It’s a weekday morning in 2016, and Ibby Piracha, 23, enters his neighborhood Starbucks to order a coffee. Normally he would type his order on his phone, but today, the barista uses American Sign Language to ask him what he’d like. After noticing Piracha was a regular she learned ASL to take his order, and their story went viral online.
This heartwarming interaction got plenty of media attention, but isn’t exactly common. Anywhere from nine to 22 out of every 1,000 people are hard-of-hearing or deaf, but most of the hearing world doesn’t know what life is like for the Deaf community. For starters, no two people in the community are exactly alike.
Types Of Hearing Loss
About three out of every 1,000 children in the United States are born with a detectable level of hearing loss, but the majority of people who are deaf or hard-of-hearing develop hearing loss over time or because of certain conditions.
Conductive hearing loss occurs because of damage to or a blockage in the outer or middle ear. This results in sound not being carried through the ear canal to the eardrum as it should or from the middle ear to the inner ear. For example, conductive hearing loss can be caused by earwax, a perforated eardrum or a buildup of fluid in the middle ear from a cold. These issues can often be treated effectively by a medical professional, so the hearing loss would be temporary. Conductive hearing loss can also be permanent depending on the cause and the extent of damage.
Sensorineural hearing loss is the most common type of permanent hearing loss and occurs when there is damage to the hair cells in the cochlea, which is what converts sound waves into neural signals. Its usual causes include aging, trauma to the head, malformation of the inner ear, exposure to loud noises, illness or hereditary hearing loss.
Mixed hearing loss is a combination of both conductive and sensorineural hearing losses. For example, you may have mixed hearing loss if you work around loud noises and also have fluid buildup following a cold, making your hearing worse than it would be with just the noise exposure. The sensorineural component of the hearing loss is permanent, while the conductive component may be permanent or temporary.
Auditory neuropathy occurs when the auditory nerve has difficulty transmitting auditory signals from the cochlea of the ear to the brain. People with this type of hearing loss may have trouble understanding speech when there is background noise, and hearing ability varies between each person. Assistive technologies can usually help reduce the effects of auditory neuropathy. It can be caused by neurological disorders, immune disorders, genetic conditions, infectious diseases or exposure to ototoxic medications.
How To Talk About The Deaf Community
In the deaf and hard-of-hearing community, there are many ways a person can identify. That’s because there are so many possible causes of hearing loss, different levels of hearing and numerous communication methods to choose from, so no one label fits each person.
“Do they identify themselves as being a deaf individual or a hard-of-hearing individual?” says Sheri Arthur, lead ASL interpreter at Osceola Middle School. “It depends on their culture, their family influences, their friend-base and what they choose to identify with.”
Today, the World Federation of the Deaf suggests using “deaf,” “Deaf” and “hard-of-hearing” when speaking to or about people with hearing loss. According to the National Association of the Deaf (NAD), here are the differences between the terms “deaf,” “Deaf” and “hard-of-hearing”:
deaf: used when referring to the audiological condition of not hearing
Deaf: used when referring to the culture and community of Deaf people
hard-of-hearing: can refer to a person with mild-to-moderate hearing loss, a deaf person who doesn’t want cultural affiliation with the Deaf community or both.
Within the Deaf community, some people will identify with these terms or get more specific. Some may feel “hearing loss” doesn’t apply to them because they were born without hearing, and others may identify as “late-deafened” because they became deaf later in life.
One term to avoid: hearing-impaired. Although hearing-impaired used to be viewed as politically correct, the Deaf community feels that “hearing-impaired” focuses on what they can’t do.
“It’s not an impairment,” says Ann Rainey, a deaf and hard-of-hearing itinerant teacher with Marion County Public Schools. “The motto for the deaf community is, ‘We can do everything but hear.’ That was coined by I. King Jordan, the first deaf president of Gallaudet University.”
When in doubt about how to respectfully refer to someone in the deaf community, just ask how they identify themselves.
What Is Deaf Culture?
Michael Stultz is a deaf education instructor at the University of North Florida, where he helps prepare future teachers to work with students who are deaf or hard-of-hearing. He is also deaf and says the heart of Deaf culture is just like any other shared culture: sharing experiences and supporting each other.
“The point of Deaf culture is identity and support. It’s about being able to sign together with ASL and having communication,” Stultz explains.
“Having our own identity is important for confidence. The outside world is tough to navigate, and we have to go through a lot of hardships. The Deaf community is where we feel like we belong. We’re unique, our language is visual and there’s so many different ways people identify.”
In the last few years, he has noticed snippets of Deaf culture creeping into the mainstream. Movies like A Quiet Place star a deaf actress and show the cast signing with her. But Deaf culture has carved out its own space, too.
“We have our own cultural events, like deaf theater. We have our own sports leagues in different cities nationwide, and we compete against one another, like deaf basketball and bowling. There’s even deaf bingo,” he says. “We share that common experience of being oppressed and that understanding. We support one another and society kind of looks down on us, so
we look forward to signing and having that communication with each other.”
And just like English changes with culture—words like memes, viral and more take on new meanings as society evolves—ASL adapts, too.
