Introduction:

I am deaf and hard-of-hearing (DHH). During early childhood, my two sisters and I were diagnosed with progressive high-frequency hearing losses that slowly (and abruptly, at times) transitioned our identities from hard-of-hearing to deaf, and we were fitted for hearing aids, provided speech therapy, and mainstreamed for primary and secondary education. Despite our audiologist’s prediction that we would struggle with literacy beyond the fourth-grade level, my sisters and I graduated with both high school and college diplomas, and our narratives are sometimes touted as “mainstreamed DHH success stories.” Today, in my forties, I have a Ph.D. in English, and I am employed as a professor of technical communication at Angelo State University in San Angelo, Texas. In this brief piece, I provide educators of DHH students with what I wish my teachers had known when I was in K-12. These tips are from my experience, my sisters’ experiences, my DHH friends’ experiences, and the researched literature.

Disclaimer: These tips are not designed to replace an individualized education program (IEP). Please follow applicable laws, such as the Individuals with Disabilities Education Act (IDEA).

Sight, Not Sound:

Most suggestions for teaching DHH students center around improving auditory outcomes: making sure hearing aids are fitted and turned on (with the batteries not run down), using cochlear implants, speaking in elevated tones and with more deliberate pronunciations, wearing FM systems that direct audio to receivers, and improving the acoustics of a classroom (e.g. minimizing background noise and peer voices). While these suggestions are necessary, they tend to minimize how most DHH individuals shift from the modality of hearing to the modality of sight as a primary mechanism for sensory input. DHH individuals are labeled as “people of the eye” (Lane, et. al, 2011) or as having an epistemology (a way of knowing and learning) that relies on vision (Hauser, et. al, 2010). The best educational outcomes from my education came from teachers who were self-conscious about their communication strategies and able to re-orient their pedagogy toward visuality. Suggestions include:

• Make sure that non-verbal communication strategies predominate, such as the ability to see lips, interpreters, hand gestures, closed captioning, and other educational materials (such as the white board).
• Institute a hand-raising policy for anyone who speaks in class; such slows down the flow of communication and allows for the DHH student to identify speakers and have a better chance of following the classroom discussion.
• Convert oral communications into visual communications. In one poignant memory, I recall attending a Shakespearean play during high school, but not knowing what was being “said,” despite the play being built off a visual modality (a script). I would have benefitted from having a copy of the play and a peer or teacher assigned to direct me visually (via sign, writing, or finger points) to the correct Act and Scene.
• Ensure adequate lighting, preferably rooms with windows and no curtains/shades (I recall a traumatic experience of being left behind when my kindergarten class was watching a movie in a dark room, and I did not realize that my classmates had left).
• Arrange physical spaces to allow the DHH child to see as much of the visual landscape as necessary, insofar as these variables are within your control (e.g. sitting up front, round tables for discussion, small group “discussions,” smaller rooms, smaller class sizes).
• For DHH students with stronger literacy skills, consider investing in auto-transcription technology. Such technologies are slowly improving in quality and are available on augmented reality glasses, on computer monitors (via online meeting software, such as Webex or Zoom), on recorded videos as captions (most video services have auto-captions), and on portable devices.

Remember Owen Wrigley’s (1996, p. 31) brilliant insight that we would not expect a blind child to see; similarly, we should not expect a DHH child to hear. Just as blind individuals shift to auditory/tactile communication, DHH individuals shift to visual/tactile communication.

Exhaustion, Not Inattention:

Due to a reliance on visuality, DHH individuals feel an exorbitant amount of fatigue, and DHH individuals will “frequently complain of being more tired than hearing people from focusing on visual information all day” (Schild & Dalenberg, 2016, p. 877-878). Such was my experience. I relied primarily on lip reading during spoken communication, and lip reading requires intense concentration to do well, even for a few minutes. More importantly, it is highly imprecise (see my article on this, published in 2018) and requires an enhanced cognitive load to fill in the “gaps” of communication. As such, DHH individuals are working much harder for less information. To combat this, be self-conscious about workload.

• Allow times in which the DHH student does not have to focus (literally) on the world around them. As a senior in high school, I had a “free” period in which I started taking daily naps; such helped reset my system each day.
• DHH students need visual breaks. One of the downsides of visual communication is that a teacher will know when a DHH is not “paying attention.” As such, teachers should resist the temptation to continually re-direct a DHH student’s attention back to visual communication (e.g. lips, signs, text, visuals). I have vivid flashbacks of a teacher calling me out, publicly, for not paying attention, which only expedites fatigue and anxiety. Hearing students are not always called out for inattention; DHH should not be called out, either.
• While perhaps not an option for most DHH students, I was homeschooled for a year and a half. Such allowed me to physically and emotionally recover from several years of DHH educational challenges.

Reading and Writing, Not Listening:

For some DHH students with residual hearing, listening might serve as a gateway for learning a spoken language; however, the ultimate goal of education is to achieve high levels of literacy (a visual form of communication) and rely less on listening (an aural form of communication). Once a DHH student becomes a proficient reader, educators become mentors rather than teachers. While high literacy levels are a holy grail for many DHH individuals, if DHH individuals successfully achieve literacy like my sisters and I did, they become “bookworms” (Oliva, 2004, p. 2) with a love of literature and, subsequently, become authors themselves; DHH literature is replete with individuals who fit this mold: Brenda Jo Brueggeman, Henry Kisor, Noel Patrick O’Connell, Michael Chorost, Joseph Michael Valente, Haben Girma, Helen Keller, Paul Gordon Jacobs. Literacy unlocks the metaphorical “key” to language development and self-directed learning, which should be the end goal of traditional education.

• Encourage parents to read to their DHH children and to be involved in their literacy instruction. As Marschark and Hauser (2012) state, “[w]hen we look at only the best deaf readers, we find that there is essentially one factor that separates them from all of the others: the amount of parental involvement in their child’s education” (p. 108).
• Provide opportunities for learning via literacy, not face-to-face “hearing.” During high school, I enrolled in an introduction to computer programming class, and my teacher loaned me the instructor’s copy of the textbook when he discovered that I had a knack for programming but needed the visuality of a textbook to illustrate coding rather than “hearing” it.
• Encourage reading and writing as assignments out-of-class and activities within-class.

DHH Inclusion, Not Passing:

DHH individuals are under an extreme pressure to pretend that we hear more than we do. This technique is called “passing” in the literature, and it is a coping strategy that encourages DHH individuals to “overcome” something that cannot be overcome: to be hearing when we are not.

• Be self-aware about how certain activities require “hearing” and will force students into a passing performance. I recall being in Bible classes (I was in a private school for half of my K-12 education) where I could not hear the prayers when my “head is bowed” and my “eyes are closed.” Children are less able to advocate for themselves and ask for their eyes to remain open; as such, we learn to “pretend” that we are hearing the prayer via eye peaks and listening to acoustic information besides the prayer (e.g. crowd noise).
• Help to redirect passing behaviors toward more inclusive communications. When you see your DHH student nodding their head without knowing what is said or fake laughing at a joke or bowing their head during a prayer, make modifications to the communication dynamics. Resist the temptation to say “I’ll tell you later” or “It is not important.” Passing is most dangerous to mental health because it eliminates reciprocity in communication: both parties expect to be “heard” during conversations, and passing eliminates that expectation. As such, some DHH individuals are “least alone when [they are] alone” (Meadow-Orlans & Orlans, 1990, p. 424), a paradox that emerges from knowing that “hearing” individuals will exclude “DHH” individuals from conversations and “passing” allows for one to pretend that one is not excluded.
• Connect DHH individuals to other DHH individuals. DHH individuals who are mainstreamed will often be more socially isolated and lonely. In one poignant example in the literature, a DHH teenager who played sports, was a Girl Scout, and was active in her church and community reported that “she is lonely” (Charlson et al, 1992, p. 265, emphasis mine). She suggested that knowing American Sign Language (ASL) would have helped with this isolation. As such, mainstreamed DHH individuals tend to be on an “island of misfits” (Cue et al, 2019, p. 418). We are not part of Hearing World, and during mainstreamed class periods, we are isolated from Deaf culture.

DHH Advocacy, Not Resignation:

Education embraces the Greek aphorism of “know thyself.” When a DHH student matriculates, they must know that they are a DHH individual living in a “Hearing World,” capable of adapting to that world and advocating for change. Teachers can facilitate that.

• Teach your DHH students by both encouraging and modeling strong advocacy. If students are excluded from educational situations, intervene.
• Engage in dialogue. Ask how your DHH student is feeling, and with their approval, assist them in making changes. Dialogue allows DHH students to know that they matter and that they can successfully demand change.
• Create a d/Deaf environment. Learn and teach introductory sign language and the ASL alphabet so that names/words/ideas can be more easily shared. I have positive memories of learning a person’s name for the first time and my friend (who knew the ASL alphabet) signed the name for me. Such creates an inclusive environment built on visuality, rather than orality.
• Embrace d/Deaf pride and read the literature surrounding “Deaf Gain” which focuses on the gains of being DHH rather than the loss of hearing. Today, I am proud to be DHH, something that I would not have claimed during my educational years: I have a unique cognition, epistemology, knowledge, and life-experience. These gains should be showcased to students. The edited collection of Deaf Gain: Raising the Stakes for Human Diversity (2014) might be a good place to start.
• Lastly, allow your DHH student to invert the educational experience: DHH students should educate the educators. Remember that 25% of all people will have measurable hearing loss by 2050 according to the World Health Organization (2021). True change begins when educators stop viewing DHH and disability as a “headache that won’t go away” and, instead, adopt a “reversal” (Baker, 2022, p. 697) where you recognize that you have your own hearing limitations, will (someday, if not today) be DHH, and might learn from your DHH students today.

