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Use of a Certified Deaf Interpreter

About the CDI

A Certified Deaf Interpreter (CDI) is an individual who is deaf or hard of hearing and has been certified by the Registry of Interpreters for the Deaf as an interpreter.

Specialized Training and/or Experience

In addition to excellent general communication skills and general interpreter training, the CDI may also have specialized training and/or experience in use of gesture, mime, props, drawings and other tools to enhance communication. The CDI has an extensive knowledge and understanding of deafness, the deaf community, and/or Deaf culture which combined with excellent communication skills, can bring added expertise into both routine and uniquely difficult interpreting situations.

Meeting Special Communication Challenges

A Certified Deaf Interpreter may be needed when the communication mode of a deaf consumer is so unique that interpreters who are hearing cannot adequately access it. Some such situations may involve individuals whom:

  • use idiosyncratic non-standard signs or gestures such as those commonly referred to as “home signs” which are unique to a family
  • use a foreign signed language
  • have minimal or limited communication skills
  • are deaf-blind or deaf with limited vision
  • use signs particular to a given region, ethnic or age group
  • have characteristics reflective of Deaf Culture not familiar to hearing interpreters.

The CDI at Work

As a Team Member

Often a Certified Deaf Interpreter works as a team member with a certified interpreter who is hearing. In some situations, a CDI/hearing interpreter team can communicate more effectively than a hearing interpreter alone or a team of two hearing interpreters or a CDI alone. In the CDI/hearing interpreter team situation, the CDI transmits message content between a deaf consumer and a hearing interpreter; the hearing interpreter transmits message content between the CDI and a hearing consumer. While this process resembles message relay, it is more than that. Each interpreter receives the message in one communication mode (or language), processes it linguistically and culturally, and then passes it on in the appropriate communication mode. In even more challenging situations, the CDI and hearing interpreter may work together to understand a deaf individual’s message, confer with each other to arrive at their best interpretation, then convey that interpretation to the hearing party.

For Deaf-Blind Individuals

When a consumer who is deaf-blind is involved, the CDI may receive a speaker’s message visually, then relay it to the deaf-blind individual through the sense of touch or at close visual range. This process is not a simple relay in which the CDI sees the signs and copies them for the person who is deaf-blind. The CDI processes the message then transmits it in the mode most easily understood by the individual who is deaf-blind.

Solo

The CDI sometimes works as the sole interpreter in a situation. In these instances, the CDI may use sign language or other communication modes that are effective with a particular deaf individual; and may use with the hearing consumer a combination of speech, speech reading, residual hearing, and written communication.

On the Platform

The CDI sometimes functions as interpreter before an audience. This may involve the CDI watching a hearing interpreter and restating the message to the audience in a different sign mode. At other times, the CDI may be in front of the audience to “mirror” comments or questions from a signing member of the audience so that the rest of the audience can see them.

Benefits of using a Certified Deaf Interpreter are:

  • optimal understanding by all parties
  • efficient use of time and resources
  • clarification of linguistic and/or cultural confusion and misunderstanding(s)
  • arrival at a clear conclusion in the interpreting situation.

The Association Believes

The Association Believes that when use of a Certified Deaf Interpreter (CDI) is appropriate, the CDI and a certified interpreter who is hearing can function as a highly effective team to provide quality communication access for everyone involved.

Coordinating Interpreters for Conferences

People who are deaf are participating more often in international, national, regional and local conferences sponsored by organizations predominately composed of hearing people. Conference planners face the challenge of making it possible for participants who are deaf to take part in every aspect of conference. The following information is provided to assist the conference planner in providing optimum services for all deaf participants or presenters who attend the conference being arranged.

The conference needs can include interpreting for people who use American Sign Language (ASL) or an English sign or cued system; deaf-blind people who use tactile or close visual signing; oral deaf people who use speechreading, with little or no signing, and other deaf people who may desire assistive listening devices, such as an FM or infrared loop system, or live (real-time) captioning.

Advance planning for the conference should include:

  • for larger conferences of two or more days duration, a coordinator of interpreting services should be hired as an adjunct member of the conference planning committee
  • provide space on all registration forms for a registrant to notify the conference staff of special communication needs:
    • Interpreter services
      • ASL – American Sign Language
      • An English sign system
      • Tactile or close visual signing
      • Oral
    • Ethnic/cultural language preferences
    • assistive listening devices (ALDs)
    • visual assistive devices
    • notetaking services
    • other (e.g. Cued Speech, Real Time Captioning, Telebraille, etc.)

