 Hello, everyone. My name is Sarah Burns and today we have Dr. Gabrielle Lomas here to speak to us about students who are deaf and hard of hearing as a vulnerable population. I was first introduced to Dr. Lomas's work through Hands and Voices, our children's safety project. If you're unfamiliar with this project, Hands and Voices is actively working to include training around some of the preventive principles that Dr. Lomas presents today. I listened to his presentation a year ago on childhood safety and ACEs, which is adverse childhood experiences over a year ago. And this presentation and the information contained in it has remained with me. Dr. Lomas teaches in both the school and clinical counseling training programs at Western Connecticut State University. He holds an undergraduate degree in history, special education from the University of Texas in San Antonio, a graduate teaching certificate in deaf education from Lamar University, a master's of arts in counseling from Gallaudet University, and a PhD in counseling education and school psychology from Sam Houston State University. He has published widely in books and journals in the combined fields of counseling and deaf individuals. Dr. Lomas has lectured nationally and internationally, primarily on topics related to mental health and deaf people. He maintains a small clinical practice and continues to serve as a forensic consultant to attorneys and courts and state governments. It is with this introduction that I'd like to introduce Dr. Lomas. Thank you for coming. Thanks for having me. Can you give me some signal to let me know you hear me? I can see the interpreter. Okay, so she's definitely signing. She can definitely see me or hear me. We have a lot of material to cover in one hour of time, so I want you to go ahead and raise your hand, interrupt me if you have questions. It looks like there is a chat box, and I can see that people say that they can hear me, so that's great. I'm going to probably move at a fairly rapid pace through the slides. So if you have a question, stop me, and as soon as I see it pop up on the chat, I will pause and read the question. So it doesn't look like I'm controlling the slide, so if I can have somebody move to the first, the next slide. There we go. All right, so I wanted to start off with something that may seem initially a little irrelevant, but I think it's very powerful. You guys who know history, well, most of us know that in the 1800s, cholera was really a major epidemic. It was either control, especially in London, and in big cities it was killing people pretty regularly. Over 15,000 people were killed in two epidemics of cholera in the mid-1800s. Nearly a million people were killed in a pandemic in India during the same time period. Now, at that time, it was believed that cholera was something that existed in the air, and that we were all vulnerable to cholera. A gentleman by the name of Dr. John Snow began to study a study at thinking that it may not be something that was in the air, but perhaps it was a different source. So as he began to go through the streets of London, he identified that there was wastewater flowing into the freshwater, causing contamination, and he hypothesized that that was the source of cholera. It was very clear that he was correct, because once that was cleared up, in urbanized developed countries they saw almost no cholera, and in fact, resources show that Canada has about one case of cholera per year. The United States is more populated. We have less than 10 per year. So what does that tell us? It tells us that prevention can be much more effective than treatment. I mean, to me, that's profound. That we can tackle diseases before they ever start. It's a turning point in how we address disease, and it led to the rise of immunizations, and it changed the focus of research for medical professionals. So it really grew the field of public health and preventative medicine. So by ensuring that the wastewater was separate from the freshwater, we were able to reduce vulnerability and make sure that people were less vulnerable to illness. In my model world, that's pretty profound stuff, and I get excited by that. Now, I share that with you, because just about 20 years ago, there was another study that I think has the same sort of potential for impact. I think probably 20 or 30 years from now, we'll be looking back at another study that was done by the Centers for Disease Control and the Kaiser Clinic. Now, if you're not heavily into behavioral health, mental health, psychology, counseling, social work, or if you're not into public health or medicine, you may not have heard of ACEs. What they did is this researchers took a questionnaire that they had developed with 10 questions on it, and they gave it to patients as they went in for their primary care visit in the Kaiser Clinic system in Southern California. During this time period, over 17,000 different individuals responded to the study. So they got a massive amount of data on this whole cohort of people. Let's go to the next slide and check out some of that information. So the study was called the ACE study, and what we see from the results from that study were clear correlations with lower life expectancy. I mean, that's powerful, too, to think like, wow, whatever that you answer, if you say yes to these questions, you're going to live a shorter life. They also saw increases in health care costs. So if you say yes to those questions, you're going to be sicker more often, and it's going to be more expensive to take care of you. They see increases in mental illnesses. So again, if you say yes to more of those questions, you're more likely to have a mental illness. The same with substance abuse and then other specific diseases like heart disease, lung disease, sexually transmitted diseases, and so on. The research really is profound. Now, if I could tell you early on that your life expectancy is going to be lowered if you