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Headshot of Kendra KuehnTackling Audism:  Confronting Assumptions and Reaching the Deaf and Hard of Hearing

by Kendra Kuehn, MSW, National Adult Protective Services Association

When you meet with a client or prepare a training what assumptions do you make around communication? Do you consider audience members that are deaf or hard of hearing? According to the Vera Institute of Justice, “audism – the belief that one is superior based on one’s ability to hear – is engrained in our society, shaping our world around the idea that hearing people are the norm and contributing to the discrimination and disparities d/Deaf people face in our country.” The National Voluntary Consensus Guidelines for State Adult Protective Services Systems from the U.S. Administration for Community Living highlights person-centered services as an ethical foundation of adult protective services (APS) including understanding a client’s goals, needs, and forms of communication. To uphold this principle, we need to look at how audism impacts our practice.

Building Barriers: The Impact of Hearing

According to the National Institute on Deafness and Other Communication Disorders (NIDCD), 15% of U.S. adults (37.5 million) say they have some trouble with hearing. About 3.6% of the U.S. population (11 million people) consider themselves deaf or have serious difficulty hearing based on Census Bureau data. The majority of those who are deaf and hard of hearing are over 65 years of age. The total population is not known, but many deaf and hard of hearing people identify as part of the Deaf culture. According to Gallaudet University, American Deaf culture uses American Sign Language (ASL) and centers on identification and unity with other people who are deaf. It also includes behavioral norms around conversation and getting a person’s attention.

According to 2018 National Adult Maltreatment Reporting System (NAMRS) data, 3.6% of adult maltreatment victims are deaf or have serious difficulty hearing. Hearing loss in older adults has also been associated with cognitive decline and other challenges that increase the potential for self-neglect. A Vera Institute report on serving deaf survivors of abuse notes there is limited research on this population but what is available suggests that deaf and hard of hearing individuals face a higher rate of intimate partner violence, emotional abuse, sexual assault, and physical abuse than their hearing counterparts. In the same report, the authors note that there are many barriers facing deaf and hard of hearing victims and few organizations and agencies are addressing them. These barriers often revolve around lack of accessible communication.

Breaking Barriers: Client Communications

We can begin to break down these barriers by understanding available resources and highlighting gaps. The National Association of the Deaf (NAD) does not currently have APS recommendations but their Position Statement on Improving Child Protective Services for Families with Deaf Individuals best practices recommend having qualified and trained ASL-fluent staff and interpreters. Staff who are trained in both communication methods and APS practice are better able to build an effective, person-centered approach than relying on a non-specialized interpreter. In general, APS investigators should not rely on those close to the case, such as family or friends, to provide interpretation. At least, the initial visit should be with a professional interpreter who does not know the client. You can learn more about interpreters and resources for your agency through the Registry of Interpreters for the Deaf.

Other communication challenges have also surfaced due to the COVID-19 pandemic. As APS workers go back into the field and are required to wear masks, deaf and hard of hearing clients and other contacts who rely on lip-reading fully or to support their understanding face new challenges. By their nature, face masks hide both our mouth and much of our facial expressions. Using clear masks or face shields can help alleviate some of this challenge. The FDA has approved one surgical mask with a clear window and others are available. Always be sure to follow any agency and public health department requirements. The APS TARC provides a tip sheet specific to APS use of face masks. NIDCD has also created a flyer with tips on communicating while wearing a facemask including limiting background noise and communicating through other ways such as writing or talk-to-text applications if necessary. Check out both the APS TARC’s list of suggested apps and NAD’s list of technology tools for ideas.

Breaking Barriers: Education and Outreach

There may also be barriers in our education, training, and outreach efforts. When planning events, what accommodations are you able to provide? Are you reaching the Deaf community in your area? The Vera Institute has a “Designing Accessible Events for People with Disabilities and Deaf Individuals” web page including a tip sheet outlining best practices around engaging sign language interpreters. As training and events continue to stay virtual, APS should make sure they are reaching all audiences by being accessible to all audiences. This can range from making sure the font on slides is large and readable to using closed captioning and an accessible virtual platform. At the end of July, the Accessibility Committee of the CIO Council, the U. S. Access Board, and the U.S. Department of Labor’s Office of Disability Employment Policy provided an in-depth webinar on accessible virtual meeting platforms. While the conclusion is that no platform is perfect, these tips, with the help of your IT department, can expand the reach of programming. Also, consider reaching out to local groups for their input on needs and potential partnerships, see the resources for some starting ideas.

Breaking Barriers: Benefits

Building services and agencies that are accessible to people who are deaf and hard of hearing can not only help current clients but prevent future risk. As noted earlier, hearing loss in older adults is associated with factors that may create a greater risk of abuse and neglect. But a study out of the University of Michigan found that using a hearing aid may significantly reduce the risks of dementia, depression and anxiety, and falls. Understanding the impact of hearing loss could help reduce the risk of future abuse and neglect. Creating accessible outreach and partnerships with Deaf community organizations and agencies can build support for an often overlooked population. Partners will also bring perspectives to person-centered services that can inform APS practice.
Let us know how you are working against audism!

Resources for Barrier Breakers

Nomenclature Note – “d” vs. “D”: The National Center on Disability and Journalism’s Disability Language Style Guide notes that use of the lowercase “deaf” is used to refer to the hearing status while the use of the uppercase “Deaf” is used to refer to the community of Deaf people. It is most appropriate to use what the individual prefers.

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