This paper examines the mental health challenges facing deaf individuals who also require psychological or developmental intervention. Drawing on historical cases such as Victor of Aveyron and Helen Keller, the paper demonstrates how communication barriers have long complicated diagnosis and treatment for the deaf. It identifies three core problem areas — psychological assessment, learning, and socialization — and reviews research by Kropka and Williams, Mar, and others to propose solutions. The paper argues that adaptive assessment tools, alternative communication-based learning programs, and intentional social integration can meaningfully address gaps in care for this underserved population.
In both the world at large and the United States, the history of care for the deaf, the mentally handicapped, and those suffering from psychological disorders has followed a remarkably similar trajectory — a progression marked by confusion and misunderstanding, followed by institutionalization and education, and finally by integration. Two of the most famous cases that intertwine these three conditions are those of the mysterious boy of Aveyron and Helen Keller.
The boy of Aveyron was a young child of about twelve who was found in the French woods. His wild mannerisms suggested that he had never left the forest nor been introduced into society. He was found and taken in several times, and each time he escaped back to the mountains of Aveyron. Finally captured for the last time, he was sent to an orphanage where he was determined to be both deaf and mute. Now stationed at an institution for the deaf and mute, the boy began to work with a French doctor, Jean-Marc-Gaspard Itard. It was Itard's work with the boy that championed many of the educational processes currently used in the field of special education. To meet the boy's unique situation, Itard "developed a broad educational program for Victor to develop his senses, intellect, and emotions" (Biasini et al., n.d.). This educational program helped pioneer some of the earliest work in special education and the education of those with developmental disabilities. Though the boy, named Victor, did not make enormously vast improvements, it was clear that Itard's educational system was working — Victor was improving. Although deaf and mute, and certainly affected by the non-human existence he had lived, one cannot be certain whether Victor also suffered from a mental handicap or psychological problem. By working with him in a manner that addressed all possible conditions, however, Itard was able to make strides in the field of education for those with all three types of disabilities.
The second case in which deafness was brought together with mental handicap or psychological problems is that of Helen Keller. Keller was born a perfectly healthy child, but upon becoming ill, lost both her sight and her hearing. Although she was only about a year and a half old when she was stricken blind and deaf, her early biography shows no signs of any mental or psychological disability. Understandably frustrated by her condition, however, Keller began to demonstrate serious maladaptive behavior. She was viewed by some as a "very difficult child, smashing dishes and lamps and terrorizing the whole household with her screaming and temper tantrums. Relatives regarded her as a monster and thought she should be put into an institution" ("The Life of Helen Keller," 2008). After Anne Sullivan began to work with Keller, however, it became clear that Keller's behavioral problems stemmed from her inability to communicate. The inability to communicate has long left deaf individuals, like Victor and Keller, frustrated when seeking services to diagnose and treat their psychological or developmental problems. While treatment for these groups is improving, significant problems remain. The following review explores how a broken communication barrier results in poorer care for deaf individuals in need of mental health services, and proposes solutions to address these problems.
The largest issue affecting deaf individuals in need of mental health care is an inability to communicate. So many psychological and developmental assessment tools measure communication as one of the primary indicators of disability or psychological affliction. This not only makes it difficult for deaf individuals to complete these assessments, but also increases the likelihood that a deaf person will be incorrectly labeled as having psychological problems or being developmentally disabled simply because they cannot complete the assessments in the standard format.
For instance, in their 1979 study, Kropka and Williams argue, "Since the mentally handicapped are often found to be speech deficient, there is a danger that a deaf resident, without speech, may be mistakenly thought to be mentally retarded, or more mentally retarded, than he really is."
On the other extreme, because deaf individuals often cannot communicate in standard ways, there is concern that they may be unable to complete any form of psychological assessment. According to Mar (1998), some children who are both deaf and blind are labeled "untestable," meaning that standard assessments of their development cannot be completed because those assessments are not applicable to the student's mode of learning. Mar (1998) suggests, however, that non-standard psychological examinations can still be administered effectively.
"How deafness compounds developmental learning challenges"
"Isolation and dependency caused by institutional settings"
"Adaptive assessments, learning methods, and social integration"
Mar, H. (1998). Psychological evaluation of children who are deaf-blind: An overview with recommendations for practice. Retrieved October 20, 2008, from the National Consortium on Deaf-Blindness.
The life of Helen Keller. (2008). Retrieved October 20, 2008, from the Royal National Institute of Blind People.
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