Difficulty Identifying a Learning Disability
in the Deaf & Hard of Hearing Population
The term “learning disabilities” was coined by Dr. Sam Kirk in 1963. There are different types of learning disabilities, and they are:
- Dyslexia – difficulties with specific language skills, mainly reading
- Dyscalculia – challenges in processing math
- Dysgraphia – difficulties with spelling, poor handwriting, and trouble putting thoughts on paper
- Auditory Processing Disorder – difficulties recognizing and interpreting information by sound
- Visual Processing Disorder – difficulties recognizing and interpreting information by sight
Learning disability is a neurological disorder. It means a person's brain works or is structured differently. Processing issues affect the ability to read, write, spell, reason, organize information, or do mathematics. Some students have one or two types of learning disabilities that effect different learning modes. For instance, a student with dyslexia struggles with reading, writing, and spelling, but excels in math and science. Conversely for a student with dyscalculia; the student struggles with math, but is doing well in English. Some students have both dyslexia and dyscalculia. For those who have a visual processing disorder, it can impact some or all aspects of academic learning -- reading, writing, spelling, and math.
For years, educators, who work with deaf and hard of hearing students, have expressed their concern about their students not processing well in academics as well as others do. In addition, many students could not keep pace with their peers. They have difficulty understanding the concepts of language and mathematics, which makes it challenging to do well in school.
There are some factors why it is complicated to identify deaf and hard of hearing students with a suspected learning disability. One of the elements is that there is some disagreement on a definition of the term "learning disabled hearing impaired." Deaf and hard of hearing are not permitted to be part of the category as learning disabled because Public 94-142 states that children with learning disabilities cannot be classified as learning disabled if their difficulties are due to the sensory deficit (Plapinger & Sokora, 1990). The other factor is that it is difficult to tell whether their problems in language are related to a hearing loss or to a learning disability (Plapinger & Sokora, 1990). With these problems, it is important to develop criteria to compare the characteristic of deaf and hard of hearing students that differentiate from non-learning disability and non-learning disabled deaf and hard of hearing students (Plapinger & Sokora, 1990).
Some deaf and hard of hearing students are over diagnosed with a learning disability because of their language and reading delays. According to LaSasso (1985, 1992), their language and reading delays are often misinterpreted as a learning disability when they are actually the norm for deaf or hard of hearing individuals. Due to a different kinds of processing problems, it can be challenging to identify whether or not deaf or hard of hearing students have a learning disability because of their academic delays, especially language which may be caused by their hearing loss. Psychologists also misdiagnose deaf and hard of hearing individuals for learning disabilities because of their lack of understanding of deafness and the interpretation of test results. They are also unable to communicate with them due to their lack of skills in sign language. In order to know what kind of processing problems they have, the assessment should consist of teacher observations, appropriate standardized assessment measures, and informal assessment procedures.
Unfortunately, there are a lack of test instruments and qualified evaluators that meet the needs of deaf and hard of hearing students with a suspected learning disability. There are not many test instruments that are the norm for them, and there are very few appropriate psychological and educational tests for assessing processing problems. When deaf and hard of hearing students have difficulty in reading and other subjects, it is crucial to determine whether they have learning disabilities or their learning difficulties are the result of their hearing loss (Plapinger & Sikora, 1990).
With proper training, teachers can help recognize their students’ processing problems and refer them to a psychologist for an assessment. A psychologist is encouraged to include the DSM-5 Set of Diagnostic Criteria on the student's evaluation report. It will help the student and family know where they stand and address the student's specific learning needs in positive and effective ways that will help him/her learn more easily. For example, my daughter, who was in 4th grade, tested for a possible learning disability in her previous school. Her psychological evaluation indicated her diagnosis of visual-spatial processing issues and functional limitations. Because she was so young, she did not understand why she was struggling academically. Despite our support, she was lost without guidance or direction. Consequently, her academic struggles persisted and so did her frustration. In high school (a different deaf school), she was retested for confirmation and got the same diagnosis results. Finally, she was old enough to understand her diagnosis and functional limitations. Much to my surprise, she began to progress academically and develop coping strategies to compensate for her learning challenges. As stated in my Tearing Down the Wall” story, my diagnosis helped built my self-awareness because it actually explained my frustration and also helped me understand my areas of strengths and weakness as well as a way to target and improve my academic skills. The evaluation was like a map. It helped me find a way to succeed in college. Thus, I cannot stress how important it is for the psychologist to include the diagnosis in their report to better provide guidance, like a map, as explained above.
