deaf culture research essays

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Deaf Culture: Exploring Deaf Communities in the United States

2018, Ear & Hearing

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Sign Language Studies

Breda Carty

Carla Barbe

Jacqueline Humphries

The American Deaf community for several decades has been involved in sometimes complicated and often contested ways of defining what it means to be Deaf. It is our thesis that the processes of identity construction and the recent discourse of Deaf identity are not unique phenomena at all but echo the experience of other embedded cultural groups around the world, particularly those that are stressed by the assertion of hegemony over them by others. We turn to 2 particular theorists, Jose Martı ́ and W. E. B. DuBois, to help us un-derstand both the dilemmas that Deaf people face and the possible solutions that they propose. This article argues that identities are constructed not just within Deaf communities but within the social contexts in which Deaf communities are embedded. This article discusses how Deaf people’s identities are

Glenn Anderson

Ross E Mitchell

Julie Park , Corinna Howland

Kim Pudans-Smith

Names are both personal and political, as they relate to identity. Woodward’s 1975 etic article first mentioned a naming convention for D/deaf and prominent scholars have debated the issue since. To evaluate current preferences, the research team used an online questionnaire to gather emic insights and opinions from the community, as well as a more etic perspective from hearing individuals for work with these issues. Data from these three self-identified groups of participants, Deaf, deaf, and hearing, were analyzed. Results found high variability among responses related to the terms, D/deaf, and whether or not certain terms should remain in the lexicon. Results are discussed and presented both to contribute and to further research in the field. It is recommended that the usage of existing term(s) be adhered to and that an individual’s preferred naming conventions be respected and utilized whenever possible.

Bencie Woll

Journal of Deaf Studies and Deaf …

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The focus and concerns establishing Deaf Studies in the 1970s have rigidified into a reactive stance toward changing historical conditions and the variety of deaf lives today. This critique analyzes the theoretical foundation of this stance: a tendency to downplay established research in the field of Deaf Studies and linguistics, the employment of outdated examples of discrimination, an uncritical acceptance of Derrida's phonocentrism, flawed uses of Saussure's linguistic theory, and reliance on the limiting metaphor of colonialism. The purpose of the critique ultimately is to point Deaf Studies in a new direction. Issues with conceptualizing an expanded Deaf Studies are the focus of a companion article (this issue), “Inclusive Deaf Studies: Barriers and Pathways" -- at http://jdsde.oxfordjournals.org/content/15/1/17.full

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Interventions aimed at improving healthcare and health education equity for adult d/Deaf patients: a systematic review

Kevin morisod.

Department of Vulnerabilities and Social Medicine, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland

Mary Malebranche

Department of Medicine, Dalhousie University, Halifax, NS, Canada

Joachim Marti

Department of Epidemiology and Health Systems, Centre for Primary Care and Public Health (Unisanté), Lausanne, Switzerland

Jacques Spycher

Véronique s grazioli, patrick bodenmann, associated data.

d/Deaf people suffer from inequitable access to healthcare and health information. This results in worse health literacy and poorer mental and physical health compared to hearing populations. Various interventions aimed at improving health equity for d/Deaf people have been documented but not systematically analyzed. The purpose of this systematic review is to obtain a global overview of what we know about interventions aimed at improving health equity for d/Deaf people.

Medline Ovid SP, Embase, CINAHL EBSCO, PsycINFO Ovid SP, Central—Cochrane Library Wiley and Web of Science were searched for relevant studies on access to healthcare and health-related interventions for d/Deaf people following the PRISMA-equity guidelines. We focused on interventions aimed at achieving equitable care and equitable access to health information for d/Deaf people.

Forty-six studies were identified and analyzed. Seven categories of interventions facing healthcare or health education inequities emerged: use of Sign Language (1), translation, validation and identification of clinical tools and scales (2), healthcare provider training program (3), development of adapted healthcare facilities (4), online interventions (5), education programs (6) and videos (7). Despite some methodological limitations or lack of data, these interventions seem relevant to improve equity of care and health education for d/Deaf people.

Interventions that promote healthcare equity, health education amongst d/Deaf patients and healthcare provider awareness of communication barriers and cultural sensitivity show promise in achieving more equitable care for d/Deaf patients. Meaningful engagement of d/Deaf individuals in the conceptualization, implementation and evaluation of health-related interventions is imperative.

Introduction

According to the WHO, more than 460 million people worldwide have disabling hearing loss and are considered as d/Deaf. 1 The term ‘d/Deaf’ refers to individuals with severe to profound hearing loss (‘deaf’) which impairs communication, as well as to members of Deaf communities around the world (‘Deaf’), which are distinct cultural and linguistic minorities that use Sign Language to communicate and share common experiences and values. The term ‘d/Deaf’ does not include hard of hearing people (who refers to a hearing loss where there may be enough residual hearing that an auditory device, such as a hearing aid or FM system, provides adequate assistance to process speech). For Deaf communities, deafness is considered an alternative way of being, as opposed to a disability that requires correction. 2 Statistics concerning the number of individuals who identify as members of the Deaf community, however, are not well captured on a global scale but evidence from Canada suggests that they represent about 1 in 1000 individuals. 3

International literature has highlighted that many health inequities are experienced by d/Deaf populations including barriers in accessing and receiving high-quality healthcare and in achieving optimal health outcomes. 4–6 Specifically, d/Deaf people have significant difficulties communicating with health professionals. 7 This is thought to stem from a lack of access to Sign Language interpreters, as well as a lack of awareness and focused training in culturally appropriate communication with d/Deaf individuals amongst healthcare professionals. 8 , 9 This access to information extends beyond the healthcare setting, adversely impacting the health literacy of d/Deaf individuals who face limited access to hearing-based mass media, ambient conversations and public health messaging designed for the hearing world. 10 In fact, public health programs are often poorly adapted to this population which can have unintended negative consequences. 11 For example, during the AIDS epidemic in the 1980s, d/Deaf individuals long believed that AIDS was transmitted by solar radiation, following a poster campaign depicting the HIV virus over top of a large yellow mass resembling a Sun. 12

With regards to health outcomes, evidence suggests that d/Deaf individuals experience worse health outcomes than the general hearing population. 13 For example, d/Deaf people are at greater risk of developing chronic diseases including hypertension and diabetes in their lifetime. 14 They also disproportionately suffer from mental illness 15 including anxiety and depression 16 , 17 and are at higher risk of suicide compared to hearing individuals. 18 Finally, d/Deaf people tend to perceive their health to be worse than the general hearing population. 5 , 15

Over the past three decades, a rich body of literature has highlighted the barriers experienced by d/Deaf people in accessing healthcare and in benefiting from public health or preventative health messaging, documenting the resultant inequities in health outcomes they experience. 5 However, there is a paucity of literature on solutions or ways forward in addressing these inequities. 5 , 19 In recent years, research teams around the world have begun to describe and evaluate interventions aimed at addressing and reducing health and healthcare inequities for d/Deaf people, in particular to improve their health literacy 20 through a better access to health informations or to develop specialized healthcare facilities for d/Deaf people. 19 However, to date this growing body of literature has not been systematically reviewed. The purpose of this article is to review what interventions have been described that aim to achieve equitable access to healthcare and health information for d/Deaf people, and of those what types of interventions show promise in improving health and healthcare equity for d/Deaf people.