The deadline for requests should be a minimum of one month prior to the conference to provide enough lead-time for planning of services. The conference can guarantee services only for those registered by the deadline. For late registrants, services may be difficult to obtain on short notice.

Requesting interpreting services prior to the conference allows for the planning necessary to provide a high quality of service. Planning time can be used to obtain the following necessary information:

  • presenters’ preferences regarding interpreting services
  • copies of presentation materials (speeches, songs, poems, etc.) for preview by interpreters
  • information regarding the format of the presentations
  • information regarding terminology, topic areas, acronyms, conference agenda, and any expected speaker dialects

Selection of interpreters for the conference should be based on the following factors:

  • A minimum of two interpreters is necessary for each session a deaf person will be attending. When planning for more than one deaf person in a conference with concurrent sessions, enough interpreters need to be scheduled to allow participants to attend the sessions of their choice.1
  • The same team of interpreters (rather than hourly substitutes) should be used throughout the conference as the team will acquire knowledge of the consumers, logistics, specialized vocabulary, and topic areas
  • RID certified interpreters should be used whenever possible, preferable those who have prior experience and/or knowledge of the topic or theme of the conference.
  • Ethnic, cultural and linguistic concerns of the consumers should be taken into account in selection of interpreters.

Interpreting Policies

Some issues,2 which should be agreed upon in advance of the conference are:

  • What is the cancellation policy for letting interpreters know that they are not needed for the conference, after they have been scheduled to work?
  • What happens when more interpreters are scheduled than are needed at conference time?
  • What is expected of the interpreter(s) if the consumers do not show?
  • What is the expected general attire of interpreters?
  • What is the arrangement for payment of the interpreter?
  • What policies apply to overtime for interpreters?
  • What are the policies applying to videotaping conference activities involving interpreters?

During a pre-conference site visit, the conference planner or coordinator of interpreting services should attend to the following concerns:

  • proper lighting of interpreters
  • physical location for the interpreters including a check for
    • a) a visual background that is non-distracting to the participants
    • b) the ability of interpreters to view consumers and their comments
    • c) elimination of traffic between interpreters and participants
  • easy, inconspicuous switching of team interpreters
  • adequate, suitably located space for planning of interpreters’ logistical needs
  • appropriate signage to information and locations

The conference planner should inform presenters on these basic points of protocol for working with interpreters. Presenter and interpreter(s) should meet prior to the presentation, when possible to:

  • preview the general content of the presentation
  • preview special content such as jokes, poems, or songs
  • forewarn interpreters of special occurrences that might be alarming or disconcerting if unexpected.

Presenters should not involve interpreters as “models” in demonstrations.

Presenters and interpreters are encouraged to talk at break or between sessions about how the interpreting process is going and make appropriate adjustments.

Coordinator of Interpreting Services

Conference needs may vary depending on size, nature and duration. For a larger conference of two or more days, a coordinator should be hired as an adjunct member of the conference planning committee early in the planning process. The person hired for the position of coordinator should have knowledge of the skills of interpreters as well as the needs of deaf and hearing consumers. The coordinator should be a flexible person possessing excellent scheduling skills as well as a calm professional demeanor.

The coordinator would be responsible for:

  • contacting/recruiting and scheduling appropriate , qualified, RID certified interpreters for the dates and times needed during the conference
  • services as liaison for contracts, payment negotiations, cancellation policies, and payment for interpreting services
  • providing entrance credentials, badges, schedules and information regarding sessions for the interpreters upon their arrivals at the site
  • deploying interpreters according to need
  • arranging last minute substitutions or changes
  • providing technical and logistical assistance to the conference personnel
  • problem solving or “putting out fires”
  • coordinating with other language interpreters
  • providing post-conference reports, summaries and final report on expenses as requested by the conference planning committee.

The coordinator of interpreting services and the conference interpreters might be hired through an interpreter service agency. If the coordinator is also an interpreter, it is best that this person not be scheduled for interpreting duties, but be available for contact at all times through a pager system.

The Association Believes

The Association believes that the planning for and use of skilled conference interpreters provides optimum services for the needs of deaf and hearing consumers alike who attend the conference. The conference planner can enhance the provision of equal access to all conference proceedings through this good use of qualified conference interpreters.