Did You Know?
I applaud my daughter, DJK’s courageousness for telling her friend that she has a learning disability. At school in the fall of 2018, her academically gifted friend told DJK that she thinks people with learning disabilities are stupid. Out of defense, DJK told her that she has a LD. Her friend was stunned and said, “It’s impossible! You look smart.” DJK also told her that one of their friends also has a LD (in reading comprehension). She was speechless. Thru the conversation, the other friend (also academically gifted) told that friend that her brother (also deaf) has a LD in math. She was flabbergasted. I thought that was hilarious. I couldn’t be prouder of her for speaking up. Perhaps Deaf Education needs training in language deprivation, learning disabilities, and Irlen Syndrome issues to gain understanding and sensitively responding to the academic struggling students. (They all come from a Deaf family and go to the same deaf school).
I applaud my daughter, DJK’s courageousness for telling her friend that she has a learning disability. At school in the fall of 2018, her academically gifted friend told DJK that she thinks people with learning disabilities are stupid. Out of defense, DJK told her that she has a LD. Her friend was stunned and said, “It’s impossible! You look smart.” DJK also told her that one of their friends also has a LD (in reading comprehension). She was speechless. Thru the conversation, the other friend (also academically gifted) told that friend that her brother (also deaf) has a LD in math. She was flabbergasted. I thought that was hilarious. I couldn’t be prouder of her for speaking up. Perhaps Deaf Education needs training in language deprivation, learning disabilities, and Irlen Syndrome issues to gain understanding and sensitively responding to the academic struggling students. (They all come from a Deaf family and go to the same deaf school).
Difficulty Diagnosing a Learning Disability
in Deaf and Hard of Hearing Students
Diagnosing a learning disability in a deaf or hard of hearing student is extremely complicated due to the lack of assessment instruments and qualified evaluators that meet deaf and hard of hearing students with suspected learning disabilities. There are not many test instruments that are standard for these students, and there are very few appropriate psychological and educational tests for assessing on their learning process (Rush & Baechle, 1992). These factors have an impact on deaf and hard of hearing students from receiving appropriate services in the secondary/postsecondary system.
The evaluators misdiagnose deaf and hard of hearing persons for learning disabilities because of their lack of understanding in deafness and the interpretation of test results. They are unable to communicate with students due to evaluators’ lack of skills in sign language. It is important to have direct communication between the evaluator and student. However, if the evaluator does not know sign language, an interpreter must be provided so they can have clearer communication with a deaf or hard of hearing student in order to prevent from affecting assessment instruments’ scores.
The evaluators frequently misdiagnose deaf and hard of hearing persons for learning disabilities because of their reading and writing delays. If deaf and hard of hearing students’ literacy skills are delayed, it does not necessarily mean they have learning disabilities. According to LaSasso (1985, 1992), their language and reading delays are often misinterpreted as a learning disability when they are actually the norm for deaf or hard of hearing individuals. For example, a 9-year-old deaf child is on the first-grade level which is normal. The expectation would be that by the time the child is 15, he or she would be reading on a third or fourth-grade level. If the same child were still reading on the first-grade level at age 15, one would strongly suspect learning disabilities (Morgan & Vernon, 1994). This is an example of how to identify learning disabilities in deaf and hard of hearing students. It does not mean it is okay for them be stuck with their reading level because of their hearing loss and/or learning disability. I find it somewhat unacceptable. As noted in the “Resources/Services” section, we have tools and strategies available to help students with reading. In this case, they CAN improve their reading skills with positive encouragement and push. The tools can also help build their improved reading skills.
