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37 | COLUMBIA SOCIAL WORK REVIEW, VOL. 18 

ADDRESSING COMMUNICATION BARRIERS AMONG 
DEAF POPULATIONS WHO USE AMERICAN SIGN 
LANGUAGE IN HEARING-CENTRIC SOCIAL  
WORK SETTINGS

YUNHE BAI AND DAVID “DT” BRUNO

 
ABSTRACT

The primary mission of social workers is to provide services to meet 
the needs of vulnerable populations, including people who are deaf and 
use American Sign Language (ASL). It is imperative for social workers to 
conduct culturally and linguistically competent practices to address deaf 
clients’ unique requirements. However, due to a shortage of competent social 
workers specializing in the deaf population, deaf people are likely to interact 
with hearing social workers who have insufficient knowledge of ASL, Deaf 
culture, and proper accommodations for deaf people. This paper explores core 
issues that impact deaf people’s access to social work services and urges that 
hearing social workers become familiar with the policies that protect the rights 
of clients with disabilities. Critical recommendations are offered to enhance 
access for deaf clients using ASL to more comprehensive social work services.

Note: Throughout this document, “deaf” will be used in an all-inclusive 
manner to refer to the population with hearing loss, regardless of their 
languages or community affiliations, including those who identify as D/deaf, 
hard-hearing, and late-deafened. When discussing Deaf culture and the Deaf 
community, a capitalized “Deaf” will be used.

INTRODUCTION
The United States Census Bureau estimates that there are nearly 11 

million people who are deaf in the United States (Mitchell, 2006). While it 
is difficult to determine the exact number of deaf people who use American 
Sign Language (ASL), as many national surveys do not investigate the use 
of ASL, it is estimated that five percent of the deaf population in the United 
States are ASL users, approximately 500,000 people (Mitchell et al., 2006). A 
significant portion of the deaf population who use ASL identify ASL as their 
primary or preferred language (Hoang, LaHousse, Nakaji & Sadler, 2010). 
Since the deaf population is relatively small in the United States, many social 
workers may not regularly interact with deaf people.  

Throughout history, deaf individuals have faced many challenges 
in using sign language due to hearing people’s exclusionary practices 
(Greenwald & Van Cleve, 2015). In the 19th century, the Second 
International Congress on the Education of the Deaf, commonly known 
as the Milan Conference of 1880, stripped deaf children of their access to 



COLUMBIA SOCIAL WORK REVIEW, VOL. 18 | 38 

sign language (Monaghan, 2016). As a result of declaring that oral education 
was better than sign language education, many deaf children experienced 
language deprivation. Language deprivation occurs when deaf children lack 
linguistic stimuli necessary for appropriate language acquisition during the 
first five years of life, known as the critical period. Language deprivation 
has been a significant and prevalent issue among the deaf population, as 
it has been associated with negative outcomes in cognitive and learning 
development processes (Ryan & Johnson, 2019). Given the hearing-centric 
environment across the United States, deaf individuals encounter a variety 
of obstacles due to inaccessibility and ineffective communication (Steinberg 
et al., 1998). Since deaf people tend to rely on their sense of sight and touch, 
including those who use ASL, hearing social workers need to consider the 
importance of ASL in how it enhances equitable access to communication 
and professional services for deaf people (Ulloa, 2014).

Just like hearing individuals, deaf individuals are referred to social work 
services for a variety of reasons including, but not limited to, healthcare, 
mental health, vocational services, and education (Glickman, 2013). Due 
to the limited number of social workers who are able to provide culturally 
and linguistically competent services, deaf individuals are often left at a 
disadvantage with barriers to communication (Sheridan et al., 2010). 
In working with deaf clients, both cultural and linguistic competencies 
are important to foster effective and appropriate interactions. These 
competencies include having empathy towards those who are deaf and a 
familiarity with the intricacies of ASL. Currently, many deaf clients are 
overlooked by social work services that are exclusively catered towards 
the hearing community. Hearing social workers generally lack training 
opportunities to learn about Deaf culture and the Deaf community and are 
often unfamiliar with the legal requirements for accommodating deaf clients 
(Harmer, 1999; Meador & Zazove, 2005). 

ASL interpreting services have emerged as the most preferred 
communication approach among deaf people who use ASL or have limited 
literacy in English. Apart from ASL interpreters, Video Remote Interpreting 
and Video Relay Services have been proposed as new technologies that 
enable deaf people to communicate with hearing people remotely. However, 
research on these technologies is still limited. This article presents current 
policies that address communication barriers between deaf clients and 
hearing social workers, as well as proper accommodations for deaf clients 
in hearing-centric settings, including the relatively recent technologies 
of Video Remote Interpreting and Video Relay Services. The information 
provided may bring the social work profession closer towards the goal of 
providing comprehensive and appropriate services to the Deaf community, 
consistent with ethical guidelines.

