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Implications of Hearing Loss For First Responders and Disaster Planners Jonathan O’Dell Communication Access, Training a

Implications of Hearing Loss For First Responders and Disaster Planners Jonathan O’Dell Communication Access, Training and Technology Services. Massachusetts Commission for the Deaf And Hard of Hearing. COMMUNICATION PROTOCOL. Role of CART Provider/Interpreter

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Implications of Hearing Loss For First Responders and Disaster Planners Jonathan O’Dell Communication Access, Training a

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  1. Implications of Hearing Loss For First Responders and Disaster Planners Jonathan O’Dell Communication Access, Training and Technology Services Massachusetts Commission for the Deaf And Hard of Hearing

  2. COMMUNICATION PROTOCOL • Role of CART Provider/Interpreter • Please feel free to participate actively; be as kind as to raise your hand if you have a question so I may respond • Thank you for taking time to attend this presentation!

  3. Who we are • MCDHH is under the Executive Office of Health and Human Services • Offices in Boston, Plymouth, Worcester, Springfield and Pittsfield • Contract with regional DHILS centers for IL Services • About 48 staff statewide • 3 departments: • Communication Access Training & Technology • Interpreter and CART Services • Case Management • Children and Family Services, Mass EDP

  4. Have you ever been in an emergency situation where you wish you were able to communicate more effectively?

  5. THE ADA • The Americans with Disabilities Act is the most significant law dealing with civil rights and discrimination issues for persons with disabilities. • Title I addresses Employment • Title II addresses the responsibilities of State and Local Government • Title III addresses Places of Public Accommodation • Title IV addresses Telecommunications

  6. Section One Understanding Deafness and Hearing Loss

  7. Population Demographics Approximately 622,000 citizens of Massachusetts live with some degree of hearing loss or deafness. The National Institutes of Health suggests that one out of every eight persons in the United States lives with a significant hearing loss. This translates into 28 million people

  8. HEARING LOSS IS INVISIBLE • Because of this, it is often impossible to visually identify people who need additional assistance to follow verbal directions and audible clues in an emergency • Deafness and hearing loss prevent the absorption of “incidental” information that could prevent or minimize risk exposure

  9. MANY CAUSES OF HEARING LOSS • Illness – mother at birth, post-birth • Genetics – inherited and spontaneous • Medication • Trauma • Etiology Unknown • Aging – “wear and tear” • Occupational and long term exposure • Sudden Hearing Loss

  10. Hearing Loss • There are two kinds of hearing losses: • Conductive, in which something blocks the passage of sound into the ear • Sensorineural, in which the mechanism for the pickup of sound waves and their conversion into electrical signals is somehow disrupted • Conductive losses may sometimes be reversible. Sensorineural losses, which are far more common, are usually irreversible. Either way only an ENT can make a correct diagnosis.

  11. Undamaged Hair Cells Damaged Hair Cells

  12. The Inner Hair Cells, which respond to higher frequencies, are the first to be affected by wear and tear. This leads to high frequency hearing losses, in which understanding what one hears, not volume alone, is the problem

  13. Hearing Aids • Hearing Aids amplify sounds. They do not make them any clearer, or distinguish between desired sound sources and background noise • They DO NOT EVER restore normal hearing. • They require batteries to operate, and are sensitive to moisture and chemicals. Hearing aids will be destroyed by most decontamination procedures.

  14. Understanding the Populations • Culturally Deaf Persons • Oral Deaf Persons • Hard of Hearing Persons • Late Deafened Persons • DeafBlind individuals

  15. Understanding the role of ASL interpreters • Each country has its own sign language and different regions within countries often have different “dialects”. • American Sign Language (ASL) is a language in its own right with its own syntax and structure, used by Deaf individuals living in the United States to communicate with one another. • An ASL interpreter interprets between ASL and English just as a “regular” interpreter might interpret between French and English.

  16. An ASL interpreter must complete an accredited study program, and must at a minimum pass screening/certification by the Registry of Interpreters for the Deaf. • Interpreters develop different skill sets and specializations – medical, legal, substance abuse, to name several examples. • A CDI, or Certified Deaf Interpreter, is a Deaf interpreter who can interpret between a formal ASL interpreter and “home signs” or “visual gestural” communication.