In fact, deaf and hard of hearing students have difficulties learning in literacy skills. There are two reasons why reading and writing are difficult areas for them to learn. First, when they enter school, most of their language skills are not equal to their hearing peers. They begin to acquire their linguistic skills when reading instruction starts. In fact, they have difficulty using the rules of language. Second, learning to read is developed by auditory measures. It is challenging to do decoding because of their lack of auditory feedback (Plapinger & Sikora, 1990). When deaf and hard of hearing students have difficulties in reading and other subjects, it is crucial to determine whether they have learning disabilities or their learning disabilities are the result of their hearing loss (Plapinger & Sikora, 1990). Hence, the guidelines need to be established in order to diagnose these students with learning disabilities accurately. In order to assess deaf and hard of hearing students for learning disabilities, the evaluators need to have broad knowledge the following:
- Deaf and hard of hearing students’ communication modes.
- Deaf students’ unique culture known as Deaf Culture.
- How degree of hearing loss and types of educational experiences affect these students.
- These students’ functions in the areas of cognition, intelligence, academic achievement, and social-emotional functioning.
- The appropriate assessment technique of deaf and hard of hearing students.
- The discrepancies between potential and achievement among these students (Kachman, 1999, Morgan & Vernon, 1994).
Also, the evaluators need to consider the students' educational background, cultural background, academic records, primary language, family and medical histories, and audiogram before the assessment is given. Collecting data is vital because the evaluators need to know where a student is coming from. Most importantly, the data helps them become extremely cautious with diagnosing a student for suspected learning disabilities. After gathering data, they need to find out what their academic strengths and weaknesses are in order to overcome the obstacles of academic work and to receive reasonable accommodations. The evaluation should include verbal and nonverbal reasoning, language processing, memory, visual-motor skills, executive functioning and attention, and achievement in reading writing, and/or mathematics. By evaluating a wide array of aspects, they can then understand and work on which areas are the strengths and weaknesses of the student.
As mentioned in my “Tearing Down the Wall” story, I wish to add that for those deaf or hard of hearing individuals who suspect that they have a learning disability, you will want to make sure to select an evaluator, who is aware of deaf issues and knows sign language, for diagnosis. My high school psychologist was rare; it doesn't happen very often. If you are unable to locate one, an interpreter should be provided. Keep in mind that it is essential for evaluators not to misdiagnose deaf and hard of hearing individuals with learning disabilities. Today, more and more deaf and hard of hearing individuals are being identified as having a learning disability. It is essential for them to receive appropriate services in order to progress and advance their education through the use of reasonable accommodations.
Suffice, it is vital for evaluators to know what kind of assessment instruments they need to use to assess deaf and hard of hearing students for a possible learning disability. Enclosed is the link of the "Guidelines for Documentation of a Learning Disability in Gallaudet University Student" for more information on how to appropriately assess the students for a possible learning disability.
Can a Deaf and Hard of Hearing Student
Have a Learning Disability
Under the Special Education Guidelines?
Researchers and practitioners face a dilemma because of insufficiencies in the definition of the term “learning disabled hearing impaired.” According to Public Law 94-142, there are two reasons why the definition of learning disabilities is inappropriate for deaf and hard of hearing students. The first reason is that the term “learning disabilities” cannot be classified as learning disabled in deaf and hard of hearing individuals due to their hearing loss. In fact, this law does not include individuals who have problems which are primarily the result of visual, hearing, or other sensory impairments. Therefore, they are not allowed to be part of the learning disabilities category. The second reason is to determine whether the language deficits are a normal result of the deafness or are due to a learning disability. In spite of the problems with the “legal” definition of learning disabilities, deaf and hard of hearing students with suspected learning disabilities could be classified as learning disabled by qualified professionals.
