Team Provides Outpatient Mental Health Therapy for Deaf and Hard-of-Hearing Patients

Bedolla (left), 18, has been seeing therapist Julia Petersen from time to time since she was 8 years old.

Yajaira Bedolla was 11 months old when her parents learned she was deaf.

Living in Uruapan, Mexico, Bedolla’s parents searched their town for resources to help with the unknowns of raising a deaf child. The limited resources they found focused on teaching deaf children just to speak, rather than also learn sign language.

They expanded their search and, in doing so, briefly moved to California and back to Mexico before landing in Seattle when Bedolla was 8. Here, they found Seattle Children’s and Petersen, a mental health therapist who provides outpatient therapy and support for deaf patients and their families.

Ten years later, Julia still meets with Bedolla and her mom, Elizabeth Hernandez. Petersen is one of four therapists in the Department of Psychiatry and Behavioral Medicine at Seattle Children’s who specializes in outpatient therapy for deaf and hard-of-hearing patients. With her colleagues Susan Sidman, Regina McGinnis and Sam McGinnis, this team supports patients and families as they navigate the unique challenges that being deaf or hard-of-hearing can bring to a child’s life, and to their family dynamic.

Blending two worlds

Deaf and hard-of-hearing children typically grow up in a hearing world — at least 90% of deaf children are born to hearing parents. These kids — especially those born into hearing families — can experience challenges communicating and understanding the world around them.

“The difficulty of a parent not being able to fluently communicate with their child, and the difficulty of a child trying to communicate in a largely non-signing world can, over time, contribute to mental health issues that bring them here,” says Sidman.

That was the case for Bedolla and her parents. “When I first came here for individual therapy with Julia, I wasn’t signing very much,” says Bedolla. “Julia would gesture to me, and we made pictures. She was very visual until I learned sign language.”

“Depending on what language exposure children have, they may have fairly disjointed language and may not be fluent in American Sign Language (ASL) or Signing Exact English (SEE),” says Sidman, which can make it difficult for hearing therapists who are not fluent in sign to communicate through interpreters.

Petersen helped Bedolla’s family, who are all hearing, understand Bedolla’s perspective — and helped them learn to communicate with her. As she learned ASL, so did her parents and siblings.

Even so, growing up in a hearing family is often lonely, Bedolla says.

“Sometimes I see them speaking, but I’m not part of the family, in terms of being part of the conversation,” she says. “My brothers will talk about homework or ask for the car, just general conversations, and I’ll be looking around, not understanding what they’re saying.”

Those situations are challenging, which sometimes leads to arguments.

“She does have a quick temper,” says Hernandez. But therapy with Julia has helped tremendously. “She’s learned to control her emotions more, and I’ve learned to have more patience,” she says.

Culturally and linguistically sensitive care

Challenges for deaf and hard-of-hearing children go beyond language. In some cases children don’t understand the relationships between family members or people in their home because nobody has explained to them who, for example, a cousin or grandparent is, and they aren’t exposed to contextual cues in the way hearing children are.

“We often spend so much time just explaining to kids who their family is, because they don’t know,” says Sidman. “These kids need to have somebody who understands their perspective and their experience to help them be successful and navigate the things that happen in their lives.”

For example, “People who do not specialize in the deaf and hard-of-hearing population might assume a hard-of-hearing child is fine,” says Petersen. “But with minimal or unilateral hearing loss, children can hear, but sometimes they’re not sure where the sound is coming from. We can give them communication tips, like raising hands at the dinner table before speaking, so they know who is talking.”

The four therapists are all fluent in sign language and have in-depth training in child development and working with deaf and hard-of-hearing children and their families.

Each also brings their individual training and backgrounds to the job: Like many of their patients, Petersen and McGinnis are deaf; and Sidman is also fluent in Spanish.

Together, this group of trained specialists provides patients and their families with culturally and linguistically sensitive care.

Not-so-unique challenges

In addition to the unique challenges deaf and hard-of-hearing children face, these kids are also prone to mental health issues hearing children are affected by, too, like attention deficit hyperactivity disorder (ADHD), anxiety, depression or autism.

This team is specially equipped to support those children and their families. “If a deaf child has an ADHD diagnosis, for example, we’re able to differentiate whether a behavior is related to ADHD, or to a cultural behavior that’s specific to this population, or both,” says Petersen.

Communicating directly and fluently with patients in their primary language and/or communication mode is also a significant benefit. “When you use an interpreter, there’s a time gap in the interpretation,” says Petersen. “If I’m signing, the deaf patient is receiving the information immediately and has the first opportunity to express themselves.”

We’re available!

This specialized team of therapists is available for same-day or next-day appointments.

They offer a wide range of services, including:

  • Individual and family therapy;
  • Support groups for deaf and hard-of-hearing middle and high school students, which is funded by the Childhood Communication Center (CCC);
  • Support groups for parents of children who are deaf or hard-of-hearing and on the autism spectrum;
  • Sign language class/support group for Spanish-speaking families who have deaf and hard-of-hearing children, funded by the CCC;
  • A summer program for patients age 6 to 12 and their siblings;
  • Consultation with other hospital staff and faculty who are caring for deaf and hard-of-hearing children;
  • Consultation with professionals in children’s lives, such as primary care doctors and teachers.
Hernandez (left) learned ASL to communicate with her daughter, Yajaira

Petersen is also coordinating a Children’s-hosted event in Ellensburg, Wash. this March called the Deaf Fiesta, an annual one-day conference for Spanish-speaking families with deaf and hard-of-hearing children. The event, which is also funded by the CCC, is a chance for kids and parents to connect, share resources and learn how to advocate for their children.

The family attends the fiesta every year, and both Bedolla and Hernandez have been presenters. “I’ve learned so much that I wish I had known when I was younger, and I want to share that,” says Hernandez.

Bedolla also attends the teen support group. “We all get together and talk about our feelings and learn how to better interact,” she says. “We learn from different presentations, for example, from deaf and hard-of-hearing adults who have good jobs. Or we visit a place where deaf and hard-of-hearing people work and we’ll see the possibilities for careers.”

Bedolla, who just graduated from the Washington School for the Deaf in Vancouver, Wash., is taking classes at Highline College in Des Moines, Wash. Next, she hopes to attend Gallaudet University in Washington, D.C., which offers undergraduate and graduate programs specifically designed for deaf and hard-of-hearing students.

“Julia has been a role model for Yajaira,” says Hernandez. “It’s really given her motivation to pursue her dreams.”

What’s her dream? “To be a mental health counselor, like Julia,” says Bedolla.

For general questions and inquiries about the program, please call 206-987-5197.