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Deaf Cultural Competency 101 MINIMUM COMPETENCIES for Working with Deaf, Deaf-blind, Hard of Hearing, Late Deafened Adults and Youth

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Title: Deaf Cultural Competency 101 MINIMUM COMPETENCIES for Working with Deaf, Deaf-blind, Hard of Hearing, Late Deafened Adults and Youth


1
Deaf 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

2
INTRODUCTIONS
  • 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

3
OBJECTIVES 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

4
PRE-TEST
5
MEDICAL ASPECTS OF DEAFNESS
  • Audiogram Reading
  • Date of Deafness
  • Pre-lingual
  • Post-Lingual
  • Developmental Delays
  • VIP why?
  • Language Delays

6
CAUSES
7
DIAGNOSIS 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

8
CLASSIFICATIONS
  • 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

9
WITH 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

10
MEDICAL 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)

11
THE 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

12
BENEFITS FROM MEDICAL MODEL
  • Technology
  • Safety
  • Professions
  • Diagnosis Based
  • Treatment
  • Consequences
  • Cure(s)
  • Benefits Some

13
TESTING ? 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

14
WHY 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

15
THE 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.

16
THE 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

17
DEAF 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

18
MYTHS 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

19
HEARING-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

20
WHERE DID ASL ORIGINATE?
  • Mixed
  • French
  • Clerc Galluadet
  • Not English Based
  • Modern ASL/French
  • Closer than English
  • Not Universal

21
ACQUIRING 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.)

22
LANGUAGE 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

23
WRITE 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

24
DEAF 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

25
TECHNOLOGY ASSISTIVE DEVICES
  • Internet
  • Closed Captioning /Open
  • TTY/TDD devices
  • Interpreter
  • Visual Ring Signalers
  • Alarms
  • Message-Relay Service
  • FM Systems
  • IR/ rear-view

26
TTY 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
27
TIPS
  • 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

28
THE 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)

30
ROAD 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

31
BARRIERS SOLUTIONS
  • Cultural Bias
  • Medical Model /Consumer Model
  • Communication Bias
  • Oralism/Sign Language
  • Social
  • Technologies
  • Legal

32
CHEAT 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)

33
TIPS S.A.F.E. R.O.O.M
  1. SEE Make sure the person can see you clearly
    (i.e., avoid sitting in front of a window)
  2. AttentionObtain the consumer's attention before
    you begin to communicate. Stand or sit no more
    than three feet away
  3. Face Always allow the consumer to see the face
    of the person who is speaking. (uses all
    available auditory visual cues)
  4. Environment Reduce background noise/visual
    distractions

34
TIPS S.A.F.E. R.O.O.M
  1. 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"
  2. One at a time only one person speaks at a time
  3. Options Have options ready before they walk in
  4. ModesUse as many ways to convey the information
    as possible (augment your communication using
    multiple modes, e.g., pictures, gestures,
    pantomimes, etc.)

35
TIP 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.")

36
KNOWING 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
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38
OOPS- SKILLS REQUIRED
  • Drugs
  • list
  • DUI
  • Drink and Drive
  • Weapon
  • Legal
  • Social
  • Suicide
  • Sexual Signs

39
INTERPRETERS 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

40
TUGG 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

41
EFFECTIVE COMMUNICATION ADA
receptively
effective
impartial
expressively
Use specialized language
accurate
Their language and skill
Cert not required
42
EFFECTIVE 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

43
GA LAW YOU
  • Georgia Terp Law
  • 24-9-100
  • Must Have Terp
  • Must Be QA/RID
  • Dont Have to Ask

44
POST- TEST
45
EVALUATION
  • What did You Like?
  • Not Like?
  • How Improve?
  • What Will You Take With You?
  • Class Again?
  • Overall? A B C D F
  • Comments

46
Q A
47
RESOURCES
  • 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)

48
THANK YOU
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