WORKING WITH DEAF

POPULATIONS
Eve Chesivoir
AGENDA
Definitions
Background
Challenges to treatment
Relevant APA Ethical Guidelines
Best practices
DISCUSSION
QUESTION
What preconceived notions do you have about
deaf people and/or the Deaf community?
 TERMINOLOGY

deaf
"A loss of hearing sufficiently severe to render
an understanding of conversational speech
impossible in most situations with or without a
hearing aid"
Deaf
Being affiliated with a culture based on American
Sign Language (ASL) (Boness, 2016).
DISCUSSION
QUESTION
How might the distinction
between deaf and Deaf people
complicate clinical practice?
BACKGROUND
QUICK STATS
• About 7.6 million people (3.1%) in the United States have
experienced hearing difficulties (Boness, 2016)
• 1.1 million have a severe hearing difficulty
• Only about 500,000 DHH people use ASL (Lacke, 2020)
• Approximately 90-95% of deaf people are born to hearing
parents who don’t know ASL (Dougherty, 2017)
• At most, 40% of families with school-aged deaf children
use ASL at home
• Only about 30% of English can be read on the lips
• 35-50% of deaf people have an additional disability (Wilkins et
al., 2022)
UNLESS EXTRAORDINARY
MEASURES ARE TAKEN, A NEW
TOXIC VARIETY OF THE HUMAN
RACE WILL EMERGE.
Alexander Graham Bell
BACKGROUND
HISTORY
• The deaf community has experienced a long history of oppression
(MacDougall, 2022)
• Before 1816, most deaf Americans did not have access to education
that met their needs
• In 1880, the Milan Declaration forbade the use of sign language in
the educational system in favor of teaching oralism
• Today, there are 2 general conceptualizations of deaf people:
1. Deafness as a disability: deaf people can develop speech
with the assistance of assistive devices coupled with
intensive therapy (oralist view).
2. Deafness is not a disability: deaf people have a natural
language (sign language) and positively identify as being
member of Deaf culture (ASL view).
 DISCUSSION QUESTION
What are some potential benefits/drawbacks of each
of the two common conceptualizations of deaf
people?
DEAFNESS AND
PSYCHOLOGY
• The field of psychology has largely ignored deaf people in teaching, research and
training programs (MacDougall, 2022).
• Many psychologists in the 20th century reinforced misconceptions
that deaf people are inferior in every mental capacity (especially intelligence)
due to extremely biased research (Vernon, 2005).
• Many deaf people were placed involuntarily in psychiatric hospitals during
this time.
• In the 1960s, linguists and psychologists began to study sign language and
demonstrated that it was a real language.
• Today, many psychologists who specialize in working with deaf people are
firmly divided by the 2 camps of thought and do not communicate with each
other (MacDougall, 2022).
• Although mental illness is elevated in the deaf community, many deaf people are
reluctant to seek treatment (Boness, 2016).
ETHICAL
CONSIDERATIONS
APA ETHICAL PRINCIPLES
Beneficence and Non-maleficence
• Consider your own competence in ASL/availability of ASL translator before
taking on a Deaf client

Justice
• Consider intersectionality factors (e.g., race, ethnicity, SES, co-occurring
disabilities)

Respect for People's Rights and Dignity

• Be well informed about the current local, national, and international human rights
legislation that has been responsible for emerging conceptions of deafness
(MacDougall, 2022).
ETHICAL
CONSIDERATIONS
APA MULTICULTURAL GUIDELINES
1) Identity and self-definition are fluid and complex
• Consider client's personal identity as deaf and/or Deaf
2) Move beyond conceptualizations rooted in categorical assumptions
• Deaf people are not stupid
• Not every deaf person wishes for their deafness to be "fixed"
3) Strive to recognize the role of language and communication
• Extremely important to consider a deaf client's preferred form of
communication
4) Be aware of the role of the social and physical environment
• Be aware of the client's status as a deaf person in a hearing world
5) Recognize experiences with power, privilege, and oppression
• Recognize how psychologists have failed to provide adequate care to
deaf people throughout history and in the present
PRACTICAL CONSIDERATIONS
GENERAL CONSIDERATIONS
• Communication skills/preferences of the individual
• Level of hearing loss
• Age of hearing loss onset
• Cause of hearing loss
• Use of adaptive equipment (e.g., cochlear implant, hearing aids)
• Be mindful of your own use of gestures

ASSESSMENT
• Document limitations of any measures in assessment report
• Refrain from using measures that require listening and speech
• Seek out measures developed for administration using signed language

THERAPY
• Make an effort to understand Deaf culture and associated values
• Understand your client's own view of their deafness and Deaf identity
• Use of narrative therapy may be especially helpful with Deaf clients (Boness,
2016)
DISCUSSION
QUESTIONS
What might be some other important factors to
consider when working with deaf populations?

Does a psychologist have to be deaf themselves in

order to be competent in working with deaf people?
THANK YOU!