The protocol of this systematic review was published in PROSPERO at the outset of the study ( Supplementary file S1 ). The reporting of this systematic review was based on the PRISMA-equity guidelines 21 ( Supplementary file S2 ).

Inclusion/exclusion criteria

We included studies reporting on interventions aimed at improving equity in healthcare and health education for d/Deaf people. We included all study designed (experimental, observational, quantitative or qualitative, longitudinal or cross-sectional), as long as a study described an intervention, assessed its role or compared its impact in a trial. If a study mixed epidemiological data with data regarding the impact of an intervention, we limited data extraction to data concerning the intervention. We chose to focus on d/Deaf people due to the specific needs and characteristics of this population. Studies focusing only on hard of hearing (HOH) people were excluded. If a study included both d/Deaf and HOH people, we limited data extraction to data concerning d/Deaf people only. We chose to focus on high-income countries, in order to limit the bias of the healthcare equity assessment due to the lack of resources that could affect the healthcare systems of low- and middle-income countries. We included studies on adults (age 18 and over). If a study included both children and adults, we limited data extraction to data pertaining only to adults. Searches were limited to articles in English, French and German (due to the language skills of the authors) published before December 2019.

We excluded studies that did not focus on equity, as well as opinion papers, reviews, editorials, conference abstracts and study protocols.

Search strategy

The search strategy was conducted with the assistance of a medical librarian using six databases: Medline Ovid SP, Embase, CINAHL EBSCO, PsycINFO Ovid SP, Central—Cochrane Library Wiley and Web of Science. We used keywords in the field of deafness and health equity and healthcare accessibility. We combined the Medical Subject Headings (MeSH) terms ‘Health Services Accessibility’, ‘Health Equity’ or ‘Health Care Disparities’ with a combination of terms defining deafness and deaf people. With the help of a specialized librarian, we then translated and adapted the search equations to the different databases. The final search was conducted in December 2019. The full search strategy can be found in Supplementary file S3 . Following the initial search, to identify any further relevant studies that were not initially captured, we screened reference lists of all included studies and performed Google and Google Scholar searches using key search terms.

Study selection

Two reviewers (KM and MM) screened articles independently and in duplicate. This was done in two stages. First by screening all titles and abstracts and second, by reviewing the full text of all relevant articles to determine their eligibility in the final analysis. A third reviewer (PB) provided arbitration in the event of a disagreement at both stages of screening. Reasons for the exclusion of articles at the full-text screening stage were documented.

Data extraction

Two authors (KM and MM) extracted data independently and in duplicate from included studies using Covidence ® , a systematic review management software, and any discrepancies were resolved by consulting the third reviewer (PB). Data on key characteristics of the studies were extracted in a predefined data extraction form, into an Excel ® spreadsheet. This included the design of the study, population, methodology, type of intervention, outcomes, main findings and key conclusions.

Quality and bias assessment

The methodologic quality of each study was evaluated using the 2018 version of the Mixed Method Appraisal Tool (MMAT). 22 The MMAT was specifically designed to appraise studies with diverse study designs, including qualitative, quantitative and mixed methods, rendering it an appropriate tool for this systematic review. Further, it has been validated and reliably tested in the literature. 23

The initial search yielded 1507 papers of which 46 were included in the final analysis ( figure 1 ). Of these, 38 (83%) were conducted in the US, 3 (7%) in the UK, 3 (7%) in France, 1 (2%) in New Zealand and 1 (2%) in Italy. Forty-three (93%) were written in English and 3 (7%) in French.

PRISMA Flow diagram

Among the 46 studies evaluated, 6 were qualitative, 4 used mixed-methodology and 36 were quantitative (8 randomized control trials, 16 non-randomized control studies and 12 quantitative descriptive studies).

Seven categories of interventions emerged divided into two main health equity domains: healthcare (Interventions 1–4) and health education (Interventions 5–7):

• Use of Sign language during care, (2) Translation, validation and identification of clinical tools and scales, (3) Healthcare provider training program, (4) Development of adapted healthcare facilities, (5) Online interventions, (6) Educational programs and (7) Educational videos.

Table 1 summarizes the main characteristics and risk of bias assessment of the studies analyzed in this systematic review. (See Supplementary table S1 a for detailed description of the studies and Supplementary table S2 for the full risk of bias assessment.)

Characteristics of the included studies, classified by type of interventions

MMAT, Mixed Methods Appraisal Tool, a critical tool for the appraisal stage of systematic mixed studies reviews; SLI, Sign Language interpreters; QOL, quality of life; HCPs, health care providers; RCT, randomized controlled trial; NVS, Newest Vital Sign, an instrument assessing health literacy based on a person’s ability to answer six questions about a nutrition label; MHLC, Multidimensional Health Locus of Control, one of the most commonly used parameters of health belief in planning health education programs. This scale assesses the degree to which individual believe that his or her behaviour is controlled by external or internal factors; PHQ, Patient Health Questionnaire, a widely used questionnaire (nine items) to assess depression; GAD, Generalized Anxiety Disorder, a widely used questionnaire (seven items) to assess anxiety; IPT, Iowa Pain Thermometer, a self-reported intensity pain tool.

Interventions addressing healthcare inequities

Intervention 1: use of sign language during care.