References:

Baker, B. (2002). The Hunt for Disability: The New Eugenics and the Normalization of School

Children. Teachers College Record, 104(4), 663-703.

Bauman, H. D. L. & Murray, J. J., (Eds). (2014). Deaf Gain: Raising the Stakes for Human Diversity. Minneapolis, MN: University of Minnesota Press.

Charlson, E., Strong, M., & Gold, R. (1992). How successful deaf teenagers experience and cope with isolation. American Annals of the Deaf, 137(3), 261-270.

Cue, K. R., Pudans-Smith, K. K., Wolsey, J.-L. A., Wright, S. J., & Clark, M. D. (2019). The Odyssey of Deaf epistemology: A search for meaning-making. American Annals of the Deaf, 164(3), 395–422.

Hauser, P. C., O’Hearn, A., McKee, M., Steider, A., & Thew, D. (2010). Deaf epistemology: Deafhood and deafness. American Annals of the Deaf, 154(5), 486-492.

Lane, H., Pillard, R. C., & Hedberg, U. (2011). The people of the eye: Deaf ethnicity and ancestry. New York, NY: Oxford University Press.

Marschark, M. & Hauser, P. (2012). How deaf children learn: What parents and teachers need to know. New York, NY: Oxford University Press.

Meadow-Orlans, K. P. & Orlans, H. (1990). Responses to loss of hearing in later life. In D. F. Moores & K. P. Meadow-Orlans (Eds.) Educational and Developmental Aspects of Deafness. Washington, D.C.: Gallaudet University Press.

Oliva, G. A. (2004). Alone in the mainstream: A Deaf woman remembers public school. Washington, D.C.: Gallaudet University Press.

Schild, S., & Dalenberg, C. J. (2016). Information deprivation trauma: Definition, assessment, and interventions. Journal of Aggression, Maltreatment & Trauma, 25(8), 873-889.

World Health Organization. (2021, March 12). WHO: 1 in 4 people projected to have hearing problems by 2050. Retrieved January 22, 2024, from https://www. who. int/news/item/02-03-2021-who-1-in-4-peopleprojected-to-have-hearing-problems-by-2050.2021-03-21.

Wrigley, O. (1996). The politics of deafness. Washington DC: Gallaudet University Press.

About the Author:

Kevin Garrison is a deaf/hard-of-hearing professor of English at Angelo State University. He resides in the central spaces between DEAF-WORLD and Hearing World, and his writings grapple with the challenges of being oral deaf. He has published academic articles, poetry, memoir, and more. More information about his vitae and writings can be found here: https://www.angelo.edu/live/profiles/361-kevin-garrison

The post What I Wish My Educators Had Known: 20 Tips from a Mainstreamed Deaf and Hard-of-Hearing (DHH) Individual first appeared on Supporting Success For Children With Hearing Loss.

What does current research indicate about mental health of D/HH children? 

Contributing factors to the increased rate of social-emotional difficulties in deaf children include being isolated, bullied, or abused⁴, experiencing feelings of loneliness or depression⁵, and experiencing difficulties in school⁶.

Also, language deprivation during the critical period (e.g., birth to 5 years of age) can have permanent consequences for long-term neurological development, which, in turn, directly affects the D/HH child’s mental health development⁷.  Language deprivation puts deaf children at risk for cognitive difficulties, mental health challenges, lower quality of life, a higher level of trauma, and restricted health literacy⁸.

When mental health services are sought, additional issues often arise. Since D/HH children are a low incidence population, mental health providers frequently lack the specific training to work with this population and are typically unaware of the specialized needs and training required to provide effective services. This can result in the incorrect diagnosis of cognitive impairments or thought disorders^{9, 10}.  In addition, assessment tools are not modified to take into account the linguistic characteristics of this population or cultural norms and values.

EXAMPLES of when further investigation and support may be needed:

• A teacher is asked by a student to frequently go to the nurse or to call her parents to ask to go home as she does not feel well, but there seem to be no underlying health conditions.
• A teacher receives reports from the educational interpreter that a student has not been watching the interpreter during the school day as he had been previously, even though the IEP team has determined the student needs the visual interpreted access to spoken information.
• A teacher observes an elementary student’s behavior change from being friendly and outgoing to being quiet and withdrawn with their D/HH and/or hearing peers.
• A teacher has a student share that she often feels ignored and neglected at home, and that no one in her family is able to communicate with her.  She mentions wanting to live with a different family.
• A student who self-identifies as Deaf expresses concerns to her teacher that she is being bullied by two other students in her integrated class; the Deaf student states that one of the students asked her if she is deaf and she replies, “No, I’m hearing.”

Indicators of Concern – Further investigation and support may be needed if you notice the following:

Communication

• Not wanting to wear/use listening devices
• Not watching/working with an educational interpreter
• No longer advocating for own communication needs
• Suppressing communication needs so not to be perceived as being different

Academic

• Difficulty with abstract thinking
• Difficulty with the construct of cause and effect
• Declining academic performance
• Not completing assignments
• Not participating in class or group activities

Social

• Isolation, lack of friends, loneliness
• Avoiding activities or people, especially those previously enjoyed before

Behaviors

• Missing several days of school or sessions without reason
• Complaining of physical aches that do not seems to have a medical reason
• Acting out in class
• Falling asleep in class
• Perseverating on certain thoughts, activities, or actions
• Sudden gain or loss in weight
• Describing hearing or seeing things that are not real

Emotions

• Sharing sad and hopeless feelings without good reason that do not go away
• Expressing unusual fears or worries
• Exhibiting fits of frustration or anger

What to consider when referring for mental health support

• Discuss your concerns with a school counselor, school social worker, school psychologist, supervisor, or an administrator.
• Gather additional information from the student’s team about their observations and concerns.
• Review with the team who will contact the family and student about concerns and discuss next steps.

When the mental health crisis is suspicion of intent to commit suicide:

If suicide is a concern, it is essential to ask a child if they have thought about harming themselves and if they have a plan. Asking these questions will not cause a child to consider taking action, but will provide more information to know what steps need to be taken next.  If a child has a detailed plan, it is important to remain calm and respond in a nonjudgmental manner. Express appreciation that they shared with you and request backup support without leaving the student on their own if possible. If immediate help is needed, it may be necessary to bring the D/HH child to the emergency room at the local hospital.  Interpreters can be requested at the hospital as needed.

When supporting families to find a mental health provider:

Ideally, the provider seeing the student should be fluent in the communication that the child is most comfortable using and have experience working with children who are D/HH. Seek referrals from other families who D/HH children, schools for the deaf, and staff working with students who are D/HH to find qualified providers in your community. If an interpreter is needed, this should not be done by a family member, but by a certified interpreter. Request the interpreter from the medical provider; the medical provider needs to cover the cost of the interpreter at no additional cost to the family.

Are additions to an IEP or creation or additions to a 504 is appropriate?  Examples:

Additions to IEP:

• Socialization goals
• Self-advocacy goals

Additions to a 504 and/or IEP:

• Additional time to take tests and/or complete assignments
• Taking breaks during the school day as needed
• Assignment of an emotional support teacher for the student to work with during the day to obtain support and take a break from the stressors of school

Additional ways to support the mental health of all Deaf and Hard of Hearing students

• Partner with mental health professionals in the school to discuss students potential mental health issues, indicators of symptoms, and outcomes when support is received. These discussions lead to overall assimilation of the value of mental health services and children becoming more comfortable discussing mental health as they would other medical issues.
• Create opportunities for peer support with D/HH students to discuss concerns with others and validate their experiences.
• Develop social skills as needed so children develop a peer group and have daily positive interactions with others.
• Create opportunities for students to interact with D/HH adults so they can envision a future for themselves.
• Be aware of cultural influences or misunderstandings creating the perception of mental health concerns; examples include strong facial expressions, heavy use of eye contact, use of touch to gain attention.
• Communicate with families when concerning indicators are observed and share information about available resources they can explore.
• When possible, offer outreach to families experiencing stress. Family and sibling support groups can bolster resilience of families who have D/HH children.

Final Thoughts

As a teacher,  your consistent contact with your students allows you to notice changes in behavior and academics. If you notice any of the concerning indicators listed above,  discuss them with your supervisor, administrator, or mental health school professional. You do not need to make the decision if treatment is needed.  Instead, focus on working with the educational team, family, and other members of the child’s community, such as their pediatrician, to develop a supportive plan.

