Working with Dual Diagnoses: A Survey of Teachers Serving Deaf or Hard of Hearing Children Who Have Autism Spectrum Disorder.
Teachers of deaf students with autism feel stranded between two fields and default to their first license—cross-training fixes this.
01Research in Context
What this study did
Mulder et al. (2020) sent a survey to teachers who serve deaf or hard-of-hearing students with autism. The team asked what training the teachers had and which strategies they used every day.
The survey showed that most teachers lean on methods from their first license area. Few feel ready to blend deaf-education and autism supports.
What they found
Teachers reported they lack resources and clear guidance. When plans clash, they pick the tools they know best, even if those tools ignore the other diagnosis.
The study found no formal roadmap for serving kids with both hearing loss and ASD.
How this fits with other research
Adams et al. (2021) asked the same questions to healthcare workers. Doctors and nurses also said daily contact, not workshops, builds skill with dual diagnoses. The pattern matches: classroom or clinic, people learn by doing.
Marrus et al. (2023) looked at psychiatry residents and found the same gap. Trainees get almost no class time on ASD or ID. Together the three surveys stretch the worry from schools to hospitals to mental-health clinics.
Light-Shriner et al. (2025) add a twist. Their survey of school BCBAs shows high teamwork even without formal collaboration courses. So some staff jump in and learn on the job, but teachers in the 2020 study stayed in their silos. The difference may be job role: BCBAs are hired to consult across teams, while teachers are hired to teach within one room.
Why it matters
If you coach or supervise school staff, push for short cross-training modules that mix deaf-education and autism tactics. Model one shared lesson plan that uses visual supports, sign language, and ABA prompts together. One co-taught demo can break the habit of choosing a single toolbox.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Pick one joint visual schedule that uses both sign and PCS symbols; teach it to the teacher and record student response.
02At a glance
03Original abstract
Although a sizable minority of students who are deaf or hard of hearing (DHH) are also diagnosed with autism spectrum disorder (ASD), there is little research examining teachers' feelings of aptitude for working with these students, nor the instructional strategies used with this population. This study reports results from a researcher-designed survey of teachers working with children who are both DHH and have ASD. Our results suggest that teachers working with this population felt under-resourced, under-prepared, and under-supported in their work with dually diagnosed students. Perhaps as a result, participants tended to use instructional strategies common to their certification area. We identify a need for cross-training teachers across disability areas. In addition, we call for research that tests the applicability of practices in either Deaf Education or ASD Education for dually diagnosed children who may have needs that are unique from children either group.
Journal of autism and developmental disorders, 2020 · doi:10.1007/s10803-018-3707-6