Communicating with deaf people: deaf awareness for librarians

Transcription

1 Health Libraries Review 1997, 14, Communicating with deaf people: deaf awareness for librarians MARGARET E. S. FORREST Health Promotion Library Scotland, Heath Education Board for Scotland, The Priory, Canaan Lane, Edinburgh EH10 4SG, UK Recent legislation in Britain and elsewhere has implications for librarians and others serving people with disabilities. This paper considers one type of disability: the communication and information needs of deaf people. A review of the literature indicates that the professional development of both health professionals and librarians is not preparing them for communication with deaf people. A growing recognition of the need for deaf awareness training among library staff is discussed. A number of training resources are mentioned with a checklist of good communication skills. Introduction In a recent survey of health professionals image of librarians, it was found that librarians and health professionals alike ranked good communication as the most important skill for librarians. 1 Although this survey did not refer to health professionals or librarians with disabilities, it is important to emphasize that libraries aim to serve the whole community and not just the articulate or mobile. 2,3 Recent legislation in the United States and Britain has implications for librarians serving disabled people. Both the Americans with Disabilities Act of 1990 and the Disability Discrimination Act of 1995 require that public and private institutions provide access to their services for people with disabilities. 4 A 1995 survey of members of the Association of Academic Health Sciences Library Directors in America was conducted to assess the level of library services available for people with disabilities. 5 The results of this survey indicate that academic health science libraries generally enjoy a reputation for good user services. However, it was recommended that if they wish to maintain this image, libraries should develop and implement plans to improve access to library programmes and services for people with disabilities. The purpose of this article is to consider one type of disability: the communication and information needs of deaf people. This paper will discuss the library community s response to these needs and offer suggestions and training resources on how to improve communication with deaf people. Statistics and types of deafness In Britain there are about 7.5 million people with some degree of hearing loss. 6 This is equal to 17% of the population. In this article, the term deaf people is used as a general term to cover all groups of people with a hearing loss Blackwell Science Ltd 23

2 24 Margaret E. S. Forrest The UK Council on Deafness defines four groups of people with significant hearing loss. 7 Hard of hearing This is by far the largest group (approximately 5.6 million in Britain). This group includes all those with moderate hearing loss and those whose hearing loss has become progressively severe. These people have difficulty in following normal speech without a hearing aid. Deafened It is estimated that there are people in this group. These are people who have become severely or profoundly deaf after the acquisition of spoken language. They are unlikely to use sign language but rely substantially on lip-reading, even if they benefit from using a hearing aid. Deaf There are approximately people in this group. They are predominantly users of sign language and are usually prelingually deaf. Deafblind The estimated number of deafblind people in Britain is These are people who have a severe degree of combined visual and auditory loss. They have special needs in the areas of communication, access to information and mobility. In an article on meeting the information needs of deaf people, DiPietro confirms that deaf people do not comprise a single, homogenous population who communicate in the same way, but are characterized by a diversity equal to that of the hearing population among whom they live. 8 Health professionals communicating with deaf people A review of the recent literature indexed in MEDLINE and CINAHL indicates that librarians are not the only professional group who are concerned about communicating with deaf people. A study published in the British Journal of Nursing was conducted among a sample of deaf people who use British Sign Language. 9 The findings indicate that deaf people are dissatisfied with the communication between themselves and healthcare staff. The author suggests that nurses professional development is not preparing them for communication with deaf people. This would appear to be borne out by Jennifer Kelsall, a midwife who has won an award for her initiative to help deaf women in pregnancy and labour. 10 Kelsall conducted a survey into the needs of deaf women during pregnancy.