answer yes to questions, wouldn't you want to change that? Of course we would. We would all want to change that. That goes back to the core of preventative medicine. Can we change outcomes in health by doing something when people are young? So that was at the core of the ACE study. Now, if you are new to this topic and you have no idea what I'm talking about, you're probably thinking I'm talking about some sort of a health care questionnaire about your body. Let's go to the next slide. These are the ACE questions, and they may be difficult for you to see. I'm not sure if you guys are in a classroom, or if you're spread apart throughout Canada. I'm not sure what kind of view you're getting of the screen, but I'll try to read a couple of them to you just so you get a sense in case you can't see these yourself. So the first question asked, did a parent or adult in the household swear at you, put you down, or humiliate you, or act in a way that made you afraid that you might be physically hurt? So let me skip through a couple and just so you get a better sense. Like number six says, were your parents ever separated or divorced? Number seven says, was your mother or stepmother often or very often pushed, slapped, or had grabbed or had something thrown at her? So that goes to the core of like a partner violence or domestic violence. Number nine says, was a household member depressed, mentally ill, or attempted suicide? Number 10 says, did a household member go to prison? So these were the questions that were asked during that study. These are all about adverse childhood experiences. They call it ACEs, A-C-E-S, adverse childhood experiences. Interesting, I think, to correlate these to healthcare. Now go ahead and change the slide. I think it's interesting to correlate them to healthcare as adults because these are things that we experienced that to some degree we have thoughts for so long have nothing to do with health. It's just watching people interact in front of you. It's how you're treated as a young person and yet they have profound effects on your life and your health as an adult. Now I think what else is interesting here is that their population, all 17,000 had health insurance. So the Kaiser Clinic, their program is a healthcare program. Now I know in Canada you guys have a state run, a government run health program. Unfortunately we do not in the United States we have private health insurance programs. So the Kaiser program is a large one in Southern California and so they had 17,000 people in their program that were participating in the study. If you think about that from a United States point of view our insurance is tied to employment. So all of these people were professional middle-class people who had jobs. They had money. They were probably primarily, well they were clearly primarily overwhelmingly Caucasian in middle class. So some of the evidence that you're going to see in the next couple of slides as I gave you the example is you might be a little surprised because when you think about people in poverty the incidences are going to be much greater than what we see here and what we're going to have to see here in the next few slides is going to be shocking I believe. Okay so this slide tells you a little bit about the population that 72% had attended college and 77% were Caucasian. Now when we think of their score we think of ACEs there's 10 possible questions so that's 10 ACEs. If you answered most people can answer yes to at least one of those. I mean 50% of the United States population is divorced so a lot of people would say yes to that question but about 25% of them one in four were exposed at least two. One in 16 were exposed at least four. One in five were sexually abused as children. Two out of three women experienced abuse or violence in their childhood and when you look at those numbers you can't help but to think that if ACEs were physiological that that would be an epidemic. That our governments would be throwing all kinds of money and research to stop ACEs. Unfortunately that has not happened although in the United States we are seeing some growth in that area. There is more energy today but this study was published 21 years ago. Okay next slide. So here's the ACEs that the data for people who have experienced sexual assault. The graph here represents zero to four ACEs so if you have never, if you have zero on the ACE scale you have about a 4% chance of being sexually assaulted. That kind of goes with the national norm. It's a pretty low chance of being assaulted. If you look up the columns the green column shows one ACE, the red one shows two ACEs, the gray one shows three and that purple one shows four ACEs. You can see how it just quickly begins to escalate and people with four ACEs are over 30% likely to have a sexual assault against them. Next slide. So this pyramid addresses ACEs through the lifespan and you can see that how at the base we've got this collective 10 negative experiences and they move up to the next group where we have disruptive neurodevelopment. In other words your beliefs, your thoughts about yourself and other people are negatively impacted and then we've got that on the next stage up we've got social, emotional and cognitive impairment meaning that you begin to function in an impaired way, you have problem behavior. The next step up we've got the adoption of health risk behaviors like you choose to drink heavily or you smoke heavily, maybe risky behavior like driving too fast, drinking and driving things like that and then at the next stage up we see disease, disability, social problems and then at the top of the pyramid we see early death. So we can see that they're all related to each other and they all are rooted in these early negative childhood experiences. So there were some other studies that were done this is kind of starting to transition to the study that I recently completed. We can see that ACEs, high ACEs correlate with the prison