Saturday, 11 January 2020

The Deaf and Mental Health (II).

Image result for mental health
Following on from the Scandal at Bury Hospital, ATR contacted leading areas of BSL interpreters including the ASLI, SignHealth, and Signature, and asked the basic question 'How many UK Interpreters of British Sign Language had a specialisation in Deaf Mental Health? and none of the areas quoted said there were ANY quotable records of such specialisation, but, what transpired at Bury was the statement 'BSL Interpreters needed a minimum level 4 BSL attainment, to work in such 'specialised' areas..", although an investigation was carried out into poor support for the deaf at that institution nobody asked if the interpreters were qualified in deaf mental health.  The CQC (Care quality commission) failed to ask the question regarding the deaf area, which suggests they are out of their depth in deaf areas or satisfied no specialisation is needed so long as BSL is there?  That seems to challenge BDA/cultural demands FOR specialisation.

It also raises the question why, areas that promote BSL and e.g. charities like the dedicated BDA, demanded such specialisation yet agreed on non-specialist terps at Bury?  If level 4 is an accepted level of deaf support for the deaf sign user with mental health issues, then why have these BSL areas objected to level 4 terps assisting with localised mental health teams?  (And why in local authority areas up and down the country they are quite happy to provide level 2 BSL as deaf support in other care areas, including deaf Alzheimer patients).

By demanding a specialisation that does not actually exist, has a trainee program or is being lobbied for, they, in essence, are accepting deaf patients need to be exported out of areas their families and friends live in, to get the support that isn't there, just different interpreters.  

BSL is a means of communication for some deaf people but the lack of other essential skills a BSL terp needs when specialist health and legal support areas are involved, is accepted as unnecessary, it's a good job Consultants don't work that way.  Are BSL terps assuming there is no point in specialising as these deaf would not understand the technical terms or explanations anyway?  Because they don't either?

The ATR mini-survey was a tentative follow-on to checks on Preston, Manchester, Bath and London deaf specialist centres as well as the recent documented Bury hospital problem where deaf care was said to be bloody awful mostly, it just said deaf support requirement was minimum level 4, but no other specialisation was required.  There did not seem to be valid, proof that psychologists and psychiatrists themselves were well-versed in BSL but were also relying on BSL Terps themselves.  

It is claimed the BDA among others demanded stand-alone 'specialised' MH areas all in BSL and these places are all there is.  At Bury, there were no checks by police or social services on support staff either.

Like most current BSL campaigns, It's the 'cart before horse' approaches that demand/insist on a specialisation that nobody is training for at present and no program of training is extant.  Are Mental health professionals in deaf areas being sold a cultural argument and not a valid clinical support program?  Is 'deaf depression' a different depression to someone with hearing having that?' Apparently, the cultural area says yes it is.  This does not seem so given only the communication is different and only then because medical staff don't know it.

We get the same 'demands' regarding education, and there again the staff do not exist to provide what they are demanding there either.   E.G. lip speakers specialise in legal matters, and rumours there are BSL terps who specialised in medical matters but they just seem minimal and localised to 3 major cities only, again, we are unable to get any numbers or background on such skills.  The RAD claim to specialise in legal matters via BSL, but are restricted to one area of the UK, but health area specialisation?

Rank and file deaf BSL users just accept the terp is all things to everyone deaf, and this is not the case. A terp needs to understand the detail even to simplify it for the patient.  If it is just a qualification to sign is all that is needed, then specialist deaf centres are not needed are they?  BSL terps already provide access to GP's and Hospitals etc.. so why not local mental health teams?

They say the only other 'specialisation' needed apart from the BSL one is a 'general awareness' of deaf culture.  We fail to see how knowledge of 1880s Milan is going to help them in the 21stc to treat patients deaf with mental health problems but...  If the terp has no specialisation, or care staff, and the diagnostic Medical staff no BSL, then how does support work?   'He said, she said, so do this?'  If the BSL community wants the sort of access and choices hearing have, then, they have to have the specialisation that go with it.  

These issues transcend the drive for cultural recognition as this is about real need, and real support surelyAreas like anxiety and depression are also NOT deaf specific, why are BSL lobbies determined to isolate these deaf by specialisation?  It is hardly inclusion is it?  It would also seem that protective and investigative areas like the CQC or health Inspectorate, to ensure clinical and care support is applied properly, stands back from the deaf area unsure what IS required so unqualified support is running deaf care?

