Author Archives: Lydia Callis

About Lydia Callis

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Realtime Captioning Services For Events: What is CART?

cart-services-for-deaf-real-time-captioning-top-asl-agency-nyc-01Live captioning services can provide those who are Deaf or Hard of Hearing with full access to presentations, lectures, or videos that they would otherwise struggle to understand. But really: every attendee at an event can benefit from captioned content!

Communication Access Realtime Translation (CART) — more commonly known as Live Captioning, or Realtime Captioning — is the instant translation of spoken word into text using a specialized set of skills and equipment.

According to Mirabai Knight, the owner of Stenoknight who has been providing professional captioning services to businesses and organizations for over a decade, the goal is “to provide realtime text transcription with as little delay as possible, as close to verbatim as possible, including sound cues and omitting filler words (like ‘um’ and ‘uh’), under the guidance of the Deaf or Hard of Hearing consumer.”

The result is precise captions which can be displayed on an individual’s computer monitor, projected onto a screen, combined with a video, or otherwise transmitted for audience accessibility. Realtime Captioning service can be employed as an auxiliary aid in certain situations to ensure equal access for those with hearing loss, as guaranteed by the Americans with Disabilities Act. If a person’s preferred means of communication is sign language, captioning can be used in tandem with ASL interpreters to ensure full access for the Deaf individual.


live-captioning-services-for-events-tri-state-east-coast-nyc-02Imagine attending an all-day conference where you’re extremely interested in the topics being discussed during the presentations, but you keep missing important bits of information making it difficult to keep up with the lectures. Perhaps your mind is fatigued after several seminars, or the presenters speak very quietly, or you missed breakfast and just can’t focus.

Most people have been in a situation where— for one reason or another— they were not able to follow along with a presentation. This can be a frustrating experience and, for those who are Deaf or Hard of Hearing, an unfortunately common one.

Approximately 15% of American adults, or 37.5 million people aged 18 and over, are currently living with some level of hearing loss. This is a significant percentage of people who might be sitting out there in the audience, either working overtime to understand the presentation, or completely disengaged because they can’t hear a thing.

As Knight explains, “post-lingually deafened or hard of hearing people who don’t sign fluently or at all tend to benefit most from captions, though signing Deaf people in highly technical or medical fields sometimes prefer realtime captioning either as an adjunct to sign interpreting or by itself in certain specific scenarios.”

Now take into consideration the number of individuals in the audience who may have learning disabilities, cognitive disabilities, or other conditions which could limit their ability to hear or focus in a crowd. There may be audience members for whom English is a second language, or a speaker with a strong accent that makes them hard to understand.

Without captioning, how many attendees are really missing the full impact of each presentation?


captioning-services-court-reporting-agency-03Providing Realtime Captioning is an easy way to increase the accessibility of an event, conference, or presentation for all audience members. Studies have shown that captioning improves both comprehension and engagement, as viewers spend about 40% more time watching captioned video. Realtime Captioning is a worthwhile investment because it offers presenters the opportunity to connect with a greater portion of the audience in a more effective manner.

Captioning providers are sometimes called stenographers. Stenographers are professionally trained to transcribe spoken language to shorthand, which is then turned into realtime text using specialized software. They strive to faithfully communicate the intention of the speaker and maintain the integrity of the message.

Professional Realtime Captioning providers are certified by the National Court Reporters Association (NCRA) and bound by a code of professional conduct, which includes ethics and confidentiality. The NCRA was created in 1937 to establish a national set of standards and best practice, and they offer a variety of certifications for various settings.

nyc-real-time-captioning-infographic-top-asl-agency-04Knight offered to share a bit of insight into the type of training and experience that stenographers accumulate. “I spent a year and a half in court reporting school attaining a speed of 225 words per minute with 95% non-realtime accuracy, but before I started I knew I wanted to do realtime captioning exclusively, so at the same time I was using my steno machine for offline captioning at a small television captioning company and rigorously training my realtime skills as I built speed.

