Models of deafness; Counseling

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  • 1. Models of deafness
    Objectives:
    • Discriminate medical and social models of deafness.
    2. Recognize related biases in self and others.

Deaf history
Repression
Inclusion
Accommodation
Segregation
3. Deaf history
1500-1600s Beginning of formal deaf education
1880 Milan Congress on Deaf Education
Oral education preferred to sign education
Homogenized deaf people
1964 Babbidge Report
Oral education method is failing deaf students
1988 Deaf President Now
Board of Gallaudet University appointed a hearing person as its 7th president
Students protest until president resigns
1990 IDEA passes
Deaf schools considered Most Restrictive Environment
4. Technological Revolution
TTYs
Closed Captioning
Mobile Text
Instant Messaging/ Skype
Video Relay Service
Assistive Devices
Hearing Aids
OAE/ABR
Newborn Hearing Screening
Cochlear Implants
5. Medical model
Deafness as pathology
Deafness as treatable
Deafness as curable
6. Sociocultural model
Deafness as identity
Deafness as special
Deafness as linguistic / cultural minority
7. World Health Organization International Classification of Functioning (ICF)
Functioning is an outcome of interactions between health conditions and contextual factors
Health conditions
Disease, disorders, injuries
Contextual factors
External: environment, social structures, terrain, etc.
Internal: personality, age, SES, education, etc.
8. Functioning and Deafness
Health Conditions
Medical
Contextual Factors
Social
9. Deaf Epistemology
Audism
Body is starting point for social classification
Deaf bodies are broken
Muteness = less intelligent
Education and occupational systems not structured to accommodate hearing loss
Visually-oriented
Hauser 2010
10. Silent news cartoon (~1994)
11. Press release 4/27/09
Cochlear Americas Launches New Rehabilitation Program for Cochlear Implant Recipients
About Cochlear AmericasCochlear Americas is the world's leader in advanced hearing technologies. Since launching the first multichannel cochlear implant system more than 25 years ago, Cochlear Limited and its U.S. headquarters have brought the miracle of sound to more than 150,000 hearing-impaired individuals across the globe. Cochlear Americas state-of-the-art cochlear implant technology, based on extensive research and development at preeminent academic institutions, provides the ability to hear sound and better understand speech, enhancing both learning capabilities and quality of life for those with severe-to-profound hearing loss.
12. How does Communication Disorders and Sciences fit into this discussion?
13. Counseling
Objectives:
Contrast informational and adjustment counseling.
Identify response types useful in counseling.
14. Informational counseling
Also called content counseling
Description of hearing loss
Explanation of intervention choices
Typically doesnt address emotional affect of hearing loss
Typically one-way, practitioner to client
15. Adjustment counseling
Provide a comfortable climate where positive and negative feelings can be expressed without penalty
Encourage client to verbalize how he/she feels others perceive him/her
Explore nature of interpersonal relations and how having a hearing loss affects them
Help client discuss, analyze and evaluate feelings
Sanders 1982
16. Adjustment counseling
Facilitate definition of situations/ events that arouse those feelings
Help client explore various ways of dealing with feelings and evaluate effectiveness of those ways
Encourage client to express feelings about self, the handicap, frustrations and aspirations
Sanders 1982
17. Closed versus open questions
Closed questions
Can be answered with a single word.
Stifle expression.
Can seem directive.
Open questions
Can be answered broadly.
Encourage expression.
Lead to further awareness.
18. Closed versus open questions
Are you sad?
How are you feeling?
When do you have that experience?
Do you like your teacher?
What are the advantages of doing it that way?
Does your mother agree?
Are you going to stop talking to that boy whos been teasing you?
19. 20. Parent concerns
My child is deaf. Shell never hear anything.
Focuses on negative, whats missing. Switch focus to positive, whats available.
Will the hearing aid/cochlear implant correct/cure the hearing problem?
Derives from hope that child can become normal.
The intervention can enhance hearing, but, unlike glasses, will not allow her to hear as though there were no impairment.
Will my child learn to talk?
Will my child be able to go to school?
Sanders 1982
21. Responding to parents
What they say vs. what they mean.
I know youll be mad, but Ashley hasnt been wearing her hearing aids the past 2 weeks
How do you respond?
22. Types of responses
Honest
Hostile
Judging
Reassuring
Reflective
Silent
Nonverbal
Clark & English 2004
23. Honest response
Give full answers with no silver linings
Give realistic answers
Do not prognosticate with insufficient supporting data
24. Hostile response
Typically a response to a perceived affront of the professionals knowledge or training
Never become hostile with a hostile patient
Show that you respect and understand their frustration
25. Judging response
Passing judgment on patients actions
Projecting onto patients how we believe they should act
Should allow patients to talk out their feelings and attitudes
26. Reassuring response
Can stifle patients ability to express how they are feeling.
How would you feel if someone told you, Its not as bad as it seems or Lots of people have it worse than you
27. Reflective response
Reflection is the attempt to understand the patients viewpoint and communicate that understanding in a way that permits the patient to examine their feelings from another perspective.
Develop an understanding through reflection of the patients feelings.
You dont feel your child is hearing significantly better in many environments?
You are angry that your teacher doesnt see how hard you are trying?
28. Silent response
Silence can provide temporal space for reflection and an opportunity for patients to assume responsibility for their own progress.
Gives patients permission to take time for struggling with emotions.
29. Nonverbal response
Includes tone of voice, posture, eye contact, gesture.
Good nonverbal responses include
Eye-level communication
Good eye contact
Leaning forward
Purposeful head-nodding
30. 31. Child concerns
Kids wont play with me because I dont hear everything they say
Im afraid to tell other kids I wear hearing aids
Im afraid to talk in class in case I didnt understand
Im afraid to talk to the cute boy who my friend says likes me
32. Child concerns
Im afraid to try out for an activity because my hearing/speech isnt good enough
Ive stopped wearing my hearing aid because Im embarrassed
The teacher wont call on me because my speech embarrasses everyone
33. Child concerns
Hearing loss will
jeopardize relationships with peers
limit developing relationships with potential dating partners
affect acceptance by teachers
limit academic achievement
34. Do not minimize the concerns!
Accept the childs statement
Its true for them
Explore the feelings
Consider situation where feeling arises
Investigate ways of dealing
If you did X, whats the worst thing that could happen?
35. Counseling checklist

  • Help children tell their story 36. Help them clarify their problem 37. Help them challenge themselves to solve the problem 38. Help them set a goal 39. Help them develop an action plan 40. Observe as they implement the plan 41. Help them evaluate the plan

From English, K. (2002) Counseling Children with Hearing Impairment and Their Families.
42. It is better to say
What do you think is the best thing for you to do next?
than
What you should do next is
43. 44. I Start, You Finish
Open-ended activity to understand childs self-awareness and self-perception
Do not sit face-to-face, but side-by-side or at right angles
I have some sentences here that have no endings. I was wondering how you would complete them. Ill start them off and ask you to finish them for me. You can add more sentences to each one if you want. We can take our time and talk about your sentences for as long as you want.
45. I Start, You Finish

  • I am happy when 46. I am sad when 47. The thing I like most in the world is 48. The thing I would most like to change is 49. Because I have a hearing problem 50. Im afraid to 51. I wish 52. One thing I do very well is 53. One thing I like about myself is

I Start, You Finish
Thank you for teaching us what its like for you. Is there any help you need from me?
Open-ended
Child can explore anything he/she chooses
If child seems uncomfortable, end the activity.
54. Dreams and Maps
Encourage childs responsibility and ownership of hearing loss by developing goals.
Each goal and each child involves unique steps, they need to be considered and discussed one