population. One study revealed that 77 to 90 percent of all women in prison have ACEs ACEs correlate with risky behavior, truancy, household instability and then incarceration itself can be a source of ACEs and trauma for the individual. In prisons people can be exposed to violence and sexual violence. About a quarter of all inmates are victims of sexual harassment or sexual assaults. Research shows that about 10 percent of inmates nationwide report being sexually assaulted during their incarceration and we know that incarceration is a source of stress for the family as well. So when a child has a caregiver that goes to prison, that facilitates a cycle of incarceration for generations. That child is much more likely to go to prison themselves and they're much more likely to have some of the health consequences that are consistent with ACEs. Okay, next slide. Now this one I think is profound for deaf people. I don't know if you guys have read the work of Saul Kassen. He's a professor of criminal justice in the John Jay College in New York City. I happen to live in about maybe about a half an hour from New York City and I work about an hour from New York City. So I haven't met Dr. Kassen but I like his work. It's pretty impressive. He focuses a lot on false confessions and I think if you can pause and think about it for a minute, you'll you know how if you've watched shows like Dateline or any of the police shows that show like real interrogations, you see how police pressure the suspect during the interrogation and how long and how tiring it can be and if you do not have a strong ego and a strong sense of self, you're more likely to give in to the pressures that the police are putting on you. So I've worked on a number of cases. I do a lot of forensic work. I worked on a number of cases where there is a deaf person involved and the deaf person is innocent or they maybe have it was maybe a misunderstanding. Maybe they did commit the crime but they didn't understand what they were doing and oftentimes they will admit to things that are inaccurate or untrue because of pressure from the police. It was a study done by Miller that shows that deaf people are overrepresented in prison. So if you think about the percentage of deaf people that there are in our schools and in our country, then if we were to sort of correlate that with the prison population, it should be about the same representation but we see that really not the same. It's really an overrepresentation of deaf people in prison. So now we don't really have specific numbers. I don't know how how sophisticated you all are in Canada, probably much more ahead of the United States but the United States prison systems are pretty well they're it's terrible. It's difficult to track people. Once somebody has gone to prison, it's difficult to kind of follow them. So we don't always know the data about them like what kind of illnesses have they had? Did they have hearing loss before they went into prison? Did somebody hit them in the head and cause hearing loss? What kind of health conditions did they have prior to entry and then during their incarceration? So there's lots of things that happen in prison that we really can't track because when somebody gets incarcerated in the United States, it's very difficult to get behind bars and to interview them. It's difficult to find out how many times they've been to see a doctor or a nurse and keep track of those people. So specific numbers and then of course we have so many states. The states report different numbers. Some of them don't report numbers at all. They might give you the total number of people in prison and sometimes they break that down by sex or by ethnic group but they really they rarely give you the information about disability. So it's not really clear how many people who are deaf are locked up. I used a mathematical algorithm to determine that it's very likely that we have about 10,000 deaf and hard of hearing juvenile offenders in the system in the United States. I honestly hope I'm wrong. I hope somebody else can prove me wrong but right now that number is going to be published in a book next year by Gallaudet Press on Juvenile and Deaf Offenders. But I think that if that is true, we are probably locking up a lot of young people who have a lot of misunderstandings. As a quick example, I used to work in a school system that had deaf children in it. The school system had a zero tolerance policy for drugs. So a young man took some ADHD medication to school with him. ADHD medication is considered a controlled substance and so when the school police, the school resource officer found out about it, they actually arrested the child and put him in a juvenile offender program. He was the only deaf person in that program. He became very depressed. So our schools really play a huge part in helping or hurting kids and locking kids up into the system, the correction system. So there have been studies that also talk about other ACEs like child abuse and neglect. Some studies are showing that deaf and hard of hearing youth are more likely to experience abuse and neglect than hearing kids. Now I think this can be debated perhaps to a degree. I mean a lot of times parents say well when we have a deaf kid we often put more attention on them but the reality is disability research says that the disability itself causes a strain on the parents and communication difficulties are often the source of serious strains at home. So even when parents maybe would want to be calm, if they feel like their kid's not understanding it, not listening, not doing what they want them to do, they will sometimes get physical with them, pushing them into a room to go clean, maybe accidentally knocking them over. And so kids, because of the communication difficulties, deaf kids often experience much more punitive and physical discipline at home than their hearing peers do. Now I don't want to spend a lot of time on this so we can