Tag Archives: hoh

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

asl-accessibility-for-doctors-06

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.

Raising A Deaf Child

Baby Sign Language NYC

After months of worrying about nursery colors and baby names, the big day has finally arrived! Your healthy bundle of joy is born with 10 fingers and 10 toes; crying and cooing in your arms. The baby is beautiful, your family is complete, everything feels perfect! Fast forward a few months down the road when, during a routine checkup, your pediatrician informs you that your infant can not hear. Suddenly, you’ve become the parent of a deaf child. What now?

Baby Sign Language

Discovering that a child is deaf can stir up a wide range of emotions in new parents. Most commonly, they feel shock, sorrow, and helplessness. Unfortunately, because many doctors deliver this news as a medical “diagnosis,” parents automatically believe that their child is ill. Or, worse, disabled! It causes a chain reaction of guilt, sadness, and fear. How will you raise your deaf child? You wonder if he or she will be able to have a good life. You wonder if you can “fix” them.

This topic is close to my heart because my grandparentsdeaf-children-asl learned that my mother was deaf when she was less than a year old. At that time, they didn’t know any deaf people, and had no idea what it would mean to raise a deaf child in a hearing world. My grandparents worried that their daughter would not be able to have a happy childhood, or a normal adolescence. Would she have friends? Would she be able to drive a car? Would she be able to laugh and have fun? There are so many misconceptions. Of course, as time went on, they discovered that deaf kids definitely can do all these things, and excel at them!

Selecting a method of communication for your child majorly influences where he or she will fit into society, and is critical to psychological development. There are several communication options to consider, depending on the child’s degree of hearing loss. Some parents choose to teach their deaf child to speak English using hearing aids and intensive speech training. In this approach, the child does not identify as deaf, and does not learn deaf communication.

ASL Cochlear Implant

Another option is the controversial, and increasingly popular cochlear implant– a fairly invasive surgical procedure where an electronic device is implanted into the baby’s head to simulate the sound-processing of a functioning ear. Modern science has come a long way with these prosthetics and, although the child will never experience hearing the same way as a non-deaf person would, they can technically hear. With many years of language therapy, cochlear implant patients can be nearly indistinguishable from their hearing peers. But communicating in the hearing world will never be simple for them, because science simply has not been able to replicate the subtle and specific nuances of our natural senses. These children are prone to rely on lip-reading and facial cues, and many require a number of educational resources to keep up with their peers in school. Parents are likely to consider this surgical procedure to “remedy” their child’s deafness because they want to make sure their child speaks and understands the same language they do. This is understandable, but is it what is really best for your deaf child?

As any deaf person will proudly tell you, deafness is an identity, not an impairment. They do not consider deafness a problem that needs to be “fixed.” Deaf culture is active, full of positive role models; and ASL is a rich, constantly evolving language. Another option for teaching your deaf child to communicate is to enroll him or her into a residential school. Deaf residential schools are staffed by deaf teachers fluent in ASL, who work with deaf toddlers all the way through high school to educate them in a way that is focused on their individual learning styles. Allowing your child to be deaf, to learn sign language, and to integrate with other deaf people is a great way to promote an atmosphere of equality, independence, and nurturing. The drawback of residential schools, of course, is that deaf children are separated from their parents. Fortunately, many have reported that the atmosphere of deaf culture fosters great mentor relationships at these institutions.

Being that I come from three generations of deafness, there is a high possibility that I may have deaf or HoH children, and I have to be prepared to teach my children both ASL and American English. If you wish to speak the same language as your deaf child, why not learn the language that was created just for them? Total communication strategy focuses on integrating both ASL and speech therapy, to provide opportunity, without altering the child’s identity. Embracing deaf culture as a family seems to me like a great compromise for helping your kids adjust to the world using all the tools available! Spoken communication is important in our audio world, but it is also extremely important for deaf children to be able to sign with their peers so they can communicate freely, and feel connected. If they decide not to speak out loud or sign later in life, that would be their choice. My guess would be they will cherish both hearing and deaf culture, and embrace both for the rest of their lives. Bilingualism is such a fantastic way to see the world through different eyes, and provides a real advantage to your deaf child! Now that I have provided you with the current options the choice is ultimately left in your hands. What will you decide to do?