Effective ASL Communication for a More Inclusive Society
“The soup of the day is a French Onion Soup, and the chef’s special is Steak Tartare. How does that sound to you, ma’am?” The waiter locked eyes with his mother, who had been nodding along absent-mindedly. The spotlight was on her now, and her smile faded. “What?” She replied, “Oh, don’t worry, someone will have to explain it to me.” She replied.
Cullen’s mother is almost completely deaf due to Meniere’s Disease, an imbalance of fluid in the inner ear that causes hearing loss and vertigo. She gets by with the help of hearing aids and lip reading. She can understand the tones of some people’s voices, but some are out of her audible range, like Cullen’s sister voice when she gets really upset. Cullen’s mother is one of the millions of Americans affected by severe hearing loss and she often finds herself in situations like this.1
The Deaf and Hard of Hearing communities are extremely diverse with wide variation in the degree and cause of hearing loss. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), about 15% of adults in the US report some trouble hearing. The largest cause of hearing loss is aging, with 33.2% of those surveyed listing getting older as the primary cause of hearing loss. About 4.7% of those who had trouble hearing were born with complete hearing loss. The CDC conducts extensive research on deafness as a medical phenomenon. However, the broad range of different cases reported calls for follow-up research on how best to communicate with the different segments of the population. Each of these groups experiences their hearing loss differently and should receive the individualized help that they need and deserve.
American Sign Language (ASL) Data in the US
If you study the United States Census Bureau’s findings released in October 2015 that summarize languages spoken in the home, you will learn a great deal about the linguistic and cultural makeup of the nation. For example, there are 166,826 people in the US who speak Navajo in the home, and 708,966 people whose first language is Italian. One thing you will not learn, however, is how many people in the US communicate primarily using American Sign Language (ASL).
Shockingly, the United States Census Bureau does not collect language data on the nation’s Deaf and Hard of Hearing communities. In fact, according to Mitchell et al. of Gallaudet University (the premier university for Deaf and Hard of Hearing communities), the most commonly-cited number for the population of ASL speakers (408,000) comes from the 1974 National Census of the Deaf Population (NCDP). Although deeply flawed, and woefully outdated, the 1974 NCDP remains the only large-scale study ever conducted on the signing abilities of the Deaf and Hard of Hearing communities in the US.
The Marginalized Deaf and Hard of Hearing Communities
One factor that contributes to this dearth of demographic data is that the nation fails to recognize the distinction between deafness as a medical condition and the use of ASL as a linguistic and cultural phenomenon. It is not commonly understood, for instance, that the overwhelming majority of deaf and hard of hearing people who lose their hearing later in life choose not to learn American Sign Language, while many hearing family members of people who are deaf grow up learning to communicate fluently in ASL. However, the biggest reason that limited reliable (and current) data exists for the ASL community might be that the nation as a whole, has traditionally chosen not to study it.
Although the US does not actively study ASL as a linguistic phenomenon, the 2014 Centers for Disease Control/National Center for Health Statistics (CDC/NCHS) National Health Interview Survey does reveal interesting information collected from individuals who are either deaf or experience varying degrees of hearing loss.
Federal and State Laws
Despite the lack of research into the use of ASL, the federal government has gone to great lengths in its efforts to support the Deaf and Hard of Hearing communities. In fact, a 2016 report funded by the US Department of Education noted that 7.1% of deaf and hard of hearing individuals are employed by the government, military, and related administration offices. The federal government also hires full-time staff as well as contractors to support deaf and hard of hearing employees.The Americans with Disabilities Act (ADA) further strengthens these efforts by mandating that “title II entities (State and local governments) and title III entities (businesses and nonprofit organizations that serve the public) must communicate effectively with people who have communication disabilities.”2 The goal is to ensure that communication with Deaf and Hard of Hearing communities is equally as effective as communication with all others. However, the key to effective communication is first understanding the diverse needs of Deaf and Hard of Hearing communities. Thankfully, the ADA lists various auxiliary aids and services that must be provided when necessary including the use of Computer Assisted Real-Time Transcription (CART) services, Video Remote Interpreting (VRI), and in-person ASL interpreters.
