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Segment II: Deaf & Hard of Hearing

Communicating with individuals who are Deaf or Hard of Hearing (HOH) has some distinct differences from communicating with inviduals who are LEP. This chapter contains helpful information for effective communication with this population and how to use an interpreter when communicating with Deaf/HOH clients.

1) Tips to Remember when Communicating with Clients who are Deaf/HOH:

  1. "Sign language" is a generic term for many forms of manual communication. Not all persons who are deaf or hard of hearing (HOH) use American Sign Language (ASL) as their primary language.
  2. Many individuals who are Deaf/HOH are not fluent in English because it is not their “first” language.  ASL has a gramatical structure that is different than English. Writing notes is not an effective means of communication, especially when discussing complex medical, financial, or legal issues, because it requires an understanding of English, which if a "foreign" language for many individuals who are Deaf/HOH.
  3. Lip-reading is not a reliable means of communication. Only about 30% of a conversation is visible on the lips, and only a small percentage of the deaf are highly skilled at lip-reading. 
  4. Many people who are Deaf or HOH do not identify as "disabled," but as members of a cultural community with its own language, values, and social norms. An individual's communication style is shaped by many factors, including educational experiences, cultural/linguistic identity of family of origin, peer influences, etc.
  5. Many aspects of communication (including tone, emphasis and some grammatical structures) using ASL is expressed through facial expressions.

(Information adapted from Deaf Empowerment Awareness Foundation (DEAF), Inc., and DEAF, Inc.

    2) Interpreter Positioning with Clients who are Deaf/HOH 

    In a typical interpreting situation, the Interpreter will stand next to the Non-Signing/Hearing advocate and across from the Sign Language User. The Sign Language Interpreter will sign everything said by the hearing advocate and say everything that is signed by the client who is deaf. See Diagram 1 below. 

    Sign Language Interpreting Diagram

    If a client does not have an adequate understanding of sign language, does not use the standard version of ASL, has vision problems or developmental delays; you may need the expertise of a Deaf Interpreter in order to communicate effectively. A Deaf Interpreter is often more familiar with subtle non-verbal communication styles and cultural framework that may lead to misunderstandings between the advocate and the client.

    The hearing interpreter will interpret from spoken English into ASL. The Deaf Interpreter will then interpret from ASL to the appropriate level or version of sign language, which often incorporates gestures and other communication strategies. The Deaf interpreter will interpret the client's remarks into ASL. The hearing interpreter will then interpret from ASL into spoken English. The two interpreters work together to make sure that the original message does not get lost in translation. See Diagram 2 below.

    Deaf Interpreter DiagramImages used with permission from Deaf Empowerment Awareness Foundation (DEAF), Inc. For more information about effective communication with clients who are Deaf or Hard of Hearing visit


    3) Self-training for Communication Effectively with Deaf, Late Deafened and Hard of Hearing (HOH) Individuals:

    This short online powerpoint training presentation, provided by the Massachusetts Commission for the Deaf and Hard of Hearing, gives basic legal protections under the ADA for individuals who are Deaf or HOH.

      Access training at


      Attached you will find a Word document of the above information to use as a resource in your organization.

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