  17. WHY USE A PROFESSIONAL SIGN LANGUAGE INTERPRETER ? • Accuracy of information guaranteed when using certified and screened interpreter • Ease and fluency of communication for both parties • Ethical and interpretative issues when using a family member or friend to interpret

  18. Factors influencing understanding • Speaker’s speech pattern and/or accent • Poor signing skills • Speaker movement • Facial hair • Poor speech-reading skills • Anxiety/Nervousness • Fatigue • Poor acoustics • Visual distractions • Insufficient lighting • Background noise • Seating arrangements • Distance from speaker

  19. Communication Tips for first responders • Get the person’s attention before starting to communicate • Maintain eye contact, use gestures and mime • Keep your face and mouth unobstructed • Make sure light is sufficient and on your face, not coming from behind you; avoid visually distracting backgrounds. • Be aware that having food, gum or other objects in your mouth while talking distorts lip movements

  20. More Tips • Speak clearly and at a moderate pace; do not overcompensate or shout • Limit number of responders interacting with any given victim • Give cues when introducing and changing subjects • Talk to the person directly - not to the interpreter, CART reporter or companion

  21. Section Two Deafness and Hearing Loss in Disaster Planning and Recovery

  22. Facts • Hearing and Understanding are NOT the same thing, amplification rarely addresses communication issues • Written information is great but not helpful to culturally Deaf individuals, at least not if complex • Environmental factors play a great role in the success or failure of communication • A high percentage of shelter seekers will be older individuals with attendant hearing losses • There are many overlapping solutions to communication issues that will benefit most population subgroup members

  23. What to think about • Identification of affected individuals in your community is essential to planning and response. How? • Councils on Aging, Senior Centers, Visiting Nurse Associations, supported living facilities, MCDHH and DHILS • Audiology offices and ENT practices; hospitals, pharmacies • Targeted and Mainstream Media • Prior communications and targeted planning ensure smoother and faster emergency response. How? • Reverse 911, voluntary registries, communication accessible community information sessions

  24. The nature of the emergency may disrupt communication • Sudden and extended power outages will render electronic devices useless immediately or when recharging is not possible. • House to house notifications/searches • If you know someone who is Deaf or HOH/LD lives at a particular location, and there is no response to first responders at door, their alerting systems are probably not working due to power outage and they cannot hear you. • Implementing evacuations and triage • Do not separate family members based on disability, have written directions/maps and visual tip sheets/communication aids on hand • Prepare for possibility that decontamination procedures will leave people without hearing aids and cochlear implants; purchase several inexpensive assistive listening devices to be used by triage staff

  25. Take into account communication methodologies employed by the targeted population. How? • More visual, less audible and textual. • Electronic communications for mobile devices, email, HTML • Use icons and universal signage/symbols, simple language • Open and closed captions on televisions • Strobes, visual alerts to get attention to message boards • Short ASL video clips formatted for mobile playback.

  26. Shelter Considerations • Light is absolutely essential for communication. • Any emergency kits must contain flashlights for use by Deaf or Hard of Hearing: LED’s are best, broader illumination with less falloff • Ability to recharge SmartPhones, pagers and CI batteries if person had enough forethought to bring devices and chargers with them

  27. A supply of 675 and 13 size hearing aid batteries, the most commonly used sizes • Have printed scripts, ASL video clips on hand dealing with shelter SOP’s and “canned” emergency information • If purchasing any media, ask that they be provided with captions or subtitles • Be aware that some Deaf and hard of hearing people may have Hearing Ear Dogs.

  28. Vital Next Steps: • At all levels, a uniform method of sharing disaster information and response with Deaf and hard of hearing people must be established. • Notifications should be geographically user-selectable but complementary with one another • Notifications cannot simply be complex text messages; need to be adjusted for target population • Icons and simple text, mobile ASL clips

  29. Examples of messages conveyed via one or two-way pager and open captioned TV: • Hurricane coming at 3:00 AM. Please go to shelter number 5 (assuming map with marked locations was distributed) • Bad dangerous flu. Do not leave home. Turn on TV watch local cable channel 3 for information. • Danger in your area. Police ask you to leave home. Please go to shelter number 5 right now.

  30. Environmental Considerations In the above scenario, the intake or triage nurse behind the desk is sitting with her back to the window. This makes the evacuees squint into the light while her face will be in the shadows. In the above scenario, the staff behind the desk is sitting with her back to the wall, the light falls on her face. This improves speechreading and communication.

  31. TECHNOLOGY

  32. TDD/TTY

  33. Phone Ringers & Amplifiers

  34. Listening Systems

  35. Smart Phones

  36. TRS, VRS, IP Relay, CapTel and VP TRS IPRelay CAPTel VRS VP

  37. In-home Hazard Alerts The most important environmental alerts are those potentially signaling threats to an individual’s health or life. In an emergency, however, this definition could expand to mean a telephone or doorbell alerting system

  38. Local and Regional Hazard Alerts Weather Radio with Strobe and Vibrator Portable battery operated SAME WR with audible and flashing LED alert

  39. Accessibility Signage Closed Captioned Amplified Phone Interpreter TTY Hearing Loss Access Information CART

  40. Questions and Answers Thank you for coming today! For feedback: Jonathan.ODell@massmail.state.ma.us MCDHH website : www.mass.gov/mcdhh

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