The Challenges We Face as a Society
Despite these well-intentioned government regulations, the millions of Americans with hearing loss and the estimated 408,000 who primarily communicate using ASL are too often overlooked by – or seen as a burden on – the hearing society. What we fail to realize is that when we marginalize the Deaf and Hard of Hearing communities, society at large suffers in various ways including negative impacts to the healthcare system and to the economy at large.
In an article written for the National Institutes of Health (NIH), Annie G. Steinberg, MD, et al. found that deaf people continue to report difficulties accessing health care even after the passage of the ADA in 1990. Deaf and hard of hearing individuals reported that “communication difficulties were ubiquitous” and that “fear, mistrust, and frustration were prominent in participants’ descriptions of health care encounters.”3
- The reluctance to engage in preventative health care due to fear of a visit to the doctor’s office can have deleterious effects on overall healthcare costs, especially when patients wait until they experience an emergency to seek help. According to the American Psychological Association (APA), the barriers faced by the Deaf and Hard of Hearing communities “directly translate to inadequate assessment, limited access to treatment, insufficient follow-up and poorer outcomes. For example, in the deaf population compared with the hearing population there are lower rates of individuals accessing preventative services, worse cardiovascular health outcomes and higher rates of obesity.”4
- In their 2016 report Deaf People and Employment in the United States, the National Deaf Center (NDC) underscores the economic disparities that are experienced by deaf people. Only 48% of deaf individuals are employed, compared to 72% of hearing individuals. However, the most fascinating aspect of this study is that deaf individuals who are actively in the labor force have similar rates of part-time and full-time work and earn on average roughly the same as hearing individuals, with deaf individuals earning on average $52,650 per year and hearing individuals earning $52,980. When we eliminate the barriers to entry caused by the marginalization of Deaf and Hard of Hearing communities, deaf individuals can succeed and contribute fully to society.
An Inclusive Society is a Prosperous Society
In an article for Greater Good Magazine, Katherine Phillips, professor of leadership and ethics at UC Berkeley, states that “the first thing to acknowledge about diversity is that it can be difficult.”5 However, as individuals and as a society, the only way that we learn and grow is by challenging ourselves and breaking free of our comfort zones. “Diversity enhances creativity,” Phillips continues, “it encourages the search for novel information and perspectives, leading to better decision making and problem solving. Diversity can improve the bottom line of companies and lead to unfettered discoveries and breakthrough innovations. Even simply being exposed to diversity can change the way you think.” Through the inclusion of Deaf and Hard of Hearing communities, we can broaden our perspective as a society and find innovative solutions to intractable problems. Here are some effective ways organizations can help to close the communication gap and create a more inclusive experience for all.
The National Institute on Deafness and Other Communication Disorders defines ASL as “a complete, natural language that has the same linguistic properties as spoken languages, with grammar that differs from English.” The Institute goes on to explain that “ASL is expressed by movements of the hands and face. It is the primary language of many North Americans who are deaf and hard of hearing, and is used by many hearing people as well.”6
Video Remote Interpreting, or VRI, is a type of sign language interpreting offered by an interpreter who typically uses a headset to hear what the hearing person is saying. “As the hearing person speaks, the interpreter signs everything said to a web camera.”7 The person who is deaf or hard of hearing can then sign back via the camera, allowing the interpreter to voice the interpretation back to the hearing individual.
Communication Access Real-time Translation, or CART, enhances communication for deaf and hard of hearing individuals. As the CART operator types spoken words in shorthand into a specialized machine, the machines’s software converts this shorthand into standard English resulting in almost simultaneous captions. These captions are then projected onto a screen or sent to a recipient’s computer or smartphone.
By removing barriers for Deaf and Hard of Hearing communities, we ensure equitable access to health care and better health care outcomes for all. We increase participation in the labor force, giving everyone a chance to share their strengths and build a better society, and we also challenge ourselves to learn from diverseperspectives. As a society we must begin to understand that we only rise when we rise together.
