**8. Case studies**

Investigating outliers of a professionally successful participant sample offers an interesting insight when considering their use of psychosocial skills. In order to better understand proactive deafness-specific tactic knowledge, the scores of the 49 participants were scrutinized and the highest and lowest scoring participants for Potential Maximization (the overall score) were selected as case studies. These participants included two deaf Anglo-Saxon males and who both used spoken language to communicate. The highest scorer was Anthony1, an American dentist in his early forties from New York. The lowest scorer was Jason, an Australian public servant in his late thirties from Canberra. English was their parents' and their own first language. Neither participant had experienced more than one year's unemployment or had an additional disability. It is prudent to note that both participants considered themselves as maximizing their potential as defined by a preliminary survey item. Both participants were also professionally successful, meaning they were two high functioning deaf individuals.

Deaf from birth, Anthony reported profound bilateral deafness, had a CI, and regarded himself as a "master" speech reader. He had attended a School for the Deaf in which the primary means of communication was spoken language. His highest educational qualification was unspecified. He learnt SL at 19 years old, and was a continued and fluent signer. He did not, however, nominate himself as Culturally Deaf or feel that his life would be better with greater Deaf community involvement. His reason was: "I have greater stimulation and more interests in the hearing world … the Deaf community/culture limits me, narrows my interests." Cultural Deafness indicates that the deaf individual selfidentifies as belonging to a community of Deaf people who share the commonalities of 1) deafness, 2) a similar language (e.g., ASL, etc.), 3) often a similar education in a segregated specialist education setting for deaf students, and 4) a shared cultural and social history

<sup>1</sup> Pseudonyms are used for both participants.

enabled the implementation of statistical procedures whereby survey items could be scored. As such, Potential Maximization was the combined score of the three grouped competencies of Control, Internal Decisions, and External Manifestations. At the time of writing, a paper reporting the empirical findings prepared by myself with Dr Louise Paatsch and Associate Professor Margaret Brown was accepted for publication with the *Volta Review*. Summarized, however, there were remarkable findings. Statistical data found no significant differences between deaf and hearing participant groups across four variables of Control, Internal Decisions, External Manifestations, and Potential Maximization. As such, this study's deaf and hearing participants shared similar psychosocial attributes, and tactics to maximize their potential. Qualitative data further revealed that deaf participants maximized their potential using two types of proactive psychosocial attributes and tactics: 1) skills that individuals with typical hearing use to socially participate combined with 2) specialized skills for identifying, circumventing, or mastering deafness-related difficulties. These attributes and tactics were uncovered using Reiff et al.'s (1995) framework, which can further be used to frame previously unpublished findings from my study (Jacobs, 2009). As such, the coming analyses of case studies may provide greater clarity of expert performance

Investigating outliers of a professionally successful participant sample offers an interesting insight when considering their use of psychosocial skills. In order to better understand proactive deafness-specific tactic knowledge, the scores of the 49 participants were scrutinized and the highest and lowest scoring participants for Potential Maximization (the overall score) were selected as case studies. These participants included two deaf Anglo-Saxon males and who both used spoken language to communicate. The highest scorer was Anthony1, an American dentist in his early forties from New York. The lowest scorer was Jason, an Australian public servant in his late thirties from Canberra. English was their parents' and their own first language. Neither participant had experienced more than one year's unemployment or had an additional disability. It is prudent to note that both participants considered themselves as maximizing their potential as defined by a preliminary survey item. Both participants were also professionally successful, meaning

Deaf from birth, Anthony reported profound bilateral deafness, had a CI, and regarded himself as a "master" speech reader. He had attended a School for the Deaf in which the primary means of communication was spoken language. His highest educational qualification was unspecified. He learnt SL at 19 years old, and was a continued and fluent signer. He did not, however, nominate himself as Culturally Deaf or feel that his life would be better with greater Deaf community involvement. His reason was: "I have greater stimulation and more interests in the hearing world … the Deaf community/culture limits me, narrows my interests." Cultural Deafness indicates that the deaf individual selfidentifies as belonging to a community of Deaf people who share the commonalities of 1) deafness, 2) a similar language (e.g., ASL, etc.), 3) often a similar education in a segregated specialist education setting for deaf students, and 4) a shared cultural and social history

that is the proactive use of specialized psychosocial skills by deaf people.

they were two high functioning deaf individuals.

1 Pseudonyms are used for both participants.

**8. Case studies** 

(Davis, L.J., 1995). In short, the Deaf community has a biological, linguistic, and cultural uniqueness that defines it as a legitimate social minority. However, the majority of deaf people do not self-identify as being culturally Deaf largely due to their having no association with this community or use of SL (Access Economics, 2006).