3 Deaf awareness for librarians 25 The survey results showed that deaf women experienced negative feelings about the poor communication between themselves and the midwives. It was also clear that deaf women were not receiving the information about childbirth, labour and infant care which they needed to know. Kelsall and her research team produced a teaching pack for midwives on issues in deafness and how to communicate with deaf patients. The team has also organized a study day which has received approval from the English National Board for Nursing, Midwifery and Health Visiting. More recently, a survey was carried out among doctors at the University of Illinois Department of Medicine on the knowledge, beliefs and practices of communicating with deaf patients. 11 This study by Ebert and Heckerling focused on communicating with deaf people who use sign language. They found that although most doctors believed that the use of sign language interpreters was preferable, only a minority used them in their practices. The survey indicates that the level of communication between doctors and deaf people is generally poor. Ebert and Heckerling s article in the Journal of the American Medical Association prompted a variety of responses on a range of topics concerning the economic, legal and ethical issues of communicating with deaf people in order to provide them with information on health care RNID campaign The importance of deaf people gaining access to information on a wide range of topics is a key issue in the Louder than Words campaign of the Royal National Institute for Deaf People (RNID). The purpose of this campaign is to encourage organizations to recognize the need to produce information which is accessible to deaf people. To this end, the RNID is asking these organizations to assess their own information provision against a charter of practical and achievable steps designed to enable deaf people to become equal citizens. 17 Libraries are clearly one of the types of organizations to which the Louder than Words campaign is addressed. Libraries have an important role to play in providing deaf people with information. The rest of this paper is devoted to library staff training in deaf awareness. Deaf people and libraries Staff awareness is not automatic is the title of an article by Mary Plackett which was published in the Library Association Record in Plackett, Librarian of the RNID commented that staff awareness of the problems involved in communicating with a deaf person is not just commonsense, it needs to be spelt out. Twenty years later this is still the case. An endnote attached to Plackett s article mentions that the Library Association s Services to the Disadvantaged Subcommittee is considering issuing notes for the

4 26 Margaret E. S. Forrest The Louder than Words charter 1. Be willing to understand and respect that deaf and hard of hearing people are entitled to the same access to information as the rest of the community. 2. Adopt a policy to allow deaf and hard of hearing people access to information. 3. Provide appropriate text telephone facilities for easy communication with many deaf and hard of hearing people. 4. Provide induction loops or amplification systems at key points of contact with customers. 5. Train staff in deaf awareness to equip them to effectively meet the needs of deaf and hard of hearing customers. 6. Provide visual and audible information to alert deaf and hard of hearing people. 7. Provide sign language interpreters for communicating with deaf people who use sign language. 8. Provide a well-lit, quiet environment in customer and client reception areas. 9. Install appropriate lighting and/or non-reflective glass to aid lip-reading and signing through customer windows. 10. Provide subtitles and sign language on video material, services or products to make them accessible to deaf and hard of hearing people. Source: RNID guidance of librarians dealing with the deaf. In 1992 the Equal Opportunities Subcommittee of the Library Association produced a booklet entitled Can Everybody Reach You?: Improving Services for Deaf People. 19 Although this very helpful guide is now out of print, an updated and revised version of the booklet is currently being prepared by the Library Association. IFLA guidelines In 1991 the International Federation of Library Associations and Institutions published its Guidelines for Library Services to Deaf People. 20 Two points made in these guidelines are of special relevance to this paper: Schools of librarianship should provide training in the provision of services to deaf people as a normal part of their basic curriculum to prepare librarians for their professional qualifications, and as part of their continuing education programmes for all levels of library staff. All library staff having contact with the library s clientele should receive training in how to communicate effectively with deaf people. Deaf awareness training My experience in deaf awareness training began in 1990 when I took on the role of volunteer co-ordinator for the Sympathetic Hearing Scheme in the Edinburgh area.

