Psychological Testing of Deaf Children: A Brief Comparison of Services and Viewpoints

by Anonymous

As a doctor holding a Ph.D. in school psychology who has previously specialized in assessment of the intellectual and educational abilities of children, I have learned much about the importance of, and make every attempt to utilize, cultural sensitivity when assessing students who have been referred for evaluation who are outside of the mainstream culture. However, this importance is typically emphasized for children who are ethnically diverse – my own expertise falls within the cultural sensitivity needed when assessing Hispanic students and Native American students, as I live in the Southwest United States – and students who identify as LGBT+. There has been very little emphasis in my training on assessment of Deaf children beyond a brief mention of the Individuals with Disabilities Education Act (IDEA) special education categories of “hearing impairment,” “deafness,” and “deaf-blindness.” I obtained my degree in 2016 and have practiced within the field since then, so I have believed that I am fairly up-to-date in my knowledge of current research within Psychology. However, since I am learning about Deaf culture via learning ASL, I am surprised that deafness has been relegated to a disability that requires sensitivity in assessment, rather than a cultural difference. Therefore, I decided to compare and contrast a Guidelines paper which discusses current Best Practices in psychological assessment of Deaf and hard-of-hearing students (from the Illinois Service Resource Center), and a chapter in Harlan Lane’s excellent book decrying the disabling of the Deaf community (The Mask of Benevolence) which discusses psychological assessment, titled “Audist Psychology of the Deaf” (pp. 50-66).

Lane’s description of psychological assessment of the Deaf is bleak and asserts that most, if not all, assessments in this field are invalid. The basis of the argument that they are invalid is that these assessments are typically administered in English, which is a second language at best and potentially a completely foreign language to the Deaf person who is fluent in ASL. (This would be comparable to administering an intelligence test in English to a hearing student who speaks only Spanish. The problem is that the assessment ceases to become a valid assessment of the student’s abilities and instead becomes a measure of their understanding of the English language. Hence, it is now widely understood that IQ tests may drastically underestimate the intelligence of students who do not understand or speak English, and that tests must be given in that student’s native language.) Lane describes the heartbreaking stories of several people who, in the mid-1900s, were institutionalized with the severely intellectually disabled because they were unable to communicate in English and were therefore assumed to have severe intellectual deficiencies (p. 53). In one instance, a child was estimated to have an intelligence quotient (IQ) of 30, and she was assessed years later to discover that her IQ was actually near typical. IQ tests have a mean (average) of 100 and a standard deviation of 15, so her intelligence was underestimated by 70 points, or 4.5 standard deviations. This profound underestimation did untold damage and prevented her from living a rich and varied life. Lane asserts that these damaging assessments underestimate all Deaf people’s abilities and push an agenda of deafness-as-disability rather than deafness-as-culture. He also discusses the use of personality and projective assessments and their damaging use in asserting that Deaf people are more often labeled as emotionally disturbed or disabled than their hearing peers (p. 63). This includes a scathing indictment of the Thematic Apperception Test (TAT), the Rorschach, and the Minnesota Multiphasic Personality Inventory (MMPI). He concludes that these assessments are paternalistic in nature and frankly inappropriate for use with the Deaf community, particularly in research and decision-making, unless “Deaf people themselves [are involved] at all levels of the undertaking” (p. 66).

In the above book, it is important to note that it originally was published in 1993 and was revised in 1999. Luckily, at this point in time, personality assessments (such as the MMPI) are not frequently used in the school setting, and projective tests (such as the TAT and the Rorschach) have been widely discredited as lacking an evidence base; they are officially not recommended for use in decision-making assessments for any populations within the school setting. Therefore, his very valid complaints about these assessments have been noted. When examining the Guidelines for Psychological Testing of Deaf and Hard of Hearing Students, it does appear as though some of his concerns have also been noted in the official literature. However, it is quite obvious that an audist and disability-centric theory of Deafness is utilized within these Guidelines. For example, a glaring note within the first few pages of these guidelines indicate that Deafness is very much still seen as a disability within education: “The psychologist should consider the impact of language acquisition and development, over time, keeping in mind that deafness is a disability of communication” (emphasis included in original text; p. 2). It then states that this “disability” impacts receptive and expressive communication, incidental learning, abstract reasoning skills, relational skills (perspective taking, empathy, social skills) and concept of self/other/world, amongst other things (p. 2). However, the guidelines then state that the evaluator must use the Deaf individual’s preferred mode of communication, which may include “ASL, CASE, SEE, speech, lip reading, writing, pantomime, gesture, and speech” (p. 3). Therefore, it is at least recognized that English is not the primary method of communications for most Deaf and hard-of-hearing children.

Other statements from the Guidelines seek to educate the evaluator using statistics of the perils that Deaf and hard-of-hearing children face in mainstream classrooms. For example, it is clearly stated that “the benefits of speech reading and hearing aids are often overestimated” (p. 3); that most deaf children likely understand 5% or less of what they attempt to lip-read; and that “Fewer than 10% of families are able to communicate fluently [via ASL] with the individual who is deaf” (p. 3). It also states the importance of modifying test administration or instructions with Deaf or hard of hearing students, utilizing qualified interpreters when the evaluator is not fluent in the student’s native language, and making sure that the student understands the task (p. 4). It gives various instructions on how to simplify complex sentences, use synonyms to help the student understand intent, and minimizing auditory and visual distractions within the room (p. 5). It also clearly states the following: “The use of standardized tests to determine the cognitive abilities, academic achievement, and mental status of people who are deaf or hard of hearing may result in inaccurate or misleading test results. Few tests have been normed on deaf or hard of hearing individuals…Misdiagnosis can follow an individual throughout his/her lifetime” (p. 4). Specific guidelines then follow, such as choosing an appropriate assessment, qualifications of the interpreter and evaluator, and a list of suggested instruments.

This comparison seems to fall under the general consensus that currently exists within the field of assessment in Psychology: Standardized assessments are problematic for a variety of reasons and often underestimate the abilities of those who are not a part of the dominant culture, but they’re all we have, so we use them anyway in a careful manner and (hopefully) do not rely on them for educational and legal decision-making. I had subscribed to this notion myself and attempted to be nuanced in my assessments. However, upon starting my foray into learning ASL and learning more about the Deaf community, I realize the tremendous short-sightedness and audist nature of this (and therefore my) viewpoint. The Guidelines made no mention of Deaf culture or of the Deaf community and chose to view deafness as a “communication disability” rather than a different culture. It is imperative to not do harm to Deaf children through our flawed use of assessment within the educational system. Gaining further knowledge is the first step in advocacy, so I look forward to continuing to gain knowledge about this cultural group and hopefully becoming an ally to help advocate for Deaf rights and awareness.

Works Cited

Lane, Harlan (1999). The mask of benevolence: Disabling the deaf community. Dawn Sign Press: San Diego, CA.

Illinois Service Resource Center (2011). Guidelines for psychological testing of deaf and hard of hearing students. Retrieved from http://www.isrc.us.