Title: Deaf Cultural Competency 101 MINIMUM COMPETENCIES for Working with Deaf, Deaf-blind, Hard of Hearing, Late Deafened Adults and Youth
1Deaf Cultural Competency 101 MINIMUM
COMPETENCIES for Working with Deaf, Deaf-blind,
Hard of Hearing, Late Deafened Adults and Youth
- Produced by
- G.R.E.A.T. D.A.Y. Inc. Foundation
2INTRODUCTIONS
- Suzanne (Zan) Thornton
- G.R.E.A.T. D.A.Y.,Inc
- National Recognized Advocate (HUD)
- 12 years experience Deafness and MH/AD
- Expert Court Witness
- BSW Interpreting Degree
- Great X 5 Grand father 1st educate Deaf in USA
3OBJECTIVES R.I.B.
- Deaf Cultural Competency 101
- RESOURCES To provide 3 resources to ensure
providers, consumers, and administrators can
deliver or refer to qualified services for deaf
/hard of hearing - IMPACT To provide current research (national and
state) and their impact on Deaf cultural
competencies - BARRIERS To identify and address solutions to
the 5 barriers to Deaf Cultural competencies
4PRE-TEST
5MEDICAL ASPECTS OF DEAFNESS
- Audiogram Reading
- Date of Deafness
- Pre-lingual
- Post-Lingual
- Developmental Delays
- VIP why?
- Language Delays
6CAUSES
7DIAGNOSIS AUDIOGRAM
- A Graphic Representation of a Persons Hearing or
Auditory Responses - Specifically Thresholds or the Softest Sound
Detected 50 Percent of the Time - The Hearing Measure
- GSU
8CLASSIFICATIONS
- Minimal (Borderline)
- 15 - 25 dB
- Mild
- 26 - 40 dB
- Moderate
- 41 - 55 dB
- Moderate to Severe
- 56 - 76 dB
- Severe
- 71 to 90 dB
- Profound
- 90dB
9WITH HEARING AID AT SEVERE LEVEL
- Thunder
- Telephone ringing
- Alarm clock
- Piano
- Auto horn
- Radio at louder than average level
- Group singing
- Loud shots
- Baby crying
10MEDICAL MODEL SAYS YOU ARE BROKEN
- RESULTS
- People are so terrified of being disabled that
they believe the goal is to achieve what seems to
be most normal, i.e. the least disabled
- AUDISM
- The view that deafness is "pathological", results
in paternalistic and oppressive behaviors and
attitudes towards Deaf people - Deaf people as incapable of self-determination,
has been called "audism" - (to emphasize the fact that this view shares much
with other paternalistic perspectives such as
racism, sexism, and anti-Semitism)
11THE EXPERT/MEDICAL MODEL RESEARCH
- Responsibility to Solve The Problem on the
Expert, Not the Person(s) Responsibility - Distresses If Fail to Solve Thus Feel Cannot
Help Do Nothing-could Have Gotten Some Benefit - Goals Unrealistic and Motivated by Defensiveness
- Indicating Superiority Casting Doubt on
Expertise of the Parent/consumer(s) - Undermines Self-esteem
- Decreasing Ability to Adapt Source HILTON DAVIS,
1993
12BENEFITS FROM MEDICAL MODEL
- Technology
- Safety
- Professions
- Diagnosis Based
- Treatment
- Consequences
- Cure(s)
- Benefits Some
13TESTING ? CULTURE COMPETENCY
- Psychological test measures often are inadequate
- Vernon M., An Historical Perspective on
Psychology and Deafness, Journal of the American
Deafness and Rehabilitation Association, Vol.
29(2), pg. 11, 1995 - Few psychological tests and assessment
instruments have been developed specifically for
the deaf population -- and none have been
developed for the Asian-American deaf population - Wu C.L. and Grant N.C., Asian American and Deaf,
in Irene Leigh (Ed.), Psychotherapy with Deaf
Clients from Diverse Backgrounds, Washington,
D.C. Gallaudet University Press pg. 212, 1999
14WHY DOES IT MATTER?
