Social Work

Early Childhood

Newborn Hearing Screening laws that require a hearing screening of newborn infants before leaving the hospital have led to an increase in early identification of deafness. Infants, whose hearing level is identified at the screening, are enrolled in Early Intervention programs provided through statewide Early Hearing Detection and Intervention (EHDI) programs. Individual Family Service Plans (IFSP) often include social work services to assist families with communication choices, processing the impact of the child’s deafness, awareness and acceptance of Deaf culture, identification of resources, and strategies to ensure healthy social emotional development.

Parental expectations impact children’s self-esteem and family functioning. Some parents may feel sorry for their child and will either lower their expectations, give in to the child’s desires, or both. These approaches can foster a state of learned helplessness, as well as poor self-regulation. Another potential impact of parental expectations occurs when children receive a cochlear implant and parents expect that their child will function like a hearing child. When this does not happen, the parent’s disappointment may impact the child’s self-esteem. Parents may experience a sense of grief over the loss of their dream of the “perfect child.” Social work support helps parents as they move through the stages of loss and grief.

Language development is an important issue within the context of social emotional development. Social workers can assist parents in their awareness of this issue. Language is critical to communicate needs, engage in social interactions, learn social skills, and develop self-advocacy skills. Social workers encourage the development of a common language, help parents access available resources, and educate them on misconceptions related to communication, such as lipreading.

Social workers encourage parents to externalize inner thoughts to their child in order to facilitate language development and critical thinking skills. They can utilize visual strategies (e.g., social narratives or picture schedules) to help parents teach social skills and expectations to their children. Social workers educate parents on strategies to promote self-advocacy at a young age, such as providing choices and encouraging the child to make decisions.

Parental acknowledgement and acceptance that their child is deaf provides a foundation for the child’s development and learning. Parents need to be aware of the negative impact if their child does not develop a sense of identity at an early age. As the child moves along the continuum from childhood to adolescence to adulthood, there can be a struggle to fit in and get along. There may be a sense of being forced to conform to the hearing world, a struggle between the hearing and Deaf worlds, or a sense of not fitting into either. Families may be in denial about the impact of being deaf, or not accept that the child is deaf. Even a child with a successful cochlear implant, who is completely oral and has strong lip-reading skills, is still deaf when the implant is turned off. Social workers use a strength-based approach with families to address these issues. Social development and self-esteem are highest in children who have families that demonstrate acceptance, regardless of the selected communication option.

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