Access to professional Sign Language interpreters or to care providers who are fluent in Sign Language (i.e. Language concordant) appears to be an essential factor in achieving equitable care for d/Deaf people. In a cross-sectional survey published in 2010, the authors found that 43% of d/Deaf respondents preferred to have a direct consultation with a Sign Language fluent health professional and 50% preferred the presence of a Sign Language interpreter. 24 One study found that when Sign Language interpretation was not available during medical consultations, d/Deaf smokers or former smokers were at increased risk of poorer health outcomes. 25 Further, poor access to Sign Language interpreters has been associated with lower self-reported quality of life amongst d/Deaf patients proficient in Sign Language. 9 When language concordance between caregivers and d/Deaf patients is available (such that a Sign Language interpreter is not needed), it has been associated with higher appropriate use of preventive health services such as influenza vaccination amongst d/Deaf patients. 26 However, access to professional interpreters or language concordant care providers alone is not sufficient to achieve equitable care, most notably for those that identify as being a member of the Deaf community. For this group of d/Deaf patients, it also appears essential for healthcare providers to have an awareness of Deaf culture. 27 For example, the presence of an interpreter did not increase the willingness of d/Deaf LGBTI+ patients to communicate information about their health to their care providers. 28 Cultural sensitivity and providing non-judgemental care were also quoted as key factors for further reducing communication barriers.

Moreover, five studies analyzed the use of telemedicine with d/Deaf patients, with a predominant focus on its use in mental health. 29–33 These studies highlighted the usefulness of telemedicine in improving access to care for d/Deaf people. Indeed, the availability of Sign Language interpreters or Sign Language fluent care providers who speak sign language is sometimes very limited, particularly in rural areas. Telemedicine therefore could be useful by making it possible to carry out consultations remotely (see table 1 ).

Intervention 2: Translation, validation and identification of clinical tools and scales

This review identified eight studies that have translated and/or validated or identified diverse clinical tools in Sign Language to better assess the health issues impacting d/Deaf people, particularly in the field of mental and behavioural health and pain management (see table 1 ). 34–41

Moreover, a qualitative study concerning prescription comprehension amongst Deaf patients suggested adaptations to improve prescription comprehension for d/Deaf patients, including verifying comprehension with the patient, replacing duration with specific dates and using visual aids (i.e. calendars/tables/drawings). 41

Intervention 3: Healthcare providers training program

Two studies looked at educating healthcare professionals on the unique healthcare needs and barriers faced by d/Deaf people. 42 , 43 The first study analyses a 2-year program dedicated to training medical students by teaching them Sign Language and exposing them to the Deaf community during a summer term. 42 The second is an analysis of a reverse role-playing activity for pharmacy students where they play the role of patients in a fictitious hospital where all the staff are deaf and only speak American Sign Language. 43

Although very distinct, these two studies highlighted the importance of training healthcare staff in d/Deaf culture and improving their awareness of barriers issues when aiming to provide optimal care for d/Deaf people. In addition, both studies highlighted the relevance of using innovative pedagogical techniques to improve awareness of the linguistic and culturally distinct needs of d/Deaf patients when accessing healthcare.

Intervention 4: Development of adapted healthcare facilities

Three studies described efforts that have gone a step further in providing equitable access to care for d/Deaf people by providing integrative models of clinical care specifically designed for this distinct patient population. 38 , 44 , 45 One study described the creation of deaf-adapted services in an obstetrics and gynaecology clinic in Grenoble, France. 44 The study showed adaptations to both outpatient and inpatient care of d/Deaf patients. Adaptations included ensuring all care providers were fluent in Sign Language, care coordination between clinic staff and in-hospital care providers during admissions and ensuring barrier-free access to in-hospital Sign Language interpretation services. However, it was found that adaptations were less effective in emergency situations (i.e. in the Emergency Department). 44 Similarly, a case study described an ambulatory consultation service in France devoted to primary care for d/Deaf people, highlighting the relevance of such services. 45 One key limitation of this article was that it was purely descriptive, lacking a formal evaluation of access or health outcomes related to their innovative care model.

Lastly, an American research team demonstrated the relevance of the creation of a Deaf Mental Health Clinic (based on an integrated healthcare model) to reduce depression and anxiety among d/Deaf patients. 38

Interventions addressing inequities in health education

Intervention 5: online/e-health interventions.

Six studies were identified that describe online interventions aimed at improving dissemination and comprehension of medical and health information to d/Deaf individuals. 46–51 All six studies found a positive effect of electronic media (website-based) when translated into Sign Language. Kushalnagar and colleagues found, however, that a simple translation was not sufficient to reach d/Deaf people effectively. 50 They concluded that there was a need to develop user-friendly health websites that take into account the lower health literacy of the target audience such as easy to understand video contents and usability testing experience and feedback during the design process. 50 Similarly, another study highlighted strong preferences for interactive and visual aspects of websites (such as graphics and animations) amongst d/Deaf users. 47

Intervention 6: Educational programs

Given the barriers d/Deaf people face in accessing medical information and public health messages, specific health-focused educational programs for d/Deaf people have been developed. 11 , 52–54 A study by Jones et al. seems particularly interesting. Their research team first conducted a comprehensive community assessment of the health education priorities amongst d/Deaf adults. This revealed that learning about the cardiovascular disease was their main priority. 11 Based on these findings they created and evaluated an 8-week educational program (the Deaf Heart Health Intervention). It consists of a 16 h highly interactive class entirely in American Sign Language done by a trained deaf teacher. Its health content draws heavily from recommendations from the American Heart Association for primary prevention of cardiovascular diseases and found a statistically significant improvement in participants knowledge across different domains of cardiovascular health between baseline and 6-months post-intervention. 52

In contrast, the pilot project of Patel et al. , 53 also based on a cardiovascular health promotion program for d/Deaf people, did not show any significant short-term improvement, which the authors attribute to enrolling a small, non-representative sample of patients.

Lastly, a study by Sadler et al. focused on addressing low baseline knowledge and adherence to breast cancer screening guidelines amongst a cohort of d/Deaf women in Southern California by implementing an in-person breast cancer prevention progress using focus groups offered in ALS. Following this intervention, they found a statistically significant improvement in almost all knowledge domains analyzed amongst participants compared to their baseline pre-intervention knowledge. 54

Intervention 7: Educational videos

Thirteen studies were identified that focus on improving access to health information and health education for d/Deaf people through culturally and linguistically adapted educational videos. 55–67 These videos all focused on improving knowledge around different forms of cancer (breast, cervical and testicular) across different domains (general health knowledge to cancer-specific knowledge) (see table 1 ).

All but one published study showed significant improvements in the general knowledge and cancer prevention knowledge in the d/Deaf population after viewing the videos of interest, at least in the short term (3–6 months). However, Zazove and colleagues did not show any further benefit of adding an ASL interpreter and low-literacy captions on an existing English-speaking cancer prevention information video. 67

In recent years, a growing body of literature has focused on interventions aimed at improving equity in healthcare and health education for d/Deaf people. Our systematic review found seven different interventions to improve healthcare and health education equity for d/Deaf people ( figure 2 ).

