(Troubles psychiatriques des enfants et adolescents sourds au regard de l’expérience de la première clinique spécialisée ouverte aux Pays-Bas)
12 / 1994
For the purpose of determining IQ performance tests from the Wechsler series (Wechsler Intelligence Scale for Children, WISCH-R or Weschler Adult Intelligence Scale, WAIS)or the SON (Snijders-Oomen Non-Verbal Intelligence Test)series were administered. The average IQ in the research group (89)is much lower (15 points)than the IQ score in the control group (104). This sizable difference may be attributed largely to the fact that the target group, unlike the control group, includes 11 mentally retarded children from an institution for children with multiple handicaps. The caregiving environment of the target group differs in a number of respects from that control group. Fewer children from the target group grow up in two-parents family (58,7% versus 68,9%); they are more often raised outside the family, particularly in an institution (6,5% versus 0%)or by relatives (5,5% versus 0%). Children from the research group also spend more time in an institution voluntarily (46% versus 2,7%)while the family remains the primary caregiving environment. Parents of children in the target group are less frequently of Dutch origin (62% versus 90% of the mothers, and 62% versus 79% of the fathers).
Three disorders, as defined by the DSM3-R criteria, are found significantly more often in the target group : mental retardation/borderline intellectual functioning (41,3% versus 7,9% in the control group), pervasive developmental disorder (15,2% versus 5,8%)and oppositional-defiant behaviour (27,2% versus 17,5%). The classifications depression and dysthymia appear significantly less frequently in the target group (18,5% versus 30,8%). Within the target group the DSM3-R classifications appear to be significantly correlated with 3 variables, namely "sex", "age at onset of hearing impairment" and "etiology of hearing impairment".
The variables degree and type of hearing loss, use of residual hearing, age at which impairment was detected, and time between onset and detection of auditory handicap, as well as hearing status of parents, show no direct link with the psychiatric problems.
This paper discuss a study of the first 95 patients who were referred to the psychiatric outpatient clinic for deaf and severly hard of hearing children and adolescents at "Curium" in the period 1988 to june 1993. The aim of the study is to gain insight into relevant psychological and demographic characteristics of this group of children and into the ways these data are related to the psychiatric problems in evidence.
Conclusions should not be extrapolated from the target group, because of the heterogeneity and size of the target group, which consists predominantly of deaf patients, and the use of a control group which differs in some respects, the findings should not be generalized for the deaf population as a whole. Particularly where the classifications of pervasive developmental disorder, as well as oppositional-defiant behaviour on the one hand and depression/dysthymia on the other hand are concerned, allowance should be made for possible over-diagnosis or under-diagnosis owing to inadequate communication between the researcher and the patient about the experience of the child.
GESTES Groupe d’Etude Spécialisé "Thérapies et Surdités"organised in Paris the ESMHD European Society for Mental Health and Deafnessthird international congress, on december 1994. The publication of the proceedings will occur later on.
Written from the speeches of Tiejo VAN GENT, child and adolescent psychiatrist, head of the clinic for deaf and severely hard of hearing; Sigrid HENDRIKS, M.D, lecturer of the dept of psychiatry at Leiden University, research assistant. DE VLIER, Department for the Deaf and the Hard of Hearing, Academic Centre for Child and Adolescent psychiatry, Curium, Endegeesterstraatweg 36, 2342 AK Oegstgeest, THE NETHERLANDS.
Compte rendu de colloque, conférence, séminaire,…
VAN GENT, Tiejo; HENDRIKS, Sigrid, GESTES
GESTES (Groupe d’Etudes Spécialisé Thérapies et Surdité) - 8 rue Michel Peter, 75013 Paris, FRANCE. Tel/Fax 00(331)43 31 25 00 - France - gestes (@) free.fr