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Mental Impairment and the Deaf:  

By Scott Janczak

Mental Impairment and the Deaf

There are some individuals who not only live in a silent world, but are also diagnosed with neurological impairments such as Down syndrome.  Each year roughly 3,000 to 5,000 children are born with Down syndrome in the United States.  According to research, of those children born with Down syndrome; sixty to eighty percent of them are born with some type of hearing deficit according to Dr. Siegfried M. Pueschel. 

Dr. William I Cohen states that "Individuals with Down syndrome may have sensorineural loss, conductive loss related to otitis media, or both. Small ear canals are also associated with this syndrome." (Cohen) 

 Besides Down syndrome, many other mental impairments have been associated with deafness, including mental retardation and autism.  In 1999, the department of Audiology in Stockholm, Sweden conducted a study on 199 children: 153 boys and 46 girls.  These children were diagnosed with autism and the test was used to measure their audioligcal levels.  The test yielded the following results:

 "Mild to moderate hearing loss was diagnosed in 7.9% and unilateral hearing loss in 1.6% of those who could be tested appropriately. Pronounced to profound bilateral hearing loss or deafness was diagnosed in 3.5% of all cases, representing a prevalence considerably above that in the general population and comparable to the prevalence found in populations with mental retardation. Hearing deficits in autism occurred at similar rates at all levels of intellectual functioning, so it does not appear that the covariation with intellectual impairment per se can account for all of the variance of hearing deficit in autism. Hyperacusis was common, affecting 18.0% of the autism group and 0% in an age-matched nonautism comparison group. In addition, the rate of serous otitis media (23.5%) and related conductive hearing loss (18.3%) appeared to be increased in autistic disorder. The study emphasizes the need for auditory evaluation of individuals with autism in order to refer those with pronounced to profound hearing loss for aural habilitation and to follow those with mild to moderate hearing loss because of the risk of deterioration."

          As with autism and Down syndrome, individuals diagnosed as mentally retarded are also at risk of increased rates of hearing loss.  In fact there is a rare disorder called DOOR syndrome (Deafness, Onychdystrophy, Osteodystrophy, and Mental Retardation) which not only leaves the individual Deaf and mentally retarded, but also affects their nails and phalanges on their hands and feet and can also lead to seizures.

          Individuals who are born with mental impairments along with hearing problems face a difficult struggle each day in an attempt to communicate with others around them.  While many of them are able to learn sign language, it is not of much benefit to them unless their caregivers also are able to use sign language.  Unfortunately, there are also some individuals who function
at such a low level mentally that they are unable to learn sign language and depend on basic hand gestures.  Perhaps even more tragic is the fact that many individuals who are born with a mental impairment along with hearing problems aren't tested for possible hearing loss.  These people fall behind and in many cases by the time they are diagnosed as having a hearing loss, they are unable to fully grasp sign language.

          I have seen all of these cases first hand while working at Southeast Works, an organization that provides residential housing, employment opportunities, recreational events, and the support needed for individuals born with mental impairments.   I work directly with individuals who are diagnosed with mild to moderate mental retardation, autism, and down syndrome; and a few of our consumers (individuals within the agency) have hearing loss as well.  As an agency, we have ten residential houses and one of them is devoted strictly to those with Down syndrome and of the six individuals living there, three of them are Deaf.  We also have four other individuals within the agency who are diagnosed as mentally retarded as well as Deaf.  In fact, these individuals are the reason I decided to take a sign language class, so that I will be able to understand them and better meet their needs.  When I first started working at this agency I noticed that there were a few individuals walking around with little picture books.  They would come up to staff and point to a picture in their book in hopes that staff would understand what they were asking for or needed.  While these books seemed to work very well for the consumers, it only met a small aspect of their needs.  The book covered the basics of daily living; it contained pictures of a toilet, food, beverages, a bed, and a couple of other life necessities.  However these books didn't help when the consumer wanted to ask you how your day was, or if there was something bothering them and they wanted to talk about it.  It was easy to see the frustration on the consumers' faces when all they wanted to do was communicate with you on a personal level, but was unable to because of a sign language barrier.  Many of these individuals knew sign language, but it didn't help them because the staff around them was unable to understand it. 

          One of the main frustrations that I have observed seems to affect those that are diagnosed with a mental impairment and deafness, over those that are just Deaf, is the ability to comprehend why you can't understand them.  When working at coffee shop some years ago, we had a customer who would come in at least four times a week.  The customer was an older Deaf lady and was very understanding of our communication barrier.  Contrast that to the consumers at my work place who have a hearing loss and don't quite have the cognitive ability to realize why you are having a difficult time understanding them.  They quickly become frustrated and angry with you because you are unable to response to them and they don't quite comprehend why. 

After doing research for this paper, I was discouraged by the lack of information available on those individuals who are Deaf and mentally impaired.  While I was able to find many individual stories on people living with both impairments, it was difficult to find information on education, treatment, and life skills for these individuals.  I can only imagine how frustrating it must be for a parent of one of these children who may be trying to find information on their child's diagnosis.  Although we have come a long way in the past few decades in the diagnosis and treatment of these impairments, there still is a long way to go to allow these individuals to live a fulfilling life that they deserve.

Works Consulted:

Berke, Jamie. (2010, Sept. 29). Deaf History - Deaf, Not Retarded: When Misdiagnoses are Made, Everyone Pays. Retrieved 1, Aug. 2011: <>

Berke, Jamie. (2010, Feb. 2). Deafness and Intellectual Disability: Hearing loss Plus Intellectual Disability. Retrieved 1, Aug. 2011:

Moss, Kate. (1998, Summer). Hearing and Vision Loss Associated with Down Syndrome:  Retrieved 6, Aug. 2011:  <>

Mueller, Sandra. (2010, Oct.). Mental Illness in the Deaf Community: Increasing Awareness and Identifying Needs. Beckner, Chrisanne, Sacramento News & Review. Retrieved 3, Aug. 2011:

Sipsy, Melissa. (2009, Apr. 6). Mental illness in the Deaf Community: Retrieved 3, Aug. 2011: <>

Unknown Author. (1999, Oct. 25). Autism and Hearing Loss: Retrieve 4, Aug. 2011: Journal of Autism & Developmental Disorders. <>

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