“When I earned my speed certificate, I worked under an experienced captioner in a university for a year before striking off on my own, and earned the Certified Realtime Captioner (then the Certified CART Provider) certification soon after. I’ve continued to hone my skills in the 11 years since I began captioning professionally, earning the 260 WPM Registered Merit Reporter certification, specializing in medical and big screen technical conference work, and doing my best to seek out the most high stakes and challenging material I can find.”


top-CART-realtime-live-captioning-services-for-presentations-events-corporate-nyc-ct-nj-05There are two types of Realtime Captioning Service frequently used to accommodate the needs of those who are Deaf or Hard of Hearing during presentations.

  • Projected CART: Captions are created in realtime by the provider utilizing their steno software, and the text will appear directly on the presentation screen or monitor. This requires the venue or event planner to provide a display connection and extension cord.
  • One-to-one CART: This is best when there is only one consumer who needs captioning service, typically in a smaller venue like a classroom. The Realtime Captioning provider translates the spoken word into text and it is live streamed to the consumer’s laptop or mobile device via WiFi.


Since Realtime Captioning is such an effective way to improve communication access at conferences or events, it’s a good idea for venues and organizers to get a contract on file with a local agency that provides captioning service. Having an existing relationship with a provider makes the process of requesting services much smoother when the time comes!

live-captioning-services-cart-technology-mobile-info-faq-contact-05There are less than 650 currently NCRA certified and registered professionals working in the United States with a variety of specialties— this can put providers in short supply. Making requests for Realtime Captioning (CART) service with 14-30 days lead time, and providing the agency as much prep material as possible in advance, will help ensure coverage from a qualified stenographer.

Request the start time at least 30 minutes prior to the start time of the actual presentation to allow for technical setup. On the day of service, the stenographer will arrive on site with their equipment and software and will work along with the AV team and organizers at the venue to make sure both they and the consumers are in the correct place.

After services have been provided, be sure to check in with the consumers to gather feedback on the quality of captioning and be sure to contact the agency for followup if necessary!

LCIS is thrilled to offer CART Services to meet the Live Captioning needs of clients in the new New York City metropolitan region and New Jersey for a wide variety or entertainment or professional events. We make the process for securing CART Services and providing equal access as simple as possible. LCIS offers quality services for Deaf and Hard of Hearing consumers with a strong emphasis on client satisfaction. Call us today at (917) 210-5804.

5 Things to Look for When Hiring Sign Language Interpreters

hiring-professional-asl-deaf-interpreter-individual-business-corporation-faq-general-info-01Imagine rushing to the hospital because a family member has been injured, but when you arrive nobody can tell you what happened because you do not speak the same language. Sitting bedside, holding the hand of a loved one who is broken, bleeding and unconscious, you have no idea what occurred, what is going on, or whether they will be ok. Many hours later an interpreter finally arrives to provide communication, but they start interpreting things that don’t even make sense. Something about surgery for a basketball … test … later friendship? What? The interpreter is not effectively communicating the message from the doctors, which just results in more frustration and confusion during an already stressful situation.

All Interpreting Agencies Are Not Created Equal

hiring-sign-language-interpreter-general-info-02Unfortunately it is still common for individuals with hearing loss to endure substandard ASL interpreting services provided by low quality interpreters. Because there is no mandatory national standard for requiring licensure and certification, poor interpreting services continue to deny Deaf individuals the ability to participate in conversations that impact their lives. Hiring unqualified interpreters is ultimately a waste of financial resources, and can open an organization up to potential violation of the Americans with Disabilities Act (ADA).

A person who is hiring sign language interpreters for the first time may not be sure what to look for in a provider or agency. Ensuring quality interpreting services for Deaf individuals can be especially challenging to those who do not know American Sign Language and are unfamiliar with Deaf culture. Below are 5 things to look for when assessing the quality and capabilities of a sign language interpreting service provider.

