Those Who Suffer in Silence
People who are Deaf or Hard of Hearing (DHH) are rarely considered to be people who suffer from a physical disability. Unlike a blind person who walks with the support of a cane or someone who uses a wheelchair, people who have difficulty hearing or cannot hear at all are often referred to as those with an “invisible disability,” as their disability is not obvious to the public.
Despite the invisibility of their disability, they comprise a significant portion of the population in this country:
- A December 2016 report in JAMA Otolaryngology concluded that 18 percent of adults aged 20 to 69 have hearing loss in both ears, from exposure to loud noise at work.
- The National Institute on Deafness and Other Communication Disorders reports that 25 percent of American adults aged 65 to 74, and 50 percent of those who are 75 or older, have disabling hearing loss.
“And about 20 percent of children have some form of hearing loss,” said Emmett Hassen, licensing and certification coordinator for the Arizona Commission for the Deaf and the Hard of Hearing. “In the old days there were boomboxes and you could hear the sound from afar. But today, with Bluetooth earphones and iPods, the in-ear headphones are close enough to the ear that they affect the eardrum more significantly. And that’s causing more hearing loss.”
The Seemingly Imperfect Solution
The rapid expansion of telehealth services across the U.S. has made it possible for nearly everyone with a medical problem that isn’t an emergency to access a doctor by smartphone, pad, or laptop, often within minutes, and if not, at least on the same day.
And the revolution hasn’t stopped there. The capacity to access services remotely has been replicated in the therapeutic community as well.
Despite this, implementing these service modalities for the DHH has become a formidable challenge for some clients. Videoconferencing sessions require participants to hear what the person on the screen is saying. For some, relying upon hearing aids or sign language in the remote medium is inadequate for effective communication.
What can be done to change this?
Virtual DHH Services
First of all, it’s important to understand that the DHH community receives the same quality of therapy and therapist-student interaction online as they would face-to-face. DHH therapists and their students have access to an engaging, intuitive platform, priming children who receive therapy for success.
Secondly, the virtual venue allows therapists to instruct, assess, participate in IEPs, and communicate seamlessly with anyone with whom they need to collaborate. The remote therapy model benefits families, school staff, and outside service providers. What’s more, the technology facilitates the augmenting of additional resources needed for success.
And finally, DHH therapists often utilize innovative digital strategies to help children who are deaf and hard of hearing in ways that might not be readily available face-to-face.
Aside from addressing the putative deficits incurred by the virtual venue, remote therapy has its benefits as well for the DHH. Teletherapy communication is often streamlined and more efficient between DHH therapists, parents, and other professionals than its onsite counterpart. Sharing information digitally has been shown to increase the productivity of meetings.
3 Invaluable Teletherapy Tips
But if therapists who work with the DHH community are concerned about maximizing the therapeutic impact on their students, there are three tactics, in particular, that should be integrated into the clinical session to optimize the experience for the student.
1. Captions
All videos, real-time therapy sessions, and pre-recorded therapy sessions should be captioned. While sessions and videos must be captioned, it is important to remember that captioning alone may not provide the necessary accessibility for all students who are deaf or hard of hearing, especially those students whose reading level is below 5th grade.
If you need to caption a video or pre-recorded lecture, you can either do this in-house, through a captioning vendor, or some combination of both. And don’t forget to follow industry standards and use DIY captioning resources.
2. Technicalities
When you connect with your students through video conferencing, it is critical to remember that you need to be aware of the quality of sound, background noise, lighting, visual distraction, the placement of the camera, and captioning and/or interpreting.
3. Facial Expressions
Communication – both for those who hear and those who are unable to hear clearly, or at all – is not only about high tech, Hassen reminds us.
“Facial expressions are a part of American Sign Language,” he says. “In English, we show emotion with our tone of voice. You can tell on the phone if someone is happy, sad, or mad. And Deaf people have facial expressions, too. You can tell if we are happy, sad, or mad. Facial expressions make a big difference.”
