Students who are DHH as a vulnerable population

1. Students who are DHH as a vulnerable population Gabriel I. Lomas, Ph.D. Alberta Department of Education May 16, 2019

2. In the mid-1800’s cholera was out of control in London. Over 15,000 people were killed. The disease has devastated the globe, with nearly a million people killed in pandemics in India. • The common belief was that cholera existed in the air and all people were vulnerable. • With redirection of waste water, cholera was nearly eliminated. The current average number of cases in the USA is 6. The average in Canada is 1 per year. • Dr. Snow’s discovery essentially created the field of public health. He revolutionized medicine. • For the first time, it was clear that prevention was more effective than treatment. • This was truly a turning point in the way we address disease. It led to the rise in immunizations. It changed the focus of research for medical professionals. • By ensuring water and waste were separate and water was clean, the public was less vulnerable to illness. Dr. John Snow

3. ACE Study • In 1998, researchers from the Kaiser Clinic in San Diego, in collaboration with the CDC, published a study on ACEs. • They asked patients 10 questions when they came in for primary care. • Much like the impact of Dr. Snow’s work, the ACE study is now beginning to transform healthcare. • The ACE study should be transforming education as well, but that work is in your hands.

4. ACES as a public health challenge • With the increase of ACEs, we see clear correlations with: • Lower life expectancy • Health care costs • Mental illnesses • Substance abuse • Specific diseases such as: • Heart disease • Lung disease • Sexually Transmitted Infections • If we could tell you early on that your life expectancy will be lowered by your answer to a question, wouldn’t you want to change it? We can change it.

5. Ace Questions

6. ACE study • Their Population: • All 17,000 had health insurance. • A largely middle-class population, not likely to be exposed to street drugs, violence, poverty, malnutrition, and so on. • 72% of their population attended college • 77% of their population was Caucasian • Their ACE exposure was significant: • 1 in 4 were exposed to at least two ACEs. • 1 in 16 were exposed to at least four ACEs. • 1 in 5 were sexually abused as children. • 2 out of 3 women experienced abuse or violence in their childhood • If ACEs were a physiological disease, they would be an epidemic.

7. ACES contribute to rape0 to 4 ACES are represented in this graphic. Each ACE increases the likelihood of sexual crimes.

8. ACES set the stage for poor health • ACEs contribute to all other developmental domains. The greater the ACES, the greater the impact on domains and the greater the likelihood of illnesses and early death.

9. ACE Study • High ACE scores are related to high rates of incarceration • 77 to 90% of all women in prison have serious histories of abuse • Compared to the general population, youth in the justice system have three times more ACEs. • High ACE scores are connection to behaviors that result in CJ activity. • Higher ACEs are associated with school-related problems and truancy • Parental incarceration is itself an ACE that contributes to risky behaviors and household instability • Incarceration itself can be a source of ACE and trauma for the individual incarcerated and their family. • In prisons, inmates are often victims and perpetrators of violence • 22 to 25 percent of inmates are victims of sexual harassment or abuse • Researchers report that about 10 percent of inmates nationwide report being sexually assaulted while incarcerated • Incarceration of a family member is a source of stress and trauma, facilitating a cycle of incarceration for generations

10. ACEs and Disability • According to Kassin (2012), people with disabilities are more likely to offer false confessions than their peers without disabilities. • According to Miller (2002), DHH people are overrepresented in prisons by 2 to 5 times • According to Lomas (2022), there are about 10,000 DHH juvenile offenders in the system at any given time • DHH children and youth are more likely to experience abuse and neglect than their hearing peers • The justice system is fraught with obstacles that ultimately lead to an unfair experience for DHH people • Once incarcerated, access to ADA accommodations are poor at best

11. Procedures • Study was proposed and approved by university IRB in 2014. Initially, a grant was obtained to pay for some aspects of the study. Funding was lost due to timeline. • In the fall of 2014, the ACE questions were sent to a Deaf doctoral student at a university for interpretation. This was a labor intensive process, as the video quality was initially poor. Once the quality was adequate, the videos were sent blindly to two expert mental health interpreters in different locations in the USA. Scoring was consistent and strong for both on most questions, except the sexual questions. • In the summer of 2015, several Deaf people were interviewed to redo the videos. After several months, a suitable Deaf interpreter was identified and created the ASL interpretations. Both expert interpreters found the new videos to be valid and clear representations of the text. The reliability was near perfect for both interpreters. • In the summer of 2016, the videos were ready for the next phase: cognitive interviewing.