also, the justice system in general is filled with obstacles that lead to an unfair experience for deaf and hard of hearing people in general, whether they're children or adults. From the time that a deaf person is first encountered by the police until the time that they are let go of at some point they are, their rights are violated constantly. Oftentimes a police officer goes to question a deaf person, they will not have effective communication, not have an interpreter and it will lead to misunderstandings and sometimes lead to the person being arrested and taken away. And oftentimes the person will end up, the deaf person will go to court, the interpreter doesn't show, so the deaf person either has to pay money, post bail or they have to get locked up again. Deaf people in general come from lower socioeconomic groups and so they often are locked up and then when they get to court, if they have an interpreter sometimes they're qualified and sometimes they're not. So the obstacles are really significant. There's also literature that talks about once the deaf person is locked up in prison. Dr. Jean Andrews did a study on prison handbooks, they tell you the rules of how to function in prison. Many of them are written at a reading level that's higher than most hearing adults can follow. She did a reading analysis of many handbooks and they tend to be written at the 10th to 12th grade reading level. The average deaf child is written at 4th to 5th grade English. Most of the time deaf children who are incarcerated are reading below that because they're not understanding, they're not achieving highly in school. In the United States, we've got the Americans with Disabilities Act and their implementation in prisons is really horrendous. Oftentimes prison systems have to be sued by advocacy groups to have basic ADA access in prison. For a quick example, a deaf person who maybe was arrested for stealing some alcohol from a liquor store may have an addiction. Maybe they've been arrested a few times and so they're doing some time in state prison and they should be going to treatment while incarcerated. However, the state prison will not provide an interpreter for them to help with their treatment. That's just one example of where disability accommodations are lacking or non-existent. It's been a few years since I started to study and it took me a long time to get it completed and I'm actually writing up a revision on the manuscript now. Let me tell you about some of the work I did. What I was looking to do was connect with deaf people who had been incarcerated to identify if they had ACEs in their background. Could ACEs have been a contributor to their misfortunes? The process was really challenging. In the fall of 2014, I sent those ACE questions to a doctoral student who was deaf himself at a university. Actually, Dr. Jean Andrews, who I'd mentioned before, she knew this doctoral student and thought very highly of him. I didn't realize that could be moved. That's great. The doctoral student was religious and if you look closely at those questions that were on an earlier slide, you'll see that some of them are fairly sensitive, including a question about sexual assault. That doctoral student was uncomfortable with that interpretation and did not do it. He was spelling a lot of the language in there instead of signing it. When we sent the videos out for validation, the researchers that were working with me said these are not acceptable. I began to look all over the nation for a deaf person who could interpret the ACE questions with confidence in a professional manner and was not afraid to use questions, afraid to sign questions about sexual assault. Believe it or not, that was a pretty significant challenge. I had a lot of people interested, but when they looked at the questions, they saw how challenging the interpretation would be and they saw the content. Many of them said no. I am connected with an excellent resource. I'm not sure if you guys have heard of it, but there is a mental health interpreter training program in Alabama. I contacted my colleagues there and they helped me find people to do the validation, but they really could not help me find somebody who would interpret the videos. Just so you were aware, I am a CODA, so I'm fluent in ASL. However, as a researcher, it's not really appropriate for me to do the interpretation. It would be best if a deaf person did the interpretation. I looked through my networks and I did find somebody who was really an expert. She did a very solid job. She's deaf herself. She knows English well and she did the interpretation. I got them to the point where I thought they were fabulous. What happened was once they were done, I sent them out to experts, to mental health interpreting experts and they found their reliability was near perfect. Both interpreters separately, they don't even know each other. They rated them and they both came out with the exact same reliability ratings. That's what we want. Research is for two independent people to look at these videos and say, this interpretation is spot on. Finally, that brought us two years later to the summer of 2016. I still wasn't quite ready to deploy them. I did cognitive interviewing with people. Basically, I went around the region and I also went to friends of mine in Texas and I had them view the videos and then we asked them what they think of the videos. Not so much about the quality of the sign language because we had that validated already, but what did the video make you think of? We're trying to make sure that the video is getting to the core issues of the question. It's a process for validation that is very laborious and time consuming, but it helps to make a stronger study. I'm ready for the next slide. We had five deaf and hard of hearing people who were in the New York, New England region and we did also do the focus group in Texas and we came out with pretty solid reliability. It was excellent. Once