Did you see that Channel 4 item doing the rounds on facebook (and that apparently ended up on Russell Howard’s Good News last week) of the deaf guy in Uganda with no language until someone set up a signing course in his village?

 

It really upset me – because I can name 11-12 year olds from Cornwall, Devon, South Wales, Dorset, and Surrey for whom the exact same situation applies and we don’t get the luxury of blaming it on a Third World country.

It exists here because of ignorant hearing people with power making ignorant decisions that result in tangible harm. So… the argument is this:

• People, babies, hearing, deaf, learning disabled or not, require LANGUAGE to mediate their thoughts and understand and articulate their needs. 
• To develop a language you require considerable access to a rich language environment. 
• An accessible rich language environment is not a Teaching Assistant with Level 2 BSL. It is not a parent learning Cued Speech. It is not Sign Supported English if your audiometry compromises your speech perception. It is not Makaton. 
• A rich language environment for a deaf person is one in which they may immerse in a fully visual evolved and true language. In the UK that is BSL. 
• People in early developmental stages of language require a language environment comprising HIGH QUALITY language. Not language at a similar level to that at which they currently sit. A Level 1 signing kid requires a Level 6 BSL environment not a Level 1 one. A deaf person with learning disabilities requires a Level 6 BSL environment not Makaton. 
• OK sometimes resources preclude this, but this is the target acceptable context. Care Plans and Statements of Educational Need must state this as the aim and explain why it was not met, rather than aim low so the aim can be met regardless of the developmental harm to the individual. 

 That is it. And I challenge anyone to successfully argue otherwise.

 I had to do a quick piece on ASD and deaf children.

Autistic spectrum disorders are a constellation of difficulties typically involving communication, imagination and socialisation.

Deaf students often have other difficulties alongside of their deafness because the cause of the deafness also causes the other difficulties. Causes such as meningitis, rubella embryopathy, or prematurity. Autistic Specturm Disorder (ASD) is precisely one such difficulty.

The big difficulty is that communication and socialisation problems are often consequences of deafness (notably for the 90% of deaf children in hearing non-signing families) – and they are also hard to assess using tests based on hearing norms or if you are a non-signing deafness-naïve assessor - so it is very difficult to distinguish autistic traits from the consequences of the student’s sociolinguistic context in the home and during the early years at home and mainstream school.

There are specific deafness-related aspects of autism and ASD assessment that naïve assessors would never know. For example certain linguistic “tells” in English – such as mixing up pronouns (you and me) for example – in BSL can be far more common placement errors rather than the rare difficulty found in speech.

I am Dr Jim Cromwell MA(Hons) PsychD CPsychol AFBPsS and I am a Chartered Clinical Psychologist at the Exeter Royal Academy for Deaf Education and Associate Fellow of the British Psychological Society. I have been a Trustee and Chair of the British Society for Mental Health and Deafness, am a Level 4 signer and qualified BSL/English Sign Language Interpreter. I have worked with deaf people since 1988. 

I have been asked to provide an expert opinion on the role of valid opportunities for true socialisation for deaf children and young people. 

In addition to academic success, the critical variable contributing to developing into a well-adjusted adult is identity formation during adolescence, and for deaf people (particularly those born to hearing parents) that involves progressing through the following stages: 1) Culturally Hearing, 2) Culturally Marginal, 3) Immersion in the Deaf World, and 4) Biculturalism. Adolescence in particular is a trial at the best of times, as young people have to negotiate the complex soap opera of adolescent social lives and networks. Communication difficulties can be an enormous barrier to this development and even subtle communication difficulties can make this development extremely difficult. The only way in which this development, this maturity, can proceed is in the context of deaf peers. Age-peers with similar struggles and conflicts, experiences and solutions. 

