Oregon Deaf

1
Oregon Deaf Hard of Hearing Services
A 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
• AccidentsMajor Head Trauma
• Menieres 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 dont 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 languagestructure, 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 dont 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 (cant 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?
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Overcoming Linguistic Barriers

• It is the patients 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
  clients communication needs

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Overcoming Linguistic Barriers

• English fluency should NEVER be used to gauge a
  Deaf patients cognitive level
• Reinforce verbal instructions with written and/or
  visual instructions
• Any written instructions must be written to the
  patients 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, doesnt 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
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

• 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
•  Jeff.Brownson_at_state.or.us
• 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
• [phone] voice or TTY
• [phone] voice or TTY
• Bentley.fink_at_state.or.us
• www.oregon.gov/DHS/ODHHS