we had the videos ready to go, we put them up onto a system where they could be deployed. It was actually at a private YouTube channel and it was embedded in a survey program. Once we had them up there, we added text, we added words to the video as well so that people who looked at the videos could watch ASL and then above the video they could see the original text, the ace question and then below the video we had simplified English that was so that the questions could be asked at the fourth grade level. Then we solicited responses. We deployed it and initially we went out only to the people who were on a listserv for an organization called Heard, H-E-A-R-D. Heard is an advocacy group for deaf people who are involved in the criminal justice system. If you are not familiar with them, I suggest you Google them and look them up. We also added to that lists other professional organizations for deaf and hard of hearing people such as the Deaf Rehabilitation Counselors Association, ADERA. That's like a mental health counselor and psychologist group for deaf people. Through using all those networks we were able to get 45 people to respond. I sent everybody who responded a $25 gift card to Walmart as an incentive. Sometimes studies have incentives and sometimes they don't. In this study I felt like we needed the incentive because we were asking people to reveal that they have been incarcerated and most people are not excited to tell you about that. I think if I did not have the incentive I may have had less than 10 people. When you do statistical analysis you need to have at least 40 people. So I'm not sure that I can do it on my end but there is a sample video here. Oh yes, you can see on the video here how the interpreter signed a question. Okay, I don't know if you recognize her but her name is Trudy. She's amazing. I just love and respect Trudy so much. She's so skilled at writing, so skilled at signing, and just an amazing person. So is it possible? There we go. Yeah so now what we got in the study here are the results and I'll talk about them for just a second but I want to kind of talk about ACEs in general. Like what we're doing is in this study is we're only examining ACEs with deaf people. So we're only really kind of comparing deaf people to each other. So we did classify some people as deaf and some as hard of hearing and so we were able to run analyses on that but I think it would be it would be more interesting when my article is finished and then we can see how they compare to hearing people. But in general we see that deaf people are more likely to be emotionally abused than hard of hearing peers. I think that when we compare these to hearing people we're going to see that a lot of deaf people have what deaf and hard of hearing people are experiencing more emotional stress because of their parent-child relationships when compared to hearing people. And this just makes sense because oftentimes the relationships are limited because of sign language communication. If a child is hard of hearing they often miss information at home. If a child is profoundly deaf they miss a lot of information. It just really depends on their the parent's ability to connect with them. So sometimes kids if their parents are not signing making clear efforts to connect with them they feel they feel emotionally disconnected from their parents. Now I'm also a big fan of schools for the deaf. I think they're very important but at the same time if the child is living there in a residential setting all year long they're not really spending time with their parents in the way that other hearing kids do and so that makes them also more likely to have poor attachment to their parents really. So that one related to the first question. All right I see somebody just popped in. Let's go back to the other slide please. All right I'm still on the bullet point one but somebody popped in with a question saying did the deaf or hard of hearing groups include people with cochlear implants? I'll have to go back to my demographics. That's a good question. I don't remember if I asked them if they had cochlear implants or not. And I'll tell you why. When you do a study like this you want to make the questionnaire reasonable like when you get a survey in your inbox you'd like to have that survey done within say five to ten minutes. If it goes beyond ten minutes people are more likely to just click it and close it. So while the collection of lots of information is interesting we want to just get the most critical information so that they complete the questionnaire. So I don't recall if we included the question about do you have a cochlear implant or not but I definitely had them categorize themselves as deaf or hard of hearing and then their ability to sign to sign language or speech or both. Okay the second bullet point they're hard of hearing respondents are more likely to be sexually abused as children than deaf respondents and so now I think that in general deaf and hard of hearing kids are going to are more likely to be sexually abused than hearing kids. I mean there's research to support that as well but within these groups within this group of people with deaf and hard of hearing the hard of hearing kids are more reported more sexually abused when they were children than the deaf ones do. Females are more likely to experience separation or divorce as children than their male peers. So you know I think that I'm not so sure about this one because I think that you know divorce rates in the United States are at about 50 percent so it doesn't you know whether the parents have a male or a female child the divorce rates are going to be about the same but in our study the girls were the females were reporting that their parents were divorced more so than the men. We did not have a lot of females out to check what the what the number is on that but that was what we got on that one. This is also common too that males have longer