1. Look For: Agencies That Specialize In Signed Languages

how-to-hire-sign-language-interpreter-tri-state-03Signed languages are unique because they are visual languages, existing in 3-Dimensions. ASL is a distinct language with its own grammar rules and structure. It relies heavily on facial cues and body language, as well as the use of classifiers to convey meaning. There are signs commonly used within different industries for specific terminologies, and even regional dialects.

There are many large multi-language agencies out there offering sign language interpreting services, but they do not have a vetting process that ensures the quality of their interpreters. Working with an agency that specializes in signed languages can help assure effective communication from interpreters that have the appropriate skills and credentials.

2. Look For: Deaf-owned, Coda-owned, or Interpreter-owned Agencies

An agency that is owned by an individual who is Deaf, from a Deaf family, or a seasoned ASL interpreter can offer advantages over the competition. The owners of these agencies will have the firsthand experience to navigate language and cultural barriers, and they will be able to create workability for both Deaf and hearing parties to ensure effective communication.

sign-language-interpreters-faq-04Individuals who are Deaf, or individuals who were raised in Deaf families – Codas (Children of Deaf Adults) and Sodas (Siblings of Deaf Adults)— have a strong tie to American Sign Language and the ability of this language to empower those with hearing loss. For many of these individuals, ASL is the language of their families and/or their friends. To those involved in the Deaf community, ASL is more than just a language, it demonstrates the importance of connection and the freedom of self expression.

Interpreters who have a strong background providing reliable services in a variety of settings understand what full accessibility looks like all along the spectrum of hearing loss. Over the years, Deaf consumers will share with interpreters some of the challenges that they face. Interpreters often witness lack of access when in the field, and have experience working alongside both hearing and deaf clients to come to effective resolution.

Agencies that have direct involvement within the Deaf and Hard of Hearing community will have an understanding of current topics surrounding civil rights, technology, and social issues that concern those who are Deaf/ HoH. Cultural competency at these organizations is likely to be higher among agency staff and interpreters.

3. Look For: Agencies that Provide Resources and Support for Their Clients

hire-best-asl-interpreter-nyc-ct-nj-tri-state-info-05In the search for interpreting service providers, it’s a good idea to look for agencies that emphasize ongoing support for their clients. Seek agencies that provide not only interpreters, but information to help the communication be effective and successful.

Sure, it’s great that the interpreter showed up. But does the hearing staff know how to utilize their services? Do they know where the interpreter should sit or stand? Do they know how to address the Deaf individual through the interpreter? Do they know how to follow up if the interpreter was not effective, or displayed unprofessional behavior?

One way to assess whether an agency provides client support is to browse their website and/or social media to see what kind of resources they provide for free. Look for agencies that offer opportunities to make further connections within the Deaf community, as well as current news and events. Another way is to contact the agency directly with any questions to evaluate whether they are generally responsive and helpful.

4. Look For: Agencies That Value Their Interpreters

As with any occupation, the way that an agency treats their workers is a reflection of their company values. Interpreters are typically contractors, meaning they are freelancers who have control over their schedule and who they work with. Quality ASL interpreters will flock to agencies that show respect for their time and have a positive reputation among Deaf consumers.

How can a person looking from the outside know if an agency values their interpreters? Here are a few simple ways to tell:

