Culturally responsive adaptations to trauma identification and treatment with deaf and hard of hearing youth

Traumatic experiences occur often in the lives of children and adolescents; in fact, up to two-thirds of experience at least one or more traumatic events before adulthood. For children and adolescents who are d/Deaf or hard or hearing (DHH), research suggests that rates of interpersonal abuse, including sexual abuse, physical abuse, domestic violence, and bullying, are much higher than that experienced by hearing counterparts. Available literature discusses trauma symptom presentation and effective therapy practices with DHH adults, but little description is available regarding DHH children and adolescents. Nineteen Deaf Mental Health Care (DMHC) providers completed a 29-item Demographic Survey and responded to 17 semi-structured interview questions regarding their conceptualizations of trauma within DHH child and adolescent populations, their perspectives on client presentations and contributing factors, and their approaches to trauma identification and treatment. Using a Grounded Theory approach to data analysis, this study explored overall results as well as comparisons and contrasts between participants. Fourteen themes emerged as findings to this study, and within each theme, cultural differences between deaf and hearing participants were explored. Overall findings include: participants’ identification of communication and familial isolation experiences as highly traumatic, various indicators of trauma within cognitive, behavioral, affective, interpersonal, intrapersonal domains of functioning, and clear preference for the clinical interview as a trauma identification tool. Deaf specific findings include: emphasis on behavioral-physical indicators of trauma and emphasis on treatments that include important development of decision-making, and personal agency. Hearing specific findings include: emphasis on degree of interpersonal struggle. Limitations and future directions are discussed.