Experiences of Sign Language Interpreters and Perspectives of Interpreting Administrators During the COVID-19 Pandemic: A Qualitative Description.

OBJECTIVE: Interpreting during the COVID-19 pandemic caused stress and adverse mental health among sign language interpreters. The objective of this study was to summarize the pandemic-related work experiences of sign language interpreters and interpreting administrators upon transitioning from on-site to remote work. METHODS: From March through August 2021, we conducted focus groups with 22 sign language interpreters in 5 settings, 1 focus group for each setting: staff, educational, community/freelance, video remote interpreting, and video relay services. We also conducted 5 individual interviews with interpreting administrators or individuals in positions of administrative leadership in each represented setting. The 22 interpreters had a mean (SD) age of 43.4 (9.8) years, 18 were female, 17 were White, all identified as hearing, and all worked a mean (SD) of 30.6 (11.6) hours per week in remote interpreting. We asked participants about the positive and negative consequences of transitioning from on-site to remote at-home interpreting. We established a thematic framework by way of qualitative description for data analysis. RESULTS: We found considerable overlap across positive and negative consequences identified by interpreters and interpreting administrators. Positive consequences of transitioning from on-site to remote-at-home interpreting were realized across 5 overarching topic areas: organizational support, new opportunities, well-being, connections/relationships, and scheduling. Negative consequences emerged across 4 overarching topic areas: technology, financial aspects, availability of the interpreter workforce, and concerns about the occupational health of interpreters. CONCLUSIONS: The positive and negative consequences shared by interpreters and interpreting administrators provide foundational knowledge upon which to create recommendations for the anticipated sustainment of some remote interpreting practice in a manner that protects and promotes occupational health.

Phoneme Categorization in Prelingually Deaf Adult Cochlear Implant Users.

PURPOSE: Phoneme categorization (PC) for voice onset time and second formant transition was studied in adult cochlear implant (CI) users with early-onset deafness and hearing controls. METHOD: Identification and discrimination tasks were administered to 30 participants implanted before 4 years of age, 21 participants implanted after 7 years of age, and 21 hearing individuals. RESULTS: Distinctive identification and discrimination functions confirmed PC within all groups. Compared to hearing participants, the CI groups generally displayed longer/higher category boundaries, shallower identification function slopes, reduced identification consistency, and reduced discrimination performance. A principal component analysis revealed that identification consistency, discrimination accuracy, and identification function slope, but not boundary location, loaded on a single factor, reflecting general PC performance. Earlier implantation was associated with better PC performance within the early CI group, but not the late CI group. Within the early CI group, earlier implantation age but not PC performance was associated with better speech recognition. Conversely, within the late CI group, better PC performance but not earlier implantation age was associated with better speech recognition. CONCLUSIONS: Results suggest that implantation timing within the sensitive period before 4 years of age partly determines the level of PC performance. They also suggest that early implantation may promote development of higher level processes that can compensate for relatively poor PC performance, as can occur in challenging listening conditions.

The Occupational Health and Safety of Sign Language Interpreters Working Remotely During the COVID-19 Pandemic.

INTRODUCTION: The COVID-19 pandemic has caused a dramatic shift in work conditions, bringing increased attention to the occupational health of remote workers. We aimed to investigate the physical and mental health of sign language interpreters working remotely from home because of the pandemic. METHODS: We measured the physical and mental health of certified interpreters who worked remotely 10 or more hours per week. We evaluated associations within the overall sample and compared separate generalized linear models across primary interpreting settings and platforms. We hypothesized that physical health would be correlated with mental health and that differences across settings would exist. RESULTS: We recruited 120 interpreters to participate. We calculated scores for disability (mean score, 13.93 [standard error of the mean (SEM), 1.43] of 100), work disability (mean score, 10.86 [SEM, 1.59] of 100), and pain (mean score, 3.53 [SEM, 0.29] of 10). Shoulder pain was most prevalent (27.5%). Respondents had scores that were not within normal limits for depression (22.5%), anxiety (16.7%), and stress (24.2%). Although disability was not associated with depression, all other outcomes for physical health were correlated with mental health (r ≥ 0.223, P ≤ .02). Educational and community/freelance interpreters trended toward greater adverse physical health, whereas educational and video remote interpreters trended toward more mental health concerns. CONCLUSION: Maintaining the occupational health of sign language interpreters is critical for addressing the language barriers that have resulted in health inequities for deaf communities. Associations of disability, work disability, and pain with mental health warrant a holistic approach in the clinical treatment and research of these essential workers.