  • They assign Team Interpreters: This ensures the accuracy of services for the Deaf consumer, and protects interpreters from exhaustion. Due to the physical and mental nature of ASL interpreting, interpreters will begin to experience extreme fatigue after about an hour of interpreting alone. When a request is made for interpreting services that requires over one hour of consecutive interpreting, a second interpreter should always be assigned to work as a team throughout the requested time.
  • They assign Deaf Interpreters: Deaf interpreters work as a team with a hearing sign language interpreter to ensure the accuracy of communications when working with Deaf individuals, especially in traumatic or emotionally distressing situations, or when communicating with individuals for whom ASL is not a first language. There are times when the only person who can really understand a Deaf individual is another person who is Deaf. This is true when it comes to language skills, since not everyone uses formal American Sign Language, and it is also true when it comes to recognizing and navigating instances of institutional oppression. Agencies should advocate for the use of Deaf interpreters in situations where cultural barriers and power dynamics can influence the outcome of the communications. (More on the value of Deaf Interpreters HERE).
  • They have a fair Cancellation Policy: Most Sign Language Interpreters work as contractors, so they are freelancers responsible for filling up their own schedules to generate income. Interpreters will plan their schedules out weeks in advance to line up assignments in a way that makes sense for transporting around the city to different locations. Agencies that value their interpreters will protect the time of their contractors by ensuring they are paid by the client for the time they block off in their schedule if the request is cancelled without a reasonable amount of time to secure another job. Typically, this means at least 2 business days advance notice. Quality interpreters will only work for agencies that demonstrate value for their interpreter’s time and respect for their schedules.
  • They emphasize ongoing professional development: When reviewing agencies, it’s advisable to look for those who work with Nationally Certified interpreters and interpreters who have completed an Interpreter Training Program. Seek agencies that openly advocate for higher interpreting standards, and organizations that offer interpreter mentoring programs for those new to the field.

5. Look for: Agencies that Seek Feedback

general-info-hiring-asl-deaf-interpreter-medical-settings-businesses-06Customer and client feedback is essential to the development of any organization. Since agency owners cannot be in the field with interpreters at all times, reaching out to both Deaf and hearing consumers can help an interpreting agency maintain an exceptional level of service and to quickly resolve any issues that may arise. Seek agencies that are easy to connect with and consistently responsive to inquiries, both before and after services have been rendered. Interpreting agencies that actively solicit feedback demonstrate commitment to ensuring quality and satisfaction.

LC Interpreting Services has more than 200 highly skilled sign language interpreters working in a variety of fields to provide communication access between Deaf and hearing individuals. LCIS offers top quality interpreters for individuals and organizations of all size throughout the greater NYC metropolitan region and New Jersey. Our interpreters are carefully screened and assigned based on experience and qualifications to ensure the best possible services for clients and Deaf consumers.

Contact us today to BOOK AN INTERPRETER!

Innovative Inclusion, LLC: Resources and Solutions for Deaf and Hard of Hearing Inclusion

Over the years, LC Interpreting Services has had the unique privilege of providing Sign Language interpreting and other communication services for organizations of every size, and d/Deaf individuals from all walks of life. From our experiences, we’ve come to understand the most common difficulties that businesses encounter when it comes to providing Americans with Disabilities Act (ADA) compliant accessibility and fostering an inclusive workplace. We’ve also witnessed the frustrations that Deaf and Hard of Hearing individuals face when it comes to basic communication access in everyday situations, overcoming cultural stigmas, securing gainful employment, and advancing in their careers.

So our sister agency was born! Introducing: Innovative Inclusion, LLC.

Innovative Inclusion was created out of our desire to help build more meaningful, productive relationships between professional organizations and their Deaf and Hard of Hearing employees, clients, customers, and the community as a whole.


ada-deaf-hoh-compliance-consulting-workshops-company-programs-inclusion-diversity-01Innovative Inclusion ( See our introduction video on Vimeo here ) is a consulting agency that creates workshops, training programs, and resources for businesses that want to ensure they are meeting their legal obligations under the ADA, providing appropriate and affordable communication options, and maximizing the many benefits of working with the Deaf and Hard of Hearing population.


We design actionable diversity and inclusion initiatives that have a lasting impact. Innovative Inclusion’s programs are created in close collaboration with Deaf and Hard of Hearing advisors, and then implemented by qualified Deaf/ HoH trainers and consultants. The result is a groundbreaking set of culturally competent workshops and resources that can be beneficial on their own, or combined to create a comprehensive Deaf Cultural Competency Training Program to meet the specific needs of any business.

Our network of experts and reputable resources is continuously expanding, which allows us the unique ability to create new partnerships and innovative opportunities.


