Societal Beliefs

The Societal Beliefs layer, shown as a dark maroon color, represents the misunderstandings society has about deaf and hard of hearing people, including those who are deafblind, deafdisabled, or people of color. The negative attitudes or lack of knowledge people have can influence these misunderstandings. Parents may not realize how these societal beliefs influence their choices regarding:

• Follow-up care and early intervention
• The importance of teaching and using language with their deaf or hard of hearing children as early and consistently as possible
• Finding the right strategies to support their children’s needs

There is a need for more public education about deaf and hard of hearing children and their needs to change these attitudes. This would help raise awareness about the importance of early hearing detection and intervention (EHDI). This increased awareness could encourage more families to seek early EHDI services in their state.

Laws

The Laws layer, shown in plum, is about laws that affect state and federal systems providing services for families with deaf or hard of hearing children. The availability and types of services impact how these families learn about and make decisions about these services. The services families can receive, seek, or are already receiving are influenced by the quality and type of support offered by both federal and state organizations. For example, language policies can decide what kinds of language services parents with deaf or hard of hearing children can receive. Laws also can influence what services are provided based on funds given to them.

Systems

The Systems layer, shown in magenta, is about state and federal systems (e.g., Medicare, foster care, EHDI). They determine what services, funding, and resources are available based on laws. Survey respondents shared examples of systemic barriers. They included gaps in the EHDI system, limited Medicaid funding for families living in poverty, and difficulties with medical insurance and government assistance programs. These barriers can keep families from getting the services they need for themselves and their deaf or hard of hearing children, and the barriers increase if the child has additional disabilities.

Overall Development and Transition to Adulthood

The development of deaf and hard of hearing children from birth to adulthood, shown under the black arrow in the model, is shaped by both their families and the professionals who work with them. Families influence their children both independently and when working with professionals from different systems. The decisions and actions of both families and professionals are guided by their beliefs about deaf and hard of hearing children and their roles in supporting these children. These beliefs also affect the quality of family-professional relationships, which are further shaped by broader systems, laws, and societal attitudes.

Decision Making and Action

Decision Making and Action, shown in blue with diagonal lines, are interconnected and ongoing processes shaping deaf and hard of hearing children’s development. Families make choices about language use, hearing devices, and support. This is followed by actions such as using services, learning about their children’s needs, taking ASL classes, and/or helping with academics. These decisions and actions continue beyond high school.

Parents may also decide not to take certain actions, such as learning ASL. This may be due to resource limitations or challenges in the system. Professionals and schools make decisions based on roles, funding, and knowledge, which may impact family support. Challenges arise when school staff do not fully understand the needs of deaf and hard of hearing students, which may be due to:

• Lack of experience working with deaf and hard of hearing children
• Misunderstanding a child’s educational needs or providing unclear labels
• Making decisions without full information (e.g., assuming a deafblind child does not need a hearing aid)

Family and professional decisions also influence students’ actions and decisions. Ultimately, these decisions and actions shape the growth of deaf and hard of hearing children in areas such as language, reading, and social connections.

Deaf and Hard of Hearing Children

Deaf and Hard of Hearing Children, shown in purple in the model, are part of the Decision Making and Action layer. The decisions and actions taken by families and professionals, whether together or separately, depend on their connection and available resources. These decisions and actions affect these children’s language, thinking, reading, learning, and overall well-being.

Early in deaf or hard of hearing children’s lives, families make key decisions about language and communication that are important for their language development and interaction. These choices shape how family members can communicate with and support their children in everyday life and in different ways. When family members struggle to communicate, it can lead to delays in language development, challenges in relationships, social isolation, lower literacy and academic abilities, and less support for learning at home. The specific effects on deaf and hard of hearing children are shaped by many changing decision-making factors. These are also part of the bigger picture of the children’s overall development, from birth to adulthood.

Families

The Families layer is shown as light orange on the left side of the model. Each family has its own system. This includes household structure, resources (e.g., money, time, social connections), and beliefs about raising a deaf or hard of hearing child. Families play a crucial role in language development but face challenges such as:

• Finding time, money, and/or commitment for ASL learning or Deaf community event attendance
• Accessing necessary resources
• Navigating emotions around language choices and Deaf culture

Family resources shape communication decisions and support through high school. Limited resources can make it harder to access services, follow through, and develop language and emotional skills needed for involvement. Systemic barriers such as job challenges and transportation further complicate access. Raising a deaf or hard of hearing child requires significant personal resources and navigating complex support systems.

Systems Specific to DHH Children

Systems Specific to Deaf and Hard of Hearing Children, shown in brick red, are different from state and federal systems. They include programs such as Medicaid, foster care, and local services for families and professionals. Parents expect specialized knowledge from professionals in early intervention, ASL instruction, and counseling, but they often receive unclear or mixed messages about language options. Support depends on the quality of information, available resources, and professional training.

Families need clear, accessible resources in their first languages to support their child’s growth. Professionals must ensure families are aware of these resources. Parents rely on advice from teachers, doctors, and specialists, but grief and uncertainty can make decisions harder. Better training in counseling and supporting children with additional disabilities can improve how professionals guide families.

Family-Professional Connections
From Birth to Young Adulthood

Collaboration between families and professionals is important to ensure deaf and hard of hearing children receive language, education, and social support. This is labeled as Family-Professional Connections, shown by the dark orange arrow in the middle linking Families on the left with Systems Specific to Deaf and Hard of Hearing Children on the right.

These connections start when a child is identified as deaf or hard of hearing and evolve through school years. While families and professionals work together, their expectations differ. Some families rely heavily on professionals, while others expect schools to guide involvement. Schools are expected to provide IEP services and connect families with the Deaf community. These beliefs shape key decisions on audiology, education, and communication.

Family-professional relationships impact decisions and access to services, but misunderstandings can leave families feeling unheard or relying on personal resources (e.g., time, money). Strengthening collaboration is important to ensure these children receive the support they need.

Overall Development and Transition to Adulthood

The development of deaf and hard of hearing children from birth to adulthood, shown under the black arrow in the model, is shaped by both their families and the professionals who work with them. Families influence their children both independently and when working with professionals from different systems. The decisions and actions of both families and professionals are guided by their beliefs about deaf and hard of hearing children and their roles in supporting these children. These beliefs also affect the quality of family-professional relationships, which are further shaped by broader systems, laws, and societal attitudes.