There are many supports that can be put in place to address a student’s mental health; the earlier they are engaged, the sooner the student can continue to reach their academic potential. In some cases, when severe mental health symptoms are present, community mental health resources should be explored, at the discretion of the family. Ideally, the mental health provider would be able to communicate directly in the shared language of the D/HH child; if these resources are unavailable, encourage families to request reasonable accommodations for the child.

Ultimately, by supporting students’ mental health,
teachers facilitate students’ overall academic growth.

Additional Resources:

National Suicide Prevention Lifeline
Voice: 1-800-273-TALK (8255)
Deaf callers use VideoPhone Relay Services, e.g., P3, Sorenson, Convo, ZVRS then give the voice phone number above. Website: suicidepreventionlifeline.org

National Suicide Prevention Lifeline is a 24-hour, toll-free, confidential suicide prevention hotline available to anyone dealing with suicidal crisis or emotional distress. The call will be directed to the nearest crisis center in the national network of over 150 crisis centers. As there is no ASL hotline for suicide prevention available, this is the best option for Deaf emergency services related to suicide.

Crisis Text Line
Text: Type HOME to 741741 in the US.   Website: CrisisTextLine.org
Crisis Text Line is a free, 24/7 text support line for anyone in a mental health crisis. To chat with a trained Crisis Counselor, text HOME to 741741 from anywhere in the US. This service is free and available all day and night to anyone who is experiencing any type of crisis. Texting is a way to get mental health support and information about mental health services quickly and it is very useful for D/HH people.

References

1. “Children’s Mental Health Is in Crisis.” American Psychological Association, 1 Jan. 2022, apa.org/monitor/2022/01/special-childrens-mental-health.
2. Stevenson, J., Kreppner, J., Pimperton, H., Worsfold, S., & Kennedy, C. (2015). Emotional and behavioral difficulties in children and adolescents with hearing impairment: A systematic review and meta-analysis. European Child & Adolescent Psychiatry, 24(5), 477–496.
3. Hintermair , M. (2007). Prevalence of socioemotional problems in deaf and hard of hearing children in Germany. Am Ann Deaf, Summer;152(3):320-30.
4. Wolters N, Knoors HE, Cillessen AH, Verhoeven L. (2011). Predicting acceptance and popularity in early adolescence as a function of hearing status, gender, and educational setting. Research in Developmental Disabilities. Nov-Dec;32(6):2553-65.
5. Glickman,  N. (Spring 2007). Do You Hear Voices? Problems in Assessment of Mental Status in Deaf Persons With Severe Language Deprivation, The Journal of Deaf Studies and Deaf Education, Volume 12, Issue 2, 127–147.
6. Fellinger & Pollard.  (2012).  Mental health of deaf people. https://pubmed.ncbi.nlm.nih.gov/22423884/
7. Hall WC, Levin LL, Anderson ML. “Language deprivation syndrome: a possible neurodevelopmental disorder with sociocultural origins.” Social psychiatry and psychiatric epidemiology. 2017 Jun 0; 52(6):761-776. Epub 2017 Feb 16.
8. Gulati, S. (2014). Language deprivation syndrome. ASL Lecture Series.
9. Morgan, A. & Vernon, M.  (1994). A guide in the diagnosis of learning disabilities in deaf and hard-of-hearing children and adults.  American Annals of the Deaf, 139, (3), 358-370.
10. Hindley, P. A., Hill, P. D., McGuigan, S., & Kitson, N. (1994). Psychiatric disorder in deaf and hearing impaired children and young people: A prevalence study. Child Psychology & Psychiatry & Allied Disciplines, 35(5), 917–934.

Author: Roberta Rossman, MEd, MSW, LSW & Polly Brekke, EdD PsyS.         

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The post Supporting Mental Health of Deaf or Hard of Hearing Students in the School Setting first appeared on Supporting Success For Children With Hearing Loss.

Since 19 out of 20 children born with hearing loss are raised in families without members who are deaf or have hearing loss, it is likely that most children who are deaf/hard of hearing are the only ones in their family using hearing devices. Older brother has brown hair, sister has freckles, and the youngest child has hearing aids – hearing loss/deafness is just part of the aspects that make up the family. Most families adapt to the child’s needs by communicating within close proximity, carrying extra batteries, and checking that the child heard/understood directions, etcetera.

About the age of 4 years children begin to care about being liked by other children. Children with hearing devices entering preschool or kindergarten are very likely surrounded by peers who have never seen a hearing aid, BAHA, cochlear implant, or any kind of hearing assistance technology. Curiosity and questions are very normal.

HOW the student reacts to these questions can set the tone, along with how the classroom teacher shares information with the large group about ‘different = okay’.  If there is no preparation of the child for this situation, and no help by the teacher, then the student is at high risk for feeling it is not okay, or even bad, to be using hearing devices.

Wanting to be accepted by a group is typical throughout primary school. Our sense of self is influenced by the groups we belong to. Who we compare ourselves to can affect how we feel about ourselves, for better or worse. If the child does not encounter any other children in the group with hearing issues, then there is a subconscious message that to be able to belong, they shouldn’t use their hearing devices. This can be tough to counteract!

IDEA 1 – Read books with characters where the child can identify ‘he’s just like me!’.  These books can be read at home, long before the child starts school. SEE HERE FOR A LIST OF BOOKS. The characters may have dealt with teasing, or fitting in, or making friends. Books can introduce these concepts and open the door to discussions at home and at school. There are chapter books and young adult books that have characters with hearing loss too! Reading together, discussing ideas, and making the connection that other kids deal with being hard of hearing or deaf too, will strengthen the child or youth’s feelings that they are not alone, and that they are OKAY being a kid with hearing loss. A teacher reading a book that features a character with hearing loss to the whole class is a great way to start the early school years (suggestions: 1, 2, 3).

 
IDEA 2 – Prepare for questions or teasing. Whether the child is 4, in 4^th grade, or age 14, chances are that someone will make a comment about hearing issues or devices. Count on it. Prepare for it. Humor, sarcasm, and yes – teasing, are all a part of language development and word play. Some children are raised in families where teasing happens and are likely to tease others – in a light-hearted manner, or not. Teasing can happen when someone feels threatened or upset, and they lash out at others.

Finally teasing/bullying can occur as a way for a child to feel more powerful due to their own low self-esteem. The key is to not ‘feed’ the bully by tears, embarrassment, anger or any other negative reaction. Ignore the bully, or respond as matter of fact, i.e., ‘I know’, ‘You told me that yesterday’, ‘Yeah I wear hearing aids.’ Role playing to practice responses is vital. For preschoolers and kindergarten students, practice ways they can respond to questions like, “What are those things?” “Why do you wear that thing?”. Kids are curious and the child needs to be prepared to provide simple answers!

IDEA 3 – Connect kids with other kids who use hearing devices and/or sign.

The most POWERFUL tool we have to increase self-concept, create a strong and healthy identity that it is ‘okay to be a kid with hearing loss’ is to foster the feeling that the child is part of a group of ‘cool kids with hearing aids’ or other devices, and/or ‘cool kids who sign’.

Play dates or Zoom chats arranged by the family are fabulous! Working on self-advocacy skill development in school where students from a number of buildings can join in virtually to learn strategies, discuss issues, and realize they are not alone – terrific!  Both family and school connections – AWESOME!

Starting with ages 4-5 and going all the way through high school, opportunities to connect, complain, strategize, and celebrate cannot be underestimated in their overall effect on self-concept, less rejection of using hearing devices, greater motivation to self-advocate, and more!

Want to learn more?  Check out Building Self-Confidence & Resilience to Maximize Acceptance of Hearing Devices available inexpensively in print from Supporting Success or digitally from Teacher Tools Takeout.

Author: Karen Anderson

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Are my clothes ‘cool’ enough? Will any boy like me? Will girls think I’m a dweeb? Worries like these are common for almost all teens as they enter middle school and/or high school. They want to both assert their independence to be seen as who they are, and to hide in the crowd so they won’t be seen as too different. It is a confusing time.

From approximately age 12-19 years children develop a strong affiliation and devotion to ideals, causes, and friends. They are concerned with how they appear to others. They establish this new sense of self by using past experiences to guide their anticipation of the future (i.e., successful integration with hearing peers vs. frequent teasing due to hearing differences). In their desire to ‘be more like the person my group expects me to become’ adolescents with hearing loss who have no other DHH peers, or successful DHH role models often feel that to be part of the group, they need to pass as normal hearing. We often see this result as ‘forgetting’, breaking, or refusing to use hearing devices. It may be refusal to use HAT in the classroom, or not wearing one or both hearing aids.

At this stage students are working on how they integrate into society as a whole as an independent person, separate from family and established supports (like long time DHH support services). There are additional challenges to developing an identity when a person is a minority in a group – in this case having a hearing loss when peers are typically hearing. A higher rate of anxiety and depression as compared to hearing peers was revealed in a 2021 study¹ that asked 104 individuals ages 12-18 attending otology clinic appointments to complete a survey to look at the association between mental health and hearing loss.

Results of this study found that 25% of adolescents scored above the clinical cut-off for significant issues for anxiety or depression and 9% were found significant for both. More importantly, 30% scored in the at-risk range for depression and 21% scored in the at-risk range for anxiety.