Jason wore hearing aids and reported moderate bilateral deafness. All deaf participants in the study reported a greater severity of deafness than he. He did not specify when his deafness occurred, or whether it was gradual or sudden. Qualitative data, however, suggested that he likely lost his hearing in adulthood. Jason had attained a Masters degree. He reported no Deaf community involvement and had not learnt SL. He did, nonetheless, agree that his life would be better with greater Deaf community involvement.

From here we can look at the two participants' responses to select survey items that were guided by deafness-related studies grouped according to Reiff et al.'s (1995) framework (Jacobs, 2010). The following three tables summarize responses according the three thematic categories of Control, Internal Decisions, and External Manifestations. The purpose of such analysis is to provide a contrast effect whereby responses to survey items can illustrate trends. Table 2 summarizes the responses of the two participants for items related to Control.


Table 2. Comparisons of Anthony's and Jason's distinctive responses to items: Control

The two participants' responses to five Control items reveal some interesting insights. Anthony strongly agreed and Jason disagreed that he felt in control of both his work and social life, and also that adulthood was easier than childhood. Anthony also strongly disagreed but Jason agreed that his life is miserable because of his deafness. In addition, and interestingly, Jason simply wrote the former Australian Prime Minister "John Howard" when summarizing a deaf person maximizing their potential with hearing peers. For the same item, Anthony elaborated that such a deaf person has attributes such as acknowledging deafness-related challenges and the quickness "to formulate ways to get around the problem" by using tactics such as providing an email address or a SMS number and not "a voice phone number, and explaining it is the preferred way to contact the deaf person, etc." Anthony further agreed that he had overcome the challenges of his deafness,

Deafness-Specific Tactic Knowledge:

and Social Ecologies.

**practice**

**strengths**

**hearing people**

**social skills**

A New Understanding of Mental Health, and Social and Professional Participation 303

Two Reframing items received different responses. First, Anthony strongly agreed and Jason disagreed that he was proud of the skills he used to maximize his potential with hearing peers. Anthony also agreed and Jason disagreed that dealing with deafness had made him a better person. Jason wrote that he would be "more vocationally and socially successful" if not deaf. Anthony believed he would have been "more of a product of my parents' influence ... Mine was more on my own … I think I would have done just great no matter if I were deaf or hearing." Anthony therefore appears to have reframed negative

Table 4 shows the two participants' different answers to the items associated with the thematic codes of External Manifestations: Persistence, Goodness of Fit, Learned Creativity,

**Anthony Jason** 

Strongly agree Disagree

Strongly agree Disagree

Agree Disagree

Strongly agree Disagree

Yes No

Misunderstood concept

"No relationship between watching captions and socialising"

Focused on strengths from childhood; chose dentistry because less emphasis on hearing

Can make out irony, sarcasm, jokes which helped him with social interaction

**I am sociable with hearing peers** Strongly agree Disagree

Table 4. Comparisons of Anthony's and Jason's distinctive responses to items: External

connotations related to deafness as positives whereas Jason has not.

*Persistence*

*Goodness of Fit*

*Learned Creativity*

*Social Ecologies*

**The process of self-determinism helps** 

**me to be more self-determined** 

**deafness is not a problem**

**Mastering speech-reading requires** 

**I have chosen employment where my** 

**I have made life choices that suit my** 

**Text-based telecommunications have put me on a 'level playing field' with** 

**Captioned TV/DVD has improved my** 

**I have had a close hearing friend** 

**throughout adulthood**

Manifestations.

whereas Jason did not. Jason cited "practical, technical and aesthetic difficulties with needing to use hearing aids" as his reasons. Anthony, however, mentioned specific deafness-related social strategies: "I always let the other person know that I am deaf and lip-read, and need the other person to face me while speaking. I also ask for clarification, repetition, rephrasing when I do not understand a particular word." Summarized, Jason's responses suggest that being deaf has rendered him without a sense of control of his life. Anthony, by contrast, appears use deafness-specific tactic knowledge and to be in control of his destiny.

Table 3 shows the two participants' different answers to the items associated with the thematic codes of Internal Decisions: Desire, Goal Orientation, and Reframing.


Table 3. Comparisons of Anthony's and Jason's distinctive responses to items: Internal Decisions

Both participants had different responses to two Desire items. Anthony strongly disagreed and Jason agreed that successful people seem lucky. This is perhaps understandable considering that Anthony responses to other items suggested his greater use of purposedriven tactics that Jason appeared not to possess, let alone be able to use. Anthony also strongly agreed and Jason disagreed that negative childhood experiences made him try harder. Different responses to this item may be related to Jason not being deaf in childhood whereas Anthony was. Jason's response may also illustrate the difficulty of adjusting to the onset of deafness in adulthood.

