McCay Vernon

Interpreting in Mental Health Settings: Issues and Concerns

Sign language interpreters in mental health settings face extreme linguistic and cultural difficulties in interpreting basic, everyday language used in these settings. This is particularly true when deaf clients have limited English proficiency, which often requires interpreters to use expansion techniques in order to render messages successfully. To examine how diagnostics may be affected by interpretation, Brauer (1993), Montoya et al. (2001), and Steinberg, Lipton, Eckhardt, Goldstein, and Sullivan (1998) translated two widely used psychological screening instruments into American Sign Language (ASL). The Minnesota Multiphasic Personality Inventory (MMPI) and the Diagnostic Interview Schedule-IV (DIS-IV) were selected for translation, and data from the three studies are presented and discussed. Their implications in terms of the expectations and stresses placed on interpreters are described within a framework of demand and control theory. Finally, sections of the Code of Ethics of the Registry of Interpreters for the Deaf (RID) are examined relative to both the issue of confidentiality and what the interpreters contribution should be in mental health settings.

Violence in deaf and hard-of-hearing people: A review of the literature

The few available studies on the relationship of hearing loss to violence indicate that the prevalence of brain damage, learning disability, communication disorders, educational retardation, unemployment, and underemployment in the deaf and hard-of-hearing population creates frustration which tends to manifest in disproportionate aggression, violence, and hostility. Relative to prevalence, hearing-impaired people are overly represented in the prison population, which is the major datum the literature on violence and hearing loss yields. Other than 12 studies and an American Speech and Hearing Association Committee report documenting the fact, there is an amazing paucity of literature on hearing loss and violence. The reasons for this deficit of information are discussed and ways to remediate the problem are suggested.

A Guide to the Diagnosis of Learning Disabilities in Deaf and Hard-of-Hearing Children and Adults

This article provides a guide to psychological tests and test procedures recommended for diagnosing learning disabilities in deaf and hard-of-hearing youth and adults. Tests are evaluated relative to their usefulness with deaf and hard-of-hearing persons in school and rehabilitation settings. These data provide the basis for recommendation of a battery of tests for use by school, vocational, and general psychologists in evaluating deaf and hard-of-hearing youth and adults for learning disabilities.

Deafness and Autistic Spectrum Disorders

An orientation to autistic spectrum disorders (ASD), also known as autism, is provided, and the specific syndrome of autism and deafness is addressed. The two conditions have in common a major problem: communication. Case histories are provided, the development of treatment for autism is discussed, and the separate disorders that make up ASD are defined. Important medical conditions often present in ASD are named, and their roles in treatment and diagnosis are described. Because autism is generally regarded as increasing in prevalence, some say to epidemic proportions, there is an increase in children who are both deaf and autistic. The resulting pressure on day and residential school programs for the Deaf to accept and educate these difficult, multiply disabled children is increasing. The parents of autistic children are a sophisticated, politically active group who are demanding services through legal and legislative means, among others.

Historical Overview of Inpatient Care of Mental Patients Who Are Deaf

A review of published studies of deaf mentally ill inpatients is reported. While there are conflicts in the findings of some of the studies, several generalizations seem fairly universal across countries and time periods. For example, the data indicate a greater overall prevalence of mental illness in the deaf population than in the general population as a whole, based on the relative number of each group who are patients in psychiatric hospitals. In general, deaf patients have longer hospital stays. Characteristic symptoms leading to hospitalization of deaf people tend to be different from those of hearing patients. It was thought by most investigators that restriction of sign language use in schools was one reason for these differences. For both hearing and deaf inpatients, dual diagnosis (mental illness and substance abuse) is far more common today than in years past. All investigators found frequent misdiagnoses among deaf patients. The paucity of research on deaf inpatients over the last 2 decades is noted.

Cochlear Implants in Prelingually Deaf Children.

All private and public residential and day schools for the deaf in the U.S. that have 100 or more students were surveyed to see how many prelingually deafened students they had with cochlear implants and how many of these students were still using the device. Responses came from 70% (45 of 64) of those schools surveyed. Of the 151 implanted children identified, 71 (47%) were no longer using the cochlear implant. Of the remaining 80 children (53%) still wearing the device, we could not specifically determine by survey the percentage who derived significant benefit from the device and the percentage who did not. However, numerous comments by those returning the questionnaires indicated despondency over the results of the implant.

Free-recall learning of word lists by prelingual deaf subjects

This study examined the extent of influence which an extremely impoverished acoustic-linguistic system exerted on multitrial free recall of word lists, using 36 prelingual deaf and 36 normal-hearing S s of two age levels. In comparison with the hearing S s, the deaf S s′ recall performance was poor and their span of “echoic” memory tended to be short. Between the two groups, there was a considerable amount of common features in mnemonic organizations, as assessed by Tulvings subjective organization, Bousfields clustering, and Johnsons hierarchical clustering schemes. The deaf S s were, however, less efficient and showed no developmental improvement in these measures. These results suggest that acoustic-linguistic mediation is also crucial for deaf S s′ free-recall learning of verbal materials.

Mental Health Services for People Who Are Deaf

The issue of mental health services available to adults and children in the United States who are deaf is addressed. Included is a historical perspective on the changes in these services over the last 50 years. Within this scope, the current status of services is described in some detail. Psychological research on children who are deaf is reviewed, and current issues faced by school psychology and psychologists who evaluate deaf children in school settings are examined. The disturbing current trend toward the criminalization of people with mental illness, which affects both hearing and deaf adults with psychiatric diagnoses, is covered. Suggestions are made for improving mental health services for children and adults who are deaf.

Forensic pretrial police interviews of deaf suspects avoiding legal pitfalls.

There are 21,000,000 people in the United States with hearing loss. Of these, approximately 1,000,000 are children considered hard of hearing and 350,000 people who are profoundly deaf. It is this latter group who are the primary focus of this article (deHahn, 1994). With the passage of the Americans with Disabilities Act (ADA), deaf and other disabled persons were provided with landmark civil rights legislation. It provided legal protections in employment, access to state and local government and public transportation, public accommodations, and telecommunications. Included is a requirement that police agencies and the courts use qualified interpreters to communicate with victims, witnesses, and suspects who are deaf or hard of hearing. However, legally sound, effective interviewing of deaf and hearing-impaired suspects requires far more than simply recognizing and using an interpreter. For example, police officers and prosecutors or courts who call upon an unqualified interpreter or fail to assess the quality of the interpreter and the communication skills of their suspect, may see critical evidence ruled inadmissible and/or entire cases dismissed. Unfortunately, studies have shown that the ADA has been least effective for blind, deaf, and physically impaired persons. Perhaps it has been inappropriately relied upon for employee action, such as those claiming mental impairment. This article sets forth some basic guidelines for police, attorneys, and the court system to follow in conducting meaningful, legally admissible interviews with deaf and hard-of-hearing

Pedophilia and Deafness

Data from 22 cases of deaf individuals suffering from pedophilia are presented along with a tabular summary of recent articles from the deaf press, about deaf victims of pedophilia and deaf pedophiles. Results indicate a number of factors that distinguish deaf pedophiles from hearing pedophiles. First is the prevalence of Primitive Personality Disorder in the deaf group. Corollary to this, with a significant number of pedophiles, competence to stand trial is a major issue. Other significant differences include a high rate of brain damage, illiteracy, poor communication skills, and other psychiatric illnesses. Two of the 22 cases were deaf females with pedophilia. The mean performance IQ of the sample was 102.8 and the distribution of scores was bimodal. Case histories are presented and discussed, and legal issues, prevention, and punishment are addressed.