Innovative Inclusion offers the following flexible program options for businesses and organizations of all types and sizes:

  • Deaf and Hard of Hearing Cultural Competency Workshops
  • Employee Training Assets
  • ADA Compliance Consulting
  • Workplace Accessibility Consulting
  • American Sign Language Training
  • Captioning Services

& More! …Contact us to discuss custom packages.


best-nyc-usa-ada-deaf-compliance-consultant-company-cultural-compentency-programs-02As a community-led organization, Innovative Inclusion places high value on creating new connections. We’re always seeking motivated individuals to add to our growing network.

If you are a Deaf or Hard of Hearing individual or ally, connect with Innovative Inclusion to:

  • Learn about employment opportunities
  • Explore possibilities for consulting work
  • Develop content
  • Get involved with the Innovative Inclusion online community
  • Connect grassroots advocacy groups with a larger network

Be sure to subscribe to our newsletter and follow us on social media for the latest updates and information!


Also, to keep up to date with ADA compliance and Deaf Advocacy, community, research and trends, check out our blog at !

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5 Deaf Accessibility Solutions We Hope to See in 2018

Our society was designed from the ground up to accommodate the needs of able-bodied individuals, so there are times when everyday situations can become a struggle for those who are deaf. There are barriers to basic access that limit the rights and freedoms of those who can not hear, subtly perpetuating an existing structure of oppression.

Even with all our modern technology, progressive innovators have failed to address some of the real problems that persist when it comes to accessibility. Below are 5 accessibility issues that could use more attention in 2018.

Movie Theater Captioning

new-deaf-access-solutions-2018This past month, actor and activist Nyle DiMarco tweeted about his unfortunate experience at AMC Cinemas after attending a screening of the much anticipated Black Panther movie. Frustrated with the wild inconsistency of the captioning, which was dropping entire blocks of dialogue, DiMarco left the theater only ten minutes into the film. Hundreds of other deaf individuals joined DiMarco’s Twitter thread to share their own stories of failed captioning systems and culturally incompetent employees at cinemas; most concluding with a resignation that movie theaters are still not friendly places for deaf or otherwise disabled patrons.

Movie theaters are a place of public accommodation where people from all walks of life are entitled to share an experience. A culturally significant film such as Black Panther, or a film that elicits rabid fandom like the Star Wars series, can be meaningful to people’s lives. Everyone deserves to share in that excitement and collective social moment if they so choose.

The closed captioning devices that deaf movie-goers are given to use make it difficult to focus on both the film, which is in the background, and the screen, which is in the foreground. The constant shift in focus can be exhausting, and can also cause the viewer to miss a great deal of the action in the movie. Captioning glasses offer a similar experience.

When reading tweets in the thread started by DiMarco, it becomes clear that open captioning (with the transcript right on the screen) is the preferred accommodation for deaf audiences. But movie theaters do not want to scare off the much larger audience of hearing people by offering all showings with open captions. Captioned showings are offered infrequently, typically at odd times, and there are even reported instances of movie theaters actually turning off the captioned version after hearing viewers complain.

We live in a time of liquid HD film and 3D IMAX cinematography and hologram performers, but deaf people can’t just enjoy a simple night at the movies. Wouldn’t it be great to see an elegant technological solution that meets the needs of deaf audiences while maintaining appeal to mainstream patrons?

Text-based Emergency Alerts and Service Lines

new-deaf-access-solutions-2018-bAlthough its true that programs like text-911 and text emergency alerts are beginning to roll out across the country, they are still embarrassingly unreliable considering the availability of technological resources in this era. Emergency management systems continue to malfunction, for example the alarming recent false missile alert that was sent out to mobile phones in Hawaii, which was not corrected by a follow-up text for a full 38 minutes.

Those who can hear have more immediate access to updates during emergency situations, which literally places deaf people at a disadvantage for survival. What kind of innovative modern federal emergency alert and management solutions could be created if this issue was granted the kinds of intellectual resources, research funding, and priority that it deserves?

