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What Should Audiologists Know About the Deaf Community?

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What Should Audiologists Know About the Deaf Community?

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Resources:

1. American Speech-Language-Hearing Association. (n.d.-a) Language and communication of deaf and hard of hearing children. http://asha.org/practice-portal/professional-issues/language-communication-deaf-hard-of-hearing-children/?srsltid=AfmBOorrIX7vMkuIH70inEbpCQa9BzbG0L0MVMbos5GDKnZMgKlYENBA#collapse_1

2. American Speech-Language-Hearing Association. (n.d.-b). Person-centered care in audiology. https://www.asha.org/aud/person-centered-care-in-audiology/?srsltid=AfmBOorF3mskBYS76m80cJbI7F2ll2d5pGs32TNN1h6b6XlHCiwFPZTF

3. Cooper A. (2019). Hear Me Out: Hearing Each Other for the First Time: The Implications of Cochlear Implant Activation. Missouri medicine, 116(6), 469–471.

4. Gallaudet University (n.d.). Oral education as emancipation. https://gallaudet.edu/museum/exhibits/history-through-deaf-eyes/language-and-identity/oral-education-as-emancipation/

5. Holcomb, T. K. (n.d.). Introduction to American Deaf Culture. Retrieved from https://platform.virdocs.com/read/385933/14/#/4/22,/3:0,/3:0

6. National Deaf Center. (n.d.). Deaf awareness. https://nationaldeafcenter.org/resources/deafawareness/

7. National Association of the Deaf. (n.d.). Community and culture – frequently asked questions. https://www.nad.org/resources/american-sign-language/community-and-culture-frequentlyasked-questions

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1. Deaf vs. deaf; Not everyone identifies the same.

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1. Deaf vs. deaf; Not everyone identifies the same.

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This topic may be a bit more difficult to understand for an audiologist whose job is to help people with hearing loss. There are many ways to identify as culturally *Deaf in the community, including DeafBlind, DeafDisabled, etc (National Association of the Deaf [NAD], n.d.). However, a good rule of thumb is to understand that the term 'deaf' is "all-inclusive" including those with age-related hearing loss or who are hard of hearing (National Deaf Center [NDC], n.d.).

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2. Features and values of the Deaf community.

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2. Features and values of the Deaf community.

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To become a better audiologist, it is important to know what Deaf culture means and how it differs from other cultures. The following concepts include a sliver of the Deaf community's features:

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To communicate effectively through American Sign Language (ASL), the Deaf community MUST have "efficient and effortless visual access to the world" (Holcomb, n.d., pg. 99). Without proper visual access, they are unable to communicate. Therefore, they emphasize the use of open floor plans and good lighting in their homes and other common spaces (NDC, n.d.).

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American Sign Language (ASL) is a staple of the Deaf community. This is the community's primary mode of communication. Connecting with visual access, this is a very gestural and visual language that sets this community apart from other's seen around the world. In fact, Holcomb (n.d.) states that "Because ASL was perfectly suited for people who are visually oriented, it became the most cherished cultural value of the Deaf people" (pg. 99).

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This may come as an odd one to clinicians who specialize in "fixing" people's hearing loss. However, to the Deaf community, it is the most beautiful thing to be Deaf. There is not a negative connotation to their hearing "loss" (in quotations because they do not like to use that term) but rather a positive one as it means they are a part of people like themselves. Often, those who are born deaf are born into hearing families who have a deficit mindset when it comes to having hearing loss. So, when a Deaf person becomes surrounded by those that love and value their hearing status, it can be liberating (Holcomb, n.d., pg. 105).

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There are many things that an audiologist does when it comes to working with the Deaf and deaf communities. The following includes a few:

1. MOST IMPORTANTLY is to provide person-centered care (PCC). Person-centered care, according to ASHA (n.d.-b), is designed around the individual's needs and preferences, includes all members of the patient's team (family, other doctors, educators, etc.), "shared decision-making and goal-setting", etc. This includes providing an interpreter when needed and being respectful to and educated on Deaf culture.

2. Ensuring that the hearing tests conducted do not disregard Deaf culture or the use of American Sign Language, then it will ensure the accuracy of the reading of the hearing assessments and how the information is relayed to the family (ASHA, n.d.-a)

3. Educate the patient's team about all of their options when it comes to communication, hearing devices, etc. so "they can make informed decisions about what is best for their child and family" (ASHA, n.d.-a). However, this should be done respectfully by making sure that you do not have or display a deficit mindset. This is not a time to try to convince a Deaf family why getting an expensive hearing device is better but rather a time to educate them about their options.

4. Respect the patient and their family's right to autonomy. They have the choice to not get a hearing device or continue with your service, and that is okay. We can still provide them with resources that connect with the local Deaf community and ASL classes to ensure that they do not experience language deprivation; and resources that inform them of different communication strategies and tools, such as Video Relay Services (VRS) or visual alert systems. An audiologist should always understand that being Deaf is just another way to live and is not a disability.

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It is extremely important to remember important demographics of the community you will be serving the most. The American Speech-Language-Hearing Association (ASHA, n.d.-a) states the following statistics:

1. Approximately 95% of children identified as DHH [Deaf or hard of hearing] are born to hearing parents, into homes where spoken languages are in use at the time of birth.

2. Less than 5% have two parents who are DHH with native sign language proficiency.

But why do these matter? Because that means that the child may be delayed in their language and communication skills due to their hearing loss. Also, they are not taught about the values and features that define the Deaf community and, finally, they are not around people who are like themselves. This can affect their self-image, esteem, and confidence.

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4. Views on hearing devices, specifically cochlear implants, in the Deaf community. 

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4. Views on hearing devices, specifically cochlear implants, in the Deaf community. 

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Just like many topics out there, there are split views on this one. Cochlear implants, specifically, are negatively viewed in the community. Remember one of the values of the Deaf community is the celebration of their deafness and by implanting a hearing device into someone's brain then they are essentially taking away that deafness. They do not see it as a disability and think the common "fixing" or "curing" viewpoint of medical professions such as audiologists is offensive (Cooper, 2019).

They also think that hearing devices are going to destroy Deaf culture. The rise of cochlear implants means that ASL will be used less leading to a decline in teachers and students at Deaf institutions. These institutions are where Deaf culture is mainly taught so without teachers who pass on the knowledge and students who learn it, Deaf culture is thought to dwindle into none (Cooper, 2019).

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This photo shows a deaf child touching a teacher's throat to feel how she is producing the speech sound being taught.

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Similar to other minority groups, the Deaf community has a rich history of discrimination in all settings. More specifically, the discrimination against their primary mode of communication should be understood by audiologists.

This idea is known as oralism and the idea was urged after the Civil War around 1860. This way focused on teaching Deaf students at residential schools how to lipread and speak. Another aspect of this teaching method was the opposition to using ASL and some schools took it as far as banning the use of ASL to promote oralism (Gallaudet University, n.d.)

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There are some things that you just do not say when referring to the Deaf community because of the offensive historical context behind them. This includes but is not limited to, Deaf and Dumb, Deaf-Mute, and Hearing-impaired (NAD, n.d.).