Pupil Services and the Mental Health Needs of Students who are Deaf or Hard of Hearing

Today’s First Presenter Marcy Dicker Marcy Dicker Outreach Director Outreach Director Wisconsin Educational Services Program for the Deaf and Hard of Hearing (WESPDHH) Wisconsin Educational Services Program for the Deaf and Hard of Hearing (WESPDHH) voice voice vp vp

Today’s Second Presenter John Humphries, NCSP John Humphries, NCSP School Psychologist School Psychologist Student Services/Prevention & Wellness Team Student Services/Prevention & Wellness Team WI Department of Public Instruction WI Department of Public Instruction

Resources To obtain the resources we discuss, go to: To obtain the resources we discuss, go to: dpi.wi.gov/sped/hi_deaf.htm dpi.wi.gov/sped/hi_deaf.htm Look for links to DHH and mental health Look for links to DHH and mental health This PowerPoint This PowerPoint The Protocol for Screening The Protocol for Screening A Screening Tool (NEW) A Screening Tool (NEW)

Hearing Loss 101 2,200 students, ages 3-21, identified with hearing loss in the public schools in the state of Wisconsin. 2,200 students, ages 3-21, identified with hearing loss in the public schools in the state of Wisconsin. 2/3 of these students are thought to be “hard of hearing” and 1/3 are considered “deaf” 2/3 of these students are thought to be “hard of hearing” and 1/3 are considered “deaf” Hearing Loss Simulation – What would a hearing loss “look like”? What would it sound like? Hearing Loss Simulation – What would a hearing loss “look like”? What would it sound like?

Hearing Loss Simulation Normal 0-25 dB Normal 0-25 dB Mild dB Mild dB Moderate dB Moderate dB Severe dB Severe dB Profound dB Profound dB Cochlear Implant Cochlear Implant Knock, knock – who’s there? Time for bed. Pick up your toys. Would you like more juice? The wife helped her husband

Visual Representation of Hearing Loss and aided hearing

What are the issues? Impact of severe and profound hearing loss, when the child uses ASL on social emotional development Impact of severe and profound hearing loss, when the child uses ASL on social emotional development Parents may not have the language skills to communicate effectively around the abstract concepts of emotional and interpersonal issues. Parents may not have the language skills to communicate effectively around the abstract concepts of emotional and interpersonal issues. Students face challenges in building close social relationships with peers and staff because of the inability to communicate in a common language. Students face challenges in building close social relationships with peers and staff because of the inability to communicate in a common language. Students cannot communicate directly with their hearing peers – most must use an interpreter Students cannot communicate directly with their hearing peers – most must use an interpreter All these factors lead to ISOLATION All these factors lead to ISOLATION

What are the issues? Impact of mild and moderate hearing loss – more subtle, yet equally important… Impact of mild and moderate hearing loss – more subtle, yet equally important… Students miss out on conversations between others (containing important social information) Students miss out on conversations between others (containing important social information) Students miss social language cues – how to initiate a conversation, turn taking, etc. Students miss social language cues – how to initiate a conversation, turn taking, etc. Misunderstandings are common Misunderstandings are common Assumptions that hearing aids “fix” the problem and students “smile and nod” response Assumptions that hearing aids “fix” the problem and students “smile and nod” response These students will also cope with ISOLATION These students will also cope with ISOLATION

Mental Health Challenges begin with a sense of isolation and result in a lack of: Success in building meaningful friendships Success in building meaningful friendships Opportunities to build a healthy self-concept Opportunities to build a healthy self-concept Ability to understand and manage conflict Ability to understand and manage conflict Opportunities to develop appropriate coping and problem-solving skills Opportunities to develop appropriate coping and problem-solving skills

Proactive support for Mental Wellness Identify Environments that foster positive self esteem in Deaf and Hard of Hearing Provide access to deaf and hard of hearing role models Recognize the value of direct access to communication and interaction Ensure and support the student’s access and participate in school events, community events and society-at-large Increase awareness of mental health issues for these students (protocol) and provide appropriate supports

End of Hearing 101 Now, what can Pupil Services providers do for DHH students?

