Effects of psychosocial development
The child who is born deaf and deprived of the full verbal communicative interaction with the parents is prone to internalize thoughts and feelings, lacking the opportunity to experience the full range of sensory experiences necessary to relate to the parent and the environment. The deaf child usually is impulsive and socially immature, struggling to adapt in any way possible to the deficit. As Boothroyd (1982) has noted: “They perceive themselves as being acted upon more than acting and may compensate by developing rigid and manipulative behaviors”. Hess (1960) writes of the tendency for these children to have a fantasy life that excludes awareness of the individuality of others and being unable to approach new situations in a flexible manner. Roberts and Hindley (1999) describe a complex interweaving of social, medical, and cultural factors related to the deaf child’s communication, which in turn may be relates etiologically or incidental to psychiatric disorder.
Because normal cognitive and speech-language development is likely to suffer in these children, it seems remarkable that many are able to adapt at all despite their isolation from a hearing environment. Perhaps, a good number of them learn to cope with their loss by utilizing other own unique defense mechanisms. Appropriate and early professional intervention and support from knowledgeable parents certainly contribute further to the adjustment. We would go beyond the scope of the present text to encompass the complex and still controversial issues surrounding the habilitation, education, and position in society of the deaf child. Hindley (1997), however, presents a though review of the psychiatric aspects of hearing-impaired children with particular emphasis on the deafened or deaf child.
Children with a lesser degree of hearing impairment, although having the advantage of greater sensory exposure to others and their environment, also may suffer psychosocially. Those who incur hearing loss after having learned speech and language have to adjust to their changed circumstances, but they do so with varying degrees of frustration, anxiety, guilt, and inappropriate behavior. They, too, are struggling to adapt and depending on the nature and degree of parental support and professional intervention, will learn to cope accordingly.
Consistent with the theme of this book, we hesitate to generalize how children will respond to their loss and the effort employed to help them. The many complex variables inherent in the interpersonal communicative process and the unique constitutional coping process of the child often determine the outcome. We should, therefore, not be surprised when we encounter profoundly deaf children who are less impaired or have already established speech and language. Indeed, “it may be easier to live with what one has never had than to live with what one has lost.”
For adolescents, deafness or acquired hearing impairment have very special implications. Because the peer group often is the determining factor defining social competence, the hearing-impaired adolescent is vulnerable to social rejection, precipitating depression, withdrawal, or regression to a less mature emotional state. Christopher, Nangle, and Hansen (1993) review extensively procedures in social-skills training with adolescents, employing a behavioral approach that appears promising. For the individual who was born deaf, depending on earlier educational and habilitative intervention, adolescence is the crossroads for embarking on a path toward the world of the deaf, the world of the hearing, or a compromised adaptation to both. Regardless of degree of impairment, the entire adjustment is shaped by intellectual, family, and unique individual character factors as well as by the quality of previous educational and habilitative efforts.