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

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

2. Today’s First Presenter • Marcy Dicker • Outreach Director • Wisconsin Educational Services Program for the Deaf and Hard of Hearing (WESPDHH) • 262-787-9540 voice • 866-552-7792 vp • marcy.dicker@wesp-dhh.wi.gov

3. Today’s Second Presenter • John Humphries, NCSP • School Psychologist • Student Services/Prevention & Wellness Team • WI Department of Public Instruction • 608-266-7189 • john.humphries@dpi.wi.gov

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

5. Hearing Loss 101 • 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” • Hearing Loss Simulation – What would a hearing loss “look like”? What would it sound like?

6. Hearing Loss Simulation • Normal 0-25 dB • Mild 25-40 dB • Moderate 40-70 dB • Severe 70-90 dB • Profound 90-110 dB • Cochlear Implant Knock, knock – who’s there? Time for bed. Pick up your toys. Would you like more juice? The wife helped her husband

7. Visual Representation of Hearing Loss and aided hearing

8. What are the issues? • 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. • 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 • All these factors lead to ISOLATION

9. What are the issues? • 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 social language cues – how to initiate a conversation, turn taking, etc. • Misunderstandings are common • Assumptions that hearing aids “fix” the problem and students “smile and nod” response • These students will also cope with ISOLATION

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

11. 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

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

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

14. Step 1: Identify DHH students • Contact your DHH teacher • Talk about cues for mental health and illness • 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

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

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

17. 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. • Always face the student when speaking • Be aware of background noise • You may need to define or explain terms • Ask the student to repeat back some of your questions to check for understanding

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

19. Step 4: Meet with the Student • Establish rapport • Share the limits of confidentiality • 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 • NEW: Use Screening Tool from DPI or other source

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

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

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

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