Deaf/Hearing Impaired Culture
The deaf culture is a group of individuals who pride themselves on the tight bonds they form. As a group there are many differences and similarities with hearing communities. The deaf culture incorporates differences in communication, biological variations, social organizations, and space.
By Briauna Marquis
The main form of language used among deaf and hard of hearing individuals is American Sign Language (ASL) (Greer, Holcomb, & Siple, 2004). Other methods of communication include reading lips, cued speech, and tactile sign language (Berke, 2008). The goal for most deaf individuals is to perform and understand ASL because it is the most universal form of language for the deaf culture. In comparison to the hearing community who prefer to identify as individuals, the deaf community prefers to be a part of a group because it allows them to associate with other individuals who are deaf (Marthinussen & Wilkinson, 1997). When deaf individuals speak to each other they require constant eye contact because they look at facial expressions, lips, arm movements/gestures, and sign language if used (“Comparative Chart”, 2004). Hearing people tend to be uncomfortable when others look directly in their eyes for long periods of time. Deaf individuals feel that if someone isn’t keeping eye contact with them while they speak, it is a sign of indifference (“Comparative Chart”, 2004). When deaf individuals speak they are very direct and straightforward, which can come off as being rude to hearing individuals because hearing individuals tend to soften their meaning with use of certain words (“Comparative Chart”, 2004). Communication for the deaf community is very different than the hearing community because of the type of language they use, their constant eye contact, the directness of their communication, and their overall enjoyment of being part of a group.
By Briauna Marquis
The deaf community tends to congregate together. During communication it is normal for deaf individuals to keep a locked gaze for long periods of time without any awkwardness (“Comparative Chart”, 2004). When deaf individuals are in a group, it is common practice to make eye contact with the group and announce their departure from the room, even for just a few minutes (“Comparative Chart”, 2004). This prevents other group members from becoming frantic when they realize the member is gone. Touch is widely accepted among the deaf community because it is a way to obtain the deaf individuals attention (“Comparative Chart”, 2004). Touch is hard for some hearing people to allow, but it is needed in the deaf community. Overall, the deaf value good eye contact and visibility in
order to make signing more comfortable (“Comparative Chart”, 2004). As for social interaction, many deaf people participate in sporting events and other social customs similar to hearing people (“Comparative Chart”, 2004). However, if a deaf individual is in a mainstream school rather than a deaf school, they may find that his/her participation in sports isn’t accepted by the hearing individuals. This is due to communication problems that are involved between the teammates (“Compartive Chart”, 2004). At deaf schools all individuals are allowed to participate regardless of level of skill. Furthermore, social interaction and relationships rely on communication skills and the willingness to communicate.
By Lisa Graham
Learning takes place for the hearing impaired in much the same way as for hearing people. Our environment and those in it help dictate how well and how much we are presented to learn. Brown (1977) noted that there are two categories of deaf people: “high verbal” and “low verbal”. The high verbal are those who have a well rounded ability to read and write the standard English language. They are more likely to use speech, reading, writing, visual aids, finger spelling, signs, American Sign Language (ASL), and manual or signed English as tools for learning. The low verbal are those who have very limited use of the standard English language. They mostly rely on mime and signing. Since this group is less versed on finger spelling or ASL, communication is made more difficult, even for a trained interpreter.
Personnel from West Virginia University (2007) created a link http://www.as.wvu.edu/~scidis/hearing.html titled “Strategies for Teaching Students with Hearing Impairments”. Their link gives examples of some simple courteous steps the hearing population can use to help the hearing impaired population process and learn what is being spoken. Regardless of a person’s verbal ability, a trained and certified interpreter is recommended in the medical setting, especially when explaining procedures, giving instructions, and asking for consent.
By Joshua Eggert
Another important value to deaf people is their name sign. A name sign is sort of a short hand version of a person’s name. It makes it easier to mention a person’s name rather than spell it out entirely. Name signs can only be given to any person by another deaf person, because it is something unique that a deaf person notices about another person. When you receive that name sign it is with you for life, so be on your best behavior because there are some pretty nasty name signs out there.
By Joshua Eggert
Joking is another norm within the deaf culture. It is purely an escape. Being deaf may be normal for many, but it is still stressful. Joking is a release, and it is very common among any deaf conversation. Once again, remember that deaf people are very straight forward with communication, and many of these jokes may be very foul and/or sexual in nature. This is just a common occurrence within their own culture, and deaf people value their culture very much.