Educators raise questions whether any deaf and hard of hearing students are eligible to be classified as learning disabled and receive special education services based on this condition (Bunch & Melnky, 1989; LaSasso, 1985). In order to establish services for deaf and hard of hearing students with learning disabilities, the National Joint Committee on Learning Disabilities (NJCLD) revised the definition that would remove the federal obstacle from developing services for these students in the school system. NJCLD defines “learning disabilities” as it may occur concomitantly with other handicapping (for example, sensory impairment, mental retardation, serious emotional disturbance) or with extrinsic influences (such as cultural difference, insufficient or inappropriate instruction), they are not the result of these conditions or influences” (Bunch & Melynk, 1989, p. 298).
According to the federal definition, “there are no…hearing…impaired learning disabled children in the world – the idiocy of such a rule denies the evidence” (Sabatino, 1983, p. 26). Hammill, Leigh, McNutt, and Larsen (1981) also criticized the definition of learning disabilities. They perceive it to be a misconception that learning disabilities can neither occur in conjunction with other handicapping conditions or the presence of environmental, cultural, or economic advantage.
As noted in my “Tearing Down the Wall” story, I beg to differ. In spite of the problem with the "legal" definition of learning disabilities, deaf and hard of hearing students with identified learning disabilities should be classified as learning disabled by qualified professionals. I firmly believe that deaf and hard of hearing students with learning disabilities do exist. They deserve to be part of the learning disabilities category and receive appropriate services from the secondary and postsecondary institutions. After all, I am living proof of this situation.
@https://www.knowable.com/stories/1823179/something-you-may-not-know-about-keira-knightley/
LEAD-K: Food for Thought
@http://www.cad1906.org
The purpose of the Language Equality and Acquisition for Deaf Kids (LEAD-K) is to advocate for equal access to language acquisition and literacy for deaf and hard of hearing children before they are academically ready for kindergarten. More and more states passed it into law or policy.
Suffice to say, LEAD-K requires all deaf and hard of hearing babies go through language acquisition assessments every six months until they turn five. However, it may be challenging to detect those with dyslexia or visual processing disorder during the first five years unless one of their parents has one.
If you notice a student with learning loss display any characteristics that are not usually seen with a hearing loss, we should watch closely for the possibility of having dyslexia or visual processing issues. As stated in the "Our D/LD Journey" section, you may want to ask the child for a description of his/her reading challenges and see if their symptoms are consistent with dyslexia or visual perception problems. Dyslexia and visual processing issues are not the same thing. Let's take a look at the chart that lays out the difference between them. Looking back, I wish I were fully educated about dyslexia/visual processing issues and its impacts on academic advancement. I regret not providing an early reading intervention for DJK.
I would like to advise educators to keep dyslexia and eight types of visual processing issues in mind while identifying the capacities as well as limitations of perception processing issues. It may help detect early reading problems among deaf and hard of hearing children.
Suffice to say, LEAD-K requires all deaf and hard of hearing babies go through language acquisition assessments every six months until they turn five. However, it may be challenging to detect those with dyslexia or visual processing disorder during the first five years unless one of their parents has one.
If you notice a student with learning loss display any characteristics that are not usually seen with a hearing loss, we should watch closely for the possibility of having dyslexia or visual processing issues. As stated in the "Our D/LD Journey" section, you may want to ask the child for a description of his/her reading challenges and see if their symptoms are consistent with dyslexia or visual perception problems. Dyslexia and visual processing issues are not the same thing. Let's take a look at the chart that lays out the difference between them. Looking back, I wish I were fully educated about dyslexia/visual processing issues and its impacts on academic advancement. I regret not providing an early reading intervention for DJK.
I would like to advise educators to keep dyslexia and eight types of visual processing issues in mind while identifying the capacities as well as limitations of perception processing issues. It may help detect early reading problems among deaf and hard of hearing children.
Language Deprivation and Deaf Mental Health
Many of you may be aware of a book called, “Language Deprivation and Deaf Mental Health” has come out and has spread awareness in the Deaf community. For years, I often have wondered if a deaf individual’s literacy challenges are related to language deprivation or learning disability. Of course, we may easily identify this area with deaf children of deaf parents. However, the majority of deaf children are born to hearing parents. This is a gray area, which makes it challenging for an evaluator to diagnose a child with a learning disability in reading or writing. Often, they are misdiagnosed when, in fact, it should be associated with language deprivation syndrome.