RID has a series of Standard Practice Papers available upon request. Footnotes frequently reference these materials

1See Team Interpreting and Use of a CDI

2See Business Practices: Job Billing


Timeline For Scheduling Conference Interpreting Services

 

Activity
2 – 3 mo
1 mo
2 wks
On site
2 wk Post
Hire Interpreter coordinator
X
Secure names of interpreters
X
Mail contracts to interpreters
X
Registration requests received
X
Contracts returned
X
Written presentations / songs / audio tapes to interpeters
X
Names of deaf participants
X
Cancellation of services
X
Conference logistics
X
Payment to interpreters
X
Post-conference meeting to evaluate services
X

Cumulative Motion Injury

Cumulative Motion Injury (CMI), also called Cumulative Trauma Disorder, Repetitive Motion Injury, Repetitive Use Injury, or Repetitive Stress Disorder, can occur in sign language interpreters who perform the same rapid motions multiple times during a work day. Activities that require forceful, speedy, repeated movements, combined with awkward postures and insufficient rest time between movements put interpreters at greatest risk for injuries. The most common injuries are to the wrist (Carpal tunnel Syndrome), the arm (tendinitis), the shoulder (bursitis), and the back. Cumulative Motion Injury has the potential to prematurely remove people from employment in the sign language interpreting field. Years of education, training, and experience may be lost to the practicing interpreter, consumers, and employer.

Although Cumulative Motion Injury has traditionally been associated with workers in manufacturing or computer related jobs, doctors are now seeing an increased incidence of such injuries among sign language interpreters. Some causes of Cumulative Motion Injury are:

  • forceful, epeedy, repeated movements
  • awkward hand positions and postures
  • insufficient rest time between movements
  • insufficient time for warm up and cool down of muscles
  • insufficient rest time between periods of intense work
  • tight muscles in arms and upper body during work time

Cumulative Motion Injury usually begins as body parts intended to move smoothly together begin to drag against each other. The friction causes tiny tears in the muscles and tendons that then become inflamed. As the tears heal, scar tissue forms causing body parts to drag even more against each other. The continuous, repeated friction causes stiffness and pain and inflammation. In the early stages the pain and stiffness may go away when the activity is discontinued overnight or for a few days. As the condition grows worse, relief requires longer and longer periods of rest, and the symptoms may recur more quickly on recommencing the activity. In many cases, the symptoms persist and medical attention is required. If the activity is continued without proper treatment and rest, nerve damage results in numbness, loss of strength and flexibility and chronic pain.

Employers concerned about the health and safety of employees can help the interpreter avoid injury. Some preventative measures the employer may take in consultation with the interpreter are:

provide 15 minutes of rest or alternative work for each 1.5-2 hours of interpreting
utilize more than one interpreter for sessions exceeding 1.5 hours.1
consider diversification of work duties to include those which do not require use of the same major muscle groups.2
provide educational opportunities for the interpreter to learn use of preventative techniques and early recognition of problems.
Work with the interpreter to analyze the work site to identify and eliminate, when possible, “stressors,” such as standing in the same place for a long time, sitting in chairs which are not ergonomically designed, being exposed to extremes in temperature, and assuming awkward positions to interpret.

Avoid continuous interpreting with heavy work output requiring intense concentration for long periods of time. The amount of time that should be spent actually interpreting may vary from one job to another.

Since continuous work with little or no breaks can be a strong factor in the onset of CMI, interpreters should take the initiative in working with employers in identifying and preventing problems by:

  • not working lengthy interpreting situations alone
  • ensuring sufficient breaks in their work day
  • not working too many hours in a single day

Some specific preventative measures interpreters may take are:

  • educate the employer in the use of preventative techniques and early recognition of problems
  • use a less forceful signing style or fingerspelling with the hand orientation turned slightly in, rather than fully facing the consumer
  • do stretching and range of motion exercises for body and handsdo strengthening exercises for arms and hands
  • consider alternative preventative and treatment approaches such as therapeutic massage, chiropractic manipulation, paraffin baths, and acupuncture

There is no one treatment or relief for many of the symptoms of Cumulative Motion Injury(s). Far superior to treatments, prevention of CMI is the best choice for interpreters. A lifestyle for health and fitness combined with prudent work habits can reduce the interpreter’s chances of suffering this potentially debilitating condition. Measures employers take to prevent the occurrence of CMI are well worth the costs. Improved performances and bolstered morale can actually reduce employer costs for substitutes, worker’s compensation, and health insurance. Working together, employers and interpreters, can ensure a safe working environment in which the interpreter can work effectively and without risk of CMI.

The Association Believes

The Association believes that through cooperation with employers, appropriate education, and preventative techniques, the interpreter’s years of education, training, and experience will not be lost because of Cumulative Motion Injury.
RID has a series of Standard Practice Papers available upon request. Footnotes frequently reference these materials.