Deaf young people require a social context in which they feel they belong, and not where they are merely included and presumed to be equal. For deaf adolescents, whose eyes are unproblematic and whose ears are not, that belonging is amongst people who communicate visually (British Sign Language) and who have experienced similar difficulties commonly experienced by deaf people – being a linguistic minority, struggling with day-to-day communication barriers, not sharing a common language with one’s parents, isolation, a distorted and sometimes negative perception of their future, extremely limited knowledge of things that hearing young people pick up incidentally on TV, overheard conversation, and gossip and so on. 

Direct teaching and PSHE, and parental advice, goes some way towards preparing young people for adult life, but that only provides the seeds of knowledge which only becomes deeper and more finessed on a day-to-day basis rubbing shoulders with, and sharing one’s concerns with, like-minded individuals in similar circumstances. That cannot and does not happen for deaf young people deprived of the opportunity to mix with their peers to a comparable level as hearing adolescents can with theirs. 

Deprived of such an opportunity, deaf people often fail to develop an integrated sense of self. They often fail to develop a meaningful and significant sense of belonging in society and gain only a poor understanding of social rules, mores, and responsibilities. They feel isolated, oppressed (albeit perhaps tacitly), and disenfranchised. This combination leads to a highly increased probability of mental health problems, poverty, and civil and criminal offences. Compounding this problem, prosecutions of deaf people are often not followed through for minor offences – because of the technical difficulties of booking PACE interpreters and a desire not to disadvantage the disabled person. No deterrent effect is therefore in place, offending increases until it cannot be ignored, and the deaf person ends up in prison where they cannot access the rehabilitative programmes that they must complete to be considered for parole. 

This is a highly damaging cycle for the deaf person as well as, of course, for society at large. However there is a preventive solution, and that is to absolutely maximise the deaf young person’s opportunities for social development and maturity in a context of like-minded individuals with visual language.

Today I realised a handy thing. "Priority" is not a nominal construct - It is ordinal.

That is, "Priority" is not a label that can be applied to a task (or a bunch of tasks, or - like the reason why I realise this today - all tasks.) A task can only take priority over other tasks (and perhaps not over others). It is to do with ordering tasks.

So if somebody says "Can you make this a priority?", the question must be "A priority over what?" Otherwise it is meaningless.

I had a realisation today which I am deeply embarrassed to have taken twenty five years to figure out. However, it's worth sharing.

I happened to walk past a hearing person using their voice (plus signs) with a deaf boy who admittedly likes you to do that. He replied using speech which, to be blunt but accurate, was not understandable. I realised that since there is nothing wrong with his mouth, tongue, lips, jaw, vocal chords etc, the parts of his speech that are missing or indistinct are missing or indistinct because he cannot hear either other people making them or himself trying to make them.

No shit, Sherlock. Well, indeed. As I say: feel a bit foolish.

I checked this hypothesis out and it turns out that deafened people's speech, people who were hearing and had perfect speech patterns, lose parts of their own speech in a pattern that exactly reflects their hearing loss (of course!)

Therefore, hearing people can get a VERY good idea of what their own speech sounds like to a particular deaf person, by paying attention to the voice of that deaf person, and that can be an enormous help in reminding you of the need, sometimes, to stop relying on it.

I was asked to write a bit of a biog and, in case I need one in future, I'm leaving it here.

I am profoundly hearing. From many generations of genetically hearing people.

I decided to go to university to study English, but did not plan very well, only applied to universities with beaches, and ended up in St Andrews (three beaches!) where I discovered that in Scotland you study three subjects, not one…! Erk. I followed someone into Psychology, so started doing that. (I followed someone into Logic and Metaphysics as well, but there’s no jobs in that…!) During holidays I had a job doing care work with children with physical and learning disabilities – but the home closed down and they suggested I try RNID Poolemead for bank work.

So I randomly began studying psychology and working with Deaf people in 1988.

I worked mostly with a prelingually profoundly deaf, culturally Deaf man in his mid-twenties, who lost his sight in late teens. He was amazing. Really clever, and clearly not someone I could usefully communicate with, with my RNID-BSL that consisted entirely of TEA, TOILET, NO, and THANK YOU. So I learned Deaf-Blind manual to communicate with him, slowly, and he taught me a lot of BSL. He even taught me ASL fingerspelling one day, when I knelt in front of him doing DBManual on his left hand while he showed me the corresponding ASL on his right. I’ll never forget that.

