ACGME - Deaf / HH Patients | gatecommunications

DEAF / HARD OF HEARING PATIENTS

Want to understand your patients with hearing loss?
Then you need to understand both the clinical and the cultural side of their experience. This page has great insight to help you begin to understand
your patients and your students.

Statistics on Deafness

15% of people in the U.S. have a hearing loss.
2% of the population of the U.S. is deaf.
3 in 1000 babies are born with a hearing loss.
1 in 1000 babies are born deaf, making it the most common birth defect in the U.S.
There are 400+ forms of genetic deafness.
More than 50% of deafness in children is hereditary deafness.
Between 20 - 40% of individuals with an unknown source of hearing loss
are deafened by the CONNEXIN 26 gene.
3% - 6% of deaf children have Ushers Syndrome.
About 4000 new cases of "sudden deafness" occur each year.
360 million people worldwide have a disabling hearing loss (a loss over 40 dB).
For every 10 decibels of hearing loss, the risk of social isolation increases by 52%.
Many believe American Sign Language is the third most commonly used language in the United States.

Clinical Information About Hearing Loss

CAUSES OF DEAFNESS

Congenital causes of Deafness:
- Maternal Rubella, Syphilis or certain other infections during pregnancy
- Low birth weight
- Birth Asphyxia (a lack of oxygen at the time of birth)
- Inappropriate use of ototoxic drugs (such as Aminoglycosides, Cytotoxic drugs, Antimalarial drugs and Diuretics) during pregnancy
- Severe jaundice in the neonatal period.
Aquired causes of Deafness:
- Infectious diseases such as Meningitis, Measles and Mumps can lead to hearing loss, mostly in childhood, but also later in life.
- Chronic ear infection, which commonly presents as discharging ears, can lead to hearing loss. In certain cases this condition can also lead to serious, life-threatening complications, such as brain abscesses or meningitis.
- Collection of fluid in the ear (otitis media) can cause hearing loss.
- Use of ototoxic drugs at any age, such as some antibiotic and antimalarial medicines for example, can damage the inner ear.
- Head injury or injury to the ear can cause hearing loss.
- Excessive noise, including working with noisy machinery, and exposure to loud music or other loud noises, such as gunfire or explosions, can harm a person’s hearing.
- Age-related hearing loss (presbycusis) is caused by degeneration of sensory cells.
- Wax or foreign bodies blocking the ear canal can cause hearing loss at any age. Such hearing loss is usually mild and can be readily corrected.

MEDICAL INTERVENTION

Deaf individuals can choose to receive some form of medical intervention to improve their hearing. This intervention could be the use of a hearing aid, a Bone Anchored Hearing Aid (BAHA), a Cochlear Implant (CI), or even an Auditory Brainstem Implant (ABI). For more information about available devices, visit the company COMMUNICATION AIDS page. The external devices have few side effects or risk of complications, but the internal devices do come with a much higher risk and in some cases are ineffective after facing the physiological risks, financial responsibilities, and time involved. Gate Communications has seen the undeniable success stories and the undeniable failures of all these devices. In the end, there is no cure for deafness. No device allows a deaf person to hear voluminous sounds heard by Hearing people. No device will always work. No device guarantees the patient will learn to speak clearly (we have seen this time and time again). No device guarantees the patient will be able to recognize sounds. No device is perfect, and no device is perfect for all people. Organizations outside of healthcare see sides of device usage that no medical office will ever see. People who walk in our doors are very honest, and confess they lie or "cushion the truth" about the effectiveness, positive outcomes, and frustrations of device usage to their friends, family, and medical practitioners. We have been the resource to many when devices have failed them. Medical intervention, whether invasive or non-invasive, is a personal choice for deaf/hard of hearing individuals. Opinions on the subject are vast. Know your patients and your students will see their hearing loss through their own unique lens, not solely as a disability, if they see it as a disability at all.

Now that you know the medical side of deafness, take a moment to find out more about the personal side of hearing loss.

The Personal Side of Hearing Loss

Non-Cultural vs Cultural Deafness

Individual Perspectives, Preferences, & Identities

Your Deaf & Hard of Hearing patients come in all different shapes and sizes
and they all have different communication needs.
To create a successful environment for your patients, you first need to understand your patients.

+ one final group...

Any one of these individuals could walk into your office, and it's possible 2 or more will walk in at the same time. To find out more about providing accessibility for these patients, visit our ACCOMMODATIONS page. It's actually a lot easier than you might think. Apps, technology, and interpreter contacts can make communication flow smoothly. A little preparation, and asking the right questions will make the process relatively seamless. Click on our accessibility page for more info.

READY FOR A DEEPER UNDERSTANDING OF YOUR PATIENTS & THEIR FAMILIES?

Hearing individuals often misunderstand cultural Deafness which negatively impacts interaction with the Deaf. Find out more about this group rich in culture and guided by a unique identity on our MEDICAL vs CULTURAL MODELS OF DEAFNESS page, but before you head that way, watch the videos below to increase your understanding of the unique people you may serve.

SIGN LANGUAGES & SYSTEMS USED

If your deaf patients sign, will they all sign the same?
NO! Sign language is not universal. Every country has their own signed language although many underdeveloped nations don't have any formal sign language used across their nation. Sign language is so different, people in the U.S. can't speak to people in Great Britain. If a foreign deaf individual walks into your office, finding an interpreter for them becomes a lot more complicated. Remember, just because a foreign patient writes in Spanish, does not mean that individual communicates in Mexican Sign Language (LSM). Each country's languages are unique. With whom can Americans communicate? We can communicate with the people of English speaking Canada, Jamaica, Puerto Rico, and the Dominican Republic. A few additional countries have small pockets of ASL users as well.

In America, we have an official "native" sign language called ASL or American Sign Language, but we also have 2 primary signed systems, PSE/Pidgin Signed English, and SEE/Signing Exact English. Believe it or not there are even more systems, but these are the top 3 you will encounter. When you have a deaf patient, it's good to ask if they sign, and if they do, what sign language/system they use. In addition to all these methods, some deaf individuals will use "home signs" which are signs created in the home or among friends. You may have a patient that is Deaf/Blind and that individual may speak, may use ASL, may use a mobile braille device, or may even use the latest communication technique, Pro-Tactile. And yes, there is more. Some deaf individuals prefer to lipread but use Cued Speech, a gestural system to supplement oral forms of communication, as most individuals who lipread can only comprehend about 35% of what is said, leaving tremendous gaps in comprehension. To find out more about these languages, systems, and modes of communication, watch the videos below.

As you can see, every person with hearing loss is unique and their communication needs and styles are often unique as well. Learning about your patients is step one to creating an environment of health equity!

NOT SURE WHO IS IN YOUR OFFICE OR HOW TO SERVE THEM?
JUST ASK!

Visit our PATIENT ACCOMMODATIONS PAGE for more information ideas on how to provide for your patients. Visit our MEDICAL SCHOOL ACCOMMODATIONS page for information on providing services for your students.