Synthesis of the results

The results highlight the fundamental importance of access to community sign language interpreters to ensure healthcare equity for d/Deaf patients. Telemedicine can improve this access to overcome the lack of sign language interpreters in some rural or socio-economically disadvantaged areas. The average level of bias assessment of this intervention is fair. However, in the quasi absence of experimental comparative study design (one randomized controlled trial and one pre–post study), more evidence is needed to quantify the impact of this intervention.

In the absence of sign language interpreters, the adaptation of clinical assessment tools for d/Deaf patients appears to be a relevant, easily implementable and cost-effective intervention. These tools could compensate for the lack of community interpreters in certain situations (such as emergencies).

Moreover, increasing awareness amongst healthcare professionals of the issues involved in communicating with d/Deaf people, the barriers they face and improving their understanding of Deaf culture will provide skills for caregivers to better interact with these patients and probably improve healthcare equity. However, the scientific evidence for this intervention is relatively low. The number of studies and the poor average level of bias assessment of the article published do not allow a clear conclusion on the relevance of such an intervention. Research in this area needs to be strengthened.

Similarly, the descriptive design and the poor average level of bias assessment of the studies analyzing the development of adapted healthcare facilities (Intervention 4) do not allow any firm conclusion. Then, it appears to be costly and requires a medico-economic cost-effectiveness analysis to evaluate its feasibility. Pilot projects carried out in France and the USA should better assess this intervention in the coming years.

Linguistically and culturally adapted videos offer a valuable health education intervention. In addition, the development of training programs for d/Deaf people also appears to be a relevant intervention for improving equity in health education. Still, the overall level of evidence is lower, and such an intervention seems less cost-effective.

The use of computer technology to develop websites or culturally and linguistically adapted software is also a relevant intervention to enhance access to health information and ultimately improve the health education of d/Deaf people.

Besides identifying seven categories of interventions, two main messages emerged from this literature review.

The first is that technology, when appropriately leveraged, can markedly improve communication between healthcare providers and d/Deaf patients, as illustrated by the numerous studies on e-health (including telehealth) and health education videos. Moreover, promising innovations are underway, such as artificial intelligence-based innovations for Sign Language interpretation into clinical care like KinTrans ( www.kintrans.com ), SignAll ( www.signall.us ) or the European SignSpeak project 68 and may help in the future to improve health equity for d/Deaf people.

The second message is that it is imperative to involve d/Deaf communities as active participants and meaningful contributors into all steps of intervention design and implementation (from the conception of the intervention to its implementation and evaluation). 51 , 52 , 56

Our systematic review has some limitations. First, populations included across analysed studies are heterogeneous (e.g. some included only those who identify as members of the Deaf community, whereas others mentioned Deaf Sign Language users who may or may not identify as members of the Deaf community). However, our initial focus was explicitly on d/Deaf people (we purposely excluded hard of hearing people), limiting the heterogeneity of the analysed population. Second, the literature is heavily US-focused (83% of identified studies were conducted in the USA) and therefore limits the transferability of the findings. This is probably due to well-established research groups specifically composed of d/Deaf researchers in the USA. Third, the quality and bias assessment highlighted some methodological issues concerning the selected studies. However, many of these methodological limitations are probably associated with the study population, which is too often overlooked in the medical literature (e.g. the small sample size). Finally, numerous articles were found that describe an intervention but did not conduct or report an empirical evaluation of its impact. We believe there are likely many innovative interventions aimed at improving care for d/Deaf individuals worldwide. Conducting and publishing assessments of such interventions would add significant value to the current scientific literature and improve healthcare equity for d/Deaf individuals.

In the absence of one silver bullet, the way forward in improving health equity for d/Deaf people seems to be through the implementation and evaluations (including cost-effectiveness) of context-sensitive interventions in healthcare and health education. Moreover, the early involvement of members of the Deaf community and d/Deaf patients in the research and implementation process seems to be crucial. The search for health equity has involved innovation, curiosity and open-mindedness to adapt a practice or system by integrating all of these beneficiaries, as highlighted by the diversity of the literature concerning health equity for d/Deaf patients.

Supplementary data

Supplementary data are available at EURPUB online.

• Many innovative interventions have been developed to improve equity in healthcare and health education for d/Deaf people.
• Technology and e-health play a fundamental role in tackling health inequities.
• Community-based participatory research will strengthen the success of new projects, their evaluation and implementation in close collaboration with the d/Deaf people.
• Strong evidence is still needed to better assess the effectiveness and the relevance of interventions aimed at reducing health inequities.

Supplementary Material

Ckac056_supplementary_data, acknowledgements.

The authors would like to warmly thank Mr Thomas Brauchli, librarian, for his important contribution to this review in developing the search strategy.

Conflicts of interest : None declared.

Contributor Information

Kevin Morisod, Department of Vulnerabilities and Social Medicine, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.

Mary Malebranche, Department of Vulnerabilities and Social Medicine, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland. Department of Medicine, Dalhousie University, Halifax, NS, Canada.

Joachim Marti, Department of Epidemiology and Health Systems, Centre for Primary Care and Public Health (Unisanté), Lausanne, Switzerland.

Jacques Spycher, Department of Epidemiology and Health Systems, Centre for Primary Care and Public Health (Unisanté), Lausanne, Switzerland.

Véronique S Grazioli, Department of Vulnerabilities and Social Medicine, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.

Patrick Bodenmann, Department of Vulnerabilities and Social Medicine, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.

Additional references 41 and 68 are provided in Supplementary material .

Chapter 8: COVID and learning

8.6.2 Communication in the Deaf community during COVID-19 (research essay)

English 102, april 2020.

To conclude my time in English 102 I plan on diving deeper into the topic of communication in the deaf community. Deaf culture is slowly becoming more socially accepted in society. I plan on discussing the differences and difficulties that the deaf community must face and answering some research questions. I chose to continue writing about this topic because I am currently in an American Sign Language class and my professor is deaf, and it got my thinking about any struggles the deaf community encounters. I plan on relating this to the circumstances we as a world are facing. I am also going to discuss the difficulties the deaf community faces in a day to day life.

To help develop my paper, I have five research questions. Those being: How is higher education different for those who are deaf or hearing impaired compared to those who are hearing? What are different causations of becoming deaf? (different levels of deafness) How hard is it to get a stable job as a deaf person? What are strategies to teach hearing individuals American Sign Language? Why is it easier to learn ASL from a deaf individual?