Children with depression and/or anxiety are 7 times more likely to have accrued more than 2 weeks of school absences and are 3 times more likely to be non-compliant with recommendations like refusing use of hearing devices, which, as a result will negatively affect communication abilities, quality of life, speech understanding, and social interactions.

If we know that students with hearing loss are at much higher risk for anxiety and depression, what can we do?²

Four types of integration in this case must be considered and facilitated:

a) Coming to feel like I belong to my peer group and immediate community
b) Coming to feel like I am an integrated part of the community of persons with hearing loss
c) Internally integrating how much I am like my peer group along with my differences
d) Coming out – or feeling okay with how I present myself as a person with hearing loss (disclosure)

Focus on all four of these components is necessary for the person to feel empowered and integrated into the hearing community as a person who is deaf or hard of hearing, along with integrating into the DHH community itself.

Early Skill Building Is Not Enough.  Building resilience to teasing, skills at making friends, and developing perseverance in challenging communication situations will go far in helping ANY student to weather the travails of adolescence. Even with attention to these skills, the drive to ‘fit in’ is often so strong that the student with hearing loss feels he must reconcile who he knows he is (a student who has a hearing loss) with what he perceives his peer group wants him to be (someone who does not use hearing devices).

The greatest impact in this situation occurs when the student to comes to realize
1) he is not alone in having a hearing loss and facing these challenges, and
2) there are plenty of examples of successful people who have gone through what he is going through now.

Secondary schools pool student bodies from a number of elementary or middle schools. If a student was a ‘one and only’ in elementary, there may be a small number of DHH peers attending the same secondary school. For the sake of student mental health, continued device use, and resulting academic performance, it should become a high priority to get together secondary students. If this cannot be accomplished at the same building, then it should be pursued in an online format.

Suggestions for what to share in a group or discuss with individual teens:
Teacher Tools Takeout Subscribers have access to Kool Kidz Vidz to show, share, and discuss with one or more teens. Play A Wizard’s Challenge Game to get at what it feels like to be a ‘wizard’ in a world of ‘muggles’. Talk about How to Be Cool with the group. Teachers can read more about self-concept, strategies and assessment. Other items from Teacher Tools Takeout – search for Self-Concept or 0366, 0374, 0658.

1. https://journals.lww.com/thehearingjournal/Fulltext/2021/04000/Understanding_Depression_and_Anxiety_in.5.aspx
2. Building Self-Confidence & Resilience to Maximize Acceptance of Hearing Devices (book) https://teachertoolstakeout.com/0637-interpretation-assessment

Author: Karen L. Anderson, PhD
Click here to download this article

The post Teens and the Price to Pass as ‘Normal’ first appeared on Supporting Success For Children With Hearing Loss.

Self-Concept for Infants, Toddlers, Preschoolers

Self-Concept for School-Age

Self-Concept for Adolescents

Bullying/Teasing and Students with Hearing Loss

A Guide to Support Mental Health and Well-Being of Children and Youth who are Deaf/deaf and Hard of Hearing was created in 2015 for children in Ontario’s schools. It provides grade specific tools and strategies for parents and teachers, specifies risk factors and relevant child development.

WHAT IS SELF-CONCEPT?

A child’s self-concept is his belief about how worthwhile he is. Self-concept is how the child sees himself. It is made up of a sense of belonging and being accepted, a sense of being good, and a sense of being capable of doing things well. Self-concept represents the sum of an individual’s beliefs about his or her own attributes.

Self-concept is built on good relationships – and good relationships are built on communication.  Children with hearing loss are at-risk for lower self-concepts. This is because they miss communication and subtle social interactions that occur outside of their ‘listening bubble’. It is also related to how people in their environment react to their wearing hearing devices and/or using visual communication methods.

Self-concept influences a child’s ability to learn, grow, be creative, relate to others, make healthy choices, and reach goals. (1)

• Toddlers tend to have a lot of self-confidence. They are eager to explore new thoughts, feelings, objects, and people.
• School-age children are often unsure. They may doubt their abilities as they learn to do things on their own.
• Pre-adolescents may feel embarrassed and sensitive about their bodies. As they mature, they may feel confident one minute and insecure the next.
• High-school kids feel the challenge of independence. They need to stand apart from their parents and other adults. Peer acceptance becomes an importance confidence-builder.

A child or teen with a positive self-concept will be able to:(2)

• act independently
• assume responsibility
• take pride in his accomplishments
• tolerate frustration
• attempt new tasks and challenges
• handle positive and negative emotions
• offer assistance to others

On the other hand, a child with a negative self-concept will:

• avoid trying new things
• feel unloved and unwanted
• blame others for his own shortcomings
• feel, or pretend to feel, emotionally indifferent
• be unable to tolerate a normal level of frustration
• put down his own talents and abilities
• be easily influenced

Look here for worksheets you can use to develop recognizing emotions and self-esteem.

Ten steps you can take to help a child develop a positive self-concept:

1. Teach children to change their demands to preferences. Point out to children that there is no reason they must get everything they want and that they need not feel angry either. Encourage them to work against anger by setting a good example and by reinforcing them when they display appropriate irritation rather than anger.
2. Encourage children to ask for what they want assertively, pointing out that there is no guarantee that they will get it. Reinforce them for asking and avoid anticipating their desires.
3. Let children know they create and are responsible for any feeling they experience. Likewise, they are not responsible for others’ feelings. Avoid blaming children for how you feel.
4. Encourage children to develop hobbies and interests which give them pleasure and which they can pursue independently.
5. Let children settle their own disputes between siblings and friends as much as possible.
6. Help children develop “tease tolerance” by pointing out that some teasing can’t hurt. Help children learn to cope with teasing by ignoring it while using positive self-talk such as “names can never hurt me,” “teases have no power over me,” and “if I can resist this tease, then I’m building emotional muscle.”
7. Help children learn to focus on their strengths by pointing out to them all the things they can do.
8. Encourage children to behave toward themselves the way they’d like their friends to behave toward them.
9. Help children think in terms of alternative options and possibilities rather than depending upon one option for satisfaction. A child who has only one friend and loses that friend is friendless. However, a child who has many friends and loses one, still has many. This same principle holds true in many different areas. Whenever you think there is only one thing which can satisfy you, you limit your potential for being satisfied! The more you help a child realize that there are many options in every situation, the more you increase his or her potential for satisfaction.
10. Laugh with the child and encourage them to laugh at themselves. People who take themselves very seriously are undoubtedly decreasing their enjoyment in life. A good sense of humor and the ability to make light of life are important ingredients for increasing one’s overall enjoyment.

Resources used for this webpage:

1. http://shop.channing-bete.com/onlinestore/storeitem.html?iid=166627&cid=134813&item=You%2C+Your+Child+And+Self-Esteem
2. http://childdevelopmentinfo.com/child-development/self-esteem.shtml

Posted by Karen L. Anderson, PhD, Supporting Success for Children with Hearing Loss, March 26, 2013. Bullying

The post Self-Concept: How the Child with Hearing Loss Sees Himself first appeared on Supporting Success For Children With Hearing Loss.

“I know how to handle bullying in my classroom!” may be a battle cry from any experienced and successful teachers, but the landscape of bullying has changed.

For starters, bullying most often occurs when adults are not watching. It happens online with social media or email or texting. It happens in private places where those who bully are most powerful and those who are bullied are most vulnerable.

Even more significantly, current research on bullying targets a high incidence of bullying in the deaf/hard of hearing student population.  Traditional approaches to modify and end bullying behaviors as well as methods and curricula for teaching social skills need an update.

Studies on the frequency of bullying with deaf and hard of hearing students – a jolting reality

• In 2018, the University of Texas found that adolescents with hearing loss endured significantly higher incidence of bullying versus the general population (50.0% vs. 28.0%), particularly for exclusion (26.3% vs. 4.7%) and coercion (17.5% vs. 3.6%). Children younger than 12 years with hearing loss reported lower rates of bullying (38.7%) than adolescents with hearing loss, but rates did not differ significantly. Author of the study, Dr. Andrew Warner-Cryz, revealed: “I thought more children and adolescents with hearing loss would report getting picked on, but I did not expect the rates to be twice as high as the general population”
• A 2018 study by Van den Bedem, N.P., published in the International Journal of Language and Communicative Disorders found that students who had lower language abilities were more vulnerable to victimization if they lacked understanding of their own emotions and levels of anger, sadness, and fear. Another red flag for teachers of the deaf and hard of hearing whose students may lack self-esteem, feel isolated, or different from the larger population of hearing students.
• A 2013 Gallaudet study on bullying and school climate found that 812 deaf and hard of hearing students in eleven U.S. schools reported instances of bullying at rates 2-3 times higher than reported by hearing students. Deaf and hard of hearing students reported that school personnel were less likely to intervene when bullying was reported. The study examined perspectives among deaf and hard of hearing students in residential and large day schools regarding bullying, and compared these perspectives with those of a national database of hearing students. The participants were 812 deaf and hard of hearing students in 11 U.S. schools. Significant bullying problems were found in deaf school programs.  Results indicate the need for school climate improvement for all students, regardless of hearing status.