In 2018, the National Association of the Deaf (NAD) shared their ‘priority proposals’ which NAD members then voted on to decide what their immediate focuses would be. One of the proposals was to add language deprivation syndrome (LDS) to both ICD-10 & DSM-5 (proposed by Mickey Morales). I, of course, as a NAD member voted for it. However, it did not make it to the top five priorities. I think we need to push it to make it happen. It will help identify the often misunderstood categories of diagnosis before providing services. Often, I work with deaf college students who are not on par with English and retention has been difficult. If they are diagnosed with language deprivation syndrome, we, both school and college can provide accommodations and the support they need to succeed in life. It is the most overlooked area, but an important one.
In 2018, the National Association of the Deaf (NAD) shared their ‘priority proposals’ which NAD members then voted on to decide what their immediate focuses would be. One of the proposals was to add language deprivation syndrome (LDS) to both ICD-10 & DSM-5 (proposed by Mickey Morales). I, of course, as a NAD member voted for it. However, it did not make it to the top five priorities. I think we need to push it to make it happen. It will help identify the often misunderstood categories of diagnosis before providing services. Often, I work with deaf college students who are not on par with English and retention has been difficult. If they are diagnosed with language deprivation syndrome, we, both school and college can provide accommodations and the support they need to succeed in life. It is the most overlooked area, but an important one.
References
Bunch, G.O. & Melnyk, T.L., (1989). A review of the evidence for a learning disabled, hearing-impaired sub-group. American Annals of the Deaf, 134(5), 297-300.
Hammill, D. D., Leigh, J.E., McHutt, G., & Larsen, S.C. (1981). A new definition of learning disabilities. Learning Disabilities Quarterly, 4,336-342.
Kachman, W. (1999). Identifying learning disabilities in deaf and hard of hearing college students. Conference Proceeding Bridge the Gap Between Research and Practice in the Fields of Learning Disabilities and Deafness, Washington, D.C. (35-43).
LaSasso, C. (1985). Learning disabilities: Let’s be careful before labeling deaf children. Perspectives, 3(5), 2-4.
Morgan, A. & Vernon, M. (1994). A guide in the diagnosis of learning disabilities in deaf and hard-of-hearing children and adults. American Annals of the Deaf, 139, (3), 358-370.
Plapinger, D., & Sikora, D. (1990). Diagnosing a learning disability in a hearing-impaired child: A study case. American Annals of the Deaf, 135(4), 285-292.
Rush, P. & Baechle, C. (1992). Learning disabilities and deafness: An emergency field. Gallaudet Today, 22(3), 20-26.
Sabatino, D. (1983). The house that Jack built. Journal of Learning Disabilities, 16, 26-27.
Bunch, G.O. & Melnyk, T.L., (1989). A review of the evidence for a learning disabled, hearing-impaired sub-group. American Annals of the Deaf, 134(5), 297-300.
Hammill, D. D., Leigh, J.E., McHutt, G., & Larsen, S.C. (1981). A new definition of learning disabilities. Learning Disabilities Quarterly, 4,336-342.
Kachman, W. (1999). Identifying learning disabilities in deaf and hard of hearing college students. Conference Proceeding Bridge the Gap Between Research and Practice in the Fields of Learning Disabilities and Deafness, Washington, D.C. (35-43).
LaSasso, C. (1985). Learning disabilities: Let’s be careful before labeling deaf children. Perspectives, 3(5), 2-4.
Morgan, A. & Vernon, M. (1994). A guide in the diagnosis of learning disabilities in deaf and hard-of-hearing children and adults. American Annals of the Deaf, 139, (3), 358-370.
Plapinger, D., & Sikora, D. (1990). Diagnosing a learning disability in a hearing-impaired child: A study case. American Annals of the Deaf, 135(4), 285-292.
Rush, P. & Baechle, C. (1992). Learning disabilities and deafness: An emergency field. Gallaudet Today, 22(3), 20-26.
Sabatino, D. (1983). The house that Jack built. Journal of Learning Disabilities, 16, 26-27.