Friday, 10 January 2020

How HoH/Pre-Deaf communicate.



Who needs sign language?

Difficult Decisions

North Staffordshire NHS on consulting whether to cut more hearing loss services and provision. Social media of the hard of hearing variety a bit apathetic about the whole thing. Cuts to hearing aid provisions in the pipeline (Again!).

Difficult Decisions - (what Staffs NHS said:) Help us to Prioritise and Align Clinical Policies The six CCGs in Staffordshire and Stoke-on-Trent are seeking views from patients across five service areas. Altogether the six CCGs commission over 800 different services and treatments, are up for cuts.  Social Media responses included.... 

#1 "I have heard they want to stop issuing hearing aids on the NHS."

#2 "Yup, its because we as a (HoH), community don't complain enough!"

#3 "Quite agree. Considering there are at least 12 MILLION folk in the UK who have a hearing loss (and of the 12 MILLION only 250,000 use sign) and we are the largest body of disabled folk in the UK too, we are comparatively silent on our problems!! Sadly, shoving the HAs in a drawer and not persevering is a real negative to the overall picture and presents confusing information to the public."

ATR   12m in denial is all I see, and I have yet to see a Hard of hearing 'community'.   The whole thing about stats is none are actually true or sourced, so that suggests charity or focus groups can quote whatever they want, even the BDA (which is a source of complete inaccuracy and BS about the UK sign user, and more focused on cultural than clinical need than support).  Their own figures go nowhere near 250K BSL users, that is an outrageous 'guesstimate'.

Fact: The last 4 years the BDA went from 15,000 to 95,000 BSL using deaf, and then refused to name any of their sources, degree and usage is the only real definition and that 250K figure appears to include 152K HEARING people again no description of skills or usages either.   The BDA near folded last year after a mass resignation of all their trustees took place and rumours of insolvency were aired.

Fact: The AOHL (The UK's largest 'HoH' charity), quotes the 1 in 6/7, aka 12m with hearing loss, a random number taken from various health/clinical areas and the AOHL the sole source of that statistic. Because of the Data Protection Act, nobody was able to get an accurate figure on hearing loss or deafness in the UK, let alone sign usage, and educated guesses went out the window years ago.   The question then is "HOW did the AOHL arrive at the 12m figure, given the DPA blocks anyone knowing what need there is?"  There is no suggestion areas are prioritising charity FOI's over anyone else's.

ATR tried 9 YEARS via freedom of Information requests and has been blocked by charities (themselves exempt from FOI requests), and the NHS every time. Basically, nobody is allowed to ask any individual with hearing loss how the loss affects them, or what they use or need to manage it, that is considered an 'invasion' of personal privacy hence the DPA comes into play, so if there IS a widespread need for services and provisions we can't know about it, all we can read is social media complaints or if the individual presents to the health/social services, BSL is not considered an issue in itself by those who use it.  Politicians refer you straight back to charity statistics probably because the last thing they want to see is more demands for more service provision.

How to assume need?  One would assume need is defined by checking how many people applied for support to manage, and sign language, by how many cannot function without it etc, otherwise, these blanket numbers are meaningless, primarily designed some would suggest making hearing loss or BSL needs more of an issue than is actually being presented.   Grassroots need to demand what they need for themselves, not that need assumed and demanded by others.  It falls down at the first hurdle of proof.  Each area provision is localised.

Charities ASSUME need to (A) perpetuate themselves and (B) to raise funding, so any high figure suits them, few have any grassroots as membership any more.  Putting my cynical hat on has ANYONE seen any real advances in the last 15 years for the '12m'? I haven't, I have seen huge profile raised by an odd few 1,000 sign users who use the 12m stat as well as inflating BSL use to the realms of fantasy. 

Need is driven by demand there is no other criteria, WHERE is the HoH demand? You don't ask you don't get, it is as simple as that.  Current loss needs are defined by the sign users not the hard of hearing which only serves to confuse needs even more.

A Hearing Aid with eyes.

OrCam is expanding to hearing impairment with the OrCam Hear. It can be particularly useful in loud rooms. The device helps you identify and isolate a speaker’s voice so you can follow a conversation even in a public space. You pair it with your existing Bluetooth hearing aids. 