Responses to a Goal Orientation item saw Anthony strongly agree and Jason disagree that he was a risk-taker. Jason believed he would be in "the same place, vocationally, socially, physically" in five years time, and wrote "Nil" as strategies he would use. In contrast, Anthony stated "I want to finish off my 115 North East 4000' mountains." He also explained the importance of continuing a balanced life while working hard, and "not dwelling on failure" as strategies he will use. While not disability-specific, Anthony's response expresses comparatively greater exploration – a key prerequisite for the acquisition of tactic knowledge (Sternberg, 2003) – than does Jason's response.

whereas Jason did not. Jason cited "practical, technical and aesthetic difficulties with needing to use hearing aids" as his reasons. Anthony, however, mentioned specific deafness-related social strategies: "I always let the other person know that I am deaf and lip-read, and need the other person to face me while speaking. I also ask for clarification, repetition, rephrasing when I do not understand a particular word." Summarized, Jason's responses suggest that being deaf has rendered him without a sense of control of his life. Anthony, by contrast, appears use

Table 3 shows the two participants' different answers to the items associated with the

**Anthony Jason** 

Strongly agree Disagree

Strongly agree Disagree

Agree Disagree

deafness-specific tactic knowledge and to be in control of his destiny.

*Desire*

*Goal Orientation*

*Reframing*

knowledge (Sternberg, 2003) – than does Jason's response.

**Negative childhood experiences made** 

**I am proud of the skills I use to maximize potential with hearing peers**

onset of deafness in adulthood.

**Dealing with deafness has made me a** 

**me try harder**

**better person**

Decisions

thematic codes of Internal Decisions: Desire, Goal Orientation, and Reframing.

**Successful people seem to be lucky** Strongly disagree Agree

**I am a risk taker** Strongly agree Disagree

Table 3. Comparisons of Anthony's and Jason's distinctive responses to items: Internal

Both participants had different responses to two Desire items. Anthony strongly disagreed and Jason agreed that successful people seem lucky. This is perhaps understandable considering that Anthony responses to other items suggested his greater use of purposedriven tactics that Jason appeared not to possess, let alone be able to use. Anthony also strongly agreed and Jason disagreed that negative childhood experiences made him try harder. Different responses to this item may be related to Jason not being deaf in childhood whereas Anthony was. Jason's response may also illustrate the difficulty of adjusting to the

Responses to a Goal Orientation item saw Anthony strongly agree and Jason disagree that he was a risk-taker. Jason believed he would be in "the same place, vocationally, socially, physically" in five years time, and wrote "Nil" as strategies he would use. In contrast, Anthony stated "I want to finish off my 115 North East 4000' mountains." He also explained the importance of continuing a balanced life while working hard, and "not dwelling on failure" as strategies he will use. While not disability-specific, Anthony's response expresses comparatively greater exploration – a key prerequisite for the acquisition of tactic Two Reframing items received different responses. First, Anthony strongly agreed and Jason disagreed that he was proud of the skills he used to maximize his potential with hearing peers. Anthony also agreed and Jason disagreed that dealing with deafness had made him a better person. Jason wrote that he would be "more vocationally and socially successful" if not deaf. Anthony believed he would have been "more of a product of my parents' influence ... Mine was more on my own … I think I would have done just great no matter if I were deaf or hearing." Anthony therefore appears to have reframed negative connotations related to deafness as positives whereas Jason has not.

Table 4 shows the two participants' different answers to the items associated with the thematic codes of External Manifestations: Persistence, Goodness of Fit, Learned Creativity, and Social Ecologies.


Table 4. Comparisons of Anthony's and Jason's distinctive responses to items: External Manifestations.

Deafness-Specific Tactic Knowledge:

health.

traumatic.

**10. Conclusion** 

A New Understanding of Mental Health, and Social and Professional Participation 305

answering hypothetical questions such as "what would you do if this happened to you?" This seems to be an effective strategy to gain tactic knowledge that his deafness may otherwise prevent him from gaining. However, Jason's apparent lack of social interaction

The case studies illustrate three important findings. First, Reiff et al.'s (1995) framework can be applied across disabilities from a LD to a deafness context. Second, the framework is a useful tool for identifying proactive psychosocial attributes and tactics in deaf participants. Third, the case studies suggest that certain deaf individuals have more deafness-related tactic knowledge than do others. Anthony's survey responses differed greatly to Jason's both quantitatively and qualitatively. Anthony clearly appeared to be maximizing his psychosocial potential more so than Jason. Compared with Jason, Anthony displayed consistently a greater range of psychosocial skills specific to identifying, circumventing, and mastering deafness-related social and professional challenges. A key to this trend can be found in the relative pessimism and helplessness that Jason reported compared with Anthony's optimism and resourcefulness – which are telling indicators of their mental