Anecdotal stories support the findings.

In 2016, the story of a deaf high school student in Nebraska was reported on television news.  Students had taken his backpack during a lunch period and dumped it in a toilet.  Contained inside were his tablet, school supplies, homework, debit card, and his cochlear implant.  The student, Alexis Hernandez, reported: “Those students think it’s ok to bully a deaf student, but it’s not.  It’s not OK to bully someone who is disabled, deaf, or hard of hearing.  Or anyone for that matter.”

Incidents of “put downs,” teasing, rummaging in school bags or desks, and stealing among students in an urban program for deaf/hard of hearing students give further anecdotal support.  In one story, teacher reports to administration of teasing a deaf student about his speech and hearing aids went unheeded until parents called the principal directly.  After all, the principal had reasoned, there had been no physical harm.

Definitions:  Shaming, Blaming, and More

The National Deaf Children Society (NDCS) in the UK provides the following comprehensive description of bullying in their publication: “Bullying Advice for Parents of Deaf Children.”

Bullying may comprise one or more of these behaviors:

Verbal: name-calling, insulting, teasing, ridiculing

Emotional/indirect: ignoring or deliberately excluding, spreading rumors or nasty stories, turning friends against the child, laughing at them or talking about them behind their back, taking, hiding or damaging their personal belongings, drawing unkind pictures of the child, using a feature of the child’s disability to bully them, (e.g. deliberately making loud noises near a deaf child who is known to find loud noises unpleasant, creeping up on them from behind to scare them, deliberately making a noise when the teacher is giving instructions).

Physical: any physical contact which would hurt such as hitting, kicking, pinching, shoving, tripping up, pulling out hearing aids.

Manipulation/controlling behavior: using the child’s vulnerability as a way of controlling them or making them do something the bully wants them to do.

Cyberbullying: using electronic media (internet, mobile phones) to bully someone. This includes bullying through text messages, instant messaging, email, chat forums, online games and social networking websites.

Healthy Self Esteem is the Gatekeeper

If individuals value themselves, feel worthy, loved, able to handle rejections and bounce back – they possess qualities that naturally help guard against bullying, or becoming bullies.  Take teasing, for instance.  Although it can become ugly and demeaning, there is a place for gentle teasing that allows individuals to laugh at themselves in a healthy way.  We all make mistakes!  We’re “human.”

Self Esteem in Fictional Heroes

Two well-known stories give us perfect examples of what healthy self-esteem looks like. Characters in books or movies so often provide our best “teachable moments” for learning about behaviors in the real world. These are two heroes of fiction for kids of all ages: J. K. Rowling’s Harry Potter and R. J. Palacio’s Augie Pullman of Wonder.  

In her insightful work, “Harry Potter and Hearing Loss – A Whimsical Look at Similarities and Successes, ” Karen Anderson draws comparisons between J. K. Rowling’s famous Harry and his experiences as a new student at Hogwarts School of Witchcraft and Wizardry with the experiences of deaf/ hard of hearing students in the mainstream.

There were many times when Harry was an outcast, made fun of, and treated poorly by groups of students. He usually did not react or lash out at his tormentors… He did not ask to be special. But Harry, with the help of his friends and teachers, persevered, tried his hardest and was true to who he was as a person. Therefore he succeeded against all odds. 

Most children who are deaf or hard of hearing did not wish to have a hearing loss.  It is not fair that they need to wear amplification or have therapy and other services that most children do not need.  It is not fair that they face listening and understanding challenges in many situations that are effortless for their peers who have typical hearing…. Ultimately, children with hearing loss will be successful because they try hard an dhave support and assistance from their families and teachers. They need to believe in themselves and that they can succeed. Children who are deaf or hard of hearing, with the help of their families, friends, teachers, and therapists, must persevere and be true to who they are as people to be able to succeed in a hearing world.     

Entering a mainstream school for Augie Pullman in R. J. Palacio’s Wonder, is another example of confronting, and dealing with diversity. Augie’s facial deformities set him far apart from the norm, vulnerable to the stares and smirks of other students. He persevered, but not without the support of his family, friends, and teachers.

Two clear lessons about self-esteem from these two fictional characters: 

Positive self-esteem is an anchor (our “gatekeeper”).

It takes a “village” of support to maintain it.

Other Ways to Build Self Esteem

There are many exercises that can help foster a healthier sense of self esteem for our children and students.  A few suggestions for teachers and parents:

Allow mistakes and accidents to happen.

Do not shame and blame others

Accept differences in other people, families, cultures

Find the humor in your own missteps and mistakes

Make an effort to talk about the things for which you are grateful

Find ways to help others

CONFRONT Bullying HEAD ON:

Incorporate routine screening for bullying via direct questions⁶:

Ask the child about friends. A response of “none” or “few friends” deserves additional prompting (i.e., “Why do you think this is?”)  

Inquire if the child avoids going to school and find out why.

Ask the child directly if he or she has experienced bullying. If the child answers yes, ask follow-up questions and refer the child to school and community resources. .

Address developing skills to reduce victimization in the student IEP:

Issues related to peer victimization can be included on individualized education plans or 504 plans in the following ways:

Informing teachers and classmates about hearing loss.

Providing a safe environment statement to designate a “home base” where a student can go when feeling unsafe and/or a “safe person” with whom a student can discuss difficult situations.

Including strategies to reduce vulnerability by targeting social pragmatic skills (e.g., taking turns and asking questions; reading facial expressions and body language) via one-on-one instruction, role playing, or social stories.

For teachers:

Keep the discussion of bullying behavior alive and ongoing – not a lesson plan to be covered, completed, and put away.

Organize a social skills group to help children develop social competencies in a supportive environment.

Clinicians can also help patients address assertiveness and/or self-advocacy, with specific training to identify and report bullying, say “no” to stop the situation, and request assistance from a trusted source.

Give your students a safe and open communication pathway for reporting incidents of bullying.

Recognize that bullying will most often happen when you are not watching – In the lunchroom, the bathrooms, the playground, the hallways. Just because you did not see it does not mean it did not happen!

Be a listener.

Be supportive.

Report incidents to your school administration as promptly as possible.

For parents:

Talk to your child about feelings – openly and often. They need to know that when things go wrong, you will be there to support them.

Stay closely involved with school administrators and teachers.

Be ASSERTIVE with school personnel when your child reports bullying behaviors.

Cyberbullying – How do we deal with an invisible bully?

While our deaf and hard of hearing students find invaluable and positive connections online, the potential for negative interactions is, unfortunately, highly correlated with increased internet use.

PACER has developed a comprehensive website, PACER’s National Bullying Prevention Center which lists the following attributes of online bullying:  a) electronic forms of contact, b) an aggressive act, c) intent, d) repetition, e) harm to the target (Hutson, 2016 ).

The technology, accessed through computers or cell phones, used to cyberbully includes: Personal websites, blogs, e-mail, texting, social networking sites, chat rooms, message boards, instant messaging, photographs, video games  Feinberg & Robey, 2009.

PACER concludes that those who are most at risk to cyberbullying are those who experience lower self-esteem, social isolation, and academic problems.

The joys of communicating online for our students who are deaf or hard of hearing are threatened by the simple act of “logging on.”

How Can We Be Proactive about Cyberbullying?

RECOGNIZE: By being fully aware of what websites are being used.  If we as adults continue to make excuses about our lack of skill or disdain for social media, we are inadvertently providing limitless opportunities for our children to be vulnerable to cyberbullying.

REACT: Explicit teaching about security and boundaries

Passwords cannot be shared, even with close friends.

Do not allow people to be “friends” on Facebook or Instagram unless they are real friends!

Do not post pictures on Facebook or Instagram without permission of each person in the picture. Even better: do not post pictures on Facebook or Instagram.

Do not respond to emails or texts from people you do not know.

RAISE AWARENESS:  The following is a comprehensive list of materials available on the  from Pacer’s National Bullying Prevention Center website.

Cyberbullying Starts Earlier Than You Might Think — Here’s How to Protect Your Child Now

What Every Parents Needs to Know About Protecting Their Child from Cyberbullying

Helping Your Child Understand Cyberbullying

Cyberbullying: What Parents Can Do to Protect Their Children

Safety in the Online Community: A conversation with your 13-year-old about Facebook and Instagram – Facebook and Instagram partnered with PACER’s National Bullying Prevention Center to create this guide to help parents talk with their teens about using social media.

What Parents Should Know About Bullying – This guide, created in partnership with Verizon, offers a comprehensive overview for parents to learn what they can do to address and prevent bullying, featuring a section on mobile and online safety.

Teens Against Bullying on Cyberbullying – Teens Against Bullying is a place for middle and high school students to find ways to address bullying, to take action, and to be heard.

How to Prevent Cyberbullying: Hands Off the Keyboard Until You’re Calm!

http://www.nea.org/tools/lessons/teaching-students-to-prevent-bullying

https://stompoutbullying.org/get-help/about-bullying-and-cyberbullying

https://www.lebonheur.org/blogs/practical-parenting/keeping-up-with-your-child-online

APPS TO LOCK INAPPROPRIATE WEBSITES:

Mobicip. This free app blocks sites, including chat sites and social networking apps that may be inappropriate, depending on the age of the user. There are three restriction levels.

