Our five year old son has mild to moderate bilateral sensorineural hearing loss. He has had hearing aids since he was 2 1/2 years old. He is speaking very well due to all the support he has received from speech therapists and deaf educators over the past two years. When he was three we put him in two different half day programs for children with hearing loss. He seemed to flourish in those settings. However, he recently began Kindergarten at a school that specializes in D/HH children, but is mainly hearing students. He is one of two in his class who has hearing loss. We have begun to see behavioral issues that he did not have (or at least did not rise to this level) at his preschools. At one point he pushed a little boy and pulled his hair and spit on him. These behaviors are odd for him outside of the home. (He has a three year old brother who he sometimes hits). He has also began to act very odd when he leave certain places. For instance, last night we went to his open house at school and he was doing fine, but when we were getting ready to leave he began to lay on the ground and laugh and would not cooperate. He recently did this at a park as well. We also continue to have problems with him in the bus line, where he is hitting/pushing kids.
Since this is all new for us we are unsure what measures to take. He has a deaf educator who is in his classroom in the mornings and she has been very helpful. I should also mention that this summer we had a baby and moved to a bigger house, so he has had a lot of change. I appreciate any information that you might be able to offer.
I must start by saying that without spending time with your son and looking closely at everything in his life, it is impossible to explain what is happening with any level of confidence. What I can do is offer some thoughts on possible explanations given what you have described.
My first thought is that you’ve described a number of quite significant changes in his life. He is now in a different sort of school program, he has a new sibling in the family, and is living in a different house. Even with all the best preparation, that can be very hard to accept and adjust to. It also can leave a youngster feeling like life is not in his control. Some of the behaviors you’ve described seem to be connected to exerting control – pushing other kids out of his way, not transitioning out of an activity, and those sorts of things. This is one possible underlying theme.
I’m also struck by the change from being in a school program for kids with hearing loss to one where most of his peers are hearing, even though the program specializes in kids with a hearing loss. It’s wonderful that he has made such good progress with his aids and speech therapy, but it is critical to keep in mind that a youngster with a hearing loss living in a hearing environment expends a great deal of energy over the course of a day. Even the most skilled oral communicators will admit to being completely tired out at the end of the day. Constantly working to fill in the blanks in the sound stream of language can be exhausting. When children are stressed or simply very tired, their ability to cope with everyday stresses of playing with peers, learning, moving in and out of activities is diminished. While you described some problems at home, such as difficulties leaving the park, many of the issues appear to involve school in some way. This would suggest examining the challenges of the new school.
Some ways to address this include giving him as much reasonable decision making power as is possible, and giving lots of warning about transitions. If he feels many things have changed without his “input,” one way to help with that is to emphasize the things he can make decisions about, such as clothes to wear, games to play, and any of the normal choices 5-year-olds make in a day. For managing school stresses, perhaps some quiet times during the day when he need not worry about what his classmates are saying, or some structured time where the communication is adult mediated and made clear to all could be integrated.
If these issues do not resolve with reasonable understanding and support, it would be wise to involve the school counselor or school psychologist for help with further evaluation to understand more deeply what might be happening.
I’m a pediatric occupational therapist who only occasionally works with deaf children. I don’t have time (or a library) to read papers and books about deaf children. Is there something like Cliff’s Notes on deaf kids?
Yes, Virginia, there is a Santa Claus. (sorry!)
Raising and Educating Deaf Children is a new site offering objective, evidence-based information for policy-making and practice associated with raising and educating deaf children – with an eye to improving them. New eBulletins are posted quarterly; each includes sections on The Issue, What We Know, What We Don’t Know, and Implications about various topics, all written so as to be accessible to parents as well as professionals. eBulletins include Further Readings with content offered free of charge by Oxford University Press.
Over the years I have had many hard of hearing students deny their hearing losses and refuse to wear any amplification. I usually tell students that amplification needs should be discussed with their parents. I generally support whatever the parent wants to do.