incarceration than their female peers so we we know that the deaf males are going to be locked up for longer periods of time now they also may have committed more serious crimes which is often the case where females commit less serious crimes. In general two judges and courts tend to extend more trust to females than they do to males and so they are often given shorter sentences and then of course the number of aces like to me this is the most interesting one the number of aces was positively correlated with the number of times incarcerated and this is especially true for males so when you've got when you when the more childhood abuse that you experience the more or that you perceive the the more times that you're likely to get incarcerated or for longer stains so I think we kind of come to the conclusion here that that the deaf people who are incarcerated are clearly have aces in their in their childhood and and and they're reporting that they impacted their function as adults so as we get to the last 15 minutes here I want to go ahead and talk about you know resiliency like what what what can we do about this so I like to use an ecological approach I'm not sure if you guys are familiar with this it's it's it's becoming more common in the United States but it's really not common enough I think a lot of times we look at issues in isolation and we forget that we are all living in a system I mean your school's function in a system where there's leadership and the things that you do affect the people around you so I like this graphic because it's it's done by Yuri Bronfenbrenner and Bronfenbrenner is a big fan of the ecological approach and he talks about how these for a child it's the systems that are closest to them that affect them the most so the school the family and the community around them but then if you start to expand that there's an exo system that's the parents workplace health services extended family those also affect the child just indirectly let me give you an example in case you're not catching it okay if if you're if a person is working a job where the boss says you can't you can't flex your time you have to be here by 8 o'clock in the morning and the child doesn't go to school till 8 30 then that that adds stress to the parent and and and it may result in a change of employment or maybe a lower income family stress maybe increased risk for domestic violence at home so there's there's there's a lot of implications for the workplace and then on the outer edge the macro system we've got the laws the government we've got the bigger picture and if you think about about about that you know how does that impact the child directly I mean I think about about you know law laws that we have in the United States I mean sometimes there's there's a government policies that fund people who have children you know it helps them with their child care if they're from a lower socioeconomic group if the government decides they're going to cut that then a parent may struggle you know to make ends meet and the child may have less supervision they may have less parental time with their parents so all of these systems do interact and they have an impact on the child so we all we all play a part in helping to reduce ACEs let's go to the next slide I want to be sure I finish I'm not sure where I'm at because it's hard to see the total number okay so I want to talk about building resiliency these are some things and we don't have to spend a lot of time on these but these next couple slides are things that could potentially help deaf kids like for example child welfare programs should be focusing on the needs of deaf kids like I don't know about in Canada but in the United States it's very rare for states to try to identify and search for foster parents you know sign language that's really not hard to do you know if they were if they were to have a media campaign to try to recruit parents who know sign language I would imagine lots of interpreters and and and and parents of other of deaf children would say I'll go through that process I'll become certified as a foster parent you know I have never seen that happening by any state government in the United States but it should be happening to try to improve the child welfare system when kids are abused also you know schools should be part of the system educating children on risk on reporting and on personal safety and in the United States there's not enough of this there's so much pressure on academics you can walk into elementary schools and see um children sitting and not they're not really doing life skills they're doing academic skills they're not learning about personal safety and they're not they're not doing some of the things that they that I think could be helpful for them we could also schools could also be screening using modified ACE screeners where they identify kids who have ACEs in their homes and they follow them and track them and monitor them and try to offer support when needed let's go to the next slide the justice system I don't know about Canada but in the United States the justice system is is really you know unfair there's not enough training for attorneys to understand you know the needs of deaf and hard of hearing people you know oftentimes attorneys misunderstand you know why a deaf person might commit a crime and they uh don't realize that they could potentially be innocent or they're they don't understand that their language functioning is not is not has nothing to do with their cognitive functioning and so they might think that a deaf person who can't speak has uh has a cognitive delay and intellectual impairment I mean really we need to be training attorneys to work better so that deaf people can can go can get a fair shot at the justice system and those who are incarcerated should be identified and tracked okay let's go on to the next slide family stressors you know one of the issues here is if you're looking at the slide the underlying