FamiSafe. Designed to block inappropriate websites for business employees or family members.  Detects and alerts parents to explicit content on all social media platforms

Internet Blocker – Freedom.  Used worldwide to help protect children from harmful threats.

Cold Turkey.  This app will temporarily block websites from target devices.

References

Warner-Czyz, A. D., et. al. (2018) Effect of hearing loss on peer victimization in school-age children. Exceptional Children. https://medicalxpress.com/news/2018-04-children-loss-bullying.html . Download from: https://successforkidswithhearingloss.com/wp-content/uploads/2019/09/Children-with-hearing-loss-face-more-bullying-2018.pdf

2016 news: https://www.newschannel5.com/news/national/burke-high-school-investigating-bullying-incident-after-it-goes-viral

Van den Bedem, N.P., et al, (2018). Victimization, bullying, and emotional competence: Longitudinal associations in (Pre)Adolescents with and without developmental language disorder, Journal of Speech, Language, and Hearing Research, 61, 2028-2044.

Goberis, D., Beams, D., Daples, M., Abrisch, A., Baca, R. & Yoshinaga-Itano, C. (2012). The Missing Link in Language Development of Deaf and Hard of Hearing Children: Pragmatic language development. Seminars in Speech and Language, (2012), 33:4, 297-309.

Bullying Advice for Parents of Deaf Children. National Deaf Children Society in the UK. Download from: https://successforkidswithhearingloss.com/wp-content/uploads/2019/09/Bullying-Advice-for-Parents-of-Deaf-Children-NDCS-UK.pdf

Warner-Czyz, A. D. (2018). Peer victimization of children with hearing loss. The Hearing Journal, October. Download from: https://successforkidswithhearingloss.com/wp-content/uploads/2019/09/Peer_Victimization_of_Children_with_Hearing_Loss.4.pdf

Webpage posted October 2019. Author Jean Snowden, NBCT. Jean has had 30 years of experience as a teacher of the deaf in varied settings and also experience teaching English as a Second Language.  She has been an author of Language Strategies and Social Strategies sections of the Supporting Success Teacher Tools e-magazine. Jean is co-founder of Jack Apps Education and is a teacher-author at Teachers Pay Teachers.

The post Bullying and Students with Hearing Loss first appeared on Supporting Success For Children With Hearing Loss.

October is National Bullying Prevention Month.

Gallaudet researchers found that 812 deaf and hard of hearing students in eleven U.S. schools reported instances of bullying at rates 2-3 times higher than reported by hearing students.  It is obvious that bullying is a serious problem.  What is not always so clear is how parents, teachers, and deaf/hard of hearing students can work together to resolve it.

The Problem:

The incidence of bullying in the deaf or hard of hearing student population is a significant, even startling, reality. A 2018 study¹ found that adolescents with hearing loss endured significantly higher incidence of bullying versus the general population (50.0% vs. 28.0%), particularly for exclusion (26.3% vs. 4.7%) and coercion (17.5% vs. 3.6%). Children younger than 12 years with hearing loss reported lower rates of bullying (38.7%) than adolescents with HL, but rates did not differ significantly.

“I thought more children and adolescents with hearing loss would report getting picked on, but I did not expect the rates to be twice as high as the general population,” said Dr. Andrea Warner-Czyz, study author.

In 2016², the story of a deaf high school student in Nebraska was reported on television news.  Students had taken his backpack during a lunch period and dumped it in a toilet.  Contained inside were his tablet, school supplies, homework, debit card, and his cochlear implant.  The student, Alexis Hernandez, reported: “Those students think it’s ok to bully a deaf student, but it’s not.  It’s not OK to bully someone who is disabled, deaf, or hard of hearing.  Or anyone for that matter.”

Another study³ found that students who had lower language abilities were more vulnerable to victimization if they lacked understanding of their own emotions and levels of anger, sadness, and fear. As students with hearing loss have a greater risk for difficulty in being able to identify and describe emotional states⁴, recognizing that these challenges may contribute to victimization has important implications for intervention.

Bullying can be⁵:

• verbal: name-calling, insulting, teasing, ridiculing
• emotional/indirect: ignoring or deliberately excluding, spreading rumors or nasty stories, turning friends against the child, laughing at them or talking about them behind their back, taking, hiding or damaging their personal belongings, drawing unkind pictures of the child, using a feature of the child’s disability to bully them, e.g. deliberately making loud noises near a deaf child who is known to find loud noises unpleasant, creeping up on them from behind to scare them, deliberately making a noise when the teacher is giving instructions.
• physical: any physical contact which would hurt such as hitting, kicking, pinching, pushing, shoving, tripping up, pulling out hearing aids.
• manipulation/controlling behavior: using the child’s vulnerability as a way of controlling them or making them do something the bully wants them to do.
• cyberbullying: using electronic media (internet, mobile phones) to bully someone. This includes bullying through text messages, instant messaging, email, chat forums, online games and social networking websites.

Solutions:

Once we recognize what forms the behavior takes, what possible solutions are available for our students who are vulnerable?

Incorporate routine screening for bullying via direct questions⁶:

1. 1. Ask the child about friends. A response of “none” or “few friends” deserves additional prompting (Why do you think that is?).
2. 2. Inquire if the child avoids going to school and request more information on the assistance the child has accessed.
3. 3. Ask the child directly if he or she has experienced bullying. If the child answers “yes,” ask follow-up questions and refer the child to school and community resources.

Address developing skills to reduce victimization in the student IEP⁶:

Issues related to peer victimization can also be included on individualized education plans or 504 plans. For example, educational plans can specify informing teachers and classmates about hearing loss. Plans can also include a safe environment statement designating a “home base” where a student can go when feeling unsafe and/or a “safe person” with whom a student can discuss difficult situations. Additionally, education plans could include strategies to reduce vulnerability and improve response to bullying by targeting social pragmatic skills (e.g., taking turns and asking questions; reading facial expressions and body language) via one-on-one instruction, role playing, or social stories. Organizing a social skills group can help children develop social competencies in a supportive environment. Clinicians can also help patients address assertiveness and/or self-advocacy, with specific training to identify and report bullying, say “no” to stop the situation, and request assistance from a trusted source.

For teachers:  provide ongoing education to keep students aware that the bullying they may be experiencing – or doing to others – is unacceptable.  Give your students a safe and open communication pathway for reporting incidents of bullying.  Recognize that bullying will most often happen when you are not watching – In the lunchroom, the bathrooms, the playground, the hallways.  Just because you did not see it does not mean it did not happen!

Be a listener. Be supportive.   Report incidents to your school administration as promptly as possible.

For parents:  talk to your child about feelings – openly and often.  They need to know that when things go wrong, you will be there to support them.  Stay closely involved with

school administrators and teachers.  Does the staff understand about hearing loss?  Really understand?

About cyberbullying:  This form of bullying may be the most insidious and dangerous of all. While our deaf and hard of hearing students find invaluable and positive connections online, the potential for negative interactions has increased disproportionately.

How can we be proactive about cyberbullying?  By being fully aware of what websites are being used.  If we as adults continue to make excuses about our lack of skill or disdain for social media, we are inadvertently providing limitless opportunities for our children to be vulnerable to cyberbullying.

Recognize, React, and Raise Awareness

October month is dedicated to Bullying Prevention but teachers and parents of deaf and hard of hearing children are fully aware that the need to protect vulnerable students is ongoing. Find a wealth of resources to stop bullying in your family or classroom or school in the following websites.

Resources for Teachers and Parents

• http://www.nea.org/tools/lessons/teaching-students-to-prevent-bullying
• https://stompoutbullying.org/get-help/about-bullying-and-cyberbullying
• https://www.lebonheur.org/blogs/practical-parenting/keeping-up-with-your-child-online
• https://www.pacer.org/bullying/classroom/planet-fitness/
• Kraizer, S. (2007). 10 Days to a Bully-Proof Child. Marlowe & Co., New York. https://www.amazon.com/10-Days-Bully-Proof-Child-Confidence/dp/1569242534

References

1. 1. Warner-Czyz, A. D., et. al. (2018) Effect of hearing loss on peer victimization in school-age children. Exceptional Children. https://medicalxpress.com/news/2018-04-children-loss-bullying.html . Download from: https://successforkidswithhearingloss.com/wp-content/uploads/2019/09/Children-with-hearing-loss-face-more-bullying-2018.pdf
2. 2. 2016 news: https://www.newschannel5.com/news/national/burke-high-school-investigating-bullying-incident-after-it-goes-viral
3. 3. Van den Bedem, N.P., et al, (2018). Victimization, bullying, and emotional competence: Longitudinal associations in (Pre)Adolescents with and without developmental language disorder, Journal of Speech, Language, and Hearing Research, 61, 2028-2044.
4. 4. Goberis, D., Beams, D., Daples, M., Abrisch, A., Baca, R. & Yoshinaga-Itano, C. (2012). The Missing Link in Language Development of Deaf and Hard of Hearing Children: Pragmatic language development. Seminars in Speech and Language, (2012), 33:4, 297-309.
5. 5. Bullying Advice for Parents of Deaf Children. National Deaf Children Society in the UK. Download from: https://successforkidswithhearingloss.com/wp-content/uploads/2019/09/Bullying-Advice-for-Parents-of-Deaf-Children-NDCS-UK.pdf
6. 6. Warner-Czyz, A. D. (2018). Peer victimization of children with hearing loss. The Hearing Journal, October. Download from: https://successforkidswithhearingloss.com/wp-content/uploads/2019/09/Peer_Victimization_of_Children_with_Hearing_Loss.4.pdf

Click Here to Download this Article

The post Bullying / Teasing Happens! first appeared on Supporting Success For Children With Hearing Loss.

