Deaf children and children with ADHD in the inclusive classroom: working memory matters

This study compared the working memory functioning of deaf children, children with ADHD and typically developing children. Working memory is involved in the storage and mental manipulation of information during classroom learning activities that are crucial for the acquisition of complex skills and knowledge. Thus, it is important to determine how these groups compare in this regard as this has implications for teaching them together in an inclusive classroom. Simple and complex visuo-spatial and verbal working memory were assessed in 24 children with ADHD and 20 control children with no diagnosed ADHD, to determine whether any differences existed between these groups. A second comparison occurred between the simple and complex visuo-spatial working memory of the latter two groups, as well as 24 deaf children, all matched on age, gender and home language. The control group scored significantly higher than the deaf children and the children with ADHD on all components of simple and complex working memory. The implications of this finding are that children with ADHD and deaf children may share similar working memory profiles, making it easier to accommodate both sets of children together in the inclusive classroom. Suggestions are given for how educators could assist these children by reducing the demands on working memory.     

Longitudinal Study of Reading Disability and Attention-Deficit/Hyperactivity Disorder: Implications for Education

ABSTRACT— The majority of children who receive special education services meet criteria for reading disability (RD) or attention-deficit/hyperactivity disorder (ADHD), but additional research is needed to understand the long-term academic outcome of children in these groups. Individuals with RD only ( N = 71), ADHD only ( N = 66), both RD and ADHD ( N = 51), or neither disorder ( N = 118) were identified through the ongoing Colorado Learning Disabilities Research Center twin study and retested 5 years later. Results of the follow-up testing indicated that, in addition to ongoing reading difficulties, individuals with RD exhibited higher rates of academic difficulties, depression, and adolescent-onset conduct disorder. Initial ADHD status was associated with academic and social difficulties and elevated rates of nearly all comorbid disorders 5 years later. The group with comorbid RD and ADHD had more stable reading deficits than the group with RD without ADHD and exhibited greater impairment than groups with either disorder alone on outcome measures of academic functioning and social difficulties. These results suggest that individuals with both RD and ADHD are at increased risk for negative outcomes as adolescents and young adults and that when RD and ADHD co-occur, interventions should be provided for both disorders.     

Children's attitudes towards ADHD,depression and learning disabilities

Attention deficit hyperactivity disorder (ADHD), depression and general learning disabilities (LD) are common difficulties for British primary school children. It has been found that characteristics associated with these difficulties can result in negative attitudes and stigma from other children, causing problems with peer relationships. Furthermore, problematic peer relations can intensify the difficulties associated with these disorders. Packages such as ‘Tackling Stigma: A Practical Toolkit’ aim to combat stigma in schools. However, these packages have not been based on evidence regarding children's attitudes towards different disorders. This study aims to explore children's attitudes towards ADHD, depression and LD from a conative (measure of social distance) and cognitive (measure of positive or negative attributes ascribed to a person) perspective. Participants were 273 children (M= 9.2 years). Vignettes were used to describe a child with ADHD, depression, or LD or a ‘normal’ child. The Shared Activities Questionnaire was utilised to assess conative attitudes, and the Adjective Checklist was utilised to assess cognitive attitudes. Results showed that children generally displayed more negative attitudes to vignettes describing mental health difficulties (MHD) (ADHD and depression) than LD. Children had more negative attitudes towards the ADHD (externalising disorder) vignette than the depression vignette (internalising disorder). Younger children had more positive conative attitudes than older children. Those who had previous contact with children with ADHD, depression and LD had more positive attitudes. These findings can enhance current stigma reduction interventions through contributing a deeper understanding of children's attitudes towards the most common MHD and LD in childhood.     