one language deprivation you know there's there is a lot of new research that's going into language deprivation you know if a child can't hear and they're only being exposed to oral education and that's not being that's not effective for them then they really are language deprived and that often leads to a lot of confusion and it's very possible that that is the first ace for most deaf kids that they're not able to communicate and that puts them at risk as well but there's all there's lots of things that we can do to improve you know the situation for families you know for example doing home visits I don't know if they do this in Canada but in the US when a child is zero to three they do home visits but those really could be extended to like zero to seven helping parents to communicate better and connect better with their kids research shows that home visits also improve safety at home for example if a parent who's aggressive knows that a social worker is going to come visit them once a week they're less likely to be physically aggressive with a child let's go to the next slide okay I don't know why that I don't see anything there that's can you click it I don't see anything do you all know Dr. Lomas there wasn't anything on the slide nor the resources slide I thought you're going to be giving us bullets on those points or else I would have let you know that okay all right did you guys grab the most recent one I sent you all that okay okay well I'm gonna have the moderators forward you all my most most recent one I I thought I had sent it to to the to the moderators but maybe I didn't I want you guys to know that there's a lot of work that's going on to reduce vulnerability and I'll end with this okay the the hands and voices group in partnership with them well with really with the whole with a number of people have been trying to they've been trying to reduce vulnerability by just building awareness of child abuse and neglect early on um so they have a white paper on child maltreatment that's been approved by the leadership of the council for exceptional children CEC on deathbed.net deathbed.net on the website there there's a whole list of resources there where you can go to and you can download papers and sample IEPs individual education plans on child safety so that you can include it in student curricula. There is there's also other resources there's a there's a website that was that was developed by researchers in deaf education called the radical middle um and these these are researchers who felt that we have too many people in our field who are kind of working on the fringes like it has to be oral or it has to be sign language and we're not coming together enough to prevent a you to present a unified voice and so if you go to if you google the radical middle deaf education you'll find a website there and you can find resources about about reducing vulnerability and improving child safety on that site as well um I don't remember some of the other pieces that I had in the slide so I think since I've only got about two minutes left I'd like to just I don't know who's there maybe we could open it for a question or two. Dr. Lomas am I on? We do have a couple of questions uh it's I'm sorry I have to read off of a computer here sorry. In Edmonton we have students who are newcomers and meaning new to Canada and the deaf and hard of hearing some of the newcomers are refugees who have fled their homes war or conflict they have witnessed parents family and community members tortured or killed clearly this is a trauma would this be considered part of ACE does ACE continue to require adaptations or changes? Absolutely you know child abuse is is sorry are you ready yeah witnessing child abuse is just as traumatic as experiencing child abuse witnessing violence can be just as traumatic as experiencing it so I would say that those children that you are identifying are part of that group that I think should be tracked for several years and there there should be perhaps special programming for their caregivers there's some interventions that are wonderful parent child relationship therapies um there's um one called fair play where it helps the caregiver bond better with the child through through play and through some contact like um it's called the MIM the marsh shark interaction method where the parent and the child connect better where they build trust so and then making sure that they have good communication and counseling for their prior trauma so critical good question thank you um there's one other question and it is um regarding your study on ACEs and it was on average how many ACEs did your participants have gosh that's a great question I see it down there in the bottom corner and I I wish that I had that at my fingertips but I do not so I'll I'll tell you what when I'm done with my write-up in the next four to six weeks I'll forward the manuscript on and you guys and I'll answer your question for sure thank you for that Dr. Lomas and thank you for providing this information to us and the overview of your research um I look forward to reading your research but also I'm wondering if you this is Sarah Burns if you could forward to me the slides that we're missing I'm sorry I should have nudged you regarding that and I will forward it to the people who are attending and it's it's valuable information it's not always pleasant information but I think many of our children are are needing to have that lens as we work with them thank you for your time I need to speak to the group and remind them that our March professional learning community was changed to June 11th and we will and if you the individual who is speaking has a Manchester accent there from England and if you need to you can preview the video of him uh and I sent that out to people uh last month thank you Carla for interpreting and Jeff for captioning and this media team Terri and Mo and Elena for their continued support here thank you