Social adjustment is an important overall goal for all children with multiple disabilities. Concerns about social adjustment have become particularly complex and intermingled with controversy over oral versus manual approaches for children with hearing impairments. Maximizing speech reception and production is sometimes considered a key to entering the mainstream of society. Some people believe that individuals with significant hearing impairments will always be at a disadvantage in a “vocal society,” but they can become fully functioning members of a “signing society” and so should be encouraged to develop the skills for which they have the greatest potential. Because children with multiple disabilities typically encounter difficulty with acceptance among either group, regardless of their predominant communication mode, this controversy may seem moot, but it does point out the general importance of communication skills for acceptance in either group. Undoubtedly, functional communication skill training in realistically available environments is a major factor in social adjustment.

Self-stimulating behaviors producing auditory feedback (sometimes called “deafisms”) are common among children with multiple disabilities including hearing impairments. Rather than attempting to suppress this behavior, intervention should be aimed at developing more suitable behavior and replacing inappropriate stimulation with more fitting auditory input.

No aspect of educational inclusion has been as controversial as the education of students with severe hearing impairments. Although inclusion with students who can hear typically improves social adjustment in the general community (e.g., Esposito & Koorland, 1989), difficulty with speech as the primary method of communication typically leaves individuals with hearing impairments at a disadvantage. Within the deaf community, however, the relevance of speech is vastly diminished, and the individual who is deaf can be a fully functioning member of this vital community. Thus, some individuals view inclusion as pushing children toward adult roles as second-class members of the hearing community and depriving them of the opportunity to develop into first-class members of the deaf community. Ideally, individuals who are deaf should develop the skills that allow them to fully adjust to both communities and permit free choice and easily movement between the deaf community and the hearing community. Unfortunately, only a few individuals seem to achieve this and difficult choices are often necessary in educational planning. this issue may be less relevant to children with multiple disabilities who are deaf because their other disabilities often interfere with the acquisition of a common alternative language (e.g., ASL) and make their inclusion in the deaf community as complex as their inclusion in the hearing community. An assessment of social adjustment and communication development may provide useful data for guiding decisions regarding integration for these individuals. As a rule, the community, age-appropriate, natural environment should be considered the best educational environment. Nevertheless, contact with other individuals who are deaf should be encouraged, and ASL or an appropriate, commonly used alternative should be taught whenever possible through bilingual and bicultural education (Reiman & Bullis, 1989). If social adjustment to the deaf community and nonspeech communication skills are developing at a rate that suggests the individual may adjust better to the deaf community, this choice should be encouraged.


References

Esposito, B.G., & Koorland, M.A. (1989). Play behavior of hearing impaired children: Integrated and segregated settings. Exceptional Children, 55, 412–419.

Reiman, J.W., & Bullis, M. (1989). Integrating students with deafness into mainstream public education. In R. Gaylord-Ross (Ed.), Integration strategies for students with handicaps (pp. 105–128). Baltimore: Paul H. Brookes Publishing Co.