- Determines Relationship to and With the Deaf
Community - Bias Affects the Outcome
- Attitudes Towards the Community's Language and
Its Culture Determine Ones Perspective Towards
Deaf People - PICK ONE Medical /Pathological or Cultural View
of the Deaf Community - Your View Will Affect Your Outcomes
- Example 1 Milan 1880
- Example 2 ASL at GSU
15THE RESOLUTION 1880 MILAN
- Considering the incontestable Superiority by
articulation over signs in restoring the
deaf-mute to society and giving him a fuller
knowledge of language, The Congress Declares
that The oral method should be preferred to that
of signs in the education and instruction of
deaf-mutes. - Considering that the simultaneous use of speech
and signs has the disadvantage of injuring
articulation and lip-reading and the precision of
ideas, Declares that The pure oral method should
be preferred.
16THE JUXTAPOSITION ASL, CULTURE
- ASL as a foreign language credit strikes me as
an irresponsible action unworthy of any academic
institution that purports to have..the students
best interest
- These hearing centric doctrines have condemned
the deaf. - The value based ideology has caused extreme
problems within the educational communities
17DEAF COMMUNITY
- A Group of Persons
- Share a Language
- Basis for their Identity
- Common Culture
- Visual World
- Norms Based on Visual Community
- Not Necessarily Family Based
- 90 of Deaf Childrens Parents do not sign
- ASL learned in School/Comm-Not home
- Values
- Time, Community, Deaf 1st
18MYTHS AND MISCONCEPTIONS
- MYTH Deaf people are less intelligent.
- FACT inability to hear unrelated to
intelligence. Hearing peoples lack of knowledge
about deafness, however, has often limited
educational and occupational opportunities for
deaf people. - MYTHDeaf people Can Not Hear/Can Not Talk
- FACT Physical Ability vs. choice
- MYTH All Deaf People Read Lips
- FACT 30-40 Readable on Lips
- MYTH Deaf Children Who Learn Sign Will Never
Learn to Speak or Sign Language Isolates Them
(makes different) - FACT 'latest research suggests that an ASL-first
approach can lead to better English learning
outcomes.' - Singleton and Sam Supalla, PhD, of the University
of Arizona - MYTH ASL is Universal
- FACT More than 114 different Signed Languages
- http//library.gallaudet.edu/dr/faq-world-sl-name.
html - http//www.dhs.state.mn.us/ECS/dhhs/myths.htm
19HEARING-IMPAIRED
- Medical Model Term/ Hearing Peoples term
- because they view it as politically correct
- Why? mainstream society, to boldly state one's
disability (e.g., deaf, blind, etc.) is somewhat
rude and impolite - a well-meaning word
- But much-resented by deaf and hard of hearing
people - Deaf and hard of hearing community views
"hearing-impaired" as negative, because the label
focuses on what they can't do - Deficit based -not asset based
- http//www.nad.org/infocenter/infotogo/dcc/terms.h
tml
20WHERE DID ASL ORIGINATE?
- Mixed
- French
- Clerc Galluadet
- Not English Based
- Modern ASL/French
- Closer than English
- Not Universal
21ACQUIRING A SECOND LANGUAGE
- 1-2 Years for Conversational Skills (Grammar,
Basic Vocabulary, Pronunciation) - 5-7 Years to Develop the Academic Linguistic
Proficiency (Literacy, Problem-solving, and
Critical Thinking Skills) Needed for Academic
Success (Moore Beatty, 1995.) - The Development of Competence in English Is a
Function of the Level of Competence Previously
Developed in the First Language (Cummins, 1984
Ortiz, 1994.)
22LANGUAGE ENGLISH ? NOT
- Most would agree that the ages of 3 to 7 are
critical - Lacking language input during this time can
result in an adult without fluency and competence
in any language, including ASL - Sacks O (1989), Seeing Voices A Journey into the
World of the Deaf. Berkeley, Calif. University
of California Press
23WRITE NOTES? NOT
- never assume that a written note will be
understood by a deaf person unless that
individual has demonstrated a facility with
English - Haskins, Barbara M.D. Serving and Assessing Deaf
Patients Implications for Psychiatry.
