Educating Deaf Children with Multiple Challenges

The issue


Deaf children with multiple challenges are not a single subset of the population of deaf children.  Deaf children, like hearing children, may experience a range of developmental, physical, emotional, and psychiatric challenges, and their educational needs will vary significantly depending upon the nature of the disability.  A deaf child on the autism spectrum will have very different needs than the deaf child with a severe emotional disorder.  In both cases, the low incidence of deaf children with such disabilities and the need to prioritize language access pose unique challenges for educational decision making.

What we know and what we don’t know

We know that when special education services are needed, finding an appropriate placement is dependent upon first obtaining a reliable evaluation of the child’s abilities and needs.  We also know that when a child has a complex profile with multiple disabilities, the evaluation becomes more critical.  And we know that when that child is also deaf, finding qualified evaluators can be extremely difficult.

Evaluations must be done by qualified and licensed professionals who understand the nature of the child’s disabilities, the impact of those disabilities on learning, and the implications for educational placement.  What makes the assessment of a deaf child unique is something often taken for granted in other situations: the evaluator must be able to communicate fluently and effectively with the child.

Full language access is essential.  A child whose primary language is American Sign Language must be evaluated by persons fluent in that language.  The evaluator must also understand how being deaf shapes that child’s cultural and social experiences.  For children who do not sign, the evaluator must understand the child’s language abilities and limitations, and the potential impact they may have on the validity of test results.  All evaluators must also be aware that a deaf child’s English language skills cannot be considered indicative of his/her cognitive abilities.

The evaluation is essential but cannot stand alone. An evaluator cannot know firsthand how a child responds over time.  Nor can anyone know the many factors that may affect assessment results. Parents, other caregivers, and educators offer a rich perspective of the child’s abilities and needs that cannot be obtained through testing.

Once an appropriate evaluation is completed and the team has met to discuss parent/caregiver assessment of needs and review the child’s history, the question then becomes “How does one find the school placement to meet those needs?”  Language access is a prerequisite to learning, but while this must be the first consideration, the child’s cognitive, behavioral, emotional, and medical/physical needs must also be addressed through specialized educational programming.   Placing a deaf child with significant disabilities in a classroom of deaf children without the structure or supports that child needs will compromise the education of all children in that class.

In addition to language access, one must consider:

  • The nature and severity of the disability
  • The child’s age, prior education, and current functioning
  • His/her ability to work independently and in groups
  • Support services needed – speech and language, mobility, occupational and/or physical therapy, behavioral support, mental health services

There are specialized programs for deaf-blind children; some schools for deaf children now include programs and services for deaf children on the autism spectrum; and there are several residential treatment programs in the United States specifically designed for deaf children with severe emotional and psychiatric challenges.   Because of the low incidence of deaf children with multiple challenges, an out-of-district placement may be the only way to meet the child’s educational and language access needs.  And at times, the ideal placement may not exist.  In such instances the family, evaluation team, and school professionals must utilize the results of the evaluation to design the most effective linguistically accessible placement for that child.

Even in the best of circumstances, we cannot know with certainty what will work for a child with a unique profile of complex needs.  We must continually observe, assess, review progress and be prepared to make changes if needed.


To provide an appropriate education to deaf children with multiple challenges, special education directors and school psychologists need to be educated about the unique needs of these children and given resources to seek assessments beyond their school district teams.  Those responsible for the placement of deaf children with significant disabilities need to become aware of existing resources in their district, state and region, and must understand that for these children, “least restrictive environment” may well be an out-of-district placement.

Posted on April 1, 2014 by
Judy Vreeland,
The Learning Center, Framingham, MA

Further reading

Cupples, L., Ching, T.Y.C., Crow, K., Seeto, M., Leigh, G., Street, L., Day, J., Marnane, V., & Thomson, J., (2014). outcomes of 3-year-old children with hearing loss and different types of addtional disabilities. Journal of Deaf Studies and Deaf Education, 19, 20-39. view details

Van Dijk, R., Nelson, C., Postma, A., & van Dijk, J. (2010). Deaf children with severe multiple disabilities: Etiologies, intervention, and assessment. In M. Marschark and P. Spencer (Eds.), Oxford handbook of deaf studies, language, and education, volume 2 (pp, 172-191). New York: Oxford University Press. view details

Wiley, S., Gustafson, S., & Rozniak, J. (2014). Needs of parents of children who are deaf/hard of hearing with Autism Spectrum Disorder. Journal of Deaf Studies and Deaf Education, 19, 40-49. view details