oregon deaf hard of hearing services a program of l.
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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
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
things to know when working with deaf hh patients3
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
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
  • 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”
myths about hearing loss
MYTHS about hearing loss
  • Everyone can lip-read
  • Lip-reading gives 100% understanding

**KEY = Context

myths about hearing loss7
MYTHS about hearing loss
  • Hearing aids are the solution
  • Everyone knows sign language
  • Everyone knows English
medical model vs social cultural model of deafness
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
clues that a person may have a hearing loss
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
clues that a person may have a hearing loss10
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
communication tips
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
communication modes
Communication Modes
  • Oral, Lip-Read
  • Total Communication
  • Gesture ~ Body Language
  • Writing
american sign language asl
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.
components of asl
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.
characteristics of deaf people
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).
deaf culture
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


Hello, This is Joe. I will be late


I need a vaccine shot


My face has broken out in purple rash


Do I need to renew my driving license?

overcoming linguistic barriers
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
overcoming linguistic barriers19
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.
how to use an interpreter
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
sign language interpreter
Sign Language Interpreter
  • Since ASL (American Sign Language) is a completely different language from English; it cannot be translated "word for word",
interpreter vs signer
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
how to request an interpreter
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



(interpreter request form)


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