SOCIAL WORK ETHICS AND PRACTICE STANDARDS
The National Association of Social Workers (NASW) Code of Ethics 

declares that social workers are bound, legally and ethically, not to 



39 | COLUMBIA SOCIAL WORK REVIEW, VOL. 18 

discriminate against clients on the basis of mental and physical disability 
(National Association of Social Workers, 2008). Standard 9 in the NASW 
Standards and Indicators for Cultural Competence in Social Work Practice 
states that, 
 “Social workers shall provide and advocate for effective 

communication with clients of all cultural groups, including people 
of limited English proficiency or low literacy skills, people who are 
blind or have low vision, people who are deaf or hard of hearing, and 
people with disabilities.” (Bonner et al., 2015)

Standard 9 further specifies that both social workers and organizations are 
required to evaluate each client’s preferred language and provide suitable 
assistance to ensure effective communication (Bonner et al., 2015). 

In other words, social workers must be able to communicate respectfully 
and effectively with clients from diverse cultural and linguistic backgrounds. 
This depth of communication requires proficiency in the client’s preferred 
language as well as proper knowledge of the client’s cultural values and 
identities (Simmons et al., 2008). When working with deaf clients, social 
workers would address this need by providing various accommodations, 
including professional sign language interpreters. Professional sign language 
interpreters should be treated as members of the social work service team 
and familiarize themselves with the types of settings and services that are 
being provided, such as legal services, mental health services, and child 
welfare services (National Association of Social Workers, 2007).

AMERICANS WITH DISABILITIES  
ACT REQUIREMENTS

Social workers are required by the Americans with Disabilities Act 
(ADA) (1990)  to provide deaf people with equal access to various forms of 
services, along with necessary considerations on local and state laws that 
may have stronger regulations (Morgan & Polowy, 2009). The ADA prohibits 
discrimination against people with disabilities, including deaf people. It 
requires covered entities from both public and private sectors, including 
social work services, to provide reasonable accommodations for people with 
disabilities to have equitable opportunities to participate in and enjoy the 
benefits of their programs and services (Americans with Disabilities Act, 
1990b). In 2008, the United States Congress amended the ADA by updating 
the definition of “disability,” thereby broadening the scope of who would 
be protected and increasing the number of people protected under the law 
(Georgetown University Law Library, 2020).

According to Title III of the ADA for Public Accommodations and 
Commercial Facilities, it is the responsibility of both public and private 
entities to provide necessary auxiliary aids and services to ensure effective 
communication with people with disabilities (Americans with Disabilities 
Act, 1990a). Entities are only exempt from providing accommodations if 



COLUMBIA SOCIAL WORK REVIEW, VOL. 18 | 40 

they can prove that it would impose an undue burden on the operation of 
their business. Nonetheless, exempt entities are still strongly encouraged to 
make every effort to provide proper accommodations for deaf people. These 
accommodations include, but are not limited to, qualified interpreters, 
written materials, telecommunication devices, videotext displays, open and 
closed captioning, and other methods of making aurally delivered materials 
available to deaf people. It is important to note that denying deaf clients 
these accommodations and, in some instances, requiring Deaf people to pay 
for accommodations, is an unlawful form of discrimination (Americans with 
Disabilities Act, 1990a).1 Research on the effectiveness of the ADA is limited, 
as employers are not required to monitor and report their ADA compliance 
efforts. However, the accommodations that the ADA advocates support 
have been proven to benefit deaf individuals who seek support for their 
communication (United States Department of Justice, 1994).

ACCOMMODATIONS FOR IMPROVED  
COMMUNICATION WITH DEAF CLIENTS

Recurring findings indicate that many deaf people experience limited 
access to social work services due to communication barriers (Steinberg et 
al., 1998; Mueller, 2006). Those communication barriers, which are the result 
of inadequate knowledge of ASL and Deaf culture among hearing social 
workers, leave deaf people vulnerable to isolation, poor service delivery, and 
place an unnecessary burden on their lives (Cabral et al., 2013; Fellinger et 
al., 2012). In order to determine which communication approaches are most 
appropriate for deaf clients, social workers must evaluate the preferences 
of the clients and identify the needed services. Stewart (1986) does this by 
identifying “...strengths and limitations of the disabled individuals as well 
as the strengths and limitations of the disabled person’s environment and to 
assist the individual to realize his or her potentials through an enhancement 
of the environment or ecological circumstances” (p. 11). When deaf clients 
disclose their preferred accommodations, social workers need to familiarize 
themselves with these accommodations and incorporate them into their 
practices. This section discusses recommendations on accommodations 
for deaf people, including ASL interpreters, Video Remote Interpreting, and 
Video Relay Services. All are discussed in relation to the communication 
barriers faced regularly by deaf clients. 