Pupil Services Protocol Follow basic screening protocol as with any area of concern Follow basic screening protocol as with any area of concern Prepare to screen Prepare to screen Identify students Identify students Get consent Get consent Screen Screen Follow up Follow up

Step 1: Identify DHH students Contact your DHH teacher Contact your DHH teacher Talk about cues for mental health and illness Talk about cues for mental health and illness How do they perceive student’s mental health needs? How do they perceive student’s mental health needs? Also contact general education staff to identify students who are not in special education or who do not have a 504 Plan who have a mild hearing loss Also contact general education staff to identify students who are not in special education or who do not have a 504 Plan who have a mild hearing loss

Step 2: Obtain Consent for Screening Talk with parents about your school’s efforts to prevent mental illness and promote mental health Talk with parents about your school’s efforts to prevent mental illness and promote mental health Explain procedures Explain procedures Use a standard consent for pupil services form Use a standard consent for pupil services form

Step 3: Identify Communication Needs Talk with the DHH teacher to identify how the student effectively communicates Talk with the DHH teacher to identify how the student effectively communicates Discuss supports to meet communication needs Discuss supports to meet communication needs Consider hearing technology and visual supports Consider hearing technology and visual supports

If you don’t need an interpreter Note the needs for lighting in the room. Allow the student to sit with their back to the window. Note the needs for lighting in the room. Allow the student to sit with their back to the window. Always face the student when speaking Always face the student when speaking Be aware of background noise Be aware of background noise You may need to define or explain terms You may need to define or explain terms Ask the student to repeat back some of your questions to check for understanding Ask the student to repeat back some of your questions to check for understanding

If you do need an interpreter Using the educational interpreter is a last resort Using the educational interpreter is a last resort Recognize limitations of the teacher of the deaf Recognize limitations of the teacher of the deaf Consider a mental health interpreter Consider a mental health interpreter Clarify the limits of confidentiality Clarify the limits of confidentiality Interpreters are NOT mandated reporters Interpreters are NOT mandated reporters The role of the interpreter is solely to interpret The role of the interpreter is solely to interpret

Step 4: Meet with the Student Establish rapport Establish rapport Share the limits of confidentiality Share the limits of confidentiality Ensure that any other person in the room (interpreter), also agrees to uphold the confidentiality of the meeting Ensure that any other person in the room (interpreter), also agrees to uphold the confidentiality of the meeting Be aware of state law and follow any local policies and procedures in this regard Be aware of state law and follow any local policies and procedures in this regard NEW: Use Screening Tool from DPI or other source NEW: Use Screening Tool from DPI or other source

Step 5: Prioritize Read the protocol for specific suggestions Read the protocol for specific suggestions Low Level of Mental Health Need Low Level of Mental Health Need Moderate Level Moderate Level High Level High Level Note crisis reponse Note crisis reponse

Step 5: Plan Share the results with parents Share the results with parents Consider Consider Thoughts Thoughts Moods Moods Behaviors Behaviors And And Severity Severity Chronicity Chronicity Frequency of symptoms Frequency of symptoms

Planning Domains Case management Case management Home-school coordination/communication Home-school coordination/communication Extending or strengthening the social networks Extending or strengthening the social networks Get the help of the DHH teacher Get the help of the DHH teacher Group or individual services at school Group or individual services at school Document in IEP and possibly reconvene Document in IEP and possibly reconvene Mental health services in the community Mental health services in the community Follow up on crisis issues as with any student Follow up on crisis issues as with any student

Conclusion Students who are DHH have high liklihood of mental health need Students who are DHH have high liklihood of mental health need Use a screening protocol to identify needs Use a screening protocol to identify needs Follow through with help in multiple domains and consistent with the level of need Follow through with help in multiple domains and consistent with the level of need For more information, go to: For more information, go to: dpi.wi.gov/sped/hi_deaf.htm dpi.wi.gov/sped/hi_deaf.htm Look for links to DHH and mental health Look for links to DHH and mental health