Assessment & Research

Communicative deficits associated with maladaptive behavior in individuals with deafness and special needs.

Fellinger et al. (2022) · Frontiers in Psychiatry 2022
★ The Verdict

Language and social-communication skills—not IQ—drive behavior problems in deaf adults with ID.

✓ Read this if BCBAs working with deaf or hard-signing adults with ID in residential or day programs.
✗ Skip if Clinicians serving only hearing clients or children under 12.

01Research in Context

01

What this study did

The team looked at 41 deaf adults living in a residential center. All had intellectual disability.

They used rating scales to measure maladaptive behavior, language skills, and social communication.

The goal was to see which skills best predicted behavior problems.

02

What they found

Four out of ten adults showed high levels of problem behavior.

Poor language and weak social communication—not low IQ—were the strongest predictors.

In plain words: when people could not express needs or connect with others, behavior got worse.

03

How this fits with other research

Smith et al. (2020) found the same link in hearing Irish adults with ID. Their 2020 study shows the pattern holds across hearing and deaf groups.

Hao et al. (2010) looked at deaf adults with little language. They found these adults could still show advanced social understanding if they had rich early interaction. This seems to clash with Fellinger’s finding that poor language drives behavior problems. The difference is focus: Jian studied hidden social skills, while Fellinger studied day-to-day communication that keeps life calm.

Matson et al. (2009) showed adults with ID have tiny social networks. Fellinger adds that deafness plus poor language makes those networks even smaller, feeding problem behavior.

04

Why it matters

If you serve deaf clients with ID, screen language and social skills first. Boosting sign vocabulary, turn-taking, and joint attention may cut problem behavior more than teaching compliance. Start small: add five new functional signs this week and watch for fewer outbursts.

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Pick one client and teach five new functional signs for daily needs; track problem behavior before and after.

02At a glance

Intervention
not applicable
Design
other
Sample size
61
Population
intellectual disability, mixed clinical
Finding
not reported

03Original abstract

At least one in three individuals who are prelingually deaf has special needs, most commonly due to intellectual disabilities. The scant literature on challenging behavior in this population, however, suggests high rates of prevalence and an important need to better understand the contributing factors. We sought to analyze the prevalence of maladaptive behavior and its association with intellectual functioning, adaptive skills, language skills, and social communication in a population of adults with deafness and special needs. Participants were 61 individuals from three therapeutic living communities established for people with deafness and special needs. The participants had a mean age of 54.7 years, 64% were male. Intellectual functioning was measured with two versions of the Snijders–Oomen Non-verbal Intelligence Scale. The Vineland-II Scales were used to assess adaptive and maladaptive behavior. Language skills were measured with instruments specifically adapted for this population, including the Reynell Developmental Language Comprehension Scale, the comprehension scale of the Child Development Inventory, and the Profile of Multiple Language Proficiencies. Due to high correlations between instruments, a composite language score was used. A specific questionnaire to measure social communication in adults with intellectual disabilities was also utilized. The mean nonverbal developmental reference age was 6.5 years, whereas the equivalent for the language measures was about 3.5 years. The prevalence rate of elevated maladaptive behavior was 41% (v-scale score ≥18) and 18% of the participants had a clinically significant score (v-scale score ≥21). Regression analyses showed that only language and social communication skills were significantly associated with maladaptive behavior, while intellectual functioning and adaptive skills were not. These findings emphasize the importance of the constant promotion of communicative skills, as those people with better language and social communication skills demonstrate lower levels of maladaptive behavior.

Frontiers in Psychiatry, 2022 · doi:10.3389/fpsyt.2022.944719