Interpreted Concerts and Performances

kimmell-2chains-performance-asl-translator-cThis is a fact that was for too long hidden, covered up, and denied, so it deserves to be repeated with great frequency: people who are d/Deaf deserve full access to the cultural arts!

People who are deaf deserve access to every moment of shared collective joy, pain, awe, introspection, and outward rage that can be elicited through performance. To deny a person this experience is to deny them access to the very culture in which they live and the possibility of meaningful human connection. From Broadway shows, to the national anthem at a baseball game, to a pop concert, and everything in between, each and every person in attendance should be able to share in the energy.

This is an accessibility issue that can be resolved without the use of robotics or engineering! For those who use ASL to communicate, a properly placed, qualified sign language interpreter is the best option for full access, and if possible, hiring a deaf interpreter or trained performer. Yet there remains a stubborn set of barriers when it comes to access for the performing arts, namely a lack of cultural competency when it comes to accommodating a deaf audience. Often those organizing and hosting cultural events overlook their ADA obligation to provide equal access when creating a budget for the production, then find themselves scrambling to find the funding for accommodations.

Performing arts are an outlet for self expression; a way to explore complex human emotions and taboo topics. Theaters, venues, and even musicians themselves are being pressured to evolve to meet the demands of culturally aware audiences, who value inclusion.

Video phone services in jails and prisons

new-deaf-access-solutions-prisons-incarcerated-2018The rights of deaf inmates are extremely limited and often violated. There are thousands of deaf prisoners all across the country — a number of them wrongfully convicted — yet less than 10 prisons in the United States have video phones.

Inmates are routinely denied access to their families, friends and legal counsel because effective communication technologies are not present, or because the staff does not know how to operate or “supervise” calls on the outdated and unreliable equipment. Incarcerated deaf people grow increasingly isolated.

As inmates, deaf people are left out of orientations and safety meetings, and denied possibilities for social interaction. Prison televisions without captioning remove yet another line to the outside world. Deaf prisoners are denied access to post-secondary education and extracurricular activities. The end result is emotional withdrawal and deteriorating mental health.

The increase of civil rights activism in our country paired with the constant evolution of technologies could truly benefit prisoners who are deaf. Technological developers seeking a way to “give back” or solve a real social problem should consider assisting this extremely marginalized and silenced segment of the population.

Public and private transportation

new-deaf-access-solutions-notifications-emergencies-2018-bIt’s hard to believe that it’s 2018 and we still haven’t found a consistent and effective means of communicating time, gate, and route changes for major transportation methods. Deaf people still frequently miss train and plane announcements, which often happen at the last minute. Visual notifications at airports can lag, and airport staff are not all trained to be culturally aware when interacting with a lost passenger who is deaf.

Transportations apps are great in theory, but in-practice they’re often glitchy, not updated in real-time, or cannot be accessed while traveling underground. This not only impacts deaf passengers. For example: if a flight boards 30 minutes early, any passengers who have just stepped out to get some fresh air or who are in a smoking area can very easily miss the overhead announcement. Transportation companion apps are rarely innovative or even user-friendly. Sometimes the apps work smoothly and as intended, then other times the apps crash or close out at critical moments, leaving travelers without the tools they need. For passengers who can not hear, this can be very confusing and frustrating.

If airlines and public transportation companies hope to regain the numbers they continue to lose, they may want to make a serious investment in the way they digitally connect with passengers. Making transportation a seamless and integrated experience in people’s lives can help more people experience the benefits of traveling.

new-deaf-access-solutions-robotics-ai-2018-eIntricate robotic communication devices, such as “sign language gloves” and intuitive interpreting apps, have always captivated the minds of innovators looking to help bridge the gap between the deaf and hearing world. If advanced to a stage of development where they functioned as intended, these types of devices would offer an interesting new option for deaf and hearing individuals to communicate in one-to-one, or maybe even small group settings. However, most people who are actively involved with the deaf community know that navigating the language barrier during calm, planned personal interactions isn’t the most pressing accessibility issue that people who are d/Deaf/Hard of hearing face.

