Recommendations for deaf/ hearing impaired people
Before you read our recommendations, please keep in mind that hearing impaired people are a heterogenic group according to their communication skills. Some are unable to understand or read spoken language. Similarly, there might be a need of simplification of spoken/written language. Some are able to communicate in sign language. Communication skills depend on the time of becoming hearing impaired (pre-, peri-, postlingual adaption), severity of hearing loss, other diseases/disabilities, age, socialization and education. Universal design means to take all possible kinds of communication skills into account. Moreover hearing impairment rarely means a hearing loss by 100%, many hearing impaired people do hear some frequencies or have a better hearing ear. Some hearing impaired do also have ear noises.
- Deaf/hearing impaired individuals react just as hearing individuals during times of crisis.
- Cooperation, networking, communication, exchange with deaf/ hearing impairment associations is helpful and necessary ("Nothing about us without us")
- Deaf/ hearing impaired mostly do not like to describe themselves as "disabled". They consider themselves as being part of a "linguistic and cultural minority group".
- Use and adapt existing structures and services, try to find universal designs. Services should be offered all over the country and should not be centralized.
- Sentisize the population (possible zero-responders) and professionals about deafness/hearing impairment. Sensitization via: school-education, information material (e.g. via Flyer (Government of Germany distributed about 20000 flyer including information about communication with Deaf), internet & media, trainings. Sensitization should include: self experience (e.g. case studies). (In Israel, fire fighters are required to work for 30 hours with disabled people), culture, communication skills & possibilities to communicate (e.g. difficulties of lip-reading - max. 30% of spoken can be apprehended; Czech Republic has a DVD about communication with Deaf in emergency)
Rights of deaf/ hearing impaired persons
- Learn basics about/in sign language
- Implement the possibility to call interpreters in emergency without going through whole bureaucracy to ensure communication with Deaf speaking sign language. Solve financial issues for communication with e.g. interpreters.
- Develop information material about acute, mid- and longterm services for deaf/hearing impaired after disasters in different versions according to communication skills (written design, videos, media, internet, blogs etc.)
- Communicate information (e.g. about existing dangers, present situation and development after disaster) in several different ways: TV, media, Internet, SMS, Apps, etc. (in written text, spoken language, sign language)
- Assemble a network of interpreters (translating via video vs. in personal) to be called upon during times of emergency who are trained in specific fields such as medicine or welfare.
- Create information material (in written text, spoken language, sign language) for deaf/hearing impaired including: rights of deaf/hearing impaired, recommend to have all necessary equipment (e.g. cell phone, hearing aid with spare battery, etc.) with you, information about inclusive alert- and emergency-call-systems, stress reaction after disaster, general advice how to cope with stress reactions, services and particularly how to access services (address & contact details)
- Educate deaf/hearing impaired individuals to be prepared for disaster, first aid, etc. (e.g. via deaf/hearing impaired associations)
- Establish a voluntary database of people with disability for easier contact, crisis communication and warning.
- Use multi-sensual alert-systems (e.g. sound, vibration and flashlight) and emergency-call-systems (e.g. Telephone, SMS, FAX, Apps, Skype, Internet, E-Mail). It is important to develop backup-tools for communication which aren't based on electricity, internet and mobile phones etc. as during disaster this might not work anymore. You could: write with pencil on paper / use laminated document with pictures showing where it hurts on the body so that deaf/hearing impaired individuals are able to point to relevant pictures
- Create inclusive standards for evacuation and emergency routines for employers/ schools/ communities/ public-traffic systems/ public places etc. In particular deaf/hearing impaired individuals should take part in disaster drills and simulation. (If trained deaf/hearing impaired people might be an enormous resource, in disaster when there is so much noise and no one but them find their way out and is used to communicate and orientate without spoken language)
Psychosocial First Aid
- Try not to separate deaf/ hearing impaired individuals from each other or their relatives/friends as these people promote their feeling of security and their chance to communicate and receive information
- Specific communication advice: ask for preferred way of communication (e.g. spoken language, written language, sign language), call sign language interpreter if deaf/hearing impaired prefers sign language, this should not be the responsibility of the hearing impaired individual. Point and use basic signs, gestures or cards (with sign language like in Sweden) etc. that symbolize cohesion, help, security etc., speak slowly and clearly, do not shout (as many hard of hearing people show symptoms of hypo- and hyperacusia at the same time), stay in eye-contact and observe their mimes and reactions, make sure there is enough light so they can see your face and what is going on around them, ask what a deaf/ hearing impaired person has understood or offer to repeat your communicated information to make sure he/ she did understand your message
- Signal values and symbols are extremely important in chaotic situations (e.g. logos, orange vest, blanket) in order to signal warmth and security. Especially deaf/ hearing impaired individuals tend to be visually oriented. If first responders (etc. firemen and police men) wear safety helmets outside the danger zone, they should take them off, so the deaf/hearing impaired have the chance to lip-read and see facial expressions.
- Deaf/ hearing impaired individuals are most vulnerable in the dark or while asleep when they can not compensate their hearing loss with the visual sense.
- Psychiatric centers should be able to treat deaf/hearing impaired in general not only at one place per country
- Make their preferred way of communication possible. A sign language interpreter should automatically be provided - it should not be the responsibility of the hearing impaired individual.
- Specific communication advice: see paragraph `Psychosocial First Aid´
- Deaf/ hearing impaired individuals have the same needs as hearing individuals in the therapy situation e.g. closeness, empathy, humor etc.
- Psychopathology: Deaf/ hearing impaired suffer from the same psychiatric disorders as hearing individuals but there is evidence for generally increased incidence of psychiatric problems in this population. Incidence of PTSD is not well illuminated so far. There is a need for more research. Hard of hearing people or people who suffer from increasing loss of hearing often report of Hyper- and Hypoacusia at the same time. This phenomenon is quite similar to the frequently coexisting numbing/ avoidance and the hyperactivation subsyndromes in post traumatic stress disorder. This is why qualified personnel should find out if a person is affected by this syndrome as well.
- Therapy and Sign Language: Trauma treatment is difficult if it has to be done via a sign language interpreter; eye contact is extremely important during therapy and this is lost if one uses an interpreter. Therapists speaking sign language are the preferred option. If therapists are not able to speak sign language it is preferable to use the same interpreter again if multiple sessions are needed. Sign language interpreters have to remain neutral and should be unknown to the hearing impaired individual. On the other hand deaf may not want a deaf psychologist/therapist because there is a high risk of meeting them in deaf community.