Before answering my research questions, I want to mention common misconceptions within the deaf community. One of the biggest misconceptions is that American Sign Language is an easy language to learn. Most people believe that if you learn a few signs that you will be okay. That mindset is the reason people don’t take ASL seriously. It is just as difficult as learning a second language. “Learning ASL as a second language may be natural for a few students, extremely difficult for a few, and somewhere between fairly not-so-hard and some difficult for the rest of the students. It is a typical curve” Jolanta Lapiak from Handspeak discusses how challenging it is to learn ASL in the article,  How   challenging is it to master American Sign Language?   Lapiak breaks down the difficulty of learning a language into categories. The categories are from The Foreign Service Institute (FSI) of the U.S. Department of State and they break the languages down based on how many hours you need to practice being “fluent” in a certain language. While ASL is not on this list, some argue that ASL should be in Category II. Category II requires about 30 weeks of practice or 750 hours and is the equivalent to learning German. Others argue that ASL is Category IV. Category IV requires about 44 weeks of practice or 1100 hours. ASL is constantly gaining new signs which makes it difficult to learn quickly.

Another common misconception for ASL is that it is universal. While some signs are the same, like numbers, others like the alphabet are different. ASL is not universal even within the United States. My ASL professor, Mary Mougey, told my class that signs in Ohio are different in California. Signs are different because of slang and geographic regions. Those who learn in different locations may learn signs differently than other people learning in another region. For example, the alphabet in British Sign Language is completely different than the alphabet in ASL. Finally, ASL has their own syntax. Syntax is the set of rules on how to structure a sentence. For English, sentences are typically structured by the order subject, verb, and object. ASL syntax follows TLSOV? which is time, location, subject, object, verb, and question words. For example, a sentence in English syntax would be “My family goes to the lake in New York for vacation every summer.” ASL syntax would change the sentence to, “Every summer lake in New York my family goes.” While it is confusing to learn at first, this helps the deaf community understand the sentences easier.

An additional misconception is that deaf people can’t speak. While it is true for some, others chose to not speak because of their “deaf accent.” When you first learn to talk and learn new words, you are aware of what you sound like and if you are saying something correctly or not. However, since the deaf cannot hear themselves, that is where the deaf accent comes in. Most deaf people chose not to speak because they don’t want a hearing person think, they are weird or sound funny. Depending on what age the person went deaf is the reason why people have a deaf accent. Someone who became deaf or hard-of-hearing may have learned how to speak and was hearing for years. Those we are born deaf don’t know how to say things correctly, which causes the accent.

There are quite a few academic fields that are involved with the deaf community, one being interpreters. Interpreters are people who know sign and can sign what someone is saying to a deaf person. ASL interpreters require a bachelors’ degree in ASL, have experience in the field, understand and are fluent in another language, most commonly English, and ASL. The demand for interpreters has been on the rise since 2012 and is projected to rise over 19 percent between years 2018 to 2028. The deaf has been more openly included in society for the past few years, which explains the job rise (U.S. Bureau of Labor).

Typically, interpreters are hearing; however, there are some interpreters that are deaf. For example, the governor of Ohio, Mike Dewine, has an interpreter during the COVID-19 briefings and her name is Maria Berkowitz. She is deaf and has someone who is hearing sign to her in English syntax. In an interview with WBNS, a news station located in Columbus, Ohio, Berkowitz explains how she interprets during the COVID-19 briefings. Berkowitz says that she has two interpreters at the briefings, one to sign to her, and another to make sure she is signing correctly (Tegna). Berkowitz also talks about the importance of facial expressions while signing saying, to convey an important message to the deaf, you must use facial expressions to express the importance of things (Tegna).

Another academic field that is interested in the deaf community is teachers. Teachers are there to help students with anything. However, special education teachers have specialized in how to help those who are lacking something. Usually within a special education classroom, there are students who have behavioral issues, attention issues, or they have a disability that requires them to need some help. There are teachers who are there to help hearing impaired students. Those teachers have certain specifications they must meet to become a teacher for the deaf. They must have a bachelor’s degree along with at least two years of experience working with deaf students in a learning setting. Some schools and jobs require their teachers to have a master’s degree but that is special for certain schools.

During COVID-19, the deaf community has been faced many more problems than most people realize. Due to the implication of masks, the deaf struggles to communicate with those who don’t know sign language. Many deaf people rely on lip-reading but the masks inhibit that. While most news stations have an interpreter during COVID-19 briefings, smaller stations are struggling. News stations are also trying to have closed captions for the deaf; however, sometimes the captions aren’t correct. Even at the White House, there has not been an interpreter at those briefings, even though many advocates for the deaf community have requested one. This time is extremely difficult for everyone but more so for those who are deaf, hard-of-hearing, and deafblind.

Moving into my research questions, the first one is asking about higher education and how it is different for hearing individuals. Firstly, the deaf have their own colleges. One of the most popular is Gallaudet University located in Washington D.C. Gallaudet was founded in 1864 by Edward Miner and is open to those who are deaf, hard-of-hearing, and hearing individuals. Gallaudet is more popular because it was one of the first colleges for the deaf. It was also the first place American Sign Language was recognized as an actual language (Gallaudet). Gallaudet also offers free ASL classes to help spread awareness. Another college that has had a big impact on the deaf community is Rochester Institute of Technology’s National Technical Institute for the Deaf in Rochester in New York. NTID was founded in 1829 by Peter Peterson Hall. Rochester, New York is the most populated place of deaf people. About six out of ten people in Rochester are deaf. When the British settlers were travelling from Kent, England to the US, typically the first piece of land the pilgrims were going to hit was by Martha’s Vineyard and Cape Cod. Until about 1954, about 200 years, there was a close deaf community living on Cape Cod. They had families and everyone who lived in their community knew sign, even hearing individuals. Unfortunately, their dialect was never recorded and the last person to die was in 1954.

Before these colleges were established, the deaf community was believed to be dumb. People back then assumed that if you couldn’t hear that you were automatically stupid. While this is obviously absurd and completely wrong, the deaf couldn’t do much. Throughout their schooling, teachers would force the deaf to sit on their hands so they wouldn’t sign. Sign language was almost outlawed in 1880. It was uncommon for the deaf to get degrees. Most deaf or hard-of-hearing people have about a tenth-grade reading level. Going to college was difficult because of their reading level. It was very uncommon for the deaf to go to college and get a degree because of their reading level. The deaf community has been more welcomed this past decade than any time before. With the opening of Gallaudet University and Rochester’s National Technical Institute for the Deaf, the deaf finally have a place to fit in.