AMERICAN SIGN LANGUAGE INTERPRETERS
American Sign Language interpreters make communication possible 

between deaf people who use ASL and people who hear by interpreting 
both ASL and spoken English (Olson & Swabey, 2016). ASL has its own 
grammatical rules, sentence structure, and cultural implications, thereby 
making interpretation between ASL and spoken English a complex process 
that requires a high degree of cognitive, linguistic, and technical skill. 
1 The terms “auxiliary aids and services” and “accommodations” are used interchangeably in 
this paper to represent the available services for deaf people as required by the ADA 



41 | COLUMBIA SOCIAL WORK REVIEW, VOL. 18 

Long sentences of spoken English can be interpreted into equivalent signs 
conveying the meaning of an English sentence (Professional Standards 
Committee, 2007). Interpreters enhance real-time communication by 
providing both simultaneous and consecutive interpretations. Simultaneous 
interpretation is one-way communication where ASL is interpreted at the 
same time as spoken English is delivered. Consecutive interpretation is a 
one-on-one conversation where ASL is interpreted after a hearing person 
speaks and pauses, which affords deaf people more time to comprehend the 
interpreted message (Janzen, 2005). ASL interpreters should have adequate 
knowledge of Deaf culture and possess sign language certifications such as 
the National Interpretation Certificate (NIC) from the Registry Interpreters 
for the Deaf (RID) (Landa & Clark, 2019).  

Due to different linguistic and sociocultural contexts among the 
deaf population because of racial and regionalized signs, including Black 
American Sign Language and other variations, deaf individuals vary 
in their experience acquiring proficiency in ASL and have their own 
preferred communication style (National Institute on Deafness and 
Other Communication Disorders, 2019). For example, deaf people in the 
Northeastern region of the U.S. tend to use one-handed variants of signs, 
whereas deaf people in the Southern and Western regions favor more 
traditional two-handed variations (Lucas & Bailey, 2011). While some 
social work professionals are familiar with arranging ASL interpreters, 
there are too many social workers who have not made regular contact 
with deaf people (O’Hearn, 2006). When it comes to working with deaf 
clients, social workers without adequate ASL skills and experience with 
deaf clients commonly utilize improper communication approaches that 
lead to potential misunderstandings and misconceptions of information 
conveyed between the parties, such as lip-reading, speaking, and written 
communication (Hommes, Borash, Hartwig & Degracia, 2018). 

Deaf clients have a better chance of receiving comprehensive 
services when social workers are able to take a role in accommodating 
the preferences of the clients and understand the logistics of working 
with ASL interpreters. It would likewise be beneficial if ASL interpreters 
have experience with social workers and are familiar with social work 
terminologies. When deaf clients request ASL interpreters, social workers 
should book ASL interpreters through interpreting agencies or contracts 
with ASL interpreters. When ASL interpreters are provided, the following 
suggestions should be made to ensure effective communication between 
deaf clients and social workers. The social worker should speak directly 
to the client and maintain eye contact with the client instead of the ASL 
interpreter. The social worker should pay attention to the client’s facial 
expression, body language, and behaviors, while the ASL interpreter is 
interpreting for the client. The social worker should also be close to the 
ASL interpreter and face towards the client together and should not begin 
speaking until either the deaf client finishes signing or the interpreter 



COLUMBIA SOCIAL WORK REVIEW, VOL. 18 | 42 

finishes interpreting (Chapple, 2019). 
There are some circumstances where deaf clients may not understand 

interpreters using ASL driven by English-based word order because the 
interpreters acquired ASL as a second language after English. Likewise, 
there may be times where ASL interpreters may not understand the signing 
of deaf clients because of limited exposure to different signing styles among 
the deaf population. When deaf clients and ASL interpreters struggle to 
understand each other, Deaf interpreters may facilitate a more effective 
conversation among all parties (Metzger et al., 2014). Deaf interpreters 
are native or near-native users of ASL and have profound knowledge of 
Deaf culture (Guardino, 2018). Although deaf interpreting services are 
not relatively new, it did not obtain professional status until the 1980s. 
Therefore, deaf clients and hearing social workers are often unaware of the 
option to request a Deaf interpreter (Boudreault, 2016). 

Deaf interpreters are used to assisting deaf people who use home signs 
or non-standard signs, who experienced a delay in language acquisition, or 
who use ethnic or regionalized signs (Professional Standards Committee, 
2007). When a hearing person speaks, a hearing ASL-English interpreter 
interprets the message to a Deaf interpreter. The Deaf interpreter is 
responsible for interpreting the message to a deaf client in ASL, along with 
more visual gestures. Once the deaf client comprehends and responds, the 
Deaf interpreter interprets the deaf client’s signed message back to the 
ASL interpreter, and the ASL interpreter interprets the message in spoken 
English back to the hearing person. 