By Megan Gordy
The work environment can be extremely overwhelming to a hearing impaired individual. Issues concerning availability of an interpreter, use of the TTY (a telecommunication device for the deaf), informal conversations, and meetings with large groups of people all can interfere with clear communication. Foster and MacLeod (2003) identified several strategies hearing impaired/deaf individuals used while working (specifically in management positions). The first strategy mentioned was flexibility (Foster & MacLeod, 2003). This meant that many of the individuals varied their communication style depending on the situation and the importance of the conversation. One participant mentioned how useful work email was. This enabled the participant to clearly communicate what s/he wanted done with his/her employees. If there were any questions an interpreter could be called. Other participants mentioned how receptive employees tried to learn some basic sign language in order to help clear communication. Others mentioned how during a group meeting they always requested an interpreter due to the number of people involved.
The next strategy was taking control of the communication event or creating the environment to enhance communication (Foster & MacLeod, 2003). Examples given were meetings where multiple people were involved (managers meetings). The participant made sure to meet with them one on one to ensure they understood all of the information covered in the meeting. Another example given was driving to meetings some distance away. The participant made sure not to be the driver in order to face whoever was speaking in the car so they could remain involved in the conversation.
The next strategy noted was being in a position of authority (people need to communicate with you) (Foster & MacLeod, 2003). Examples included encouraging and requiring that employees communicate in some fashion with the hearing impaired/deaf individual. In this study the participants were in some sort of manager role. This required communication between the employees and themselves. This may mean working in a small branch or creating your own business according to some of the participants in the study (Foster & MacLeod, 2003).
Next was educating hearing people about communication needs (Foster & MacLeod, 2003). This includes asking individuals to move if they are sitting in the spot that provides the hearing impaired individual the best view of faces, or switching someone places if the lighting behind them is poor.
Next is identifying and cultivating key informants (Foster & MacLeod, 2003). Examples of being excluded from informal conversations was a common example from the participants. The solution was to find someone in the office that was willing to fill you in so that you were up to date with what was going on.
Last is finding a balance (Foster & MacLeod, 2003). From the participants this meant standing up for the hearing impaired/deaf culture but knowing that it will take time and patience for change to happen. It also included purchasing the tools and incorporating the services you need in order to be successful in your job and life. This may mean purchasing a flash or strobe light that will alert you when someone is at the door or being understanding of the staff trying to learn some signs in order to better communicate.
Source: National Center for health statistics, data from the National Health Interview Survey Series 10, Number 188, Table 16, 1994.
Estimate of labor force participation of adult population who have hearing impairments by age group, U.S., 1990-91 (N=19,327,000).
Source: National Center for health statistics, data from the National Health Interview Survey Series 10, Number 188, Table 5, 1994.
By Megan Gordy
- About 2-4 of every 1,000 people in the United States have a severe or profound hearing loss (have become deaf at some point in their lives). At least half of these people became deaf relatively late in life; about 1 out of every 1,000 people in the United States became deaf before 18 years of age.
- If people with a severe hearing impairment, but not likely to be deaf, are included then the number is 4 to 8 times higher. That is, anywhere from 9 to 34 out of every 1,000 people have a severe hearing impairment or are deaf. Again, at least half of these people lost their hearing after 64 years of age.
- If everyone who has any kind of “trouble” with their hearing is included then anywhere from 38 to 140 out of every 1,000 people in the United States have some kind of hearing loss. And yet again, almost half of these people are at least 65 years old.
- Hearing loss is the most preventable disability in the world.
- Number of people who need hearing aids: 25 million.
- Number of people who own hearing aids: 5 million
- 15 of every 1000 people under age 18 have hearing loss.
- Nearly 90% of people over age 80 have hearing loss.
- Percentage of inductees into the Rock and Roll Hall of Fame who are hearing-impaired: 60%
- As a result of the aging population, between 1990 and 2050 the number of hearing-impaired Americans will increase at a faster rate than the total U.S. population.
- Ten million Americans have suffered irreversible noise induced hearing loss, and 30 million more are exposed to dangerous noise levels each day.
- At least 12 million Americans have tinnitus. Of these, at least 1 million experience it so severely that it interferes with their daily activities.
- Approximately 59,000 people worldwide have received cochlear implants. About 250,000 people would be good candidates for a cochlear implant. In the United States, about 13,000 adults and nearly 10,000 children have cochlear implants.
- Approximately 4,000 new cases of sudden deafness occur each year in the United States. Hearing loss affects only 1 ear in 9 out of 10 people who experience sudden deafness. Only 10 to 15 percent of patients with sudden deafness know what caused their loss.