To answer my second research question about different causations and levels of deafness, I found an explanation on different causes of deafness. Some deafness is caused by sickness, while some is caused by birth defects. There are three different types of hearing loss which include conductive hearing loss, sensorineural hearing loss, and mixed hearing loss. Conductive hearing loss is the lowest level of hearing loss and is typically caused by a buildup of ear wax. Sensorineural hearing loss is most caused by damaged hair cells within the cochlea, which is in the inner ear. Mixed hearing loss is a combination of both conductive hearing loss and sensorineural hearing loss. In addition to the three different types of hearing loss there is also four levels of deafness. The first is mild deafness or mild hearing impairment. If a person experiences this level of deafness, they can only detect between 25 and 29 decibels. The person could find it hard to understand the words other people say, especially if there is a lot of background noise. The next level is moderate deafness or moderate hearing impairment. This person can only detect sounds between 40 and 69 decibels. For this person, it may be hard to follow a conversation without a hearing aid. The third level is severe deafness. This person can only hear sounds 70 to 89 decibels. People who are severely deaf must lip-read or use sign language to have conversations. Finally, the last level is profound deafness. Anyone who cannot hear a sound below 90 decibels falls into this last level. To put all this information into perspective, a normal person with no hearing issues can hear anything between 0 to 20 decibels (Felman).

In the article, “Parental strategies used in communication with their Deaf infants”, the authors Willie Beatrijs, Van Lierde Kristiane, and Van Herreweghe Mieke, begin to describe what will happen during the article. First, they start off by describing their recorded interactions between parents and Deaf children. All children which were used throughout the study were under the age of three. They also included Deaf and hearing parents to see the difference between the interaction and communication taking place. Moving forward, the authors introduce the background information. It was found that most children do not get screened for any hearing deficiencies and most children who are Deaf, grow up in a home where both parents are hearing (166).  However, in Flanders, where this observation took place, an agency began to systematically screen all newborns for hearing loss. This occurred in 1998 and has since gotten the ball rolling on parents to start getting audio tests while their children are young. It has been shown that the younger the hearing loss is detected, the chances of having a positive outcome increase (Beatrijs, et al.166).  After parents or caregivers find out if their child has hearing loss, they tend to investigate cochlear implants and get the procedure for their child. Authors then discuss how a child’s successful communication is often related to their development of visual attention. The results from the study find that Deaf parents engage with their children with visuals. Deaf parents tend to rely on a combination of “implicit” and “tactile” strategies more than oral strategies. While incorporating implicit and tactile strategies this helps the parents become a Deaf role model for their Deaf children (176). Almost all schools offer hearing tests from kindergarten and do them once a year. Parents typically don’t get their child’s hearing tested at a young age unless they notice something is wrong.

Finding and obtaining a job is not an easy task for most people, but for those who have any disabilities, it is even harder. Deaf or hard-of-hearing people may experience discrimination before or even after they get a job. While there are legal rights to protect those who disabilities, it doesn’t always stop those from being discriminatory. According to the National Deaf Center, about 48% of deaf individuals are employed, leaving 47% not in the labor force and 4.6% are unemployed. In 2017, only 53.3% of deaf people between the ages 25 and 64 were employed. Comparing this to hearing individuals 75.8% were employed, which leaves about a 22% gap. Employment and pay gaps increase based from race, ethnicity, gender, and disability (National Deaf Center). About 42.9% of the deaf opt out for working, more than double of hearing individuals. While the low labor force is not due to the lack of interest, but it is because of the lack of options. The deaf are often hired for jobs that don’t have much development or advancement. Deaf people get burned out from facing so many barriers (National Deaf Center).

In the article, “Hearing Managers of Deaf Workers: A Phenomenological Investigation in the Restaurant Industry,” the main idea is hearing impaired people in the workplace. Authors Hayley Stokar and John Orwat begin their article with a brief overview of Deaf people struggling to fit in the workplace. Up front they bring in statistics backing up their topic saying that limits within the workplace reflect on Deaf employment rates. People who are hearing have an employment rate that is 26.5% larger than those who are a part of the Deaf community (14). This comparison alone shows people with hearing loss struggle to get a job due to them being Deaf. And while the Rehabilitation Act and the Americans With Disabilities Act are there to prevent any discrimination against the Deaf, it doesn’t guarantee them a job where they feel accepted. Stokar and Orwat conducted a study that had research questions that investigated the issues of “accommodation and integration” within the workplace (15). They had four research questions to better understand the accommodations that were being made for Deaf employees. The study included two subgroups, hearing managers and Deaf employees. After asking the four questions, they proceeded to have interviews with six hearing managers and six deaf employees. All the managers possessed the same qualities which included working as a supervisor in a high- volume restaurant, physically and culturally identified as hearing, had a direct contact with a deaf worker, and lacked information on ASL. Looking at the analysis of the entire study, most managers had a lack of knowledge of the ADA accommodations. Even with the ADA, most employers don’t know the special requirements the deaf community requires.

For my last two research questions, I interviewed my American Sign Language professor, Mary Mougey. Mary is deaf and has taught ASL and other deaf classes at Cleveland State University for a few years now. During the interview I asked her what her strategies are to teach hearing people sign language and why is it better to learn sign language from someone who is a part of the deaf community. People often walk into ASL and believe it’ll be easy, Mougey says that when a student believes that she knows they will be surprised. Mougey said after about four classes people begin to fully understand that there is more than just learning a few signs. One thing Mougey witnesses firsthand while teaching ASL to hearing students is the level of frustration. Mougey stresses to all her classes that it is okay if you forget a sign. It is extremely difficult. She says that with encouraging words, she lets her students know that they won’t learn everything in five months, and that is okay.

When asked why it is better to learn ASL from someone who is deaf, Mary Mougey says it is because it is their first language. They have firsthand experience using it. She says that for those who are born deaf, they are immersed immediately into the culture of sign. When learning sign, you are also taught about the history of it, which was discussed in the paragraph that answers question one. People tend to have a better appreciation and awareness for the deaf community when learning American Sign Language from someone who is deaf.

To conclude, communication within the Deaf community is significantly more difficult than communication in the hearing community. Communicating in a society with predominately hearing people is often difficult for hearing impaired persons. Deaf and hard-of-hearing people depend on facial expressions and body language to help them convey and understand a conversation. During a time with a global pandemic happening, communication for the deaf has become more difficult especially with the implication of face masks. While society has been more accepting of people with disabilities, people still don’t know how to accommodate the Deaf.  With the opening of deaf colleges, the deaf have a place to fit in.  Interpreters have become more popular and I believe the effect of COVID-19 will cause the job rise to increase more than it already has.  Disabilities have become normalized and I hope people understand that they are just the same as us “normal” people.

Works Cited

“Employment Report Shows Strong Labor Market Passing by Deaf Americans.”  National Deaf

Center , 14 Nov. 2019,  www.nationaldeafcenter.org/news/employment-report-shows  strong-labor-market-passing-deaf-americans.

