worry me. My paediatrician has said that it’s all frustration. I don’t go out with him because of the looks I get off of other people and because he has no sense of danger.

Question from K.M., England. Posted December 9, 2012.

When children don’t have language yet they express their needs or wants through their behaviour. In terms of your son, the paediatrician might be right that he is frustrated. But knowing that won’t just stop the behaviour. Your son should be assessed to determine if his hearing aids are giving him the best amplification and. even more importantly, your son needs to have language in the most accessible modality.  If an oral approach is not working, do not waste time! Begin using a more accessible language like sign language. In addition, your son should see a clinical psychologist familiar with deafness to assess if there are other issues that need to be addressed.

My son is 5 1/2, hard of hearing, moderately-severe to profound, bilateral aids since he was 4 months old. He is currently in a mainstream school, and also knows ASL, although he doesn’t like to use it. His reading skills are incredible – he has read dozens of “chapter books” since he learned to read last winter/spring. He has really good fine-motor control. But his pencil skills however are truly awful, well behind everyone else in his class, and he is even very unwilling to even try printing/tracing letters. He is on the waiting list to see the school board OT about a possible dysgraphia diagnosis. Is there any connection between his written language problems and his hearing problems? Or between his written language problems, and his unwillingness to use ASL?

Question from J.B., Ontario. Posted October 18, 2012.

It appears that your son’s problem is not a written language problem. Instead, as you have described it here, the problem is with his handwriting. If his reading skills are strong, then his written language skills may also be strong. However, you and his teachers will need to bypass handwriting in order to accurately assess his written language knowledge and skills. That can be done easily with the use of magnetic letters and/or the computer. He can construct his stories using magnetic letters or he can type his stories, instead of trying to print them.  I used this approach with a kindergarten student who was hard of hearing and also had cerebral palsy and could not write with a pencil. She was allowed to compose her stories using magnetic letters until she had learned the alphabet and then on the computer. The approach was highly successful.

I cannot say whether your son’s handwriting problem is related to his hearing loss. A consult with the school’s occupational therapist is definitely in order.

With regard to his unwillingness to use ASL, that is most likely an identity issue. Most children, regardless of age, do not want to be different from their peers. Because your son is mainstreamed with children who are hearing and use spoken language to communicate, I am not at all surprised that he doesn’t want to use ASL.  My best guess is that he wants to be like his peers and use spoken language to communicate.  Using ASL sets him apart from his peer—makes him different—the very thing children try to avoid.

I am from Turkey. My son has autism and was born with a profound sensorineural hearing loss. He was implanted at 5 years of age. He is now 12 years old.. He cannot speak or write. It seems there isn’t anybody else like him in Turkey and I cannot get any assistance in dealing with his multiple challenges. I want to teach him speak. How can I do that? How can I help my son?

Question from M.Y., Turkey. Posted September 27, 2012.

I am sorry to hear that you have not been able to access help for your son that you feel has been useful. Certainly deafness and autism each present their own challenges, but together things are much more complex.

Autism alone is associated with language impairments that are often quite significant. Many hearing children who have autism develop only very limited speech, and some only sounds, with no functional speech. The focus for these children should usually be on communication, not speech. This means trying to build communication of any kind, including gestures, manual signs, picture systems, as well as  speech — basically anything that allows the child a chance to communicate with the world around him. And an important part is trying to motivate the child to want to or need to communicate.

Your son also has a profound hearing loss. That is also by itself a high risk factor for acquiring speech. A cochlear implant may make speech sounds more available to him. But even if that were the case, he still may be affected by the language disorder I mentioned in connection with autism. So many, many questions remain that will impact on your son’s ability to speak and to write.

So the situation is complex. But does that mean there is no hope? Absolutely not! With appropriate and consistent support, most children make significant gains in many areas. If it has not already been done recently, I would recommend having an assessment done of your son’s intellectual, language and daily living skills, so you can understand where his skill levels are currently. Then try to find someone who can provide a program of systematic behavioral therapy, with a special focus on communication in as many activities as possible.

I don’t know the availability of services in your area, but hopefully a physician might know of available services, or the professionals who did the implant, or perhaps if there is  a university in your area. Did anyone provide you with support after the implant? That person may also be able to help connect you with services. Two sources that I am ware of online are:  The Tohum Foundation   http://www.tpfund.org/TOHUM/default.asp and The Gunsigi Services  http://www.gunisigichildtherapy.com/cigdem-ergul.php

Both, I believe, are in Istanbul, but hopefully they can connect you with services where you are located. The Tohum Foundation indicates their “ key purpose is to lead and disseminate early diagnosis, education, and social integration services for children with autism throughout Turkey.”

There is a family support group in North America that you should be able to access through   http://groups.yahoo.com/group/DEAF-Autreat   I have met some of these families, and they are wonderful people and many have struggled with similar concerns.

Our daughter is 11 years old and has been educated in a mainstream setting since the age of 6years. Her first language is New Zealand Sign Language (NZSL) although she prefers to use spoken English with some people. Her peers have developed NZSL to conversational level over the years that they have been in the same class.

We are a bicultural/bilingual family with 2 of us hearing (fluent in NZSL) and 2 Deaf. We put a lot of effort into maintaining links to the Deaf community and attend events at Deaf club, however this is not enough. Our daughter has been struggling for the past year particularly in the area of friendships. She prefers to play games that are predictable and physical (i.e., swinging on the bars, and her ‘friends’ have moved on and prefer to sit on the bank and talk! it breaks my when she comes home in tears asking why isn’t there more Deaf children at school and why do the girls just want to talk.. How can we develop resilience in our daughter.

Question from O.F, New Zealand. Posted September 26, 2012.

Yes, being 11 years and preadolescent is tough. Girls are transitioning to a different kind of socialization and talking with each other is really very typical at that age. You say that your daughter prefers to play games that are predictable and physical. If there are organized sports activities that you could enroll her in, that might be helpful. Another possibility is to invite one girl at a time over regularly to be with your daughter and do different things with her. If she has at least one good friend, this will help a bit in getting her through the tough spots.

If there are deaf girls close in age to your daughter in the deaf community, try to connect your daughter with them. Above all, be there for her, tell her you are proud of her, she is special, and you understand what she is going through. That will help her to develop resilience, knowing you care for her and you are there for her, and the two of you can communicate feelings. Here’s hoping the tough times won’t happen too often…..