ABSTRACT
This report describes the authors' experience in providing medical and contraceptive care to a profoundly hearing impaired adolescent in a hospital setting. Ways to communicate effectively with the hearing impaired are described.
PIP: According to a 1985 survey, at least 50,000 children and adolescents in the US are hearing impaired. The US Rehabilitation Act, PL 93-112, Section 504, mandates hospitals to establish a protocol for effective communication with hearing impaired persons in need of emergency health care. This requires that the hospital provide an interpreter with sign language skills. The profoundly hearing impaired adolescent should be encouraged to participate in all phases of health management and given a choice of mode of communicating. A parent may serve as a communication link between staff and adolescent, but this may be a barrier in obtaining a history with regard to confidential sexual activity. Hearing impaired adolescents face the same developmental tasks as their hearing counterparts, including sexual identity and expression, but their auditory limitations cause differences in their ability to acquire and transmit information on sexual matters. They generally perceive only the taboos and innuendos regarding sex and are vulnerable to sexual abuse. Many adolescents in residential facilities may need contraceptive services from health care providers who are not aware of the contraceptive needs of the hearing impaired. To increase such awareness, the authors present the case of an 18-year-old hearing impaired black female with pelvic inflammatory disease and a need for contraceptive counseling. Counseling was provided with the aid of a licensed sign language interpreter and included use of a 3-dimensional model of the female reproductive tract and a large flip chart illustrating birth control methods. Oral contraceptives were prescribed, and the patient was given the number of a telecommunication keyboard device for the deaf at the hospital in the event of problems.
