1. CSD 5400 REHABILITATION PROCEDURES FOR THE HARD OF HEARING Hearing Loss and Identity Psychosocial Aspects Family Dynamics

2. Families David Luterman’s characteristics of healthy families: Communication among all members is clear and direct Roles and responsibilities are clearly delineated and the family allows for flexibility in role allocation The family members accept limits for the resolution of conflict Intimacy is prevalent and is a function of frequency, equal- powered transactions There is a healthy balance between change and the maintenance of stability

3. Diagnosis Stages of grief 1.Denial Deaf children look normal Deaf infants act normal Disagreement among professionals

4. Diagnosis Stages of grief 1. Denial 2. Anger 3. Depression 4. Acceptance “Welcome to Holland”

5. When Things go Wrong Instead of acceptance: Overprotection Wishful Acceptance Indifference

6. Attitude, Attachment, and Coping Coping 1. Fathers experience similar degrees of stress as mothers (Meadow- Orlans, 1994) 2. Mothers of deaf children report higher levels of stress when compared to mothers of hearing children (Quittner, Glueckauf, and Jackson, 1990) 3. Meadow-Orlans (1995) found that mother of deaf children report greater general life stress and depression compared to mothers of hearing children 4. Parents of children with additional disabilities experience higher levels of stress and depression (Meadow-Orlans, 1990) and these families are more likely to be characterized as dysfunctional (Powers, Elliot, Patterson, Shaw, and Taylor, 1995) 5. Parents using sign language can be a moderator of stress (Hagborg, 1989) 6. Parental stress increases as the child becomes older (Hagorg, 1989)

7. Coping Marital Conflict Higher divorce rates Higher rates of marital dissatisfaction Henggeler, Watson, Whelan, and Malone (1990) Meadow-Orlans (1990)

8. Child Behavior and Discipline Deaf children miss out on the incidental learning of child behavior and discipline Adams and Tidwell (1988 & 1989) Compared discipline strategies of parents with deaf kids who considered themselves successful at handling their kids misbehavior compared to parents who did not consider themselves successful

9. Siblings Negative traits: Anger Jealousy Embarrassment Guilt Sorrow Inadequacy Fear of the future Isolation

10. Siblings Positive traits: Greater independence, patience, maturity, responsibility, and compassion More tolerance and understanding Sense of pride Acceptance of responsibility Family closeness Unselfishness

11. Siblings Support groups are able to allow normally hearing siblings to: 1.meet other siblings in a relaxed and enjoyable setting 2.find out that other siblings have the same questions, feelings, and concerns 3.share problems, ways to solve them, and ways to cope 4.get information about deafness and other disabilities and to answer questions 5.get information without involving parents 6.obtain reassurance and support.

12. Psychosocial Aspects of Acquired Hearing Loss Characteristics of acquired hearing loss Gradual and progressive A problem of comprehension rather than acuity Listening in noise Can no longer listen passively Following and remembering details of conversation Denial Stress

13. Response to the Initial Diagnosis Expect the results Can still feel Sadness Worry Fear Disappointment Anger

14. Psychological Effects Reactive vs. proactive Denial Uncertainty Frustration Anger Stress

15. Other Issues Effect of hearing loss on the transmission of the message Reactions from listeners

16. Other Issues Effect of hearing loss on the family Sociological effects Interference of social efficiency stigma