(Deaf Action Center, 2005)
Thoughts on Healthcare…
By Crystal Benner-Snyder
In order for a patient to get the best possible treatment it is imperative that the practitioner understand the patient. Equally important is that the patient can understand the practitioner, is given an opportunity to verify that s/he has been understood, and to ask additional questions (Reeves & Kokoruwe, 2005). While such a description of health care may seem easily obtainable to many of us, it is not always so cut and dry. Often times, language differences make this difficult. While it may be unintentional, the deaf community sustains discrimination in the health care field. The mere fact that not every health care worker knows American Sign
Language (ASL) is evidence that deaf people do not always get the opportunity to effectively communicate with their health care providers. Because health professionals are not all trained in ASL, writing is a form of communication used with deaf patients. Although this may seem like an obvious and acceptable alternative, this also poses potential problems.
According to Reeves and Kokoruwe (2005), the typical . . . Deaf American adult has a reading age of around nine to ten years of age. Therefore, many of the words the doctors or nurses use may be unfamiliar to a deaf person. Not only does this make it hard for the patient to understand the medical staff, but it makes it difficult for the patient to clearly portray his/her health history or reason for visit. This can cause several problems. In some instances the deaf patient will leave the appointment feeling unsure of the conclusions that were drawn and why. They may have anxiety about whether the correct prescription was issued or understanding how to correctly take the medication. In other cases, a patient may go into a procedure they think is for something completely different than what actually takes place (Reeves & Kokoruwe).
As health care providers, we will need to take these things into consideration when working with deaf patients. It is imperative that we use a certified interpreter to communicate with this population so that they receive the quality of care they deserve. We can increase the effectiveness of communication with deaf persons by allowing extra time for appointments. Also, I think it is reasonable that every nurse learn the ASL alphabet at the bare minimum. If we are capable of learning all of the other things we learn in school, surely we can spare ten minutes a day for a month to learn this; it’s not that hard and it may save a life someday!
By Crystal Benner-Snyder
It is easy to regard the deaf and hearing impaired community as no different than ourselves. After all, they live in America and if ten people stood in a room without speaking to one another, there would be no discernible way to determine that one of those people was deaf. According to Thomas, Cromwell, and Miller (2006), some health care employees actually “questioned what was so unique about deaf patients that would require specialized service” (p. 308). If nurses are not educated about their differences, and never encounter a deaf person before they enter the field, they will be ill-prepared to provide them with effective health care. Nurses need to understand that although “American” is in the name, ASL is in fact a different language, and therefore requires the use of a certified interpreter. Most health care workers are taught that interpreters are available for patients who don’t speak English, but don’t consider sign language a different language and therefore may not realize that this is an option for communicating with deaf patients (Thomas, Cromwell, & Miller). In addition, having knowledge about the differences in communication norms within the deaf community may facilitate more accurate diagnoses. In the instance of deaf people with mental illness, “[health care workers] acknowledged that they would not be able to tell if seemingly aggressive signing or behavior was due to mental health problems, frustration with communication difficulties, or indeed culturally appropriate” (Thomas, Cromwell, & Miller, p. 308).
More on health….
by Megan Gordy
- Special considerations—Deaf people learn by seeing and doing (Scheier, 2009)
- Deaf people in the US receive insufficient mental health care (Scheier, 2009).
- Many deaf people are never taught about sexuality which has led to higher rates of HIV and STIs (Scheier, 2009)
- Intravenous lines should not be inserted into the hands so that the deaf person can continue to sign (Scheier, 2009).
- The average deaf high school graduate reads at a fourth grade level (Scheier, 2009). This means that most medical brochures given to patients are too complex.
- There are more than 250 facial expressions that have meaning and convey importance during communication (Scheier, 2009).
- The best lip reader can only see 30-45% of English on the speaker’s lips (Scheier, 2009) which enforces the need to have certified medical interpreter at all important conversations (medically speaking).
- Fear of receiving the wrong medication or not being understood makes doctors visits very stressful (Scheier, 2009).
By Megan Gordy
The artwork seen on this blog is by Ashleigh Rice. She was born deaf and is an active member in the Deaf community. She will be attending the Art Institute of Portland in 2011. A piece of her art is displayed at Gallaudet University. She has won several awards and won many competitions, several at the national level.
P: This gentleman has been deaf his entire life. He is very outgoing, not only with deaf people but hearing people as well. He is not afraid to communicate with anybody. What are most important to him are the friendships he forms with others. To compensate for his hearing loss, he carries around a notepad to be used with everybody including hearing people that know sign language. Hugging is how he says goodbye to somebody and tells you he loves you and values your friendship. He will squeeze you until you are ready to burst, no lie it hurts, and he enjoys the fight if you squeeze back. One thing he finds most important is jokes, something all deaf people value, and good conversation. Even when writing he still wants you to look at his eyes. If you do not, he considers you to be rude.
