Oregon Deaf & Hard of Hearing Services A Program of….

1. Oregon Deaf & Hard of Hearing ServicesA Program of….

2. 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

3. 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

4. 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

5. 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”

6. MYTHS about hearing loss • Everyone can lip-read • Lip-reading gives 100% understanding **KEY = Context

7. MYTHS about hearing loss • Hearing aids are the solution • Everyone knows sign language • Everyone knows English

8. 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

9. 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

10. 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

11. 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

12. Communication Modes • Oral, Lip-Read • Total Communication • Gesture ~ Body Language • Writing

13. 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.

14. 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.

15. 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).

16. 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

17. “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?

18. 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

19. 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.

20. 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

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

22. 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

23. 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 Jeff.Brownson@state.or.us http://oregon.gov/dhs/odhhs/ecs_home.shtml (interpreter request form)

24. 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 Bentley.fink@state.or.us www.oregon.gov/DHS/ODHHS