When a deaf client requests a Deaf interpreter, social workers must 
arrange a Deaf interpreter and an ASL interpreter as a team, understanding 
that the interpreting process requires a slight delay in the delivery of 
messages. ASL and deaf interpreting are the most common and favorable 
choice of accommodation because, while ASL interpreters assist deaf 
clients to receive information from hearing social workers, Deaf interpreters 
bring additional value in supporting deaf clients with limited literacy to 
comprehend the context. 

VIDEO REMOTE INTERPRETING
Video Remote Interpreting (VRI) is a video conferencing technology 

that brings ASL and spoken English interpreting services to deaf and 
hearing people when a local or nearby interpreter is unavailable (Steinberg 
et al., 2006). Due to rapid development in technology, VRI has emerged as 
a popular tool for hearing people to communicate with deaf people using 
ASL (Kashar, 2009) ). VRI is used through a desktop or monitor with a 
camera live-streaming an ASL interpreter from a remote site who assists the 
communication between deaf and hearing individuals who are in the same 
room (Alley, 2012). The deaf person and the ASL interpreter communicate 
in ASL through the camera while the conversation between the interpreter 
and the hearing person is aurally delivered. VRI may be mounted on an 



43 | COLUMBIA SOCIAL WORK REVIEW, VOL. 18 

adjustable rolling stand for convenient relocation, oftentimes in medical 
settings (Kushalnagar et al., 2019). For instance, when VRI is brought to 
where a deaf client is present, a social worker connects to a remote ASL 
interpreter on the tablet who will appear on the screen, and the video of the 
deaf client is also shown on the screen. VRI is identified by many hearing 
people as an effective solution towards deaf clients’ access to communication 
and professional services for a variety of reasons (Power & Power, 2010). 

VRI is not only cost-effective but more flexible when it comes to 
scheduling compared to the use of in-person interpreters, which generally 
require booking several weeks in advance and entail travel time (Masland 
et al., 2010). VRI also has a wider geographical reach, which is beneficial for 
deaf clients who live in regional or rural areas. VRI providers also employ a 
larger pool of interpreters who have expertise in specialized settings related 
to social work, including hospitals and schools (Stratus Video, 2018a). VRI 
is useful not only because it is more convenient to book a remote interpreter, 
but it also reduces the need for proximity and waiting for an in-person 
interpreter to arrive (Lightfoot, 2006). For example, VRI can quickly assist 
deaf clients with communication needs in emergency situations, even as a 
temporary solution while waiting for an in-person interpreter to arrive at 
the site if requested (Stratus Video, 2018b). 

Nevertheless, VRI is unable to produce the same quality of in-person 
interpreters in many situations (Kashar, 2009; Garrett & Maryland, 2012). 
Since VRI equipment usually depends on a wireless connection, poor 
network connection and limited bandwidth can affect the effectiveness 
of interpreting service and the quality of video screens such as blurriness, 
freezing, and disconnection (Kushalnagar et al., 2019). When the deaf 
client and the interpreter struggle to see each other clearly through the 
video screen, the accuracy and completeness of conveyed messages can be 
negatively impacted. Consequently, deaf clients are denied access to full 
information and experience lower satisfaction with VRI. 

Compared to in-person interpreters, VRI services have significant 
limitations for all parties in terms of mobility and visibility (Kashar, 2009). 
While the VRI interpreter attends remotely on the video screen, they neither 
have a broader view of their surroundings or are able to wholly focus on the 
signing and body language of deaf clients and social workers. It may also 
be difficult for VRI interpreters to filter the environment and background 
noises while listening to the social worker who speaks. As for in-person 
interpreters, they are able to independently move and easily focus on the deaf 
client and the social worker. (Kushalnagar et al., 2019). Moreover, VRI might 
not be fully accessible to deaf clients who have visual, cognitive, psychiatric, 
and linguistic difficulties (National Association of the Deaf, 2018). 

A clear and uninterrupted video screen with a qualified interpreter 
through VRI is required to foster communication between deaf clients and 
social workers. The National Association of the Deaf (2018) suggests that 
hearing people provide qualified in-person ASL interpreters and consider 



COLUMBIA SOCIAL WORK REVIEW, VOL. 18 | 44 

the use of VRI as an alternative option when an in-person interpreter is 
not available. There are several recommendations for utilizing requested 
VRI services to enhance communication access for deaf clients. Social 
workers need to ensure that the internet connection is in good condition 
when connecting to a VRI interpreter. In addition, a video screen for VRI 
should be at least 16 inches, which enables deaf clients to see interpreters 
more easily. Social workers should adjust the position of the camera, 
allowing an interpreter to have a broader view of surroundings outside the 
potentially limited angle in order to ensure the accuracy of information 
being interpreted. A 360-degree camera is ideal as it improves the visuality 
of the signing of deaf clients and the entire setting where they are presented.