“We definitely have seen it evolve throughout the years. ASL grammar and syntax pretty much stays the same, just like in English. The history of ASL has a strong English influence, and now we’re evolving more toward signing matching the word itself rather than matching the English sign. So we’re no longer going for English words, but more of the concept of the word.”
Katy Owen, a deaf/hard-of-hearing inclusion teacher in Marion County, says exposure to language is vital to children’s development whether they’re hearing or deaf.
“If you suspect your child has hearing loss, get connected and get them into early intervention in school. The earlier kids have access to language the better they will be. They don’t have hope for their future if they’re not educated, literate and able to advocate for themselves.”
The Importance Of Self-Advocating
ASL is part of Deaf culture, but it’s also crucial to a deaf person’s safety.
Colleen Metcalf is a consumer specialist with the Center for Independent Living of North Central Florida, located in Ocala and Gainesville. She works with area residents who are blind, deaf or who use wheelchairs or other assistive equipment to help them live as independently as possible.
“I work with the deaf community, and I know a bit more about the community than most,” Metcalf says via interpreter, referencing that she herself is deaf. Aside from teaching independent living skills, something she works on frequently is teaching deaf people to advocate for themselves and to know the rights granted to them by Title III of the Americans with Disabilities Act (ADA).
For example, health care providers—public and private, regardless of facility size—are required to provide appropriate auxiliary aids or interpretive services when necessary to ensure that communication with someone who is deaf or hard-of-hearing is as effective as communication with hearing patients.
“I go out to high schools and middle schools and teach deaf students to self-advocate, like to use an interpreter in a job interview,” Metcalf says. “Deaf individuals may not know how to call and tell their doctor’s office they need an interpreter. Some doctors do refuse, so then I educate them that the ADA says, by law, they’re responsible to provide interpreters for patients who are deaf or hard-of-hearing to communicate effectively.”
Maureen Tambasco, executive director of Citrus Hearing-Impaired Program Services (CHIPS), encounters this often. She says often the expectation is that a family member or friend will attend with the patient and interpret for them.
“Not all deaf people have an ASL-fluent person to walk around with them,” says Tambasco. “Having a qualified interpreter who has gone through the testing process is much more dependable to convey information than a family member. The best way to explain it is, if you took Spanish I in high school, are you going to go out there and translate? If it’s not being done correctly, they could take their medication wrong.”
Metcalf encourages any business to hire a qualified ASL interpreter for accessibility.
“There should be clarity and understanding,” says Metcalf. “Without an interpreter they can be lost. Some doctors refuse to get an interpreter, and they want to write back and forth, but every deaf person’s function is different. Some understand English, some understand ASL. Deaf people are satisfied, and they understand what a doctor is saying to them when an interpreter is present.”
Stultz adds that emergency broadcasts and preparation should always be captioned or interpreted live by a qualified interpreter.
“In Florida, there’s really no law for interpreters, so anyone who knows ASL they can use to interpret, and that’s not qualified. During a hurricane warning last year in Florida, they pulled in a lifeguard who knew some ASL to interpret, and the community missed a lot of important information that way. It’s really important the interpreters are certified and qualified because that is a huge resource. If there is a video on a website, make sure there is captioning.”
Visit ada.gov/effective-comm.htm for an overview of effective communication requirements for deaf and hard-of-hearing individuals.
Marion County Resources
Marion County Public Schools
This webpage was created to house resources for deaf and hard-of-hearing students and their families. Find ASL tutorials, information on early language development, ASL bedtime stories to aid in bonding and language acquisition at home, and so much more.
http://www.marionschools.net/domain/15147, (352) 671-7000
Center for Independent Living of North Central Florida
The CILNCF is a disability resource center operated by a majority of people living with disabilities. Their five core services are advocacy, teaching independent living skills, sharing information and referrals, providing peer support and helping with life transitions. The center serves 16 counties.
cilncf.org, (352) 368-3788
Citrus County Resources
Citrus Hearing-Impaired Program Services (CHIPS)
Resources for deaf and hard-of-hearing residents of Citrus County, including interpreting, advocacy, information, referrals, sign language classes and more.
citrushearingimpaired.org, (352) 795-5000
Florida Association of the Deaf, Inc.
FAD is an organization that promotes deaf, hard-of-hearing and late-deafened Floridians to interact with each other while also connecting them to resources they may need. Visit their website for lists of trusted interpreters, ASL-friendly churches and more.
FTRI Phone program
Florida Telecommunications Relay, Inc. is a statewide nonprofit 501(c)(3) that distributes free specialized telecommunications devices to residents who are deaf or hard-of-hearing.
ftri.org, (888) 554-1151, VP: (850) 270-2641
Florida School for the Deaf & the Blind Parent Infant Programs
The Parent Infant Programs offer early intervention programs at no charge for infants and children up to age 5 who are deaf/hard-of-hearing. Services are provided in the family’s home by a certified advisor.
fsdb.k12.fl.us/index.php/parent-services, (904) 827-2437, VP: (904) 201-4581
Sources: nad.org, ada.gov, asha.org, research.gallaudet.edu, nidcd.nih.gov, ncdj.org