From Diagnosis to From Diagnosis to Self-ActualizationSelf-Actualization

Jodee Crace, MAJodee Crace, MACindy Lawrence, MA-CCC-ACindy Lawrence, MA-CCC-A

March 4, 2005March 4, 2005EHDI ConferenceEHDI Conference

Atlanta Atlanta

IntroductionIntroduction

Purpose of presentation: A paradigm shift Purpose of presentation: A paradigm shift

from the from the medical modelmedical model of diagnosing of diagnosing

hearing loss to an hearing loss to an educational/humaneducational/human

relations modelrelations model of identity formation of identity formation

Fundamental Principle:Fundamental Principle:

““People are People are internally compelledinternally compelled to to respondrespond to situationsto situations in ways that will in ways that will support support or be consistent with or be consistent with their their beliefsbeliefs.”.”

Point: Point: Humans have the unique ability Humans have the unique ability to define their to define their identityidentity, choose their , choose their valuesvalues and establish their and establish their beliefsbeliefs..

VALUESVALUES

““A principle that promotes A principle that promotes well-being or prevents harm”well-being or prevents harm”

““Our guidelines for success”Our guidelines for success” ““Our paradigm about what is Our paradigm about what is

acceptable”acceptable”

Our Challenge:Our Challenge:

How will UNHS-EHDI support the How will UNHS-EHDI support the VALUES that will support the journey VALUES that will support the journey of parents/families becoming self-of parents/families becoming self-actualized?actualized?

How will these processes create How will these processes create Deaf/HH babies who become self-Deaf/HH babies who become self-actualized individuals?actualized individuals?

Self-ActualizationSelf-Actualization

What?What?

How?How?

Why?Why?Point:Point: When the will and the emotions When the will and the emotions

are in conflict, the emotions most often are in conflict, the emotions most often win. win. (American Psychologist: William James)(American Psychologist: William James)

How do Providers Shape How do Providers Shape Families’ Responses:Families’ Responses:

The meaning of “diagnosis” The meaning of “diagnosis” ObjectiveObjective Use of equipment to measureUse of equipment to measure ScientificScientific Medically oriented: presence or Medically oriented: presence or

absence of sound absence of sound

The meaning of “diagnosis”The meaning of “diagnosis”

Diagnosis Diagnosis Medicine.Medicine. The act or process of identifying or determining The act or process of identifying or determining

the nature and cause of a the nature and cause of a diseasedisease or or injury injury through evaluation of patient history, through evaluation of patient history, examination, and review of laboratory data. examination, and review of laboratory data.

The opinion derived from such an evaluation. The opinion derived from such an evaluation. A critical analysis of the nature of something. A critical analysis of the nature of something. The conclusion reached by such analysis. The conclusion reached by such analysis.

Diagnosis Diagnosis Biology.Biology. A brief description of the distinguishing characteristics of A brief description of the distinguishing characteristics of

an organism, as for an organism, as for taxonomic classificationtaxonomic classification..

Medical Provider Image of the Medical Provider Image of the Baby: Baby: (Study - “1 in 5 (Study - “1 in 5

doctors”)doctors”)

AuditorySociety

ObjectiveMedical

Condition

Disability

Disease

Diagnosis

Explanation of ResultsExplanation of Results

Tone, Attitude, Comfort LevelTone, Attitude, Comfort Level 4 Approaches (Marion Downs, 1978)4 Approaches (Marion Downs, 1978)

Hit and RunMinimize the Problem

ObjectivityAction Oriented

Start with Diagnosis? or Start with Diagnosis? or Identification?Identification?

Accuracy of informationAccuracy of information Identification of Identification of

A disability, A disability, medical condition,medical condition, or state of being?or state of being?

Medical diagnosis typically to Medical diagnosis typically to determine treatment, fixing or cure. determine treatment, fixing or cure.