Perhaps before developing all sorts of high-tech “solutions,” ambitious innovators could slow down and take a moment to understand the real problems faced by the deaf and disabled communities. They could help to level the playing field for these communities moving forward. By creating genuine connections with the people that they hope to help, socially-minded individuals in the STEM fields can truly begin to change the world.

Accessibility for Medical Practices

asl-accessibility-medical-practices-01I can recall a number of times throughout my childhood when my mother and siblings were turned away from receiving medical care simply because they were deaf. Sometimes they would arrive to a scheduled medical appointment where there were just no interpreters or accommodations, or other times they’d be denied the opportunity to even schedule an appointment. The person at the desk would tell my mother that their office wouldn’t accommodate the needs of deaf patients, and perhaps offer a referral to an office located all the way across the city. Not only are these practices totally illegal, but it is a form of oppression, and it unfortunately still happens today.

Despite the Americans With Disabilities Act (ADA) being law for more than 25 years, deaf individuals continue to face difficulties when seeking medical care. In 2014, a woman in Washington State arrived at the hospital for a planned induced delivery only to discover that her request for an interpreter had not been fulfilled. When the delivery became complicated and a cesarian section was necessary, the woman struggled to comprehend what was happening. Less extreme situations commonly go unreported. A deaf person who needs to see a doctor but gets turned away at the desk might get upset and frustrated, then just book an appointment somewhere else— but it would be well within their rights to bring a lawsuit against the doctor’s office for violating Title III of the ADA, which guarantees equal access to privately owned places of public accommodation.

For the most part, medical office staff do not maliciously engage in oppressive behaviors toward deaf patients. The disconnect is typically a general lack of knowledge. It should be a priority for office staff and medical practitioners to understand deafness, as more than 15% of adults in America are living with some level of hearing loss; and more than 25% of people over 65 have disabling hearing loss.

How to Interact with an individual who is deaf

asl-accessibility-for-medical-practices-02To help create positive relationships with deaf patients, medical office staff can familiarize themselves with a few basic communication strategies.

Often, the first frustrating hurdle to medical care occurs when the deaf patient calls the medical office to schedule an appointment and the receptionist hangs up on the relay call, thinking it’s a telemarketing call. Do NOT hang up on relay calls! Receptionists should be trained to recognize a call from a relay service and feel confident engaging with the deaf consumer in this way.

Some deaf people are able to read lips, but it’s not safe to assume anyone’s comfort with this method. Lip reading is generally not a reliable means of communication in a medical setting, unless the deaf individual explicitly indicates that they would prefer to receive their medical information using oral communication. Studies have shown that even the very best lip reader can only capture about 30% of what is being said. Always defer to the patient’s preferences.

If a deaf patient is in the office, notes can be a good way to communicate short, simple ideas. When interacting with a deaf individual, medical staff and providers should have a pen and paper available, or opt for digital using a smartphone or tablet to write back and forth. This can be a great way to ask the deaf person how they prefer to communicate, if they have their insurance card, or when they would like to schedule their next appointment. Notes may be a preferred method of communication for some late-deafened or hard of hearing individuals.

asl-accessibility-for-medical-practices-03However, for those who use American Sign Language as their primary form of communication, notes are not an effective way to discuss symptoms or deliver a diagnosis, since ASL is a unique language that doesn’t translate directly to English. If a deaf person who uses ASL arrives to the office and an interpreter has not been scheduled, office staff may use notes to communicate regarding the patient’s interpreter preferences and reschedule the appointment. Medical professionals must avoid pressuring deaf patients to proceed without an interpreter, as this can open up a potential liability.

Staff members and medical professionals should remember to keep checking in every step of the way to make sure the patient remains engaged. If one communication strategy doesn’t seem to be working, work together with the patient to create a more effective strategy.

Providing Interpreters

asl-accessibility-for-medical-practices-04Under the ADA, it is the obligation of the medical service provider as a public entity to offer equal access for all citizens. For those who identify as ASL users, the most reasonable accommodation is usually an interpreter.

