Daniel Holzinger

Mental health of deaf people

Deafness is a heterogeneous condition with far-reaching effects on social, emotional, and cognitive development. Onset before language has been established happens in about seven per 10,000 people. Increased rates of mental health problems are reported in deaf people. Many regard themselves as members of a cultural minority who use sign language. In this Review, we describe discrepancies between a high burden of common mental health disorders and barriers to health care. About a quarter of deaf individuals have additional disabilities and a high probability of complex mental health needs. Research into factors affecting mental health of deaf children shows that early access to effective communication with family members and peers is desirable. Improved access to health and mental health care can be achieved by provision of specialist services with professionals trained to directly communicate with deaf people and with sign-language interpreters.

Mental distress and quality of life in a deaf population

BackgroundHigh risks of mental illness within the deaf community are reported. The assessment of the level of mental distress and quality of life in the deaf community is difficult due to communication problems in spoken and written language. The deaf community is characterized by the use of sign language.MethodsA new measure of acceptable reliability using sign language is described. The interactive computerised package including special versions of the World Health Organisations Brief Quality of Life questionnaire (WHOQOL-BREF), the 12-Item General Health Questionnaire (GHQ-12) and five subscales of the Brief Symptom Inventory (BSI) was administered to a large community sample of deaf people (n=236), and results were compared with normative data for German-speaking hearing people.ResultsThe deaf sample has a significantly poorer quality of life than the general population for the physical and psychological domains (p<0.01) as measured by the WHOQOL-BREF. However, in the domain of social relationships, no significant difference (p=0.19) was demonstrated. All findings with the GHQ-12 and the BSI show much higher levels (p=0.01) of emotional distress among the deaf.ConclusionAlthough a poorer quality of life and a higher level of mental distress are demonstrated, the similarity to the general population in the domain social relationships shows that this does not affect all domains. These findings show the need for easily accessible health services for the deaf which offer sensitive communication with them.

Correlates of mental health disorders among children with hearing impairments

Aim  The aim of this study was to elucidate factors related to the high rate of mental health disorders seen in those with impaired hearing, including social factors and audiological measures.

Best Practices in Family-Centered Early Intervention for Children Who Are Deaf or Hard of Hearing: An International Consensus Statement

A diverse panel of experts convened in Bad Ischl, Austria, in June of 2012 for the purpose of coming to consensus on essential principles that guide family-centered early intervention with children who are deaf or hard of hearing (D/HH). The consensus panel included parents, deaf professionals, early intervention program leaders, early intervention specialists, and researchers from 10 nations. All participants had expertise in working with families of children who are D/HH, and focus was placed on identifying family-centered practice principles that are specific to partnering with these families. Panel members reported that the implementation of family-centered principles was uneven or inconsistent in their respective nations. During the consensus meeting, they identified 10 agreed-upon foundational principles. Following the conference, they worked to refine the principles and to develop a document that described the principles themselves, related program and provider behaviors, and evidence supporting their use (drawing upon studies from multiple disciplines and nations). The goal of this effort was to promote widespread implementation of validated, evidence-based principles for family-centered early intervention with children who are deaf and hard of hearing and their families.

An innovative and reliable way of measuring health-related quality of life and mental distress in the deaf community

BackgroundStructured assessment of quality of life and mental distress in deaf people is difficult for various reasons. This paper describes the development and reliability of an interactive computer-based assessment package for measuring quality of life and psychological distress in the deaf population.MethodsThe Brief version of the WHO Quality of Life (WHOQOL) Questionnaire, the 12-item General Health Questionnaire (GHQ-12) and the Brief Symptom Inventory (BSI) had been translated into sign-language and videotaped. A total of 236 members of the deaf community in Upper Austria participated by responding to a programme consisting of self-administered written and videotaped test-items presented to them on a notebook computer. The reliability of the various assessments was established on this large community sample.ResultsWhen reliability of the versions for the deaf was compared with that of written versions of the same measures in general population samples, it was found to be somewhat lower, although still in an acceptable range, for the WHO-QOL and the GHQ-12. For the BSI, the reliability was even higher than that of the general population.ConclusionsFor deaf individuals whose preferred communication is sign language, quality of life and mental distress can be effectively and reliably assessed with the use of carefully translated and adapted common instruments.

Early onset of family centred intervention predicts language outcomes in children with hearing loss

OBJECTIVE To investigate the impact of age at diagnosis and age at onset of intervention on language outcomes in children with hearing impairments. METHODS Receptive and expressive language outcomes of a sample of 63 children (mean age 5;1 years) with hearing loss (mean 78dB, SD 25.3) enrolled in the only specific early intervention program in Upper Austria were assessed. The sample can be regarded as representative for children with significant hearing loss. For 89% the hearing loss was congenital. Language results were related to age at diagnosis, age at first fitting of hearing aids and age at enrolment in the intervention program. Confounding variables such as IQ, degree of hearing loss and family parameters were controlled for in regression analyses. RESULTS Early commencement of family centred intervention had a significant impact on language outcomes as opposed to age at diagnosis and age at fitting of hearing aids. CONCLUSION In managing intervention in children with hearing loss, time between diagnosis and onset of early intervention should be kept as short as possible. However, age of entry to early intervention explained only about 4% of the variance in language outcomes.

Motor performance and correlates of mental health in children who are deaf or hard of hearing.

This cross‐sectional study investigates the relationship between motor performance and mental health in a representative population of children with hearing impairment.

Creating innovative clinical and service models for communication: Institut fuer Sinnes- und Sprachneurologie.

ABSTRACT: Disorders that affect communication are multifaceted and have significant impact throughout the life cycle, leading to different needs at different stages of life. This article describes the development of a comprehensive program that provides services for the whole range of patients with communication and problems over the life span.

Enhancing Resilience to Mental Health Disorders in Deaf School Children

This chapter examines the results of a large cross-sectional research program examining mental health, language development, and cognitive abilities of a representative sample of deaf (hearing loss at least 40 dB) school children in Upper Austria (n = 99). Prevalence of mental health disorders was found to be about twice as high in deaf children as in the general pediatric population, with prevalence increasing to four times as likely in children who have problems making themselves understood in the family. Practical experiences are described, and findings are linked to practical recommendations, to improve resilience to mental health disorders in deaf children.