DefinitionsDefinitions

Identify Identify       v.v. tr.tr. To establish the identity of. To establish the identity of. To ascertain the origin, nature, or definitive To ascertain the origin, nature, or definitive

characteristics of. characteristics of. To consider as identical or united; equate. To consider as identical or united; equate. To associate or affiliate (oneself) closely with a To associate or affiliate (oneself) closely with a

person or group. person or group. To establish an identification with another or others.To establish an identification with another or others. Medieval Latin identific re, Medieval Latin identific re, to make to resembleto make to resemble  :  :

Late Latin identit s, Late Latin identit s, identityidentity; see ; see identityidentity + Latin - + Latin -fic re, fic re, -fy-fy.] .] i·den ti·fi a·blei·den ti·fi a·ble adj.adj.

Key Points from Definition of Key Points from Definition of IDENTIFY:IDENTIFY:

to associate or affiliateto associate or affiliate psychological empathypsychological empathy has become common has become common

jargonjargon

The Koinonia ConnectionThe Koinonia Connection

““The coming together in a solidified The coming together in a solidified one-ness in an atmosphere of one-ness in an atmosphere of openness, honesty, trust, affirmation, openness, honesty, trust, affirmation, support and encouragement.” support and encouragement.” Greek term coined by Dave Weber , Greek term coined by Dave Weber , author of author of Sticks and Stones ExposedSticks and Stones Exposed

Parents’ Image of the BabyParents’ Image of the Baby

Self defeated

Burden

IsolationUnknown territory

Culturallyunaccepted

New parent Stress

Imperfect Child

Parents

Providing Messages Providing Messages

FearFear MythsMyths Cultural “incompetence”Cultural “incompetence” Disability modelDisability model Hearing perception of hearing societyHearing perception of hearing society

OROR

Self analysis, our view of Deaf peopleSelf analysis, our view of Deaf people

How do our feelings set a tone and send How do our feelings set a tone and send messages to parentsmessages to parents

Understanding the self actualization Understanding the self actualization process is critical to delivering the newsprocess is critical to delivering the news

Self-Actualization Self-Actualization

Survival

Security

Social Acceptance

Self Esteem

SA

Traits of Self-Actualized Traits of Self-Actualized PersonPerson

Knowing who you are and your beliefsKnowing who you are and your beliefsComfortable with yourselfComfortable with yourself

Views learning and experience as an ongoing processViews learning and experience as an ongoing processEmpoweredEmpoweredConfidentConfidentInsightfulInsightfulValuableValuable

High Self-respectHigh Self-respectHigh Self-esteemHigh Self-esteem

IndependentIndependent

How can a Deaf/HH Person be How can a Deaf/HH Person be Self-Actualized?Self-Actualized?

Confidence instilled at birthConfidence instilled at birthEncouragement from healthy othersEncouragement from healthy others

Ongoing process of learningOngoing process of learningAccepting mistakesAccepting mistakes

Taking risksTaking risksHaving role modelsHaving role models

Exposure to many opportunities/experiencesExposure to many opportunities/experiencesBeing balancedBeing balancedFeeling WholeFeeling Whole

Confidence is instilled at birthConfidence is instilled at birthFeeling Proud as a Deaf/HH Person Feeling Proud as a Deaf/HH Person

Self Determination of one’s own life plansSelf Determination of one’s own life plans

Transition from:Transition from: Diagnosis to Ability Model Diagnosis to Ability Model

Parents benefit from:Parents benefit from: Support in “letting go” of predetermined Support in “letting go” of predetermined

imageimage Time to grieve in natural healthy wayTime to grieve in natural healthy way Replacing old vision with new hopeReplacing old vision with new hope Strategies to help them feel capable as Strategies to help them feel capable as

parents of this childparents of this child

EMPOWERMENT***SELF AWARENESS***EMPOWERMENT***SELF AWARENESS***SELF-ACTUALIZATIONSELF-ACTUALIZATION

From Diagnosis to Self-Actualized From Diagnosis to Self-Actualized PersonPerson

Medical ModelMedical Model Failed screeningFailed screening DiagnosisDiagnosis Audiogram and Audiogram and

