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Oregon Deaf & Hard of Hearing Services A Program of…. Things to Know When Working With Deaf & HH Patients. Major causes of deafness Terminology Myths about hearing loss Medical model vs. social-cultural model Clues that a person may have a hearing loss Communication tips and modes.

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Things to Know When Working With Deaf & HH Patients

  • Major causes of deafness

  • Terminology

  • Myths about hearing loss

  • Medical model vs. social-cultural model

  • Clues that a person may have a hearing loss

  • Communication tips and modes


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Things to Know When Working With Deaf & HH Patients

  • American Sign Language and its components

  • Characteristics of Deaf people

  • Overcoming linguistic barriers

  • How to use an interpreter

  • How to obtain interpreters at OSH


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MAJOR CAUSES OF DEAFNESS

  • Heredity (About ½)

  • Rh Factor

  • Illness: Scarlet Fever, Rubella, Spinal Meningitis, Mumps

  • Accidents—Major Head Trauma

  • Meniere’s Disease

  • Aging

  • Noise


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Terminology

  • Use the term preferred by the person when referring to their hearing loss.

    • Most Deaf or hard of hearing people prefer “Deaf” or “hard of hearing” (usually depending on amount of residual hearing)

    • “Hearing Impaired” is seen by most Deaf and hard of hearing people as pejorative

  • “Big D” (Deaf): Culturally Deaf people (more on this later)

  • Hard of hearing: In this presentation, refers to people who have some useful residual, but who sign most or all of the time

  • DHH: Blanket term for “Deaf and hard of hearing”


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MYTHS about hearing loss

  • Everyone can lip-read

  • Lip-reading gives 100% understanding

    **KEY = Context


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MYTHS about hearing loss

  • Hearing aids are the solution

  • Everyone knows sign language

  • Everyone knows English


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Medical Model Vs. Social-Cultural Model of Deafness

  • Medical model perceives deafness as a pathology to be fixed

  • Social-Cultural model sees deafness as a difference to be accepted, much like skin or hair color

    • Recognizes that American Sign Language (ASL) is a true language with its own distinct grammar, syntax, and idioms

    • Recognizes that Deaf culture is a true culture with its own language, history, traditions, and social norms of behavior


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Clues That A Person May Have A Hearing Loss

  • Keep asking you to repeat

  • Wears hearing aid

  • Uses assistive devices

  • Straining to hear – puzzled look

  • Focus on lips instead of eyes

  • Do not respond when they can not see your face

  • Nod and smile when they really don’t understand


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Clues That A Person May Have A Hearing Loss

  • Misunderstands names & numbers (on phone)

  • Responds inappropriately

  • Speaks too loud or too soft

  • Interrupts when someone is talking

  • Participates less in group settings

  • Cannot hear in a noisy room


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Communication Tips

  • Have pad & pencil available

  • Gestures & facial expressions important

  • Refrain from putting things in your mouth or in front of your mouth

  • Do not shout or raise voice

  • Whenever possible always face the person with whom you are speaking

  • Clarify by rephrasing questions or statements

  • Select a quiet environment when possible


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Communication Modes

  • Oral, Lip-Read

  • Total Communication

  • Gesture ~ Body Language

  • Writing


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American Sign Language (ASL)

  • ASL is primary language—structure, syntax, grammar are different from English.

  • ASL is spatial & cannot be written

  • ASL is visual and Deaf think and see in pictures. Highly attuned to visual details due to hearing loss

  • 3rd to 5th grade average reading level for Deaf people.


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Components of ASL

  • Grammatical structures are indicated by facial expressions

  • Deaf people are more expressive than hearing people.

  • Expressions don’t necessarily reflect “here and now” but rather, the affect at that particular time of the experience being described.

  • Vocal sounds that do not resemble English words are common. *grunts, groans, whines* --stems from inability to hear and monitor their own voices.


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Characteristics of Deaf people

  • Inattentive to sounds and noises they make. i.e. loud steps, loud voices, smacking lips, gaseous emissions.

  • Deaf people communicate with an increased intensity when angry, upset, or in an emergency situation. Visual gestures are more dramatic or exaggerated.

  • Watching interpreters takes up more energy than does listening. Hearing is a passive sense, vision is an active sense (can’t control what you hear but can control what you see).


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Deaf Culture

  • Hearing loss necessitates a different way of behaving

    • Must have light

    • Deaf people love to chat, will often stay beyond closing

    • Cannot use drive-thru intercom, will drive directly to window

    • Deaf Standard Time (DST)—procrastination


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“HELLO JOE HERE LATE GO”

Hello, This is Joe. I will be late

“I NEED SICK SHOT”

I need a vaccine shot

“MY FACE PURPLE SPOT MANY”

My face has broken out in purple rash

“I NEED OVER LICENSE DRIVE?”

Do I need to renew my driving license?


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Overcoming Linguistic Barriers

  • It is the patient’s decision about what is “effective” communication.

    • An oral deaf person needs an oral interpreter or CART, just like a signing Deaf person needs an ASL interpreter

    • Offer an interpreter or Computer-Assisted Real Time Captioning (CART) services to every Deaf patient, every time.

  • Lower functioning Deaf patients may require a Certified Deaf Interpreter (CDI) in addition to the standard interpreter

    • CDIs are Deaf people with strong ASL skills as well as skills and training in using alternate communication modes such as drawing and gesturing; whatever is needed to meet the client’s communication needs


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Overcoming Linguistic Barriers

  • English fluency should NEVER be used to gauge a Deaf patient’s cognitive level

  • Reinforce verbal instructions with written and/or visual instructions

    • Any written instructions must be written to the patient’s level of understanding

    • See attached examples of visual instructions used for titration of medication dose

  • Test for comprehension of verbal instructions

    • Deaf people are the masters of the “smile and nod” and just because someone says they understand, doesn’t necessarily mean they do.


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How to use an interpreter

  • Speak directly to the deaf person; speaking through the interpreter, not to the interpreter.

  • Remember that hearing loss does not effect intelligence.

  • Speak at a normal rate of speed and use a natural tone of voice.

  • The interpreter should be seated next to and slightly behind the speaker.

  • In a meeting one person speaks at a time.

  • As a final courtesy, thank the interpreter


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Sign Language Interpreter

  • Since ASL (American Sign Language) is a completely different language from English; it cannot be translated "word for word",


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A certified Professional

Bound by a Code of Ethics: Confidentiality

Trained to facilitate communication

Stays within role

Skilled in interpreting

Knowledgeable in ASL & Deaf Culture

Interpreter vs. Signer

  • Family member or friend

  • Bound by trust as in friendship/family

  • May not have training

  • May interact inappropriately

  • May not be able to interpret accurately

  • May not understand ASL & Deaf Culture


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How to request an Interpreter

Jeff Brownson, Communications Coordinator

Oregon Deaf & Hard of Hearing Services

676 Church Street NE

Salem, OR 97301

503-343-7605 voice/tty

[email protected]

http://oregon.gov/dhs/odhhs/ecs_home.shtml

(interpreter request form)


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ODHHS

Oregon Deaf & Hard of Hearing Services

676 Church Street NE

Salem, Oregon 97301

(503) 373-7609 voice or TTY

(800) 358-3117 voice or TTY

[email protected]

www.oregon.gov/DHS/ODHHS


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