sign here. deafness variables communication and culture dysfluency deprivation implications for...
TRANSCRIPT
SIGN HERE
SIGN HERE
• Deafness• Variables• Communication and Culture• Dysfluency• Deprivation• Implications for Treatment
SIGN HERE
DEAFNESS
a) Degree of Deafness
b) Onset of Deafness
c) Presence of Disabilities
SIGN HERE
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)
SIGN HERE
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)
SIGN HERE
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
SIGN HERE
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
SIGN HERE
COMMUNICATION MYTHS
• Speak loudly/Shout
• Written word – average Literacy 8.5 (Conrad)
• Lipreading
• Nodding syndrome
• Understand Interpreters
SIGN HERE
• 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
SIGN HERE
• 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
SIGN HERE
• 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
SIGN HERE
• 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
SIGN HERE
• 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
SIGN HERE
• 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
SIGN HERE
Deaf people are more likely to experience
• Be excluded from local decision making about services
• Not have fair access to mainstream services and resources
• Not be able to access mainstream services
SIGN HERE
Deaf people may
CULTURAL MODEL
• Cultural / linguistic minority
• Use BSL (UK)
• Share social, interpersonal experiences
• Humour, Clubs, Rallies
DEAF PEOPLE
SIGN HERE
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.
SIGN HERE
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
SIGN HERE
EEC STUDY – CHILDHOOD DEAFNESS(T MARTIN ET AL)
3000 – Children – 9 countries
• 29% – Disability – Physical/Visual
• 9.9% - Learning Disability
SIGN HERE
Dysfluency Compared
DeafHearing
Incoherent MLS Compre- Proficient Fluent Eloquent hensible
Professor Robert Pollard – University of Rochester
SIGN HERE
SOME DEAF PEOPLE …
• Learning Disabled/ASC• Deafened• Cochlea Implants• Use spoken and written language• Cannot access Deaf Community without support• Ethnic minorities
SIGN HERE
Do not identify themselves as part of the Deaf Community
• 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
SIGN HERE
Shared PathwayM
oral
Val
ues
Recovery&
Relapse
Offence Related• SOTP• Arson• Violence
Anger Trauma Substance
Mental Disorder
Psycho education
Assessment & Risk Assessment
Rehabilitation Model
SIGN HERE
• 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
SIGN HERE
• 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
SIGN HERE
Anger
Emotion Big. You want shout, hit, punch, kick, threaten.
Emotion Posters: Definition
Lowe, Gahir, MacDonald, IAFMHS April 2012
Anger Thermometer: Intensity
Trigger / Start Build up DangerBuild up Angry stay
Anger less Angry / Upset
Anger Small/ Upset Big
UpsetCalmer Calm
big
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
SIGN HERE
Habilitation Treatment Approaches
H O P E
SIGN HERE
HEARING CARE PATHWAY
SIGN HERE
SIGN HERE
“What matters deafness of the ear when the mind hears? The true
deafness, the incurable deafness, is deafness of the mind.”
Victor Hugo, 1845
SIGN HERE
Any Questions? ? ?
SIGN HERE