David is a 10-year-old deaf boy mainstreamed in a classroom with hearing peers. His deafness was discovered when he was 3 years old, and he received a cochlear implant at age 5. His reading and writing skills are at a first grade level. Language gaps and delays in his spoken language are obvious. He has never been exposed to sign language….
David is a 10-year-old deaf boy mainstreamed in a classroom with hearing peers. His deafness was discovered when he was 3 years old, and he received a cochlear implant at age 5. His reading and writing skills are at a first grade level. Language gaps and delays in his spoken language are obvious. He has never been exposed to sign language. David is frequently disruptive in the classroom. He can’t sit still for long, doesn’t seem to focus, and isn’t advancing in academic goals. He argues and fights with peers, is perceived by others to be a bully, and doesn’t have friends.
You are called in to do an assessment of David. People want to know why he is doing so badly and how to help him. They are particularly concerned about his bullying other children. His teacher would like him moved out of her classroom.
There are many reasons why deaf children like David develop challenging behaviors. Many causes of deafness also cause learning, emotional and behavioral difficulties. David may have been born with a brain that is neurologically compromised. Deaf children, like hearing children, develop psychiatric disorders like Attention Deficit Hyperactivity Disorder (ADHD) and may have specific learning disabilities. They may experience various forms of abuse, neglect and other trauma, and without sufficient language, be unable to understand, process or communicate these experiences. They may show attachment difficulties with parents unprepared to have a deaf child.
Neurological compromise, trauma, learning and psychiatric disorders, and attachment problems all can impact cognitive and psychosocial development and cause challenging behaviors. However, the “elephant in the room” is usually language deprivation. When deaf children do not acquire language naturally and normally, when their verbal (spoken or sign) language development is delayed, they will communicate primarily through behavior. Poorly developed language skills means poorly developed verbal reasoning and problem solving skills. It should not surprise anyone to see children with these disadvantages develop behavioral problems.
With any particular deaf child, it can be difficult to parse out the role that each factor plays. Often evaluators don’t have good information, or they don’t see beyond the biases of their professional discipline. It can be very tempting to assume the child has a medical/psychiatric problem like ADHD or a neurologically based learning disability. The diagnostic criteria of poor attention and behavior are met; and the child is obviously having difficulty learning. Evaluators don’t always look deeper.
It’s also too easy to assume children are getting accessible language when they aren’t. Specialists around a deaf child with a cochlear implant may assume the child now has exposure to accessible spoken language. This may not be true. Exposure to sound is not the same as exposure to language; and exposure to simple, concrete spoken language is not the same as exposure to the complex language older children need. Similarly, when a child’s environment includes some sign language exposure, this doesn’t mean the child is developing skills in American Sign Language. The “signers” providing the sign language exposure may themselves be very poor modelers of sign language, but the people designing the educational plan may treat all signing exposure as “good enough.”
The forces that weigh on evaluators can bias them to locate the problem in the child and not in an inappropriate school placement. The school district doesn’t want to deal with the costs and practical problems of sending the child to an out of district signing program. Evaluators don’t endear themselves to school officials by recommending this. The fiscal realities of a limited educational budget often have an unseen influence on the kind of interventions which are recommended. It may be easiest to recommend the path of least resistance, some intervention designed to “fix” the child, like medication or behavior modification, which doesn’t address the suitability of the educational placement.
When a deaf child like David isn’t attending, learning or behaving well, the presumption should be that language deprivation is a chief culprit. Unless there is really strong evidence that other factors are at play, the IEP should target language development. Where can David, or others like him, find a rich signing environment he can absorb as a native user? If this isn’t available, what resources can be assembled to approximate it? Providing fully accessible language needs to be a prominent part of the educational plan, and accessible language must include the option of rich sign language exposure.
Article written by Dr Neil Glickman, Psychologist, University of Massachusetts Medical School, Worcester. Dr Glickman will be delivering the keynote at the Deaf Mental Health Care Conference: Working with Cultural and Linguistic Challenges Conference, taking place 12 – 13 September 2019.