5 Deaf awareness for librarians 27 The Sympathetic Hearing Scheme is a deaf awareness project launched in 1982 by four deaf organizations: the National Deaf Children s Society, the RNID, the British Deaf Association and the British Association of the Hard of Hearing (now called Hearing Concern). 21 The scheme is currently administered by Hearing Concern. My role as a co-ordinator was to seek out organizations interested in deaf awareness and to facilitate training sessions among staff. My special interest in libraries led me to Edinburgh City Libraries and the National Library of Scotland. In addition to staff training in local libraries, I have been involved in workshops in Southampton, Canterbury and Birmingham. Over a period of 3 years working for the Sympathetic Hearing Scheme, I attended over 40 training sessions which involved 636 participants. Returning to work full-time has meant retiring from regular deaf awareness training sessions. However, working for the Health Education Board for Scotland has enabled me to attend conferences to facilitate occasional workshops in deaf awareness and maintain my interest in this area. Training resources There are a variety of materials available for deaf awareness training. The Sympathetic Hearing Scheme produced a training video for the launch of their awareness project in the early 1980s. Although slightly dated, the essential information about good communication skills is still relevant. The Sympathetic Hearing Scheme is currently working on the production of a new training video. For further information, readers are advised to contact the scheme at the address listed at the end of this article. The National Library of Australia, in many ways a leader in the field of library services for disabled people, has published a bibliography on resources for the training of library staff in serving people with disabilities. 22 In her foreword to the bibliography, compiler Janet Murray notes that a literature review has revealed a deficit of library-specific materials on all aspects of disability awareness training. For this reason, training materials intended for a general audience are included. The present author has found that using these general materials does not hinder training, particularly if the facilitator is familiar with library work and able to relate the training materials to the working situations of the participants. A further useful resource from the National Library of Australia is the book Quiet Please! Deaf People are Coming: How to make Libraries Accessible for People with a Hearing Impairment by Graham Weir and Clifford Law. 23 Although all the contact organizations mentioned in this book are relevant to Australia only, this publication is still an excellent source of information on providing library services for deaf people. In particular, there is a useful checklist of suggestions for good communication skills and helpful tips for the beginner in manual communication and finger spelling. The whole issue of Library Trends for summer 1992 is devoted to the development of library services for deaf people. Several of these articles could be used for background

6 28 Margaret E. S. Forrest reading for deaf awareness training. One article in particular focuses on communicating with deaf people in libraries and contains helpful advice in this area. 24 It is to be expected that staff training will introduce participants to a number of new key concepts which could be listed briefly in a leaflet or handout for future reference. The RNID produces a range of leaflets on deafness and communication methods. The box below contains a list of points to remember when communicating with deaf people, which are recommended in one of the RNID s leaflets. 25 How to Make Communication Work 1. Try to chose a quiet place with good overhead lighting and soft furnishing for your conversation. Avoid unnecessary interruptions and distractions. 2. Sit or stand at the same level as the deaf person, about 3 to 6 feet apart. 3. Make sure you have his/her attention before you start talking. 4. Introduce the topic of conversation. 5. Make sure your face is clearly visible and not hidden by hands, beard, face, mask, etc. Look at the deaf person while you are talking. 6. Always make sure that the deaf person has his/her back to the light during conversation, so that your face is not in shadow. This will help the deaf person to lip-read you more clearly. 7. Speak clearly, perhaps slightly slower than normal, but maintain the normal rhythm of speech and do not over-exaggerate your mouth movements. 8. Do not shout, as this distorts your mouth, makes you look angry and may be painful to someone wearing a hearing aid. 9. Natural facial expression can make communication clearer. 10. During discussion, tactfully check that you are being understood. Do not assume that nodding means comprehension. 11. Repeat and rephrase your sentence if necessary and write down important information. 12. Always be patient and take time to communicate. Source: RNID Most staff training sessions are limited by time and do not provide the opportunity to learn a recognized form of sign language. However, participants can be introduced to the idea of learning British Sign Language (BSL) and those who are interested could pursue this in their own time. Basic Survival Signs is a helpful leaflet for library staff who wish to develop their awareness in this area. 26 What can be learned easily and in a short time is finger spelling. When communicating with a profoundly deaf person among the book stacks with no pen and paper to hand, finger spelling is a useful skill to have. The RNID provide a pocket size card illustrating the different positions to form the letters of the alphabet (Fig. 1).

7 Deaf awareness for librarians 29 Fig. 1. The standard manual alphabet. Source: RNID. Conclusion Slowly but surely the literature on library services to deaf people is growing. It is heartening to read examples of good practice from Australia, 27 America 28 and Britain. 29 It is also good to know that there are pockets of research in this area. One such study includes a survey of libraries in the north-west of England. 30 When most of the librarians interviewed for this study were asked about where they would prioritize resources, they affirmed that it would be in increasing staff awareness through deaf awareness training. This article has considered the communication and information needs of deaf people in health care and library settings. The large population of deaf people in this country and a lack of appropriate communication skills among hearing professionals is leading towards a growing awareness of the need to develop these skills and provide deaf people with greater access to information and library services. This article has offered some resources and practical suggestions in different ways to enhance communication with deaf people. Useful contacts The Royal National Institute for Deaf People Featherstone Street London EC1Y 8SL Tel.: Minicom: Fax: The Sympathetic Hearing Scheme 7 11 Armstrong Road