VIDEO RELAY SERVICES
Video Relay Services (VRS) is a telecommunication service that 

allows a deaf person who uses ASL and a hearing person who uses spoken 
English to communicate by phone. VRS makes a real-time interpretation 
possible by using a videophone application with a VRS phone number 
designated by telecommunication companies (Steinberg et al., 2006; 
Sorenson Communications, LLC, 2017). Popular companies that offer 
VRS for the deaf population in the United States include Sorenson, Convo, 
and ZVRS/Purple (Bravin, 2016). To use VRS, deaf individuals need to 
either have a VRS application installed on their electronic device, obtain 
particular VRS products, or both, which enable them to connect to an ASL 
interpreter through a video relay call (Video Relay Service, n.d.). Once 
the deaf individual is connected to the ASL interpreter by using a hearing 
person’s telephone number, the interpreter will then place a call to the 
hearing person. The hearing individual will receive a phone call and speak 
to the interpreter over the phone. As the hearing person talks, the interpreter 
interprets the message in ASL over the video screen on the VRS application 
to the deaf person and vice versa. A hearing person can make a direct call 
to a deaf person without needing VRS equipment simply by calling a deaf 
person’s VRS phone number. Upon calling the VRS phone number, the call 
will be automatically routed to an ASL interpreter, who then places a video 
call to the deaf person (Caserta, 2008). While telecommunication is rather 
straightforward, VRS requires a high-speed internet connection and a clear 
video phone screen on the deaf individual’s end, to avoid blurriness, freezing, 
and disconnections. 

Deaf clients may decide to use VRS when they do not plan to come to 
the office. In addition to texts, emails, and online written communication, 
hearing social workers have the option to contact deaf clients through VRS 
to follow up on treatment results or additional information. Deaf clients 
with limited literacy in English may find VRS more convenient compared to 
written communication, which hinders their ability to communicate in ASL. 
VRS is funded and managed by the Federal Communications Commission 
(FCC); this comes with several eligibility requirements for deaf consumers 



45 | COLUMBIA SOCIAL WORK REVIEW, VOL. 18 

ADDRESSING COMMUNICATION BARRIERS WITH DEAF CLIENTS

using VRS. For example, VRS is limited to calls between deaf and hearing 
people in different locations, as it is a violation of the federal law to use VRS 
for calls between individuals in the same room (Sorenson Relay, 2020). 
For deaf clients who need Deaf interpreters to interpret their signs, social 
workers cannot consider VRS as it does not offer deaf interpreting services. 
Social workers are encouraged to keep both text and VRS numbers of deaf 
clients when future contact through text or call is needed. 

The aforementioned types of interpreting services allow interpretation 
of messages between spoken and visual languages to promote accessible 
interactions. They each address the cultural and linguistic communication 
needs of deaf clients who use ASL, especially those who have limited literacy 
in written English. Hearing social workers are encouraged to consult with 
their deaf clients regarding their preferred procedures and processes of the 
requested interpreting services. Hearing social workers who are familiar 
with accommodations can build up a trusting relationship with deaf clients, 
though it would be ideal if they are able to sign or understand basic ASL 
from their deaf clients, especially including the common terms related to 
their work settings. 

RECOMMENDATIONS

Social workers with ASL skills and knowledge of Deaf culture are 
essential to offer more comprehensive service to deaf clients. Social 
workers with this particular expertise should educate hearing practitioners 
about working with deaf clients, especially ASL interpreters and other 
accommodations that are necessary to provide equal communication 
access. Those without this expertise are strongly encouraged to participate 
in continuing education and training programs to advance their cultural 
competence on deaf clients. Social workers should work with deaf and ASL 
interpreting practitioners, institutions, and organizations to implement 
training and workshops to improve their knowledge of accommodations 
to work with deaf clients. Moreover, those who are well versed in working 
with the deaf population should demonstrate their leadership by raising 
awareness about the ADA and NASW policies, the cultural and social 
experience of being deaf, and accommodations available for working with 
deaf people. For example, through leadership, social workers may encourage 
hearing providers who work with deaf clients to be familiar with policies for 
people with disabilities and identify key components of project design and 
service delivery that meet the various needs and preferences of deaf clients. 
Lastly, in order to produce more social work students who are capable of 
working with deaf clients in their future careers, schools of social work 
and other allied professions should incorporate  Deaf culture and disability 
policies into their educational curriculums and accreditations. 



