Deaf Persons and Computer Use

Article excerpt

DEAF PERSONS' COMPUTER USE was studied (N = 227). Respondents self-administered a survey in their preferred language (voice, American Sign Language, captions, or printed English). A small nonparticipant sample was also recruited. Demographics were consistent with those in other studies of deaf people: 63% of respondents reported computer use, mostly at home; 50% of nonparticipants reported computer use. Subjects with hearing loss due to meningitis were less likely to use computers (p = .0004). Computer use was associated with English usage at home (p = .008), with hearing persons (p = .002), and with physicians and nurses (p = .00001). It was also associated with the use of Signed English as a child to communicate (p = .02), teacher use of Signed English (p = .04), and teacher use of ASL (p = .03). Two thirds of respondents reported using computers, though nonresponder data suggested less use among all deaf persons. Computer use was associated with English use and inversely associated with hearing loss due to meningitis.

About 9% to 10% of Americans have a hearing loss (Collins, 1997), making this sensory deficit the second most common disability in the United States (Ries, 1994). Deaf and hard of hearing persons, regardless of their level of hearing loss, are known to have belowaverage socioeconomic status (Michigan Commission on Handicapped Concerns, 1989); altered patterns of health care use, with the nature of the alteration depending on the degree of hearing loss (Barnett & Franks, 2002; Zazove et al., 1993); and significant communication difficulties with physicians and other health care providers (Hochman, 2000; Ubido, Huntington, & Warburton, 2002).

People with severe or profound hearing loss are the subgroup of the deaf and hard of hearing population that suffers the greatest socioeconomic and health care impact from communication barriers. Many of them are members of the Deaf community, a well-recognized minority population (Barnett, 1999; Dolnick, 1993) with its own language (American Sign Language, or ASL), culture, and beliefs, and who capitalize the D in the word deaf to differentiate themselves from others with hearing loss. ASL is a unique language, with its own idioms, syntax, and grammar (Hogan, 1997; Peters, 2000). Deaf persons often prefer communicating with physicians via certified ASL interpreters. Other sign languages are also used by people with severe hearing loss in various language contact situations. These include Signed English and Manually Coded English, which were devised to represent English manually and are most often used in educational settings, and Signed Contact Language, which incorporates features of both English and ASL (Lucas & Valli, 1992).

Deaf persons often experience suboptimal interactions when visiting their physicians as well as consequent misunderstandings about their disease or recommended treatment. (Hochman, 2000; Woodroffe, Gorenflo, Meador, & Zazove, 1998; Zazove et al., 1993). As a group, they have poorer health care knowledge than hearing persons, including inferior understanding about current preventive medicine interventions (Tamaskar et al, 2000). Although one report has suggested that deaf persons who have interpreters present during their physician visits have better compliance with preventive recommendations than those who do not (MacKinney, Walters, Bird, & Nattinger, 1995), there are unique issues related to using ASL interpreters. These include confidentiality, differences in interpreter skills, differences in interpretation of a variety of English phrases, and a lack of interpreters when needed (Berman et al., 2000).

Much progress has been made in developing effective and accessible health care education materials for hearing persons. One of these is the award-winning computer-based video program about cancer prevention and screening behaviors and actions that was developed at the University of Michigan by the Michigan Interactive Health Kiosk Demonstration Project. …