1 See Team Interpreting
2 See Multiple Roles

Interpreting in Medical Settings

In medical settings, effective communication between consumers and health care professionals is essential. When the health care professional and the consumer do not share a common language or communication method, communication presents a challenge. The communication gap may be between the medical professional and a patient who is deaf or between the medical professional and a responsible person other than the patient, such as the deaf parent of a minor child or the deaf adult responsible for an aging parent. A qualified RID interpreter can bridge the communication gap between medical professionals and those they serve.

Health Care Professionals Using Interpreters

The health care professional in need of an interpreter may have several questions.

How do I know an interpreter will be needed?

The deaf patient (or family member) should inform you of the need for an interpreter when making an appointment or when receiving services. It is important to remember, the health care professional and the patient should work together to ensure that the necessary accommodations are provided.

Who is responsible for arranging interpreter services?

Health care providers are responsible for providing “auxiliary aids and services under the Americans with Disabilities Act to ensure that communication with people who are deaf is as effective as communication with others. Federal regulations define “auxiliary aids” to include interpreters.1 Adapting scheduling procedures may be necessary in order to provide an interpreter; for example, a walk-in clinic, where appointments are usually not made, might have to make an appointment. The health care provider cannot legally charge a patient for the interpreter services.

For what types of care should I provide interpreter services?

An interpreter should be present in all situations in which the information to be exchanged requires effective communication, such as taking a medical history, explaining tests, procedures and diagnoses, planning treatment, providing discharge instructionsand scheduling follow-up care.2

For what services and programs should I provide an interpreter?

You will want all services and programs you provide to be available and accessible equally to consumers who are deaf and hearing. For example, a deaf individual might wish to take a childbirth class, access a substance abuse program, obtain psychiatric services or attend a free lecture on health care.

How do I find a qualified interpreter?

You can engage a private practice interpreter directly or through an interpreter service agency. You will have most assurance of quality by hiring an RID certified interpreter. Interpreters certified by RID have demonstrated skills related to language and communication, as well as knowledge and practice of ethics and professionalism. To be effective, the interpreter’s communication must be compatible with that of the deaf individual; therefore, it is important that the deaf individual be consulted on the choice of interpreter. For this reason an individual who is deaf may decline to use a specific interpreter. Ethnic, cultural and linguistic concerns of the patient and family members should be considered in the selection of an interpreter. Prior to hiring the health care professional should inquire about the credentials of an interpreter.3

Why not use a family member as interpreter?

While using a family member may seem logical and convenient, it is not advisable, for several reasons. You have no assurance the family member’s language skills are adequate for communicating medical information. The relative may have attitudinal or emotional issues that could affect objectivity and impartiality and prevent accurate communication. For example, a family member might feel compelled to “protect” the patient from painful news, or to withhold potentially embarrassing information. Using a family member may compromise the patient’s right to privacy and confidentiality.

Why not use a person on staff who knows sign language?

Unless the staff person is an RID certified interpreter, you have no assurance that communication will be effective and accurate. Inaccurate or incomplete communication in general can cause greater risk than no communication. This may jeopardize patient care and become a liability issue.

What about emergencies?

In emergency health care, it may not always be possible to immediately provide a specific type of communication accommodation. However, you will want to provide the most effective communication as soon as possible. To reduce delays in acquiring an interpreter, make sure emergency and crisis staff know the policy and procedures for requesting an interpreter for all hours the facility is open. Also, maintaining phone numbers of qualified private practice interpreters and interpreter service agencies can reduce delays in acquiring interpreters on short notice. Following an established policy or procedure for effective communication with individuals who are deaf is vital to emergency patient care.

Where can I learn more about providing services for patients who are deaf?

Download ADA Questions and Answers for Health Care Providers. (this document requires that you have the free Adobe PDF reader installed on your computer. You can download Adobe Reader here.)  This document is made available courtesy of the National Association of the Deaf Law and Advocacy Center

What do I need to do in order to work effectively with an interpreter?

As you work with an interpreter, you can facilitate communication in several ways:

  • Work with the interpreter and the deaf individual to determine the best possible placement for all parties in the situation.
  • Speak directly to the individual who is deaf rather than saying to the interpreter, “Ask him….” or “Tell her…” Realize that the interpreter cannot provide any information or opinions about the patient.
  • Expect that the interpreter may occasionally pause to ask you for an explanation or clarification of terms in order to provide an accurate interpretation.
  • Recognize that the interpreter is responsible to interpret all that is said in the presence of all individuals and will not edit out anything spoken as an aside or anything that is said to others in the room.

Can I be confident the patient’s right to confidentiality will not be violated?

An RID interpreter adheres to a Code of Ethics of which confidentiality is a fundamental tenet and may be covered by the “cloak of privilege” when interpreting for a professional who has legal privilege.