Jason became deaf in adulthood whereas Anthony had been deaf since birth. Studies report that the later the onset of deafness the poorer was the participants' psychosocial adjustment (de Graaf & Bijl, 2002; Polat, 2003). Anthony has had many more years experience with challenges associated with deafness than has Jason, and therefore much more time in which to practise deafness-specific proactive psychosocial skills. Anthony's deafness-specific expertise has likely been honed through more intense practice and application – the stimulus of acquired learning and adaptation through social exposure. Jason's evident selfseclusion and introversion may also impair his acquisition of deafness-specific tactic knowledge. The onset of deafness in adulthood particularly impacts on real-time communication, which - by extension - can devastate the individual's social, professional, and romantic standings (Hogan, 2001). The onset of deafness also confronts individuals with the need to acquire esoteric deafness-specific psychosocial skills – or tactic knowledge - they had no need to practise prior to the onset of their deafness. More dauntingly, late deafened individuals typically learn the esoteric skills by trial and error without expert tuition. The ramifications for the individual's mental wellbeing are therefore likely to be negative, if not

Interestingly, Anthony attended a school for the deaf, which means he likely had access to specialist teaching and also other people (i.e., his classmates) whom have an experience of deafness. That early and continuous social exposure may have resulted in the sharing of esoteric deafness-specific knowledge that stood him good stead into his middle age. Jason's desired contact with the Deaf community also may reflect his desire for peer support and,

This chapter emphasized that deaf individuals require deafness-specific tactic knowledge to achieve a healthy mental wellbeing, and quality social and professional participation. The

perhaps, access to tuition of deafness-specific psychosocial skills.

and support is perhaps unsurprising given his responses to other items.

**9. Deafness-specific tactic knowledge and expert performance** 

Answers to two Persistence items saw Anthony strongly agree and Jason disagree that the process of self-determination helped him learn to be more self determining, and that mastering speech-reading requires continual practice. Jason believed that "selfdetermination is a trait developed in upbringing through good parenting, social interaction, and personal value. Difficult to develop later in life." This response may allude to the difficulty of acquiring and understanding deafness-specific tactic knowledge – especially without expert instruction. Anthony, however, gave three examples whereby learning to drive, doing taxes, and buying a house require proportionately greater degrees of selfdeterminism because each require exponentially more complex processes. As such, he identifies a key aspect of tactic knowledge being exponentially related to experience (Sternberg, 2003).

Different responses to a Goodness of Fit item saw Anthony agree and Jason disagree that he had chosen employment whereby deafness is not a problem. Both Jason and Anthony agreed he had made lifestyle choices that suited his strengths. A difference, however, was in the participants' understanding of the concept. Jason simply stated: "Academic and vocational choices and interests", which do not define the active engagement in social or professional settings in which success is likely. In contrast, Anthony provided a 152 word justification that began with "I analyzed my strengths in early childhood and realized that I would have to capitalize on my strengths to be used in a career that did not require hearing skills." Anthony thereafter mentioned that he ignored the advice of "well meaning teachers" who discouraged him to pursue a dentistry career. Now a dentist of 20 years, and having achieved a goodness of fit with personal interests and strengths, Anthony concluded "I look back and think 'what if I were more naïve and allowed my teachers to decide my future job for me?'"

Responses to two Learned Creativity items were different. Anthony strongly agreed and Jason disagreed that text-based telecommunications (e.g., email, sms, online chat) placed him on a 'level playing field with hearing peers' and that watching captioned DVDs and television programs had improved his social skills. Jason did not perceive text-based telecommunications as an aid for connecting with others when stating "Hearing remains a critical element in vocational and social situations." Anthony, however, wrote that he appreciated the greater ease of social contact through range of text-based telecommunication that was unavailable in his younger years. Jason additionally saw "No relationship between watching captions and socialising", whereas Anthony stated that watching captioned TV/DVD assisted his social development. Captioned TV/DVD bypasses the auditory challenge whereby subtitled dialogue can be read by the deaf person when watching a program. Anthony explained that he "was able to make out irony in spoken lines … and understand how a particular line was inflected and 'read between the lines' if a character was being sarcastic, flippant or joking, or merely making a statement, which I couldn't hear in spoken language." As such, he has creatively learned social nuances and strategies that he can use in face-to-face interaction. Again, we see Anthony's greater understanding of deafness-specific tactic knowledge.

Two Social Ecologies items received different answers. First, Anthony had close hearing friends throughout his adulthood but Jason had not. Second, Anthony strongly agreed and Jason disagreed that he was sociable with hearing peers. Anthony mentioned that his friends helped him integrate by acting as a 'sounding board' for social situations and by answering hypothetical questions such as "what would you do if this happened to you?" This seems to be an effective strategy to gain tactic knowledge that his deafness may otherwise prevent him from gaining. However, Jason's apparent lack of social interaction and support is perhaps unsurprising given his responses to other items.