OrCam is introducing the OrCam Read, a handheld AI reader. This time, you don’t clip a camera to your glasses, you take the device in your hand and point it at text. The company says it could be particularly useful for people who have reading difficulties due to dyslexia. 

Wednesday, 8 January 2020

Did Deafo! fail to get BSL in education?

Seems they got little else but publicity but played down the fact the Welsh Assembly did not in the end, endorse it despite a campaign lasting 3 years...


Comment: BSL promotes BSL there was little or no evidence the deaf were using BSL to access welsh or wanted to, and there is well-known deaf opposition to learning English grammar too, the petition was not exactly clear or explained properly.  

It is simplistic on the face of a petition that fails to be informative.  It was also a non-inclusive petition which ignores other children with hearing loss and deafness, and parents who may offer preference for speech training as opposed to sign language, the fact the professionals needed to support their petition does not exist was not stated except by assembly researchers.  Of the registered 2,000 deaf children the petition was for, no statistic was offered regarding parental or child choices or current usage.

In essence, the BSL petition is a challenge to parental choice. As stated in the video over 500 THOUSAND have hearing loss so it was unhelpful to support just one mode in that regard and ignored a 60% take-up of CI's.  The petition suggested over 1,000 signed it, of course, that is not 50% of the 2,000 odd quoted deaf children but a 1,000 people and lobbied on the street or online many not even resident in Wales.   As there are no deaf schools IN Wales just how would it work anyway?

How Useful are CI's?

Image result for ci meaning medical implants
The usefulness of cochlear implantation in children with single-sided deafness



Objectives:

Children with single-sided deafness (SSD) show a poorer performance at school, which is attributable to reduced speech discrimination in noise, to reduced localization ability, and to a decreased power of concentration due to faster hearing exhaustion. Therefore, it is important to provide children with SSD with adequate hearing amplification to restore binaural hearing. This can only be achieved by provision with a cochlear implant (CI). But these treatment options in children with SSD are still under discussion.

The aim of the present study is to evaluate audiological and clinical results in children with SSD following cochlear implantation. A special focus was placed on the duration of deafness before implantation and on the frequency of CI-use in everyday life.

Methods:

Seven children with SSD of different etiologies who were provided with a CI between 3 and 16 years of age were evaluated. Every child underwent multiple audiological tests before and after cochlear implantation. After cochlear implantation speech recognition tests in noise using the HSM (Hochmair, Schulz and Moser 1997) test and localization tests were performed. Furthermore, the frequency of implant use was evaluated.

Results:

Speech recognition in noise with CI compared to the unaided condition significantly improved in all children in different settings. Improvement of the localization ability measured by the root mean square error (RMSE) was shown in all children. All children are very satisfied with the decision to have undergone cochlear implantation and are all full-time users.

Conclusions:

Cochlear implantation benefits speech recognition in noise and sound localization ability in children with SSD at different ages. All implanted children are full-time users regardless of age or duration of deafness before implantation.

Monday, 6 January 2020

Holey Ear Batman!

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Blue Badges and the deaf.


Image result for the blue badge scheme
Can the (UK), deaf claim this concession?


"I just received information about the 'eligibility criteria' for a Blue Badge for people with hidden disabilities. The email ended with...'to be clear, people registered as deaf will not be eligible'. Interesting to see that if I felt I would 'become aggressive towards people and didn't understand why', I might have been eligible!"

ATR:  The criteria does not mention deafness specifically, but, deaf who claim certain benefits may still be eligible.  There is no case for a discrimination claim via being deaf alone.  Rules have recently been tightened up so only those with direct need get them but it is quite a strict qualification to meet and because fraudulent copies of the blue badge are rampant, enforcing the eligibility will be much easier and weed out such frauds.

Deaf won't qualify personally via deafness alone.   possibly due to the fact too many descriptives exist that cloud the issue e.g. who IS deaf? and DOES it mean you cannot walk or similar.  ATR is not supportive of their eligibility for assistance dogs, to be honest, far too many deaf with pets untrained to assist, are abusing the right and certainly are not able to provide proof they cannot go anywhere without an animal to assist them, as the blind can prove.

If the deafness also is linked to a known and recognised mobility,  (Or Mental Health issue e.g.), then yes they can qualify, but rank and file deaf NO. Primarily because anyone with a hearing loss from negligible to profound would get them whether or not their mobility was an issue. That means theoretically 12m would qualify in the UK.  Deaf would need to prove they are unable physically or mentally to go around on their own.  The 'Blue Badge' scheme is a specific allowance designed to support particularly the areas with reduced mobility.