Psychiatric Times Dec 2000 p. - http//www.psychiatrictimes.com/p001229.html
24DEAF ETIQUETTE
- Visual
- Communal
- Manners Eat Talk !
- Direct, Expressive, and Not Shy at All
- Maintain Eye Contact
- Turn Taking Slower
- Aware-let Know
- Using Incorrect Etiquette Is Interpreted As Rude
25TECHNOLOGY ASSISTIVE DEVICES
- Internet
- Closed Captioning /Open
- TTY/TDD devices
- Interpreter
- Visual Ring Signalers
- Alarms
- Message-Relay Service
- FM Systems
- IR/ rear-view
26TTY TIPS
- "Dead Air" -Don't Hang Up
- Relay service calling or Deaf person Direct Dial
- Series of electronic beeps may be a TTY call
- Put the phone receiver in the modem cradle
- Identify yourself/organization
- Act as you would with a regular business phone
call
GA Go Ahead SK Stop Keying GA TO SK or BYE to
SK Im ready to finish SK SK Sign
Off Abbreviate NBR ( number), UR your U you
CUZbecause QQQuestion
27TIPS
- ASL Syntax
- Time period comes first.
- Main topic
- Comment about the topic (either with a verb or
just an adjective). - Qualifiers like negatives ("none," "don't"),
conditionals ("must," "can't" "maybe"),
interrogatives ("which?" "when?" "who?"). - Sentences are kept short
- Ask ONE PART of a series of questions
- Open Ended QQ
28THE RELAY SERVICE 711
- ADA Title 5
- Confidential
- Operator (Ca-comm. Asst) Takes the Call and
Relays Via TDD or Voice to and From the Callers - Prior to 1992, No Relay
- Any Type Call- Voice Over, TDD to Voice, Brailled
TTY to Voice, Speech, Etc
29- Physical and mental exhaustion is commonplace
- the process of listening involves reading lips,
hearing some things, mentally guessing the
others, putting it all together to form meaning
and most likely missing what follows - Dependency behavior often develops, with no
coping skills learned, which leads to - diminished self-esteem
- a hopelessness attitude
- exacerbates the bonds in relationships
- The supportive person/s may experience as much
pain, frustration, and/or embarrassment as the
person with the hearing loss - Loss and grief
- The hard of hearing person will experience the
stages of grief and loss to various degrees
denial - anger, guilt, depression, and acceptance
(Kubler-Ross 1969)
30ROAD B.L.O.C.K.S.
- BLAME
- Deaf person gets blamed for all px
- LANGUAGE
- Decisions made without all facts
- OURS vs. YOURS
- Turfism, stepping on toes
- CULTURE CLASH
- Hearing centric vs. Deaf culture
- KNOWLEDGE
- Medical Knowledge is seen as King
- STUCK
- Same Rut, Different Day
- GSU Dr. Easterbrooks /Adapted from GSU Series
31BARRIERS SOLUTIONS
- Cultural Bias
- Medical Model /Consumer Model
- Communication Bias
- Oralism/Sign Language
- Social
- Technologies
- Legal
32CHEAT SHEET E.A.R. 2
- Extra time Needed
- scheduling an appointment with a deaf or hard of
hearing consumer - ASK 1st Contact
- ask the consumer what they need first!
- Responsibility
- Each facility/agency must provide and pay for an
assistive device or a qualified sign language
interpreter when requested - Room
- the office where an appointment occurs with a
deaf or hard of hearing consumer should have good
lighting and minimal visual/background noise - http//www.dhs.state.il.us/mhdd/omh/Services/DHHS/
standards.aspWHY20THINK20ABOUT20THIS20NOW?