M: M is a man you would think was hearing. He too has been deaf since birth; however he picks up on people’s body language quickly and pays very close attention to you as he reads your lips. To compensate for his lack of hearing he will occasionally use a notepad, which he despises, or he will attempt to speak out what he needs and read the other persons lips. What has helped him most in accomplishing this is his family. He was the only deaf child to hearing parents. His brother is two years older than him and growing up in a hearing family has helped him learn to read lips. His family learned American Sign Language (ASL) when he was young so it would be natural for him, however, they did not always use it when speaking to each other, so he learned the art of lip reading.
His brother accompanies him whenever he can, and they both have a very close relationship. M’s brother has even taught his own children ASL since they were very young, and when M babysits for his brother, it is not uncommon for his children to run around picking on M with their ASL knowledge.
When speaking to him you need eye contact, not only because it is polite, but he needs to be able to read your lips and your facial expressions. He believes every person should know finger spelling, and if you know it, he shows you the correct sign after each word, and when you finish with your sentence he will put it into correct sentence structure and expect you to repeat it back to him.
A: A has been deaf since childhood as well, however, she elected to have cochlear implants in her 20’s. She still cannot hear without the use of a hearing device, and chooses not to wear them unless she goes to a movie. Like the previous two interviewees, she finds her ‘deaf culture’ to be normal and finds the ‘hearing culture’ to be highly obnoxious and too fast paced. She can read lips, speak clear words back to you in not only English but French, Spanish, and Japanese as well. She decided to learn these languages after receiving her implants, and has a great deal of pride in the fact that she learned these languages. Like many others, she too finds eye contact to be the most important. She will ignore you if eye contact is not made.
What I found most interesting with her is how correct she is with ASL. Some deaf people get rather sloppy with their ASL, like when we get lazy with our speaking. Two signs can be very similar, and if you are not 100% with your sign, even if your facial expression shows what you mean, she will stop you and correct you.
R: R has been deaf since birth as well. He is much more on the aggressive side and not as friendly as the other interviewees. He hates being deaf, can’t afford implants, and has made it his goal to be able to speak our language as clearly as possible, so as not to come across as deaf. If you are attempting to sign and are moving too slowly for him, he will just read your lips and speak back to you. If he is feeling grumpy, he will pull the deaf card on everybody just to avoid communication with anybody. He does not feel there is any special way to communicate with him, and mostly prefers to be left alone unless he is with his deaf friends whom he has had a friendship with for many years. On a side note, M informed me that R’s name sign is similar to bear with the ‘R’ hand shape on each finger. He received this name sign because he is as grumpy as a bear.
Berke, J. (2008). Interpreting styles-different modes of interpreting. About.com:Deafness. March 19, 2010. From http://deafness.about.com /od/communicationmethods/tp/interpreting-styles.htm
Brown, W.S. (1977). Communicating with hearing-impaired patients. Patient Care West J Med, 127:164-168.
Comparative chart: Deaf and ethnic cultures. (2004). What is Deaf Culture? March 19, 2010. From http://www.deafculture.com/ethnic_culture/
Deaf Action Center. (2005). Publications and resources: Statistics. Retrieved from http://www.deafactioncentertexas.org/statistics.html
Drolsbaugh, Mark. (2010). What is deaf culture? Deaf-Culture-Online. http://www.deaf-culture-online.com/index.html
Foster, S., & MacLeod, J. (2003). Deaf people at work: Assessment of communication among deaf and hearing persons in work settings. International Journal of Audiology (42) S128-S139.
Greer, L., Holcomb, B. R., & Siple, L. (2004). Deaf culture. PEPNet Tipsheet. Retrieved from http://www.netac.rit.edu/downloads/tpsht_deaf_culture.pdf
Reeves, D., & Kokoruwe, B. (2005). Communication and communication support in primary care: A survey of deaf patients. Audiological Medicine 3(2) 95-107.
Marthinussen, B., & Wilkinson, J. (1997). Deaf culture. March 19, 2010. From http://library.thinkquest.org/11942/deafculture.html
Scheier, D.B. (2009). Barriers to health care for people with hearing loss: A review of literature. Journal of the New York State Nurses Association 4-10.
Thomas, C., Cromwell, J., & Miller, H. (2006). Community Mental Health Teams’ perspectives on providing care for deaf people with severe mental illness. Journal of Mental Health 15(3), 301-313.
Values and Norms of the Deaf Community. http://www.canyons.edu/departments/sign/values_and_norms_of_the_deaf_com.htm
West Virginia University (2007, May 31). Strategies for teaching students with hearing impairment. Retrieved March 18, 2010, from http://www.as.wvu.edu/~scidis/hearing.html