Seemingly, he also had schizophrenia, though I do not remember any actual mental health input or a coherent assessment or treatment plan. Maybe there was one, but it was not evident to me at that time. And it was that that made me decide that English was going to get me nowhere interesting, but if I pursued the psychology and the BSL I could keep doing this work I was really enjoying – but better and more effectively! So I carried on with the psychology and the holiday work at RNID, informally getting up to about CACDP Stage 1 (the olden days!), then spent a couple of years trying to get into clinical psychology training – which means I needed broader experience, so left the RNID and worked with elderly people for one year and learning disabled people for another – all hearing.

Then I managed to get into Surrey University to do Clin Psych. It could have been anywhere, but I landed a place at Surrey, which covered Springfield Hospital – one of only two Deaf adult mental health services at the time. Again – purely random luck. At Surrey I did a lot of work (as much as they would let me) on Deafness and mental health, including interpreting in therapy and prevalence research, and arranged one of my specialist placements to be at Springfield with Sally Austen.

Third piece of random luck – Sally resigned two months before my placement was due to begin and about one year before I graduated with my doctorate and obviously fairly strong and unique qualifications for her job. She agreed to supervise my placement at Springfield despite working elsewhere (thank you Sally!) and that meant that I had six months to work in the one job I wanted in the UK (I didn’t fancy Denmark House), at a time when they were dealing with their only psychology job being vacant. Frankly, if I couldn’t get the job after that, I couldn’t get it at all.

I did.

So I began working at Springfield full time in 1997, where I worked for the inpatient and community teams, as well as seeing a lot of outpatients, for the whole range of mental health problems from spider phobia to full-blown florid psychosis. Because of the RNID experience I quickly got the Stage 1 BSL certificate, and then over the years achieved Stage 2, Level 3, and Level 4. When I was Stage 1, I used interpreters, but it was never very satisfactory. During the first half of my Stage 2 course I mentioned this to Herbert Klein (during a lunchtime where I was happily and effectively sat talking to a deaf man (Herbert) about complicated mental health issues without an interpreter…!) He pointed this out and suggested I try without an interpreter (with the patients’ consent). I never used an interpreter in therapy again – and the work was entirely more effective, and the therapeutic relationships considerably more meaningful. I would add that later on, when I had Level 4, I would supervise Deaf signing clinical psychology trainees like Jo Atkinson and Sara Rhys Jones, and it was obvious from talking to them that they were able to do even better therapy than me, despite my experience, because they were Deaf. (Though of course, they are also brilliant, which helps.)

In 2007 I left the NHS, and London, to move to Devon, where I completed the NVQ4 BSL-English Interpreting qualification. I hoped to make a career of interpreting, but the Exeter Deaf Academy captured me in a big net and made me feel sufficiently guilty to return to psychology at the Academy.

I’ve been at the Academy since then, providing clinical psychology services to the school and college, doing direct and indirect work, as well as supervising the BSL counsellors. It’s easy for me to say, but I think the interpreting NVQ is a vitally important qualification to have if you work, as a hearing person, in BSL. Particularly in education. This is because it teaches you to think about the nature of language and culture in a way that is necessary to fully understand what BSL is, why it is important, why it differs from English, why SSE feels meaningful when it isn’t, and how BSL grammar evolved to be what it is.

I occasionally add to my Peripheral Brain website, about deafness and mental health. I also facilitate a peer supervision group for senior interpreters. I do very little research because I am opinionated about the piles of bad research that hide the good stuff, and am too obsessional to be able to actually produce good stuff. But I am a great reviewer of research, which I do quite a lot, and I contribute in various ways to other people’s research in the area.

That’s probably it. Narcissistic ramble over.