One of my students’ parent wants to develop a contract for hearing aid and FM use next school year for her seventh grader. The prospective seventh grader will not acknowledge the hearing loss or any of its impact. At this point, I am truly concerned for the student’s well-being. My inclination is to teach clarification and compensatory skills while working to help the student come to some acceptance of the hearing loss.
What does research say about acceptance of hearing loss or amplification use in adolescence?
Your question about available research is difficult to answer – after all these years, we still only have anecdotes to inform us, and not even enough of these to work with. But we can take an educated guess at what this young person is thinking: “I have a problem but I want it to go away; all I want is be like everyone else so I will pretend I am.”
We do know quite a bit about acceptance in general, though: a mindset that first requires the hard work (and pain) of looking at a situation honestly. This young person may need to work with a counselor to “get there.” Additionally, while working on the strategies mentioned, perhaps you might ask her to chat about the concept of resilience. It’s often more comfortable to talk less about the issue at hand (amplification decisions) and instead discuss a bigger but semi-related topic, as in: “People are talking a lot about resilience these days, have you noticed? When adversity occurs, how do people rebound? What strengths do people draw upon to recover and move forward? Any examples come to mind?” Just generally about “people,” but most of us insert ourselves into the answers. All children need practice talking about their emotions. She is fortunate to have you in her life.
Is there any good research into the psychological impact on deaf children who are in mainstream education? I am a mature student and a parent of a deaf child in mainstream and am undertaking a research project into this topic with a view to eventually working with deaf children.
This seems like an easy question but, as with many things in deaf education, the answer is a bit complex. There is an “older” (1980s-1990s, ancient!) literature from the United States indicating that deaf children in mainstream settings were more likely to report feeling lonely and isolated than those in schools and programs for deaf students. While that may still be true in some cases, the fact that the vast majority of deaf children in many countries are now in mainstream classrooms means that the dynamic now is rather different.
For reasons that are unclear, there is very little research on the social-emotional/psychological impact of mainstream education on deaf children conducted in North America (but see research by Shirin Antia and her colleagues). Most of the work in that area is being conducted in Europe, with some in the UK, Hong Kong, and other countries. The recent Teaching Deaf Learners conference in Amsterdam had a number of presentations on the topic, and you can identify/contact the authors by looking at the program. A book based on the conference (Educating Deaf Students: Creating a Global Evidence Base) is due from Oxford University Press, but not until 2015. It will include reviews of work on various aspects of psychological functioning of deaf students in mainstream and special settings. In the meantime, an “advanced search” of the Journal of Deaf Studies and Deaf Education looking for “mainstream” in “title or abstract” will yield a variety of relevant articles. You can reach the authors through the site.
Our son was born deaf and has cochlear implants. He is now 6 years old and in regular classroom with assistive devices. He seems to have a real trouble focusing and some issues with getting angry, upset, crying at times and arguing with adults. We are wondering if there are things we can do to help him gain better control of his emotions and get better focus.
It’s very important to remember that using assistive listening devices can be extremely stressful and tiring. Cochlear implants have become very sophisticated and can be highly effective for many children and adults. But, many children and adults still need to work quite hard to make sense of the auditory input they are receiving and process all that information. School can be tiring, too. So, one first step is to look at the times and situations that are most difficult for the youngster—the situations that bring up the most tears, anger, and arguing. These may be times when he has been listening and working extra hard to hear and understand everything and everyone and is tired and worried that he hasn’t gotten it all.
Tracking the times and situations that are most difficult can also help teachers and parents to intervene before the child has reached that peak of frustration and can no longer regulate their emotions (leading to crying, arguing, and anger). Once a child has “gone over the edge,” so to speak and is very upset, adults can mostly just help them gain control again. That might mean getting away from the situation, waiting out the outburst, keeping them safe, etc. But, if adults are able to recognize the warning signs, then intervening before control has been lost is possible. Helping children learn to manage difficult times while they are still in control of their emotions can be done through conversations, modeling of appropriate behavior, offering alternative activities, and basic empathic statements. And always remember to show children things they can DO when upset, as opposed to telling them what they should not do. Not doing things is much harder than having an appropriate alternative.
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?
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?
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?
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?
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.
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.