Peer Victimization and Hearing Loss

More than ¼ of school-aged children experience bullying or peer-victimization. The risk of this negative treatment increases for children who have lower social competence, presence of special needs, or overall seem “different” from their peer group.

In general, adolescents who do not “fit in” experience twice the rate of peer victimization than the general population. Adolescents with special needs are most frequently teased, gossiped about, and socially excluded.

Children with hearing loss have a higher risk of peer victimization due to the visibility of their hearing devices, poorer speech perception, articulation/ pronunciation differences, delays in language skills, social difficulties, and difficulty making and maintaining peer relationships. A 2012 study reported the incidence of peer victimization for children with hearing loss ranging from 17-67% dependent upon the degree of difference perceived by typical peers.

A recent study¹ was conducted on peer victimization of children with hearing loss who wore hearing devices, communicated orally, and were educated in the mainstream classroom. The study included 56 children ages 12-18 years. Their mean age for hearing device fitting was 3.3 years and they averaged 10.8 years of experience using their hearing devices. These participants completed a series of questionnaires exploring their communication competence, social competence, temperament, and level and type of peer victimization.

The results of this study found that adolescents who used hearing devices reported significantly higher rates of victimization than those in the general population (50% versus 28%). Compared to the general adolescent population, adolescents with hearing loss reported the following prevalence: teasing (25.8% versus 18.8%), rumors (21.1% versus 16.5%), and social exclusion (26.3% versus 4.7%), and coercion (17.5% versus 3.6%). Males and females experienced victimization at similar rates, but the type of victimization varied with males having higher rates of coercion and females having higher rates of social exclusion.

The bullied and non-bulled groups of students with hearing loss did not differ on measures of communication competence, social competence, temperament, or behavior. Children from families with lower socioeconomic states and parenting styles characterized by abuse or overprotection have higher victimization rates, whereas those who have supportive family relationships are more protected against the impact of bullying.

Peer victimization demands attention from both parents and professionals.

Stigma and Hearing Loss

Among adults not pursuing hearing care, 21% described hearing aids as “too embarrassing”, 15% described them as “unattractive”, and 14% claimed hearing aids were “too noticeable”. These all represent the perceived stigma of having a hearing loss. Stigma can be divided into two types:

External or environmental stigma – messages that people with hearing loss receive from other people, such as impatience, embarrassment, discomfort, or anger related to increased communication difficulty with the person who has the hearing loss. Examples of environmental stigma for children could include a teacher looking annoyed when a child drops of the HAT microphone, being ignored by classmates during group work, or any type of teasing or other peer-victimization. Home examples could include being excluded from family conversations, being discouraged to use hearing devices in public “so people don’t know,” or being yelled at for not following a parent’s instructions because the direction was not heard.

Internal stigma – negative messages that people with hearing loss tell themselves that are triggered by the embarrassment, vulnerability, shame, and/or fear they feel as they anticipate or experience increased communication challenges. Examples of internal stigma for children could include eating lunch alone because it is too hard to understand what peers are saying in the noisy environment, not wanting to participate in class discussions because of experiences providing an answer to a question different than the one asked, or not requesting clarification or repetition of information missed auditorily because they don’t want to “stick out.”  A home example includes the child isolating himself from family activities or acting out behaviorally because he cannot readily understand what is being said and has received impatient or angry responses when asking for clarification.

Strategies to Reduce the Impact of Stigma and Peer-Victimization

Dealing with stigma and teasing or bullying can have far-reaching effects on school performance and self-concept.  Students who expect that negative consequences will occur when they self-advocate or use their hearing devices are much more likely to reject use of their devices and not fully participate in the general education curriculum. There are some strategies in common, and some different when helping children develop resilience in dealing with these issues.

Addressing Victimization and Stigma

1. Issues related to stigma and peer victimization can be included on IEPs or 504 plans, for example:

a. Specify the need to inform teachers and classmates about hearing loss to reduce negative responses to the student and/or hearing devices.
b. Provide a safe environment statement designing a “home base” where a student can go when feeling unsafe or a “safe person” with whom a student can discuss difficult situations.
c. IEPs can include strategies to reduce vulnerability and improve response to bullying by targeting response to bully and social pragmatic skills, via 1:1 instruction, role playing, or social stories.
d. IEPs can target self-advocacy and communication repair skill development, including addressing assertiveness. Work on changing “I can’t” statements to “I can” to improve resilience when negative situations occur.
e. IEPs can target the student’s knowledge of their hearing loss and hearing devices, including understanding their most challenging listening situations, what they or others can do to improve their communication effectiveness. Students should learn and practice how to describe their hearing loss, including how to respond to questions about their hearing loss and hearing devices.

2. Identify if the student is one of the approximately 50% of students with hearing loss who are victimized. Ask the child directly if they have experienced bullying and if so, what kind (coercion, social exclusion, physical harm, gossip, teased). When is the victimization happening? In the classroom? Hall? Bus stop? How pervasive is this treatment? Help them understand that many, if not most, students experience some type of peer victimization at some point during their school years. They are not alone.

Resilience on Orange Puzzle on White Background.

3. Education about WHY students become bullies, what they get out of bullying someone, and what keeps a bully coming back for further bad treatment will help the student understand that they are not the only victims. This also goes for groups who exclude or coerce students, not only teasing situations. In the IEP include a goal to teach the specifics of what NOT to do in each of these situations, along with appropriate responses.

4. 4. Use the Kool Kidz Vidz available to members on Teacher Tools Takeout to expose ‘one and only’ students who use hearing devices in their schools to other students with hearing loss who have had the same experiences with stigma from hearing loss. The discussion points provided with each Kool Kidz Vid make these easy ‘go to’ materials with a potential for high impact.

5. Connecting students who use hearing devices with one another may have the most powerful effect on reducing the impact of stigma and bullying by strengthening self-concept, self-confidence to self-advocate, while reducing feelings of isolation. IEP goals for self-advocacy can be met via group work (face-to-face or virtually) with DHH peers using devices. Students who come into contact with DHH peers are less likely to reject use of their hearing devices. As a group:

a. Discuss all types of peer victimization with a pair of DHH peers or a larger group of DHH peers. Encourage discussion of which types of negative treatment have been experienced.
b. Discuss both external and internal stigma along with individuals having the power to overcome negative messages as part of their journey figuring out who they are and who they want to become (goals for after high school).
c. Talk about the perception of “different” and how this increases the risk for victimization. Help students work through the concept that it is the hearing loss that makes them different and this cannot be changed. Hearing devices help them behave more normally (less “different”) because they can hear, comprehend, and respond in social situations better than if they were not using hearing devices.

Resources used for this article:

Peer Victimization of Children with Hearing Loss, A. D. Warner-Czyz, Hearing Journal, Oct, 2018.

Incorporating Stigma Counseling into Audiology Practice, H. Cohen & N. M. Williams, Hearing Journal, Sept, 2018.

Download this Article

The post Reducing the Impact of Stigma and Teasing first appeared on Supporting Success For Children With Hearing Loss.

I’m not hearing impaired!

A 2003
study of students age 11, 13, 15 who were hard of hearing found that 56% did not identify themselves as having a disability. They may identify themselves as having a hearing problem, but not a disability. Those students who did identify themselves as having a disability were more likely to report feeling lonely or alone than those who did self-identify.
 (Kent, B. (2003). Identity issues for hard of hearing adolescents aged 11, 13 and 15 in mainstream setting. Journal of Deaf Studies and Deaf Education 8(3), 315-324)

Struggling ‘one and onlies’

Our identity is built upon the groups we feel a part of as in who you believe you are is defined by the groups to which you belong. With approximately *80% of students with hearing loss spending most or all of their time in the general education classroom AND with about *50% being only the only one or only one of two students in a school with hearing aids/CI, it is not surprising that our students often do not form a healthy identity as a person with hearing loss.  (*
Mitchell, R., & Karchmer, M. (2006). Demographics of deaf education: more students in more places. American Annals Of The Deaf, 151(2), 95-104.)

We define who we are by the groups of which we are a part

By connecting with other students with hearing loss, or even being exposed to what other kids say, they can make steps toward feeling okay about their hearing loss. This will contribute to hearing aid retention. As a part of
psychosocial development in the tween and teen years students are trying to figure out who they think they are and who they think their social group wants them to be. When a child is not in regular contact with other individuals with hearing loss it can be difficult, or even impossible, for them to reconcile being a student with a hearing loss among only hearing peers. This is a time when many students choose to try to “pass” without their hearing aids and/or FM, even though they know their learning will suffer. By developing a healthy self-concept that includes the identity of being an “okay kid with hearing loss” students can reconcile being a “one and only” student with hearing loss without the need to discontinue hearing aid use.

