Nigel Howard presenting with a profile view

Expanding the model of Deaf Interpreters in Healthcare Settings

Nigel Howard started off Thursday afternoon helping us all to think about how our understanding of interpreting in

Nigel Howard speaking at podium

Photo Credit: Rebecca Zenefski, By Rebecca Studios

healthcare can be expanded by including Deaf Interpreters as a part of the team.  (A note on terminology – Nigel frequently used DI which as a category in his home nation of Canada who undergone training to reach a certain level of skill – which is more equivalent to how we use CDI in the United States.)

Using DIs has a number of multiple benefits:

  • Demographics:  the largest group of Deaf people came about during the baby boom as as they age into their 70’s and 80’s, the potential for more idiosyncratic language grows;
  • Deaf Epistemology:  because of lived experience and language use, Deaf people are not simply hearing people who can’t hear.  They process information differently, have a different way of looking at and understanding the world, and so this means that Deaf Interpreters bring another worldview to the situation which strengthens an interpreting teams ability to deal with what might come in a healthcare appointment;  Nigel shared alot about how enculturation and acculturation work – and the ways that interpreters can make best use of those concepts.  If you are interested in more on this topic, check out his keynote from the 2014 CIT Conference in Portland, Oregon.
  • Bringing a sense of ease to a Deaf patient in an alien environment.  Medical facilities can frequently be very institutional feeling and for a Deaf person, having another Deaf person there can make what can be quite emotionally challenging a little more manageable.  Nigel expressed how a DIs presence can simply help patients breathe a little easier and be more able to be a participant in their care.
  • Ability to let go of the English.  Often hearing interpreters will feel that an English medical term may be more of a priority than sometimes the concept which it represents.  DIs can focus in on getting the concept through first and then providing the English term to attach it to.  It is one of those subtle things how hearing a word can influence the thinking and choices of hearing interpreters.  DIs provide a balance to that.  Nigel also gave a number of examples of how important it is to take the generic English a doctor might say, such as “Your heart valve is not functioning properly,” and change it into a more visual specific explanation of what that actually looks at.  (If you want to see an example of Nigel talking about some of those concepts, you can check out the sample of Body Language, an online module that was developed with support from the CATIE Center.)  Nigel stressed that DIs have the same goal as the physician or the hearing interpreter, but just might have a different path for achieving it.
  • Nigel referred to the importance of co-interpreting with a hearing and Deaf interpreter.  He addressed this more in a workshop session he led with Julie Simon.  Read more about that here.
  • Both Nigel, and Jimmy Beldon who was helping to facilitate the discussion, stressed how important it is for hearing interpreters to use this notion of co-interpreting/teaming when it comes to making decisions about when to have a DI present at an appointment.  Nigel stressed that his preference would be to have a DI as a default so the DI could also be part of the process in determining whether or not a deaf interpreter is really beneficial.

In the discussion, there were several questions related to how hearing and deaf interpreters can work effectively as a team.  One of the challenges brought up was that there has been experiences that hearing interpreters don’t feel like they can provide feedback or correction to Deaf interpreters.  It might be for a variety of reasons:  hearing interpreters don’t feel like they should be commenting on a Deaf person’s ASL, DIs might not be open to the feedback, etc.  Nigel and Jimmy both stressed how important it is to have that give and take.  That both interpreters should be able to give and receive feedback from each other.

Jimmy went on to share how critical it is that there is funding for both training for interpreters, but then even more importantly, mentoring.  Too often, programs are short term and don’t have the ongoing support of a mentoring component so DIs aren’t able to really grow professionally and sustain themselves.

It was a really rich two hours and I could go on and on.  Clearly, there are still a lot of challenges.  Not nearly enough qualified DIs to be available at all appointments that could benefit from them.  Not enough programs that really work for DIs to train.  But the good thing is that a number of projects are supporting a growth in the quality and quantity of DIs.  Jimmy shared about the NCIEC Deaf Interpreting curriculum project – which helps establish a foundational competencies for DIs and a curriculum for training them.  You can check those out at the links on