COLUMBIA SOCIAL WORK REVIEW, VOL. 18 | 46 

CONCLUSION
As the Deaf community is considered a vulnerable and underrepresented 

population due to continuous communication barriers, they generally 
require the accommodations to facilitate their communication. Hearing 
social workers who are not familiar with ADA-required accommodations 
could fail to work with deaf clients. Often, hearing social workers tend to 
consider a deaf client as someone living with a pathological condition rather 
than a cultural characteristic, and as a result, deaf clients may lose confidence 
in social work services. Knowing that there are not enough culturally and 
linguistically competent social workers, deaf people may feel uncertain, 
oppressed, and undervalued when seeking further social work services in 
the future (Jeffrey & Austen, 2005; Steinberg et al., 2006). Therefore, it is 
important for hearing social workers to incorporate the recommendations 
discussed in this paper into their practices with deaf clients, which would 
ultimately lead to a more positive and beneficial impact on the overall well-
being of deaf clients under the care of hearing social workers.

 
ABOUT THE AUTHORS

DAVID “DT” BRUNO was born to a deaf and signing family and grew up 
navigating the hearing-centric world, which forever shaped his experience 
as a disabled person. In 2018, DT graduated from Gallaudet University 
with a Bachelor’s degree in Social Work with minors in Family Studies 
and Public Health. DT previously presented at NASW-NYS statewide 
conference in 2018, discussing best practices for deaf/hard of hearing 
people in social work settings. At Columbia School of Social Work, DT is on 
the Advanced Clinical Practice track and is specializing in Health/Mental 
Health and Disabilities. DT’s field placement is at Partners Deaf Services, 
where DT offers behavioral health services for Deaf and Hard of Hearing 
individuals in Pennsylvania

YUNHE BAI grew up navigating the roles of deaf person and person 
of color. Through this experience, he has been exposed to various forms 
of oppression against the deaf population, mostly related to access to 
communication and opportunities for participation in public services. 
Yunhe graduated from Gallaudet University in 2019 with a bachelor’s degree 
in business administration. Yunhe’s degree was awarded with University 
Honors, and he was the undergraduate speaker at commencement. At 
Columbia School of Social Work, Yunhe is on the Social Enterprise 
Administration track. Yunhe’s field placement is with the New York Center 
for Law and Justice.



47 | COLUMBIA SOCIAL WORK REVIEW, VOL. 18 

REFERENCES
Alley, E. (2012). Exploring remote interpreting. International Journal of Interpreter 

Education, 4(1), 111-119. http://www.cit-asl.org/new/wp-content/
uploads/2012/05/IJIE-4-1-Remote-Interpreting.pdf 

Americans With Disabilities Act of 1990, Pub. L. No. 101-336, §§ 12102-12103, 104 
Stat. 328. (1990).

Americans With Disabilities Act of 1990, Pub. L. No. 101-336, §§ 12181-12183, 104 
Stat. 328. (1990).

Bonner, C. E., Bullock, C., Colon, Y., Fong, R., Jackson, V., Montemayor, A., 
Ramanthan, C. S., & Yellow Bird, N.  (2015). NASW standards and 
indicators for cultural competence in social work practice. National 
Association of Social Workers. https://www.socialworkers.org/LinkClick.
aspx?fileticket=PonPTDEBrn4%3D&portalid=0 

Boudreault, P. (2016). Interpreting: Deaf interpreter. In G. Gertz & P. Boudreault 
(Eds.), The Sage deaf studies encyclopedia (pp. 511-515). Thousand Oaks, CA: 
Sage. https://doi.org/10.4135/9781483346489.n165

Bravin, P. W. (2016). Technology, Wireless. In G. Gertz & P. Boudreault (Eds.), The 
sage deaf studies encyclopedia (Vol. 3, pp. 955-958). Thousand Oaks, CA: Sage. 
https://doi.org/10.4135/9781483346489.n165

Cabral, L. M., Muhr, K., & Savageau, J. A. (2013). Perspectives of people who are deaf 
and hard of hearing on mental health, recovery, and peer support. Community 
Mental Health Journal, 49, 649-657. https://doi.org/10.1007/s10597-012-
9569-z

Caserta, S. (2008). Providing effective communication for clients who are deaf, hard 
of hearing, or deaf/blind. Maryland Justice. https://www.mdjustice.org/files/
Deaf-Hard-of-Hearing-Handbook-Caserta.pdf 

Chapple, R. (2019). Culturally responsive social work practice with D/deaf clients. 
Social Work Education, 38(5), 576-581. https://doi.org/10.1080/02615479.
2019.1595569.

Desrosiers, P. (2017). Signed language interpreting in healthcare settings: 
Who is qualified?. https://digitalcommons.wou.edu/cgi/viewcontent.
cgi?article=1123&context=honors_theses

Fellinger, J., Holzinger, D., & Pollard, R. (2012). Mental health of deaf people. 
The Lancet, 379(9820), 1037–1044. https://doi.org/10.1016/S0140-
6736(11)61143-4

Garrett, J., & Maryland, C. T. (2012). VRI interpreting services cannot produce the 
same “quality” of interpreting in the hospital setting. VIEWS, 29(1), 29-33. 