Felman, Adam. “Deafness and Hearing Loss: Causes, Symptoms, and Treatments.”  Medical

News Today , MediLexicon International, 27 June 2018,  www.medicalnewstoday.com/articles/249285 .

Garberoglio, Carrie Lou, et al. “Deaf Employment Report.”  National Deaf Center , 2016,

www.nationaldeafcenter.org/sites/default/files/Deaf Employment Report_final.pdf.

“Interpreters and Translators : Occupational Outlook Handbook.”  U.S. Bureau of Labor

Statistics , U.S. Bureau of Labor Statistics, 19 Sept. 2019,  www.bls.gov/ooh/media-and-communication/interpreters-and-translators.htm .

Lapiak, Jolanta. “How Challenging Is It to Master American Sign Language?”  Handspeak ,

  www.handspeak.com/learn/index.php?id=205 .

Lawyer, Gloshanda. “Deaf Education and Deaf Culture: Lessons from Latin America.”  American Annals of the Deaf , vol. 162, no. 5, Winter 2018, pp. 486–488.  EBSCOhost , doi:10.1353/aad.2018.0006.

Mougey, Mary. Professor at Cleveland State University.

Stokar, Hayley, and John Orwat. “Hearing Managers of Deaf Workers: A

Phenomenological Investigation in the Restaurant Industry.”  American Annals of the Deaf , vol. 163, no. 1, Spring 2018, pp. 13–34.  EBSCOhost , doi:10.1353/aad.2018.0009.

“Table A-6. Employment Status of the Civilian Population by Sex, Age, and Disability Status,

Not Seasonally Adjusted.”  U.S. Bureau of Labor Statistics , U.S. Bureau of Labo Statistics, 3 Apr. 2020, www.bls.gov/news.release/empsit.t06.htm.

Tegna. “Meet Marla Berkowitz, Deaf Interpreter in the Spotlight during Ohio’s COVID-19

Briefings.”  WBNS-10TV Columbus, Ohio | Columbus News, Weather & Sports  15 Apr. 2020,  www.10tv.com/article/meet-marla-berkowitz-deaf-interpreter-spotlight-during-ohios-covid-19-briefings-2020-apr

“Who We Are.”  Who We Are – Gallaudet   University , www.gallaudet.edu/about/who-we-are.

Understanding Literacy in Our Lives by Sarah Ciha is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License , except where otherwise noted.

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American Deaf Culture: The Modern Deaf Community Research Paper

Introduction, deafness as a disability, deaf culture and education, integration, works cited.

Recent years have attracted attention to the deaf community. Awareness had been increasing in the last three decades. Consequently, different authors have emerged with different perspectives. Among these authors is Thomas Holcomb. The current research paper explores the American Deaf Culture in view of dynamics that exist. These include education

Holcomb explores the different elements regarding the perceptions of pioneering scholars in identifying and defining Deaf culture. The author allows the reader to track the shifts in perspectives on deaf people. The major perspectives presented by Holcomb are those introduced with compulsive judgments to the enlightened perspectives of Deaf people as a cultural identity. Deaf culture denotes a pessimistic word, revealing a public identity and self-importance. However, terms such as deafness or impaired hearing do not indicate a precise sense of belonging or pride to the community. Certain oralists contradict that the deaf culture does not exist. They fancy seeing it as awkward and false dogmatic concept. Some argue that it was articulated in ancient periods, and it poses defiance instead of reality. Therefore, this outlook contradicts the significance of ASL to the deaf community (Holcomb 96).

Deafness as a disability is often viewed as the fundamental premise of the education and reintegration of deaf people. Some pioneers of the definition view deafness as an impairment. Deaf persons who claim a socially Deaf characteristic liken themselves to the affiliates of different cultural societies (Holcomb 98). They claim to possess a culture, as well as language. The critics of deaf culture do not perceive deaf persons as associates of a marginalized culture. However, they assert that deaf people are audio coherent individuals, earshot disabled and handicapped. While exploring the definition, they place deafness as having an incapacitating impact to respond to ecological signals or relish features of conventional culture such as music. America Deaf Culture has a very huge disparity with the other deaf cultures. Holcomb largely targets scholars who interpret and training on sign dialect. He emphasizes on the diverse issues of culture rather than an expression of the language.

Higgins (1982) defines the reading on deaf culture and mentions that culture is a compound whole that comprises of learned habits, abilities, customs, decrees, art ethics, and knowledge of the human as an affiliate of the community. The author regards inter-cultural communiqué such as time point of reference, minimum and maximum framework, as well as individualism and collectivism. Typically, he communicates issues of the American deaf culture that identifies the preferential segment in the deaf community context (Higgins 10). There are dissimilar discernments of expatriates who simply study the deaf arts. Additionally, they study populace residing within the deaf community.

Holcomb confers the growth of deafened culture that the tone-deaf youngsters who attended the learning institutes found it difficult in communicating with their counterparts who have the ability to hear. Nonetheless, the current developments in regard to cultures of the deaf are endangered given that the deaf culture has no decrees that restrict deaf individuals to stay in the oblivious culture. Deaf people also aspire to be wealthier like full persons.

Deaf people must be reintegrated and end-cultured inside the hearing community. The symbolic language that is becoming useful and popular is used in classrooms or television shows. The language is not only useful to the deaf but also to the hearing community since they get enriched and learn how to relate to the deaf individuals (Holcomb 108). By understanding the language, one can freely communicate and assist the deaf community in places where they seem not to understand. However, it becomes problematic to share and communicate with deaf persons. Higgins thinks that devoid of the sign language, the deaf community will sense loneliness around the hearing society. Once the relative of the deaf cannot use sign language, they could misapprehend several things besides failing to benefit from significant info. The deaf still struggle in conversing with the hearing individuals. As a result, the hearing community should respect and adhere to sharing info with the deaf besides assisting them whenever confused.

In view of the connectedness, the deaf culture has a huge family regardless of the type of sign language they use or their country of origin. They find it informal to converse with the use of visual lingoes than diverse articulated dialects. For instance, without learning gestures or body languages they can find it easy to acquire key knowledge. However, if the hearing community does not learn some spoken languages such as Chinese, it becomes hard to comprehend. Thus, the deaf family can communicate easily and become a huge culture as opposed to the hearing society that finds it hard to communicate owing to the use of different languages. Based on the colloquial conduct, the deaf experiences both bad and polite behaviors. The disparity amid sign and spoken lingo remains that ASL has no distinct phrases like verbal language (Moore and Panara 15).