Parenting stress and social support in hearing mothers of deaf and hearing children: a longitudinal study

This longitudinal study investigated the impact of child deafness on mothers' stress, size of social networks, and satisfaction with social support. Twenty-three hearing mothers of deaf children and 23 hearing mothers of hearing children completed a series of self-report questionnaires when their children were 22 months, 3, and 4 years old. When children were 22 months, more mothers of deaf children reported pessimism about their children's achieving self-sufficiency and concerns about their children's communication abilities than did mothers of hearing children. When their children were 3 and 4 years old, mothers of deaf and hearing children did not differ in their reports of general parenting stress, as measured by the Parenting Stress Index (PSI). Likewise, mothers' ratings of satisfaction with social support were not affected by child deafness, nor did they change developmentally. Mothers of deaf and hearing children did differ in the types of support networks utilized. Mothers of deaf 22-month-olds reported significantly larger professional support networks, while mothers of hearing children reported significantly larger general support networks across all child ages. Mothers' feelings of stress and satisfaction with social support were very stable across the 2 years examined. The results suggest that most mothers of deaf children do not feel a high level of general parenting stress or dissatisfaction with their lives and support networks. However, mothers of deaf children are likely to feel stress in areas specific to deafness. In addition, because parenting stress was highly stable, special efforts should be made to intervene when mothers of deaf children are expressing high levels of stress.     

Association between attention deficit-hyperactivity disorder and learning disorders

This article discusses the relationship between attention deficit-hyperactivity disorder (ADHD) and learning disability (LD). The relevant literature is outlined, and empirical data are presented from a prospective follow-up study of 600 speech/language-impaired children. The data show an increased prevalence of both LD and ADHD among children with early speech/language impairments. Furthermore, LD was strongly associated with ADHD in both the initial and follow-up samples. Also, the children with LD had increased rates of other psychiatric disorders (e.g., behavior disorders, mood disorders, anxiety disorders). The implications of these data are discussed with regard to the possible etiology of the ADHD-LD association, treatment for children with LD and ADHD, and promising hypotheses for future research.     

Child maltreatment and trauma exposure among deaf and hard of hearing young adults

The purpose of the present study was to examine the prevalence of child maltreatment and lifetime exposure to other traumatic events in a sample of deaf and hard of hearing (DHH; n = 147) and matched hearing (H; n = 317) college students. Participants completed measures of child maltreatment (CM), adult victimization and trauma exposure, and current symptoms of posttraumatic stress disorder (PTSD). Overall, DHH participants reported significantly more instances of CM compared to H participants, with 76% of DHH reporting some type of childhood abuse or neglect. Additionally, DHH participants reported experiencing a higher number of different types of CM, and also reported increased incidents of lifetime trauma exposure and elevated PTSD symptoms. Severity of deafness increased the risk of maltreatment, with deaf participants reporting more instances of CM than hard of hearing participants, and hard of hearing participants reporting more instances of CM than H participants. Among DHH participants, having a deaf sibling was associated with reduced risk for victimization, and identification with the Deaf community was associated with fewer current symptoms of PTSD. A regression model including measures of childhood physical and sexual abuse significantly predicted adult re-victimization and accounted for 27% of the variance among DHH participants. DHH participants report significantly higher rates of CM, lifetime trauma, and PTSD symptoms compared to H participants. Severity of deafness appears to increase the risk of being victimized. Being part of the Deaf community and having access to others who are deaf appear to be important protective factors for psychological well-being among DHH individuals.     

Motor correlates of ADHD: contribution of reading disability and oppositional defiant disorder

This study investigated whether the likelihood of motor impairment in children with attention-deficit/hyperactivity disorder (ADHD) increases with the presence of other disorders, and whether the co-occurring diagnoses of reading disability (RD) and oppositional defiant disorder (ODD) account for the motor deficits seen in ADHD. A total of 291 children (218 boys, 73 girls) participated. Six groups of children were compared: ADHD only (n = 29); RD only (n = 63); ADHD and RD (n = 47); ADHD and ODD (n = 19); ADHD, RD, and ODD (n = 21); and typically developing control children (n = 112). Motor skills were assessed with the Bruininks-Oseretsky Test of Motor Proficiency and the Beery Test of Visual-Motor Integration. We found that the motor skills of the ADHD-only group did not differ from the typical control group. Furthermore, motor impairment in ADHD increased as a function of co-occurring disorders, and the presence of RD rather than ADHD predicted motor impairment.     