ABR show hearing ABR show hearing loss/impairment: loss/impairment: such as mild, such as mild, moderate, severe, moderate, severe, profound profound

Self Actualized ModelSelf Actualized Model ReferRefer IdentificationIdentification Audiogram of Audiogram of

familiar sounds familiar sounds shows hearing shows hearing levels and ranges levels and ranges of hearingof hearing

From Diagnosis to Self-Actualized From Diagnosis to Self-Actualized PersonPerson

Medical ModelMedical Model

Prescribes Prescribes technology/surgerytechnology/surgery

Prescribes Prescribes treatment plantreatment plan

Self Actualized ModelSelf Actualized Model

Fits amplificationFits amplification

Teams with parents Teams with parents to find/investigate to find/investigate resourcesresources

From Diagnosis to Self-Actualized From Diagnosis to Self-Actualized PersonPerson

Medical ModelMedical Model Clinic-directed therapy Clinic-directed therapy

for the childfor the child

Dependent on Dependent on technologytechnology

Enables parent Enables parent (therapist/teacher)(therapist/teacher)

Self Actualized ModelSelf Actualized Model Relationship based Relationship based

service providing service providing unbiased supportunbiased support

Technology enhances Technology enhances skills and abilitiesskills and abilities

Empowers family Empowers family (mentors, role models (mentors, role models as resources)as resources)

From Diagnosis to Self-Actualized From Diagnosis to Self-Actualized PersonPerson

Medical ModelMedical Model

Exclusionary/Exclusionary/isolationisolation

Transmission of Transmission of informationinformation

Make “either/or” Make “either/or” choiceschoices

Self Actualized ModelSelf Actualized Model

Collaborative/Collaborative/community sense community sense Interactive- Interactive-

experiential learningexperiential learning

Comprehensive Comprehensive opportunitiesopportunities

From Diagnosis to Self-Actualized From Diagnosis to Self-Actualized

Person Person

Medical ModelMedical Model DisabilityDisability

Sub-CultureSub-Culture

Vocationally limitedVocationally limited

Self Actualized ModelSelf Actualized Model IdentityIdentity

DiversityDiversity

Unlimited lifelong Unlimited lifelong potentialpotential

Take Home Points:Take Home Points:

Self Analysis of our valuesSelf Analysis of our values Understanding the hierarchy of human Understanding the hierarchy of human

needsneeds Identify as “deaf” or Identify “hearing levels Identify as “deaf” or Identify “hearing levels

vs. diagnosis and impairment”vs. diagnosis and impairment” Check your messages/tone: “pass/refer” Check your messages/tone: “pass/refer”

(not fail); “hearing levels” (not loss or (not fail); “hearing levels” (not loss or impairment)impairment)

How do you identify with parents?How do you identify with parents? How do you help parents “identify with” How do you help parents “identify with”

their deaf or hard of hearing baby?their deaf or hard of hearing baby?

More take home points…More take home points…

Work with Deaf communityWork with Deaf community Gain tools for teaming with members Gain tools for teaming with members

of the Deaf Communityof the Deaf Community How are parents introduced to deaf How are parents introduced to deaf

and or hard of hearing adults? What and or hard of hearing adults? What are the messages and comfort are the messages and comfort levels?levels?

From Diagnosis to From Diagnosis to Self-ActualizationSelf-Actualization

Thank you for coming to our presentation! For further Thank you for coming to our presentation! For further inquiries and/or discussion opportunities about this inquiries and/or discussion opportunities about this topic:topic:

Email – Email – JCrace@isfd.state.in.usJCrace@isfd.state.in.us CLawrence@isfd.state.in.usCLawrence@isfd.state.in.us

Websites: Websites: http://www.performance-unlimited.com/samain.htmhttp://www.performance-unlimited.com/samain.htm

http://www.performance-unlimited.com/whyaffir.htmhttp://www.performance-unlimited.com/whyaffir.htm