Fortunately, PGLS understands the importance of effective communication and the benefits of building a stronger, more connected community. Our expertise and years of experience offering professional language services for the Deaf and Hard of Hearing communities has positioned us as a strong advocate for a more inclusive and innovative society.
The PGLS Multifaceted Approach to Language Services for the Deaf and Hard of Hearing Communities
PGLS takes a multifaceted approach to services for the diverse Deaf and Hard of Hearing communities All of our professional ASL interpreters have many years of experience, are certified by the top accreditation organizations, such as the Registry of Interpreters for the Deaf (RID), and National Interpreter Certification (NIC), and have additional specialized training in a variety of fields.
PGLS is honored to regularly assist deaf and hard of hearing individuals at the VA Medical Center in Washington, DC. ASL interpreters can be provided both in-person or through PGLS’s VRI services, a simple, reliable and cost-effective solution to meet both spoken and sign language interpretation needs. Additionally, PGLS offers world-class CART services, available both on-site and remotely. Also known as ‘“real-time captioning”, CART is the system that converts speech to text, used by court reporters, closed captioners, voice writers, and others to provide language access to the Deaf and Hard of Hearing communities. The National Court Reporters Association (NCRA) describes CART services as “the instant translation of the spoken word into English text using a stenotype machine, notebook computer and real-time software.”8 These services make an incredible difference in the lives of deaf and hard of hearing individuals, helping them bridge the gap between the hearing and deaf worlds.
1 Excerpt shared by an experienced Spanish-English interpreter
2 ADA. Effective Communication. 31 Jan. 2014, www.ada.gov/effective-comm.htm.
3 Steinberg, Annie G, et al. “Health Care System Accessibility. Experiences and Perceptions of Deaf People.” Journal of General Internal Medicine, Blackwell Science Inc, Mar. 2006, www.ncbi.nlm.nih.gov/pmc/articles/PMC1828091/.
4 Pick, Lawrence. “Health Care Disparities in the Deaf Community.” American Psychological Association, American Psychological Association, Nov. 2013, www.apa.org/pi/disability/resources/publications/newsletter/2013/11/deaf-community.
5 Phillips, Dr. Katherine W. “How Diversity Makes Us Smarter.” Greater Good, 18 Sept. 2017, https://greatergood.berkeley.edu/article/item/how_diversity_makes_us_smarter.
6 “American Sign Language.” National Institute of Deafness and Other Communication Disorders, U.S. Department of Health and Human Services, 15 July 2020, www.nidcd.nih.gov/health/american-sign-language.
7 “What Is Video Remote Interpreting?” What Is Video Remote Interpreting? | DO-IT, www.washington.edu/doit/what-video-remote-interpreting.
8 “Communication Access Realtime Translation.” (2020). Retrieved November 03, 2020, from https://www.nad.org/resources/technology/captioning-for-access/communication-access-realtime-translation/
In addition to:
Bureau, US Census. “Detailed Languages Spoken at Home and Ability to Speak English.” The United States Census Bureau, 6 Oct. 2020, www.census.gov/data/tables/2013/demo/2009-2013-lang-tables.html.
Mitchell, Ross E, et al. “How Many People Use ASL in the United States? Why Estimates Need Updating”, Gallaudet University, 2006. www.gallaudet.edu/documents/Research-Support-and-International-Affairs/ASL_Users.pdf.
“Quick Statistics About Hearing.” National Institute of Deafness and Other Communication
Disorders, U.S. Department of Health and Human Services, 2 Oct. 2020, www.nidcd.nih.gov/health/statistics/quick-statistics-hearing.
Gaberoglio, Carrie Lou, et al. “Deaf People and Employment in the United States: 2016.” National Deaf Center, 2016, www.nationaldeafcenter.org/sites/default/files/Deaf%20Employment%20Report_final.pdf.
Bouton, Katherine. “Captions for Those With Hearing Loss Using CART System.” AARP, 7 Apr. 2016, www.aarp.org/health/conditions-treatments/info-2016/captions-hearing-loss-cart.html.