The ASL commonly engages some signs at the time of asking straight queries. Authors such as Higgins argue that it is rude to speaking behind the back or ask the deaf persons unsuitable question. Such bad acts include receiving a phone call without informing the deaf that the phone has rung, speaking about some sweet melodies, or asking them reasons for their deafness. Subsequently, the hearing community must comprehend the culture of the deaf in order to circumvent misinterpretation (Padden 5).

Deaf culture is a situation that often generates public discussions. In recent years, the debate on American deaf culture debates dominated the public domain. Deaf people must be reintegrated and end-cultured inside the hearing community. The symbolic language that is becoming useful and popular is used in classrooms or television shows. The language is not only useful to the deaf but also to the hearing community since they get enriched and learn how to relate to the deaf individuals By understanding the language, it is to communicate and assist the deaf community in places where they seem not to understand. In view of the connectedness, the deaf culture has a huge family regardless of the type of sign language they use or their country of origin. They find it informal to converse with the use of visual lingoes than diverse articulated dialects. Making decisions on the view one holds of deaf people is critical for it largely determines the connection one has to, and with, the Deaf Community. The mind-set towards the Community’s language and its culture determine the perception towards Deaf people. Individuals embrace either a therapeutic or an intellectual perception of the Deaf Community. It is imperative to respect the deaf community. Additionally, the hearing community ought to endeavor the protection of the values of the deaf community.

Holcomb, Thomas. Introduction to American Deaf Culture. New York, NY: Oxford University Press, 2013. Print.

Higgins, Paul. Outsiders in a Hearing World: A Sociology of Deafness. Beverly Hills, CA: Sage Publications. 1980. Print.

Moore, Main and Robert Panara, Robert Davila: Highest Ranking Government Official in Great Deaf Americans . Rochester, NY: Deaf Life Press.1996. Print.

Padden, Carol. From the Cultural to the Bicultural: The Modern Deaf Community . New York, NY: Cambridge University Press. 1996. Print.

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IvyPanda. (2020, May 11). American Deaf Culture: The Modern Deaf Community. https://ivypanda.com/essays/american-deaf-culture-the-modern-deaf-community/

"American Deaf Culture: The Modern Deaf Community." IvyPanda , 11 May 2020, ivypanda.com/essays/american-deaf-culture-the-modern-deaf-community/.

IvyPanda . (2020) 'American Deaf Culture: The Modern Deaf Community'. 11 May.

IvyPanda . 2020. "American Deaf Culture: The Modern Deaf Community." May 11, 2020. https://ivypanda.com/essays/american-deaf-culture-the-modern-deaf-community/.

1. IvyPanda . "American Deaf Culture: The Modern Deaf Community." May 11, 2020. https://ivypanda.com/essays/american-deaf-culture-the-modern-deaf-community/.

Bibliography

IvyPanda . "American Deaf Culture: The Modern Deaf Community." May 11, 2020. https://ivypanda.com/essays/american-deaf-culture-the-modern-deaf-community/.

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Deaf Studies

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What IS a Good Topic?

Choosing a good topic is a balancing act. Not too narrow. Not too broad. How can you tell if you're on the right path? 

As a general guideline, topics with 2 - 3 concepts are workable:

• How has the representation of deafness and Deaf culture changed in television and movies in the past twenty to twenty-five years?

Only one concept is too broad:

• deaf culture
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More than three concepts is usually too narrow:

• Cochlear implants in infants and their effect on acquisition of sign language in California

The above guidelines are based on information from Walden University Library . A brief exercise in choosing the best research question is available from SUNY Empire State College.  

Picking Your Topic is Research

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Deaf People and Society: Psychological, Sociological, and Educational Perspectives 2 nd Edition

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Jason P Lilly, Deaf People and Society: Psychological, Sociological, and Educational Perspectives 2 nd Edition, The Journal of Deaf Studies and Deaf Education , Volume 26, Issue 2, April 2021, Page 296, https://doi.org/10.1093/deafed/enaa040

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This second edition of Deaf People and Society is an updated and revised look at deaf culture from multiple perspectives, with the question, “What does it mean to be deaf?” at its center. The authors explore historical perspectives, diversity within the deaf community, and legal issues from a deaf perspective including hearing culture, language, education, and deaf defendant’s point of view in court. In addition, they address issues of development along with psychological and sociological insights from hearing and deaf adults. The authors themselves are a deaf/hearing bilingual team with ties to the deaf community and deaf culture. Leigh has a hearing loss and is a Professor Emerita of Psychology at Gallaudet University and Andrews is also Emerita in Deaf Studies/Deaf Education at Lamar University.

This book is organized chronologically as well as developmentally from diagnosis through childhood into adulthood, which is important because it narrates the experiences of most deaf individuals. The text allows individuals to explore challenges that people who are deaf face in U.S. society. The book is comprised of 10 case studies, which were of particular interest as they touch on real-life issues such as adoption by deaf parents, becoming deaf in childhood, being a hearing child of deaf adults, the impact of being black and deaf, healthcare for deaf patients, and more. All 10 of the case studies have activities for future learning and discussion questions attached to them. These questions are designed to foster deeper understanding of how hearing loss impacts the lives of individuals and where to find resources.

Although each chapter contains objectives, multiple subheadings, conclusions, and suggested readings, I wish the authors had included activities for further learning and discussion questions after each chapter like they did with the case studies. The authors cover issues of race in relation to deafness, but I wish other marginalized groups were more represented in the book. There is not much in terms of the LGBTQI deaf community, issues surrounding gender identity within the deaf community or gender inequalities within the community. I also saw a gap in the discussion around bimodal bilinguals and deaf education. Students who are bimodal are not new in deaf education but as we step further into the future, more students will be coming to school with Spanish or other languages as their home language instead of English. These students bring new questions surrounding bilingual educational approaches along with the already often diversive oral only or bimodal approaches to education.

An audiological appendix is placed directly after the third chapter on diagnosis and before development. This introduces the reader to the basic components of an audiogram and emphasizes that a child’s use of hearing is just one of many facets that contribute to their development. I wish the authors had emphasized the dangers of categorizing children based solely on their audiogram because each child is unique, despite having similar audiological results.

Overall, I think this book is a great resource for educators, researchers, and other professionals who want to get a better understanding of the deaf perspective. I would recommend this book for anyone interested in learning about the challenges that deaf people face in U.S. society with the understanding that this book was written in a textbook format with dense passages of information. The new chapter on the deaf defendant as well as new case studies helps to gain more understanding of issues that the deaf community face. This edition continues to focus on the deaf perspective and includes even more issues the deaf community face than the previous edition.

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