(adapted by Zan)
33TIPS S.A.F.E. R.O.O.M
- SEE Make sure the person can see you clearly
(i.e., avoid sitting in front of a window) - AttentionObtain the consumer's attention before
you begin to communicate. Stand or sit no more
than three feet away - Face Always allow the consumer to see the face
of the person who is speaking. (uses all
available auditory visual cues) - Environment Reduce background noise/visual
distractions
34TIPS S.A.F.E. R.O.O.M
- Request that the consumer tell you what he or she
understood you to say. Ask open-ended question
and do not over-estimate the consumer's ability
to understand what is said. If you ask "Do you
understand/" the response is likely to be "yes" - One at a time only one person speaks at a time
- Options Have options ready before they walk in
- ModesUse as many ways to convey the information
as possible (augment your communication using
multiple modes, e.g., pictures, gestures,
pantomimes, etc.)
35TIP BLUNTNESS
- Deaf Culture Values Frankness
- Imply wont work.
- Be Direct
- Don't be offended if your patient makes what you
consider a personal comment about you. If you are
old, fat, bald, etc., and everyone can see it, a
Deaf person will naturally refer to such physical
attributes to make her meaning clear ("The fat
doctor told me I need an X-ray.")
36KNOWING SIGN LANGUAGE DOES NOT EQUAL INTERPRETER
- Most hearing parents of deaf children never learn
fluent sign language themselves - Risk the family member will SPIN
- Not Legal
- Mistakes Can Happen
- Nodding means I am Listening, not answer
37(No Transcript)
38OOPS- SKILLS REQUIRED
- Drugs
- list
- DUI
- Drink and Drive
- Weapon
- Legal
- Social
- Suicide
- Sexual Signs
39INTERPRETERS ALLOW HEARING PEOPLE TO CONVERSE
WITH THE DEAF WORLD
- Interpreter Code of Ethics Confidentiality
- Convey messages from sign to voice, voice to sign
- Benefits ALL, not just for Deaf
- Terp not official there
- Effective Communication
- Knowledge Base/MH
40TUGG V TOWEY (1994)
- Neal Tugg, a 40-year old FLA Deaf man
- counseling RE Hurricane Andrew
- Provided by two Deaf counselors skilled in
American Sign Language (ASL) - Agency changed and a Hearing therapist and
interpreter were hired to replace the Deaf
counselors - Mr. Tugg objected and sued under the provisions
of the Americans with Disabilities Act - claimed direct communication with a signing
therapist was required in order for him to
receive counseling equal to that provided to
Hearing people - Decision guarantees
- a Deaf patient eligible for counseling the right
to a signing therapist, not just an interpreter
in conjunction with a non-signing counselor
41EFFECTIVE COMMUNICATION ADA
receptively
effective
impartial
expressively
Use specialized language
accurate
Their language and skill
Cert not required
42EFFECTIVE COMMUNICATION DEFINED
- 28 C.F.R. 35.104 . . . an individual who is
qualified is able to interpret effectively,
accurately, and impartially, both receptively and
expressively, using any necessary specialized
vocabulary...To satisfy this requirement, the
interpreter must have a proven ability to
effectively communicate the type of information
being conveyed
43GA LAW YOU
- Georgia Terp Law
- 24-9-100
- Must Have Terp
- Must Be QA/RID
- Dont Have to Ask
44POST- TEST
45EVALUATION
- What did You Like?
- Not Like?
- How Improve?
- What Will You Take With You?
- Class Again?
- Overall? A B C D F
- Comments
46Q A
47RESOURCES
- http//www.nasmhpd.org/ntac/reports/Deaf.pdf
- Cultural Diversity Series Meeting the Mental
Health Needs of Persons Who Are Deaf May 2002 - http//www.mentalhealth.org/publications/allpubs/S
MA00-3457/ch3.asp - Clinical Standards and Implementation Guidelines
- http//www.4woman.gov/wwd/wwd.cfm?page40
- http//www.apa.org/students/brochure/promote.html
- Easterbrooks, S., Ed.D (2001) Early Hearing
Detection and Intervention (EHDI) GSU Early
Intervention with Children who are Deaf and Hard
of Hearing - Part 1, Presentation 4 July 2001Susan
Easterbrooks - GACHI gachi.org (404) 292-5312
- Interpreters rid.org (freelance and agencies)
48THANK YOU