Every medical practice, without exception, ought to have a current contract on file with a reputable local interpreting agency. Deaf-owned or interpreter-owned agencies are preferred because they offer higher quality services with a focus on consumer satisfaction. Be prepared! The ADA has been law for more than 25 years so the funds for accessibility services should be allocated into the operating budget; financial hardship is difficult to prove.

When requesting services, it is advised to provide as much information as possible to ensure a good interpreter match. Note that interpreters do book up in advance, so it is ideal to make the request with at least a week’s notice to secure coverage.

Family Members and Staff Members are NOT Interpreters

Utilizing a deaf patient’s family members or medical office staff as interpreters is a HUGE no-no, and a liability lawsuit waiting to happen. Medical interpreters are trained professionals with specialized vocabularies, they navigate both linguistic and cultural barriers using an established code of ethics.

If staff members at the medical office happen to know sign language, they should only utilize it to converse with deaf patients if they are fluent. A person seeking medical care does not necessarily want to help the receptionist practice their ASL. If a staff member is not a licensed interpreter, it is not appropriate for them to provide sign language interpreting services, nor is it appropriate for the family members of deaf patients to provide interpreting services.

Cultural Competency


Cultural competency training offers exciting opportunities for medical providers and support staff to connect with a segment of the population that has for too long been forced to the sidelines when it comes to their own healthcare.

A comprehensive training program led by deaf panelists can provide employees of a medical practice a safe space to work through common misconceptions, break free of stereotypes, and consider new perspectives. As a professional development program, cultural competency training helps employees understand their legal responsibilities, and cultivates a deeper sense of compassion.

For medical providers and employees within the medical care industry, of course people are the first priority. By laying a foundation of cultural understanding, it’s easy to build a successful practice that attracts diverse members of the community, and to earn a positive reputation for accessibility.

LC Interpreting Services is thrilled to offer Cultural Competency Training seminars for businesses and organizations, including medical practices. Working with a set of d/Deaf consultants, employees at all levels can deepen their understanding of deafness, Deaf culture, and d/Deaf communication to effectively bridge the persistent gaps that exist. Deaf and Hearing World: Bridging the Cultural Gap Cultural Competency Training is an excellent solution for progressive companies ready to take it beyond basic communication.

Happy Holidays from LC Interpreting Services

The holiday season is a great time to build meaningful connections and find new ways to communicate. This year, we’d love to help the hearing population learn to spread a little Holiday Cheer to their deaf friends, family members, customers, or just complete strangers! In the accompanying Video Blog, Tiffany will demonstrate the following holiday… Continue Reading

Emergency Management Systems Neglect Deaf Citizens

During an emergency, it is important that people know what is happening, when it will happen, and what steps they are expected to take. Traditional information channels leave dangerous gaps in communication— at the first signs of crisis, d/Deaf and hard of hearing people are forgotten. While America continues to reel in the wake of… Continue Reading

Deaf and Hearing World: Bridging the Cultural Gap

  Most people know, of course, that a language difference exists between people who are deaf and those who can hear. People who are deaf communicate using a variety of strategies, ranging from lip reading and speaking, to writing notes, using gestures, or communicating via American Sign Language. Deafness can be a different experience for… Continue Reading

International Week of the Deaf 2017: 5 Civil Rights Issues You Should Know About

This week is International Week of the Deaf, a worldwide celebration of deafness, d/Deaf individuals, Deaf cultures, and signed languages which is held every year at the end of September. This year, the theme of the week is “Full Inclusion with Sign Language.” Global celebrations like International Week of the Deaf have a ripple effect… Continue Reading

ASL Interpreters: How to Represent an Agency

One of the more interesting aspects of being an ASL interpreter is having the opportunity to work in a wide variety of settings with a diverse array of individuals. As an independent contractor or employee, ASL interpreters are assigned the responsibility to faithfully represent both deaf and hearing consumers in communication. But, beyond that, when… Continue Reading