12. Procedures • Cognitive interviews were done with 5 DHH people in the New York and New England region. A focus group of DHH people was done in southeast Texas. • Respondents commented that the videos were “spot on” and made statements such as “that’s my language” and it’s “perfect.” • Two of the respondents, both with graduate degrees in rehabilitation counseling, stated that their low vision clients would have a hard time with the text. The text was presented in two formats: First, it was the actual text above the video. Second, captions were added with simple English. Studies verified that the simple English was at the 4th grade level. • The videos were placed on the WCSU university server using a web-based software program. • Respondents were solicited from HEARD initially, then expended to several professional organizations of and for DHH people. There were 45 respondents. • Respondents were all sent a $20 gift card to Wal Mart as an incentive. (SAMPLE VIDEO) Alternate Sample VIDEO

13. 1. Deaf respondents were more likely to be emotionally abused than their HOH peers. (ACE Q1)2. HOH respondents were more likely to be sexually abused as children than Deaf respondents. (ACE Q3)3. Females were more likely to have experienced separation or divorce as children than their male peers. (ACE Q6)4. Males had longer incarcerations than their female peers. (ACE Q10)5. The number of ACEs was positively correlated with the number of times incarcerated (r = .46, p<.05). This was especially true for males (r = .74, p <.05)Outcomes Initial findings Outcomes

14. ImplicationsAn ecological approach • Speak with your neighbor about things that should be changed in: • Families • Communities • Schools and Schools for the Deaf • Employers • Health Care • Laws • Government Services such as the CJ system • American Values and Customs

15. Implications: Abusebuilding resiliency • Child welfare programs should focus on the needs of Deaf children, and have mindful interventions for HOH children as well. • Parenting and parent education programs must focus on healthy attachment with D/HOH children. • Schools should be part of the system that educates children and youth on risk, reporting, and personal safety. • School helpers should be screening for ACEs. Students with high ACE scores should be monitored and support services should be available. • Schools should review existing literature on the school to prison pipeline and conduct self assessments of their institutions, with the aim to disrupt the pipeline.

16. Justice systembuilding resiliency • Protocols for representing DHH people in the justice system should be established and disseminated widely to legal professionals who work with DHH people • Lawyers should establish mentoring programs to assist attorneys who are new to the field of Deaf law. • DHH offenders should be tracked in the system so accurate counts are available. • Prisons should cluster DHH inmates together to ensure ADA accessibility. • Attorneys and courts should receive continuing education on the ACEs of DHH people, building awareness of the issues that contribute to the overrepresentation of this population in our justice system. • National protocols should be developed to train police in handling arrests and interrogations of DHH people to address their overrepresentation in the CJ system. • Reentry and rehabilitative services must consider the needs of deaf people and their children.

17. Implications: Family StressorsDomestic Violence, Divorce • Programs that aim to reduce domestic violence and promote peaceful separations and divorces should include practical interventions for parents of children with disabilities • Media campaigns to promote parent-child relationships should emphasize children with disabilities • High school curriculum can include social-emotional learning programs that promote peaceful peer and intimate relationships. Schools can teach conflict resolution and mediation skills. • Language deprivation as an ACE

18. sources of Vulnerability

19. Sources of resiliency

20. Resources: • CEC’s Policy on the Prevention and Response to Maltreatment (2018, two pages) • CEC acknowledges maltreatment among students with disabilities and • Deafed.net – Click on “Knowledge Base” and you will find multiple links to documents that foster safety with DHH youth, minimizing vulnerability.

23. http://radicalmiddledhh.org/

24. Gabriel Lomas, Ph.D. Lomasg@wcsu.edu 203-837-8512 (office) 832-746-2432 (Cell)