Will the interpreter have safety concerns?

As interpreters become part of the health care scene, they may have questions and concerns about their personal safety. The medical professional can help the interpreter by answering questions, by offering guidance regarding universal precautions, sharing action plans for volatile behaviors, and by providing appropriate protective equipment and clothing.

The Association believes that effective communication is essential to quality health care. By using qualified RID interpreters, health care professionals can do their best to provide the same standard of care to individuals who are deaf as to those who are not deaf.

RID has a series of Standard Practice Papers available upon request. Footnotes frequently reference these materials.

1 see 45 Code of Federal Regulations 84.52(d)1,3 and 28 C.F.R. 36.30(c)

2 see Professional Sign Language Interpreting, Use of a CDI and ADA questions and Answers for Health Care Providers, National Center for Law and Deafness

3 see RID information on Certification

Professional Sign Language Interpreting

What is Interpreting?

Interpreting, simply stated, is receiving a message in one language and delivering it in another. Not as simple as it sounds, interpreting is a complex process that requires a high degree of linguistic, cognitive, and technical skills.

Professional sign language interpreters develop interpreting skills through extensive training and practice over a long period of time. Interpreters continue to actively improve their skills, knowledge, and professionalism through membership in RID. An increasing number of interpreters have completed college or university interpreter education programs, earning associates, bachelors, and/or masters degrees in interpreting. Some interpreters have also obtained advanced degrees in related fields such as linguistics or cultural studies.

Sign language interpreting is a highly specialized field; simply knowing both sign language and English does not qualify a person to be an interpreter. The professional sign language interpreter is able to adjust to a broad range of deaf consumer preferences and/or needs for interpretation. Some deaf individuals use American Sign Language, a natural language with its own grammar and structure that is distinct from English. Others prefer forms of signing that more closely follow the grammar and structure of spoken English. The professional interpreter is expected to work comfortably along this wide spectrum.

Sometimes it is necessary to have two or more interpreters working simultaneously in order to satisfy the preferences and needs of a varied audience.1 On occasion, one of the interpreters may be a deaf individual2 or a person fluent in a language other than English or American Sign Language. Interpreters should be aware of and sensitive to ethnic/cultural, and linguistic concerns.

Where Professional Interpreters Work

Interpreters work in a variety of settings and situations. Many interpreters work in private practice; they are self-employed. From scheduling assignments to handling billing, the interpreter is responsible for all business aspects.3 The private practice interpreter may also receive assignments through interpreter service agencies. Other interpreters are salaried staff of an agency, institution, or corporation.4 Still others interpret in educational settings – from pre-school to graduate school and any level in between. Interpreters work in settings as intimate as a private therapy session, or as public as a televised address at a national political convention. The interpreter must be a versatile, flexible, skilled professional.

Interpreter Ethics

Professional interpreters adhere to the RID Code of Ethics. This Code holds interpreters to a high level of professionalism in matters of interpretation and business practices.

Interpreting Credentials

In the field of interpreting, as in other professions, appropriate credentials are an important indicator of an interpreter’s qualifications. The Registry of Interpreters for the Deaf (RID) awards certification to interpreters who successfully pass national tests. The tests assess not only language knowledge and communication skills, but also knowledge and judgment on issues of ethics, culture, and professionalism. An interpreter may hold one or more certifications. Information on certifications is available from RID.

Some common sign language interpreting certifications are:

NIC – National Interpreter Certification

CT – Certificate of Transliteration

CI – Certificate of Interpretation

CSC – Comprehensive Skills Certificate

SC: L – Specialist Certificate: Lega

IC – Interpretation Certificate

TC – Transliteration Certificate

CDI – Certified Deaf Interpreter

To verify an individual interpreter’s current certification status, contact the Association’s national office.

The Association has played the leading role in establishing a national standard of quality for interpreters, and is committed to continued professionalism in the practice of sign language interpretation. Local interpreter service agencies, individual interpreters of the Associate’s national office can provide information on certified interpreters and interpreting throughout the United States.

RID has a series of Standard Practice Papers available upon request. Footnotes frequently reference these materials.

  1. See Team Interpreting
  2. See Use of a CDI
  3. See Business Practices: Billing Considerations
  4. See Multiple Roles
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RID Official Papers

  • Professional Sign Language Interpreting
  • Team Interpreting
  • Multiple Roles
  • Mentoring
  • Interpreting in Medical Settings
  • Interpreters for Conferences
  • Use of a Certified Deaf Interpreter
  • Cumulative Motion Injury
  • General Information About RID and RID Code of Ethics
  • Billing Considerations
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