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Mental Health Problems and Communication of Children with Hearing Loss in Finnish Special Schools Jari Sinkkonen 17 THERE SEEMS to be universal agreement that a higher prevalence of psychopathology exists among children with hearing loss compared with their hearing peers. In their review of several epidemiological studies, Meadow and Trybus (1979) reported that serious emotional problems were three to six times as common among deaf children as among hearing children. In a Los Angeles survey of teachers, Schlesinger and Meadow (1972) found the incidence of behavioral problems among deaf children in a residential school to be 31.2 percent. Freeman, Malkin, and Hastings (1975) studied 120 deaf children in the Greater Vancouver area. They found an incidence of 22.6 percent of moderate to severe psychiatric disorders. In a recent study in Great Britain, Hindley (1993) estimated the prevalence for psychiatric disorder to be in the range of 43 to 50.3 percent in a group of eighty-one deaf or hard of hearing (D/HH) schoolchildren. Deaf people have been characterized variously as immature, impulsive, and unempathetic with poor social skills. They are also viewed as suffering from limitations in abstract conceptual abilities. These characteristics have been regarded as typical of a specific "deaf personality" (for a review, see Vernon and Andrews 1990). Chess and Fernandez (1980), in their study of 248 children with congenital rubella, concluded that it is not deafness per se but the neurological damage connected to the condition that has led to such stereotyping. Although the significance of congenital rubella in the etiology of deafness has been in constant decline lately many deaf children still have additional handicaps that complicate their rehabilitation and development (e.g., Newton 1985). Children with hearing loss have several great challenges in their development -the most important is, of course, language and communication. More than 90 percent of deaf children are born to hearing parents, which means that, initially; the children lack a shared language with their primary careThis chapter is reprinted, in a revised and abbreviated form, by permission from Psychiatria Fennica 25 (1994):52-65. 197 198 JARI SINKKONEN takers. The children's linguistic stimulation may be limited to matters of the here and now during the first two years or so (Rapin 1986). Communication between parent and child easily becomes didactic and remains "contaminated " by earlier conflicts. This, in turn, may lead to multiple problems, such as isolation (Rainer 1976) and academic difficulties. T:HE PRESENT STUDY In most European countries, deaf children in need of psychiatric hospitalization are placed in a hearing unit. In Finland, treatment facilities for the deaf have been almost nonexistent, even though much has been done in the field of prevention. The study reported here estimates the frequency of disturbed children and adolescents in the special schools for the D/HH in order to create mental health services for them. On a more theoretical level, this author-researcher analyzed the connections among hearing loss, communication, and personality development. He investigated communication strategies and pupils' abilities, as well as the frequency of additional handicaps, which obviously interfere with both cornmunication and other aspects of development. This report also highlights some important findings within a survey of the special schools for the D/HH, derived from the author (Sinkkonen 1994). SUBJECTS In Finland severely D/HH children are enrolled in special schools. All these schools (n == 18) were included in this study; their enrollments totaled 445 pupils. Thus, this study encompassed almost the entire population of intellectually normal or nearly normal children with severe hearing losses in Finland. Questionnaires were sent to the schools' teachers or their educational welfare groups. They provided data about each of the enrolled students. The return rate was 93 percent, or 416 responses. This study will only report results concerning children and adolescents sixteen years old and young;er (those who attended comprehensive schools). This group consisted of 379 subjects, of whom 210 (55.4 percent) were boys and 169 (44.6 percent) were girls. The comparison group was also sampled from comprehensive schools. It consisted of 234 pupils-Ill boys (47.4 percent) and 123 girls (52.6 percent). The study sample proved to be very heterogeneous with regard to additional handicaps, degree of hearing loss, and communication modes. It was divided into hearing loss and multiply handicapped (D/HH & MH) and Dl/HH only. The D/HH subsample was further divided into hard of hearing and deaf groups and into three groups according to communication abilities. [3.145...

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