Journal of Deaf Studies and Deaf Education Advance Access originally published online on April 8, 2008
The Journal of Deaf Studies and Deaf Education 2008 13(3):454; doi:10.1093/deafed/enn004
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Deafness and Challenging Behavior: The 360° Perspective
Northern Illinois University
S Austin and D Jeffery (2007). Deafness and Challenging Behaviour: The 360° Perspective. West Sussex, United Kingdom: John Wiley & Sons.328 342 pages. Paperback. $60.00.
In the preface to this volume, editors Sally Austen and Dave Jeffery note that "... communication is the key to large parts of the cause, prevention, and resolution of challenging behavior" (p. xii). It is this tenet that forms the philosophical framework for a compendium of information about the "... diagnosis, cause, prevention, and management of challenging behavior in deaf people" (p. xii).
The opening chapter of this edited volume begins with stories told through interviews with two "service users" (patients or clients). One describes the pain of forced restraint and years of sedation endured in hospitals equipped only to serve hearing people, followed by transformation and progress which began when he was finally placed in an appropriate program with specialized services for deaf people. The second speaks of years of violence beget in a misguided attempt to avoid the boredom of living without communication. This service user speaks of years of (over) medication that left him so sedated that he developed painful bedsores. His epiphany came through a hearing interpreter who served as a catalyst for his eventual recovery. In both these accounts, the service user speaks of the absence of communication both in the family of origin and in ineffectual treatment programs.
The contributed chapters that comprise the body of this volume cover a wide range of topics gathered into four groupings, including an introduction to the topic of deafness and challenging behaviors, a section focusing on the etiology of challenging behaviors, a section on managing challenging behaviors, and a unique section which focuses on forensic issues, including deaf people in the criminal justice system. Individual chapters focus on diverse issues such as the effect of violence and violent behavior on caregivers; challenging behavior in children; neuropsychological, behavioral, and linguistic factors contributing to challenging behaviors; psychodynamic approaches to managing challenging behaviors; autistic spectrum disorders; challenging behaviors in older adults; restraint and other methods of de-escalating behavior; the role of deaf staff and interpreters in managing challenging behavior; social skills improvement as a tool for managing behavior; and risk management.
The depth and breadth of information contained in this volume should render it an indispensable asset for all service providers involved in the diagnosis or treatment of deaf persons across the life span who exhibit challenging behaviors. Although this volume is likely to find its way to the bookshelves of psychiatrists, psychologists, therapists, and others who are well schooled in the specific issues related to serving deaf people, its greatest value may be as a source of enlightenment and information for mental health bureaucrats, administrators, and others who design systems of care. The essential point of this volume, that is that programs specifically equipped to address the social, linguistic, communication, psychological, and cultural needs of deaf persons are essential to the successful treatment of challenging behaviors, is one which must be heard by policy makers and program planners if there is to be forward progress in serving this challenging population.
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