Models of deafness: cochlear implants in the Australian daily press

This article examined a database of Australian daily newspapers on the terms cochlear implant and deaf children to investigate how journalists and columnists report competing models of deafness: as either "medical" (deafness is a condition to be cured) or "sociocultural" (deafness provides a way of life to be lived). The results from the cochlear implant search favored a medical model, but the results from the deaf children search were more balanced, with a slight preponderance of articles favoring the sociocultural model. A number of representative quotes from articles in each model are provided and discussion entered into as to the possible effects of the articles on public reactions to deafness and especially hearing parental responses to the birth of a deaf child and the life choices that this event presents them.     

A compelling desire for deafness

A case is described of a patient who has a compelling and persistent desire to become deaf. She often kept cotton wool moistened with oil in her ears and was learning sign language. Living without sound appeared to be a severe form of avoidance behavior from hyperacusis and misophonia. She had a borderline personality disorder that was associated with a poor sense of self. Her desire to be deaf may be one aspect of gaining an identity for herself and to compensate for feeling like an alien and gaining acceptance in the Deaf community. Will a compelling desire for deafness ever become a recognized mental disorder one day for which hearing patients may be offered elective deafness after a period of assessment and living like a deaf person? Those working in the field of deafness should be aware that individuals may occasionally be seeking elective deafness or self-inflicting deafness to obtain a hearing aid.     

Stress and coping in families with deaf children

More than 90% of deaf children are born to hearing parents who experience stress, not only in respose to the initial diagnosis, but also in adapting to the unique needs of their deaf child. This article is a selective literature review summarizing information from three fields in order to broaden our understanding of family adaptation to deafness. Discussion includes (1) psychology's model of individual stress and coping (2) family science's model of family stress management, and (3) literature on family adjustment to disability. The last part of the article traces the development of professionals' understanding of the reciprocal influences between deaf children and their families and describes recent research indicating that the impact of deafness on families is complex and variable. The final conclusion is that adoption of a family stress and coping paradigm would inform discussion of current issues in deafness, such as cochlear implants and bilingualism/biculturalism.     

Substance use, substance abuse, and LD among adolescents with a childhood history of ADHD

A clinic-referred sample of 109 children with attention-deficit/hyperactivity disorder (ADHD) was followed into adolescence for the ascertainment of alcohol and other drug use and abuse. Learning disability (reading or math) in childhood was examined as a predictor of adolescent substance use and substance use disorder for alcohol and marijuana. No statistically significant group differences for children with LD versus those without LD emerged even after using different methods to compute LD. IQ/achievement discrepancy scores were similarly not predictive of later use or abuse. However, children with ADHD who had higher IQs and higher levels of academic achievement in childhood were more likely to try cigarettes, to smoke daily, and to have their first drink of alcohol or first cigarette at an early age. Children with ADHD who had higher reading achievement scores were less likely to have later alcohol use disorder. Although these findings are necessarily preliminary, due to the small number of children interviewed, the pattern of results suggests that level of cognitive functioning--rather than discrepancy between IQ and achievement--is important for the prediction of later substance use and abuse, at least in this clinic-referred sample of children with ADHD. Further, different mechanisms of risk related to cognitive functioning may be operating for experimentation with legal drugs such as alcohol and tobacco, regular cigarette smoking, and problematic alcohol use.     

Frequency of reading,math, and writing disabilities in children with clinical disorders

Learning disabilities (LD) are common in clinical disorders, but no study has compared the relative prevalence in referred children with different diagnoses. Our sample comprised 949 children (6 to 16 years). LD percentages were highest for bipolar disorder (79%), ADHD combined type (71%), autism (67%), ADHD inattentive type (66%), and spina bifida (60%). Children with oppositional-defiant disorder, adjustment disorder, anxiety, and depression had relatively low LD percentages (18–19%). LD in written expression was twice as common as LD in reading or math. Findings indicate that children with neurogenetic disorders should be assessed for possible LD because of the high potential yield and the need to intervene educationally if learning problems exist.     