Why would deaf want such a badge unless that was the case?

Sunday, 5 January 2020

Finding your peer group.

Image result for finding your peer
Aka: "How To Find A Hearing Loss Support Group." I recently came across.  A short extract contained here:-

"Many hearing loss support groups exist — both actual and virtual. Hearing Loss Association of America runs the largest group in the United States, operating more than 100 local chapters and holding an annual convention each year. Click here to find a chapter in your area.  Other groups with local chapters include Say What Club, Association of Late Deafened Adults (ALDA) and A.G. Bell, all three of which also hold annual conventions for their membership. A.G. Bell focuses on families of children with hearing loss, while the other groups are primarily for adults with hearing loss. 

Many hearing loss groups host monthly meetings with educational speakers on a variety of hearing loss topics. There is usually time for socializing as well. Often, the chapters organize advocacy projects to improve accessibility for people with hearing loss in the local market. Examples include advocating for hearing loops in public spaces or getting a local movie theatre to provide open-captioned showings. 

Online, there are many blogs, websites and Facebook groups where people with hearing loss can connect with one another, including mine — Living With Hearing Loss. Visit a few and you will soon see that you are not alone in your hearing loss struggles. Share your tips and suggestions and learn from others’ experiences. Many are warm and engaging communities. You will be proud to be a part of them." 

ATR:  Obviously an American advert to raise awareness and/or support for those with hearing loss.  We just think that here in the U of K trying to put 'like with like' in this respect has no future, as those with hearing loss and/or with aids etc have no desire, leadership or backing, to emulate the 'Deaf' community to form one of their own, even on a social level, HoH retain the view they are still part of the hearing one but, with issues! As hearing is still a primary aim and direction and the clinical advance is the primary area is primarily supported.  Hence social-medical modelling has very mixed success in that area.

The nearest the UK have to this is an attempt very similar to the USA one above, run by classes that attempt to teach the UK hard of hearing lip-reading, but it is a completely random course with no real aim, no qualification and no real targetting of those who most need to attempt it, there is no success statistic to quote.  It looks a misnomer in terms to suggest those with hearing loss can benefit via lip-reading when the entrant criteria is useful hearing anyway, and the skill primarily reliant on you still having that and ignores what happens when the loss becomes too great, it seems a problem still then relying ON sound when hearing loss is the issue.  If hearing aids were removed on class entry it might be more realistic.

Those with that don't go because hearing loss is a real issue, and who struggle cannot be accommodated, as it requires intensive and long-term one on one help. There it is doubtful teachers are able to do that given classes descend into chaos and inertia if just one pupil with real hearing loss presents, all the tuitional attention then has to gravitate to that person, not the group.  Rather than actually teaching lip-reading, the idea is to create mini-groups who socialise together in the hope that will offset the hearing loss itself as social isolation is viewed as the real issue.  

We would not disagree with that view but there is no actual proof that the system or approach has worked and seems totally reliant on the existence of the class itself, which has a limited duration of a few hours a week for a few months a year.  

HoH clubs do not really exist in the UK as such, as HoH show little or no interest in them, and inclusion in deaf clubs is negligible, or they sit apart from the 'real deaf' who sign away ignoring them.  One local deaf club here initially had 11 HoH attending, 3 weeks later only 2 had stayed, now only one has.  Deaf clubs are obviously not an answer. Ironically we see 'awareness' of hard of hearing coming from an area that doesn't include them, the 'Deaf/BSL' one, or charities who offer to clean their hearing aids for free, who target elderly, mostly because this suits penny-pinching local authority care areas who see it is 'inclusion on the cheap'.  Huge financial amounts relatively are raised for that and charities but 12m HoH still seems to get by ignoring them.

There are a few 'lone wolves' of the HoH or deafened areas still lobbying for a national HoH support set up, but they get little 'grass-root' support, there doesn't seem much evidence there IS a grass root.  When such areas complain the 'Deaf' are syphoning off funding in their name, nobody seems to care much about that either or the mixed or completely inaccurate messages that are coming from 'access' campaigns.  It is pretty evident the HoH area is an area of hearing loss quite apart from the deaf one, but there is no desire even, to make that point.  Apathy rules completely (Or technology does).