Georgetown University Law Library. (2020, February 7). ADA amendments act of 
2008. https://guides.ll.georgetown.edu/c.php?g=592919&p=4230126

Glickman, N. (2013). Deaf mental health care. Abingdon, UK: Routledge.
Greenwald, B. H., & Van Cleve, J. V. (2015). “A deaf variety of the human race”: 

Historical memory, Alexander Graham Bell, and eugenics. The Journal of 
the Gilded Age and Progressive Era, 14(1), 28-48. https://doi.org/10.1017/
S1537781414000528



COLUMBIA SOCIAL WORK REVIEW, VOL. 18 | 48 

Guardino, D. L. (2018). Certified deaf interpreters’ psychological well-being and coping 
mechanisms in medical situations (Publication No. 11012625) [Doctoral 
dissertation, Gallaudet University]. ProQuest Dissertations Publishing.

Harmer, L. M. (1999). Health care delivery and deaf people: Practice, problems, and 
recommendations for change. Journal of Deaf Studies and Deaf Education, 
4(2), 73-110. https://doi.org/10.1093/deafed/4.2.73

Hoang, L., LaHousse, S. F., Nakaji, M. C., & Sadler, R. G. (2010). Assessing deaf 
cultural competency of physicians and medical students. Journal of Cancer 
Education, 26, 175–182. https://doi.org/10.1007/s13187-010-0144-4

Hommes, R., Borash, A., Hartwig, K., & Degracia, D. (2018). American Sign Language 
interpreters perceptions of barriers to healthcare communication in deaf 
and hard of hearing patients. Journal of Community Health, 43(5), 956-961. 
https://doi.org/10.1007/s10900-018-0511-3 

Illinois Department of Public Health (n.d.). Video relay service (VRS). http://www.
idph.state.il.us/idhp/VRS_FactSheet_rslfinal_9_10.pdf 

Janzen, T. (2005). Topics in signed language interpreting: Theory and practice. 
Amsterdam: John Benjamins Publishing.

Jeffrey, D., & Austen, S. (2005). Adapting de-escalation techniques with deaf 
service users. Nursing Standard, 19(49), 41-47. https://doi.org/10.7748/
ns2005.08.19.49.41.c3934

Kashar, A. (2009). Doctor, can we please communicate?. RID Views, 26(4), 12-13. 
Kushalnagar, P., Paludneviciene, R., & Kushalnagar, R. (2019). Video remote 

interpreting technology in health care: Cross-sectional study of deaf patients’ 
experiences. JMIR Rehabilitation and Assistive Technologies, 6(1): 1-8. 
https://doi.org/10.2196/13233

Landa, R., & Clark, M. (2019). L2/Ln sign language tests and assessment procedures 
and evaluation. Psychology, 10(2), 181-198. https://doi.org/10.4236/
psych.2019.102015

Lucas, C., & Bayley, R. (2011). Variation in sign languages: Recent research on ASL 
and beyond. Language and Linguistics Compass, 5(9), 677-690. https://doi.
org/10.1111/j.1749-818X.2011.00304.x

Masland, M. C., Lou, C. W., & Snowden, L. R. (2010). Use of communication 
technologies to cost-effectively increase the availability of interpretation 
services in healthcare settings. Telemedicine Journal and E-health: The 
Official Journal of the American Telemedicine Association, 16(6), 739-45. 
https://doi.org/10.1089/tmj.2009.0186

Meador, H. E., & Zazove, P. (2005). Health care interactions with deaf culture. 
Journal of the American Board of Family Medicine, 18(3), 218-222. 

Metzger, M., Collins, S. D., Stone, C., & Adam, R. (2014). Deaf interpreters at work: 
International insights. Washington, D.C.: Gallaudet University Press. 

Mitchell, R. E. (2006). How many deaf people are there in the United States? 
Estimates from the Survey of Income and Program Participation. Journal 
of Deaf Studies & Deaf Education, 11(1), 112-119. https://doi.org/10.1093/
deafed/enj004



49 | COLUMBIA SOCIAL WORK REVIEW, VOL. 18 

Mitchell, R. E., Young, T. A., Bachelda, B., & Karchmer, M. A. (2006). How many 
people use ASL in the United States? Why estimates need updating. Sign 
Language Studies, 6(3), 306–335. https://doi.org/10.1353/sls.2006.0019

Monaghan, L. (2016). Deaf education history: Milan 1880. In The SAGE Deaf Studies 
Encyclopedia (1st ed., pp. 173–178). Thousand Oaks, CA: Sage.