The term comorbidity is of questionable value in reference to developmental disorders: data and theory

Over the last decade, there has been an enormous increase in the number of studies evaluating the overlap of developmental syndromes or disorders in both children and adults. This overlap of symptoms is often referred to as comorbidity, a term we criticize in this article because of its unsubstantiated presumption of independent etiologies. The premise of this article is that discrete categories do not exist in real life, and that it is misleading to refer to overlapping categories or symptoms as "comorbidities." We illustrate our point by presenting data from 179 school-age children evaluated with rigorous research criteria for seven disorders: reading disability (RD), attention-deficit/hyperactivity disorder (ADHD), developmental coordination disorder (DCD), oppositional defiant disorder (ODD), conduct disorder (CD), depression, and anxiety. Fully 50% of this sample met the criteria for at least two diagnoses. The children with ADHD were at higher risk of having at least a second disorder compared to the children with RD. Overall, the high rates of overlap of these behavioral, emotional, and educational deficits in this broadly ascertained sample support the idea that the concept of comorbidity is inadequate. We discuss the concept of atypical brain development as an explanatory idea to interpret the high rate of overlap of developmental disorders.     

In one's own image: ethics and the reproduction of deafness

The ethics of the use of genetic screening and reproductive technologies to select against and for deafness is presented. It is argued that insofar as deafness is a disability it is ethical to act in such a way as to avoid the conception or birth of children with genetic or congenital deafness. The discovery and recognition of signing deaf communities as cultural and linguistic communities (minorities) does not alter this basic ethical position, although the consequences of widespread application of this technology appears destined to lead to the eventual disappearance of these communities. The argument that acting to avoid deafness is unethical because it will lead to the elimination of a linguistic or cultural group (genocide or ethnocide) or conversely that acting to ensure deafness is ethical, if not praiseworthy, can only be sustained if deafness is not regarded as a disability at all. I argue that the premise that deafness is not a disability of some sort is false and thus the claim that genetic selection against deafness is unethical is untenable.     

Conversations between deaf children and their hearing mothers: pragmatic and dialogic characteristics

We examined communication between hearing mothers and their deaf or hearing children longitudinally at child-ages 22 months and 3 years. Specifically, we analyzed both the effects of child deafness and developmental change on pragmatic and dialogic characteristics of communication. From 22 months to 3 years, deaf and hearing children's communicative skills improved similarly along some dimensions: as they grew older, both deaf and hearing children increased the amount they communicated, became increasingly responsive to their mothers' attentional focus, and were responsible for initiating a higher proportion of the dyads' conversations. On the other hand, deaf children were less skilled at maintaining topics, and the pragmatic function of their communication was more likely to be unclear compared to hearing children. Deaf children were also more likely to direct their mothers and less likely to ask questions than hearing children. Communication by hearing mothers was primarily examined to determine the degree to which they controlled the interactions. Overall, mothers of deaf children were only more controlling along one dimension. Mothers of deaf children used more response controls than mothers of hearing children. However, the majority of measures suggested they did not exert more topic or turn-taking controls than did mothers of hearing children. In addition, mothers of deaf and hearing children seemed equally sensitive to their children's communication abilities. Communication by mothers of both deaf and hearing children changed in similar ways as their children developed. Most of the differences in communication by mothers of deaf and hearing children seemed attributable to the deaf children's linguistic delays. The results suggest that intervention efforts should be focused on fostering linguistic development and not general communication skills or changing maternal conversational control.     

Central auditory processing ability in children with ADHD with and without learning disabilities

A few studies have shown more central auditory processing deficits in children with attention-deficit/hyperactivity disorder (ADHD) than in nondisabled children. Because these studies failed to screen participants with ADHD for learning disabilities (LD), it is not clear whether these deficits are correlates of ADHD or LD or both. In the present study, the central auditory processing ability of children with ADHD, ADHD with LD, and no disabilities was examined. Results indicated lower central auditory processing ability, and significant correlations between reading and ADHD symptoms and reading and central auditory processing ability in the ADHD with LD group compared with the other two groups. These findings suggest that central auditory processing deficits are more likely to be associated with LD than ADHD.     

