Providing access to an interpreter does not automatically make communication effective.
That idea was central to Beyond One-Size-Fits-All: Improving Communication Access for Individuals Who Are Deaf, DeafBlind and Hard of Hearing, a recent LanguageLine webinar featuring Nicole Manuel, M.E., NIC, Manager of Interpreting Services at MedStar Washington Hospital Center, and Dr. Amanda Smith-Hughes, NIC, Senior Manager of Sign Language Services at LanguageLine.
Here are three major takeaways from their discussion.
An emphasis on compliance can tempt organizations to think in terms of services offered: Was language access needed? Was Video Remote Interpreting (VRI) available? Was an auxiliary aid provided?
Those questions matter, but they miss the most important one: Could the individuals involved actually understand each other and fully participate in the interaction?
“The goal isn't just to say, check, I’ve provided accommodations,” Smith-Hughes said. “It's to provide actual communication.”
Effective communication is not achieved simply by offering an accommodation. It occurs only when information is clearly understood in both directions.
The Deaf, DeafBlind or Hard of Hearing individual must be able to ask questions, get complete and accurate answers, understand what is being said, and meaningfully participate in the conversation. Likewise, the other party—whether a clinician, educator, police officer, employee, or customer-service representative—must also be able to communicate clearly and be understood.
The presence of an interpreter or assistive tool alone does not prove that communication was effective. It does not confirm whether it worked well in that specific situation or met the needs of the people involved. It only shows that a resource was provided or used.
To meet the standard of effective communication, organizations should shift their focus from process to outcome. Instead of asking, “What did we provide?” they should ask, “Did communication actually succeed?”
That determination should not be assumed, it should be verified. Organizations should check in with all participants to confirm whether they understood and were able to engage fully. If communication was not effective, the response should be to adjust the method or provide a different accommodation, rather than assuming the requirement has been met.
No single accommodation works for every Deaf, DeafBlind or Hard of Hearing individual. Not everyone uses ASL. Some people may need CART captioning, written communication, an assistive listening device or another aid. Some use a signed language other than ASL. Vision, mobility, additional disabilities and familiarity with technology can affect what works.
The interaction matters just as much. Ordering coffee is different from giving informed consent. A routine appointment is different from an emergency, a group therapy session or a complicated diagnosis.
“The right accommodation actually depends on the person's communication needs and the circumstances,” Smith-Hughes said.
This means asking the individual what they need, ideally before the interaction ever begins. Online registration, appointment scheduling and intake all create opportunities to identify communication needs early.
Even then, organizations must remain flexible. A person’s preferred method may not be effective in a particular physical or clinical situation. Communication needs may also change during a long hospital stay. The appropriate response is not to defend the original choice, but to work with the individual to evaluate whether it is working.
“Giving people options allows them to feel empowered in their care,” Manuel said. “And that's one of the most important things we can do.”
Effective communication cannot depend on one knowledgeable employee being available at the right moment. Organizations need multiple options, clear decision points and staff who know how to activate them.
“Accessibility is actually part of the communication infrastructure that allows the organization to function effectively,” Smith-Hughes said.
That infrastructure includes knowing where equipment is stored, how to request a qualified interpreter, whom to contact when the first option fails and which situations require specialized support. Training should reflect the environments where communication occurs. A labor and delivery unit, emergency department, classroom and courtroom will not encounter the same conditions.
MedStar brings this education directly into staff huddles and other interactive settings, allowing employees to see the equipment, meet interpreters and practice the process. The goal is preparation before an urgent need arises.
Infrastructure also includes honest communication when resources are limited. If an in-person interpreter is unavailable, organizations should explain what they have tried, what can be provided now and what may become available later.
“Tell them that you're trying. Be transparent, because that's really important,” Manuel said.
LanguageLine can help your organization build a more flexible, responsive approach to serving individuals who are Deaf, DeafBlind, and Hard of Hearing. Please connect with us for a free consultation. We invite you to learn more about our ASL interpreting services, as well as our solutions for those who are DeafBlind.