Morgan, S., & Polowy, I. C. (2009). Social workers and accommodations for deaf 
and hard of hearing clients. National Association of Social Workers. https://
cdn.ymaws.com/www.naswoh.org/resource/resmgr/imported/Social%20
Workers%20and%20ADA%20Accommodations%20for%20Deaf%20
and%20Hard%20of%20Hearing%20Sep%20LTR%202009.doc.pdf

Mueller, S. (2006). Mental Illness in the Deaf Community: Increasing Awareness 
and Identifying Needs. www.lifeprint.com/asl101/topics/mentalillness.htm

National Association of Social Workers. (2007). Indicators for the achievement of the 
NASW standards for cultural competence in social work practice. Washington, 
D.C.: National Association of Social Workers Press.

National Association of Social Workers. (2008). NASW code of ethics (Guide to the 
everyday professional conduct of social workers). National Association of 
Social Workers.

National Association of the Deaf. (2018, February 13). Minimum standards for 
video remote interpreting services in medical settings. https://www.nad.org/
about-us/position-statements/minimum-standards-for-video-remote-
interpreting-services-in-medical-settings/ 

National Institute on Deafness and Other Communication Disorders. (2019). 
American Sign Language. https://www.nidcd.nih.gov/sites/default/files/
Documents/health/hearing/NIDCD-American-Sign-Language-2019.pdf 

O’Hearn, A. (2006). Deaf women’s experiences and satisfaction with prenatal care: 
A comparative study. Family Medicine, 38(10), 712-716.

Olson, A. & Swabey, L. (2016). Communication access for Deaf People in healthcare 
settings: Understanding the work of american sign language interpreters. 
Journal for Healthcare Quality, 39(4), 191-199. https://doi.org/10.1097/
JHQ.0000000000000038

Professional Standards Committee. (2007). Registry of Interpreters for the Deaf. 
https://ecfsapi.fcc.gov/file/7521826423.pdf

Power, M. & Power, D. (2010). Communicating With Australian Deaf People About 
Communication Technology. Australian and New Zealand Journal of 
Audiology. 32. https://doi.org/10.1375/audi.32.1.3l

Ryan, C., & Johnson, P. (2019). Understanding language deprivation and its role in 
deaf mental health. American Annals of the Deaf, 164(4), 519-524. https://doi.
org/10.1353/aad.2019.0030

Sheridan, M. A., White, B. J., & Mounty, J. L. (2010). Deaf and hard of hearing 
social workers accessing their profession: A call to action. Journal 
of Social Work in Disability & Rehabilitation, 9(1), 1-11. https://doi.
org/10.1080/15367100903524091



COLUMBIA SOCIAL WORK REVIEW, VOL. 18 | 50 

Simmons, C., Diaz, L., Jackson, V. & Takahashi, R. (2008). NASW cultural 
competence indicators: A new tool for the social work profession. Journal 
of Ethnic & Cultural Diversity in Social Work, 17(1), 4-20. https://doi.
org/10.1080/15313200801904869

Sorenson Communication, LLC.  (2017, April 28). End user license 
agreement. Soresons Relay. http://document.sorensonvrs.com/svrs/
legal/8-24-18/2017-04-28%20Sorenson%20Individual%20EULA%20
prevailing%20language.pdf

Sorenson Relay. (2020). Sorenson at work frequently asked questions. https://www.
sorensonvrs.com/work_faqs 

Steinberg, A. G., Barnett, S., Meador, H. E., Wiggins, E. A., & Zazove, P. (2006). Health 
care system accessibility: Experiences and perceptions of deaf people. 
Journal of general internal medicine, 21(3), 260–266. https://doi.org/10.1111/
j.1525-1497.2006.00340.x 

Steinberg, A. G., Sullivan, V. J., & Loew, R. C. (1998). Cultural and linguistic barriers 
to mental health service access: The deaf consumer’s perspective. American 
Journal of Psychiatry, 155(7), 982. https://doi.org/10.1176/ajp.155.7.982

Stewart, L. G. (1986). Psychological assessment: One perspective. In L. G. Stewart 
(Ed.), Clinical rehabilitation assessment & hearing impairment: A guide to 
quality assurance (pp. 11). Silver Spring, M.D.: National Association of the 
Deaf.

Stratus Video. (2018). Interpreter qualifications. https://www.stratusvideo.com/
interpreter-qualifications/

Stratus Video. (2018). What is VRI?. https://www.stratusvideo.com/what-is-vri/
Ulloa, A. W. (2014). Social workers’ cultural competency with deaf clients: a continuing 

education module [Master’s thesis, Western Oregon University]. Digital 
Commons at Western Oregon University.  

United States Department of Justice. (1994). Title II technical assistance Manual: 
Covering state and local government programs and services. https://www.
ada.gov/taman2.html 

Video Relay Communication with the Deaf Made Easy. (n.d.). http://www.dws.state.
ut.us/usor/vr/employer/videorelay.pdf