Attitudes Toward Deafness and Security of Attachment Relationships Among Young Deaf Children and Their Parents

This study investigated deaf children's "security of attachment" relationships with their hearing parents and the relationship of parental attitudes toward deafness. Subjects included 30 deaf children and their hearing parents. The children ranged in age from 20 to 60 months. Instruments used included the Attachment Q-Set, the Attitudes to Deafness Scale, and parental interviews. As a group there were no differences between security of attachment scores of deaf children toward either of their parents; however, there were marked differences within individual dyads of mother-child/father-child relationships. In addition, negative correlations were found between parents' attitudes towards deafness scores and their deaf children's security of attachment scores. Implications for the field include the importance of inclusion of fathers in attachment studies and fathers' active participation in early intervention programs. The relationship between parental attitudes toward their children's disability (deafness) and attachment relationship provides further evidence for the critical role of early intervention in the development of children with special needs.     

Drawing insight from pictures: the development of concepts of false drawing and false belief in children with deafness,normal hearing,and autism

Theory-of-mind concepts in children with deafness, autism, and normal development (N = 154) were examined in three experiments using a set of standard inferential false-belief tasks and matched sets of tasks involving false drawings. Results of all three experiments replicated previously published findings by showing that primary school children with deafness or autism, aged 6 to 13 years, scored significantly lower than normal-developing 4-year-old preschoolers on standard misleading-container and unseen-change tests of false-belief understanding. Furthermore, deaf and autistic children generally scored higher on drawing-based tests than on corresponding standard tests and, on the most challenging of the false-drawing tests in Experiment 2, they significantly outperformed the normal-developing preschoolers by clearly understanding their own false intentions and another person's false beliefs about an actively misleading drawing. In Experiment 3, preschoolers outperformed older deaf and autistic children on standard tasks, but did less well on a task that required the drawing of a false belief. Methodological factors could not fully explain the findings, but early social and conversational experiences in the family were deemed likely contributors.     

A developmental index using the Wechsler Intelligence Scale for Children: implications for the diagnosis and nature of ADHD.

The possible utility of Wechsler's Deterioration Index (WDI) in analyzing children's Wechsler Intelligence Scale for Children-Revised (WISC-R) results was explored in this study. Clinical records of children with learning disabilities (LD) and children with attention deficit-hyperactivity disorder (ADHD) were reviewed to determine if the WDI predicted the presence or severity of the disorders. The ages of the children ranged from 6 to 14. In two independent samples of children with LD (n = 35 and n = 26), the WDI did not predict LD status or severity. The LD samples were mostly male--85% and 57%, respectively. However, the WDI scores did significantly distinguish children with ADHD (n = 10) from nondisabled children (n = 10). The results were cross-validated on an independent sample of children with ADHD (n = 17) when compared to non-ADHD children (n = 22) who experienced significant behavioral difficulties. The ADHD samples were also mostly male--90% and 89%, respectively. The WDI classified only 59% of the children with ADHD and 86% of the non-ADHD children correctly. It is recommended that the WDI be considered a developmental index rather than a deterioration index in children. It is also recommended that significant WDI elevation (greater than .20) be considered to raise the question of ADHD, rather than simply yielding a diagnosis of ADHD.     

A school-based P.G.C.E. course: Problems and possibilities

This article explores the practice of local mainstream inclusion for deaf children and the issues this raises for pupils and teachers. Problems with both academic and social inclusion, due to difficulties with communication, are identified. It is suggested that sometimes deaf children may be excluded from educational and social opportunities by being included in local provision. Resourced provision may offer greater opportunities for inclusion. If schools are including deaf children on an individual basis then this has implications for resources, training, professional liaison, the monitoring of progress and a change in attitude towards deafness and deaf people.