A flexible and fluid identity

We all have a right to choose our own identity. This includes persons with hearing loss not choosing to consider their hearing loss as a defining aspect or trait of self, or only doing so in some contexts (i.e., with some groups or in some listening conditions). Thus, having conversations with the tween or teen about their identity and its flexibility under different conditions is critical if they are to recognize the importance of disclosing that they have a hearing loss and advocating for their communication needs, which is at the heart of self-determination.

To be self-actualized individuals who advocate for ourselves we have to know how we define ourselves and be able to convey that to others.
Megan Kemmery, PhD, Volta Voices, Nov/Dec 2014.

Resilience to challenges – “It’s a hard time right now, but I can get through it.”

Children with hearing loss must learn to bounce back from challenges, including mis-hearing directions, not being able to access peer discussions and even teasing about wearing hearing devices. Persons who have the traits of perseverance, resilience or ‘grit’ tend to be more successful than those who do not show these traits.  Choosing to endure rather than desist is a choice that an individual must work to sustain over time. Grit requires not just motivation to achieve something important but also sticking to that goal when tempted to give up. Students who choose the identify of a ‘typical kid that happens to have a hearing loss’ will be able to achieve ‘typical’ only by overcoming difficulties through the use of technology, accommodations and self-advocacy skills. For more information on perseverance read
here or watch Research My Relevant YouTube video
here or a summary of a
grit curriculum.

The post Self-Identity and Hearing Loss first appeared on Supporting Success For Children With Hearing Loss.

Some of the information below was derived from the Nov/Dec 2014 Volta Voices issue was devoted to self-concept, identity and self-esteem with hearing loss (look up
digital version).

Psychosocial Development

Erikson described the development of psychosocial skills as a series of developmental challenges, or stages. Because of reduced access to communication, progress through the stages of social development require more support if a child has a hearing loss. Refer to the chart found on page 325 of
Building Skills for Success in the Fast-Paced Classroom for more information
Only the stages for tweens and teens are discussed below. Note specifically:

• In grades 2-5 children want to show that they are competent. If they feel as though they are incapable, they may procrastinate in work because ‘it won’t be good enough anyway.’

• As they become tweens/teens (approximately ages 10-12) they are trying to reconcile “the person I am” with ” the person society/my group expects me to be.” For students who are the only person in their peer group, grade or school who had hearing devices, there is a subtle message that they should be like everyone else in their group. This often results in students who may try to ‘get by’ without their hearing devices.

What you can do:

Ellen Rhodes, in the Nov/Dec 2014 Volta Voices issue described her framework for working on psychosocial issues with tweens and teens:

• Help students to actively reframe situations in a positive light (the glass is half full rather than half empty)
• 
  
  In that same vein, take turns playing fortunately-unfortunately with one person being the optimist and the other being the pessimist in describing situations specifically from a positive and a negative perspective.
• Actively discuss how everyone can make mistakes, have failures, and experience embarrassing moments and that we can learn much from these experiences. Focus on generating a vivid positive mental image of how challenges can be handled well in the future.
• Discuss that self-identity (how you see yourself as part of the world) can change based on the situation. Under easy listening conditions they may view themselves as no different from a student with typical hearing. Under challenging listening conditions they may view themselves as hard of hearing, hearing-impaired or Deaf. It is important to help students explore their
  feelings about each of the labels and recognize the aspects that make them feel more/less “impaired” and that they can take action to deal with the challenges (self-advocacy).

• Each individual needs to feel as though they belong to one or more groups. Our identities are defined by the groups to which we belong. If a student never interacts meaningfully with other students with hearing loss, it is not surprising that he or she may reject the part of themselves that does not ‘fit in’ with the rest of the group. Whether it is face-to-face or through media, children with hearing loss need to connect!
• Encourage students who are feeling isolated to ‘take the extra step in kindness.’ By offering to help others, using their unique and positive attributes, they can realize that they are valued as group members. Often it is the students with the weakest social communication (pragmatics & theory of mind skills) who are at greatest risk for feeling isolated. These skills should always be a focus of services and skill building (see below).
  
  The Deafness Doesn’t Define You : How to Excel this School Year
  

  START EARLY

  
  
  An excellent article by Jay Luckner and Anne Molloy in the Nov/Dec 2014 Volta Voices addressed the challenge of overcoming group conversation issues. Some specific suggestions applied to what we can teach children, even starting from preschool:

  • Throughout early intervention and into early childhood, parents typically adjust their communication dynamics so that they face the child and stand close when communicating. The child with hearing loss may not realize that age-peers and other adults have no understanding of hearing loss and what they might need for successful communication.
  • Raise the child’s awareness that most people they meet will not understand that they have a hearing loss. The child, from a young age, needs to be able to simply explain to others that they have a hearing loss and may not always understand what is said.
  • The child needs to learn how to explain some strategies for successful communication such as, “Please look at me when you talk. I need to see your face when you talk so I can understand you.”
  • A strategy to learn in early elementary is to listen carefully and then summarize what people say. “You want me to get my coat and boots and meet you by the car.”  “Oh, you saw the movie Frozen and thought Olaf was funny too.”
  • A strategy to learn later in elementary is to practice ways to remind friends and classmates that  the student wants to be included in the conversation such as, “Did you just change topics? I really want to follow what you are saying and it’s kind of noisy here. Let me know when you change topics so I can follow along.”
  • The major theme to get across is to teach the child that people will be more likely to accommodate their needs if the child focuses on sharing how much they want to be able to understand what the other person is saying.
  • If these skills and strategies can be taught before the age of 10, then the child will have a way to deal with challenging conversation situations as a tween and teen.
  • 
    
    See Children’s Peer Relationship Scale
    
    

  ---

  I AM GREAT

  AG Bell’s Leadership Opportunities for Teens (LOFT) program has been a very successful means of fostering participant’s self-esteem. Ken Levinson, lead counselor of LOFT shared the I AM GREAT model in the Nov/Dec 2014 Volta Voices.

  
  I –
    Independence – it is through experience that we learn who we are and begin the journey to individualization

  A – Attitude – people are attracted to others with more positive attitudes.

  M – Mistakes are OK. We all make them and can learn from them.

  G – Groups – Teens need to find  groups that support who they are and the way they live. It is most important for tweens/teens with hearing loss to feel connected to role models and others their own age who have hearing loss.

  R – Respect – for ourselves and for others. Rather than responding to a comment about hearing loss or hearing devices negatively, take a more respectful approach to responding.

  E – Expectations – There is nothing a child who is deaf or hard of hearing should not try if it interests them. Don’t let other people reduce your respect for yourself or what you can achieve.

  A – Adults – who are important role models in the student’s life, including others with hearing loss?

  T – Tickle them. Have a good sense of humor and make fun of yourself. Poking fun at yourself is a universal teen thing to do.

Resources for Developing Self-Esteem & Exploring Feelings of Fitting In

WEIRD!
 shares the story of a girl who is picked on by a bully in her third-grade class. Luisa begins to feel bad about herself and stops doing things she likes to do. She comes to realize that she is okay just as she is and that the more that the bully thinks she doesn’t care, the more she will be left alone and not picked on anymore. It comes with teaching notes at the end.
WEIRD! is great to pair with conversations about what to say when peers ask about hearing devices or comment on having a hearing loss.

TJ really wrote this story!

I am very fortunate to travel across the US and Canada speaking to professionals who work with children with hearing loss. When I was in Kansas, I got into a discussion with a professional who described TJ and the challenges he went through with inconsistent hearing aid use and feelings of not fitting in. Her solution to helping him deal with these issues was for him to write a book about his experiences. She had it illustrated and the result is this meaningful booklet.

Available at the cost of printing, TJ’s Story is excellent to share with older elementary students, especially as a lead-in to completing the
SAC-A (Self Assessment of Communication – Adolescent) or the Secondary Survey (both of which can be done starting gr 4).

Self-Esteem Resources on the SSCHL Website

• Social Skills & “I hate my hearing aids!”
• Self Concept
• • Self-Concept for Infants, Toddlers, Preschoolers
  • Self-Concept for School-Age
  • Self-Concept for Adolescents
  • Building your Child’s Self-Confidence

Materials from the
https://successforkidswithhearingloss.com/tests webpage

• Children’s Peer Relationship Scale by Dr. Kris English
• SAC-A: Self-Assessment of Communication – Adolescent by Judy Elkayam
• SOAC-A: Significant Other Assessment of Communication: Adolescent by Judy Elkayam
• Checklist of Socio-Pragmatic Language Behaviors for Students with Sensory Impairment
  
• Various
  Social Skills Checklists
• Think About It Quiz – informal assessment of self-concept for adolescents
• The Secondary School Survey (Teacher Tools)

The post Addressing Self-Esteem and Issues of Fitting In first appeared on Supporting Success For Children With Hearing Loss.