8 30 Margaret E. S. Forrest London W3 7JL Tel.: (voice and text) Fax: The Sympathetic Hearing Scheme training video costs and is available from: The Sympathetic Hearing Scheme 7 11 Armstrong Road London W3 7JL Acknowledgement Many thanks to the Royal National Institute for Deaf People for permission to print the Louder than Words charter, How to Make Communication Work and the Standard Manual Alphabet. References 1 Blackwelder, M.B. The image of health sciences librarians: how we see ourselves and how patrons see us. Bulletin of the Medical Library Association 1996, 84(3), Date, C. Staff training in disability awareness. In: Clarke, J.M. & Going, M.E. eds. Hospital Libraries and Community Care, 4th edn. London: Library Association, 1990: Library Association. Code of Professional Conduct and Guidance Notes. London: Library Association, 1996, 3. 4 Date, C. The Disability Discrimination Act Library Association Health Libraries Group Newsletter 1996, 13(1), Nelson, P.P. Library services for people with disabilities: results of a survey. Bulletin of the Medical Library Association 1996, 84(3), Royal National Institute for Deaf People. Deaf and Hard of Hearing People. London: RNID, UK Council on Deafness. Disability Discrimination Act: Recommendations on Regulations and Codes of Practice for Auxiliary Aids and Services. (Working draft, 1996). 8 DiPietro, L. Information access for all: meeting the needs of deaf and hard of hearing people. Information and Referral 1994, 16, Wright, D. Deaf people s perceptions of communication with nurses. British Journal of Nursing 1993, 2(11), Devlin, R. Breaking the sound barrier. Nursing Times 1992, 88(46), Ebert, D.A. and Heckerling, P.S. Communication with deaf patients: knowledge, beliefs and practices of physicians. Journal of the American Medical Association 1995, 273(3), Ralston, E., Zagove P. & Gorenflo, D.W. Communicating with deaf patients [letter]. Journal of the American Medical Association 1995, 274(10), Cobey, J.C. Communicating with deaf patients [letter]. Journal of the American Association 1995, 274(10), Goldstein, A.O. Communicating with deaf patients [letter]. Journal of the American Medical Association 1995, 274(10), Kulback, S.J. Communicating with deaf patients [letter]. Journal of the American Medical Association 1995, 274(10), Ebert, D.A. & Heckerling, P.S. Communicating with deaf patients [letter]. Journal of the American Medical Association 1995, 274(10), Royal National Institute for Deaf People. Louder than Words: Action for Access to Information for Deaf People. London: RNID, Plackett, M. Staff awareness is not automatic. Library Association Record 1977, 79(7), Library Association. Can Everybody Reach You?: Improving Library Services for Deaf People. London: Library Association, Day, J.M. (ed). Guidelines for Library Services to Deaf People. IFLA Professional Reports, no. 24. The Hague: International Federation of Library Associations and Institutions Cayton, H. A sympathetic hearing? Health Education Journal 1982, 41(3), Murray, J.R. Equity and Excellence: a Select Bibliography on Resources for the Training of Library Staff in Serving People with Disabilities. Canberra: National Library of Australia, 1992.

9 Deaf awareness for librarians Weir, G. & Law, C. Quiet Please! Deaf People are Coming: How to make Libraries Accessible for People with a Hearing Impairment. Canberra: National Library of Australia, Goldman, W.R. & Mallory, J.R. Overcoming communication barriers: communicating with deaf people. Library Trends 1992, 41(1), Royal National Institute for Deaf People. Deaf and Hard of Hearing People. London: RNID, Royal National Institute for Deaf People. Basic Survival Signs. London: RNID McQuigg, K. & Khan, J. The helping hands project: exploring public library services for the deaf and hearing impaired. Link-up, 7 11 June Hollander, P. Deaf-advocacy at Queens Borough PL. American Libraries 1995, 26(6), Nixon, G. & Skinner, H. Access to information and video services for the deaf community in Cheshire. Audiovisual Librarian 1995, 21(4), Jeal, Y., de Paul Roper, V. & Ansell, E. Deaf people and libraries should there be special consideration? Part 1: traditional services. New Library World 1996, 97(1125),