Ditching the Driving: A Cross-Sectional Study on the Determinants of Remote Work From Home for Sign Language Interpreters.

Background: The coronavirus disease 2019 (COVID-19) pandemic dramatically impacted the working conditions for sign language interpreters, shifting the provision of interpreting services from onsite to remote. The goal of this cross-sectional study was to examine the perceptions of determinants of remote interpreting implementation from home by sign language interpreters during the pandemic. We hypothesized that interpreters working across the primary settings of staff (agency, government, business, or hospital employees), educational (K-12 or postsecondary), community/freelance (independent contractor), video remote (the two-way connection between onsite participants and remote interpreter), and video relay (three-way telecommunication) would present with differing experiences of the implementation process. Methods: The Determinants of Implementation Behavior Questionnaire was adapted for sign language interpreters (DIBQ-SLI) and administered to certified interpreters working remotely at least 10 h per week. The DIBQ-SLI included eight constructs (knowledge, skills, self-efficacy, perceived behavioral control, innovation characteristics, organizational resources and support, innovation strategies, and social support) and 30 items. Parametric statistics assessed differences in interpreters' perceptions across settings. Principal component analysis was conducted for data reduction and affirmation of the most critical constructs and items. Results: One hundred and six interpreters (37 video relay, 27 video remote, 18 educational, 11 community/freelance, 11 staff interpreters, and two from "other" settings) completed the DIBQ-SLI. The video relay and staff interpreters consistently demonstrated the most favorable and the educational interpreters demonstrated the least favorable perceptions. Of the total variance, 58.8% of interpreters' perceptions was explained by organizational (41%), individual (10.7%), and social (7.1%) dimensions. There were significant differences across settings for the organizational and individual principal components; however, no differences were detected for the social principal component. Conclusions: An administrative infrastructure devoted to ensuring that interpreters receive sufficient managerial support, training, materials and resources, experience with remote interpreting before having to commit, and insights based on the results of their remote work (organizational principal component) may be necessary for improving perceptions. Remote interpreting is expected to continue after the pandemic ends; thus, settings with the least favorable ratings across behavior constructs may borrow strategies from settings with the most favorable ratings to help promote perceptions of the contextual determinants of future remote interpreting implementation.

Does a Flatter General Gradient of Visual Attention Explain Peripheral Advantages and Central Deficits in Deaf Adults?

Individuals deaf from early age often outperform hearing individuals in the visual periphery on attention-dependent dorsal stream tasks (e.g., spatial localization or movement detection), but sometimes show central visual attention deficits, usually on ventral stream object identification tasks. It has been proposed that early deafness adaptively redirects attentional resources from central to peripheral vision to monitor extrapersonal space in the absence of auditory cues, producing a more evenly distributed attention gradient across visual space. However, little direct evidence exists that peripheral advantages are functionally tied to central deficits, rather than determined by independent mechanisms, and previous studies using several attention tasks typically report peripheral advantages or central deficits, not both. To test the general altered attentional gradient proposal, we employed a novel divided attention paradigm that measured target localization performance along a gradient from parafoveal to peripheral locations, independent of concurrent central object identification performance in prelingually deaf and hearing groups who differed in access to auditory input. Deaf participants without cochlear implants (No-CI), with cochlear implants (CI), and hearing participants identified vehicles presented centrally, and concurrently reported the location of parafoveal (1.4°) and peripheral (13.3°) targets among distractors. No-CI participants but not CI participants showed a central identification accuracy deficit. However, all groups displayed equivalent target localization accuracy at peripheral and parafoveal locations and nearly parallel parafoveal-peripheral gradients. Furthermore, the No-CI group's central identification deficit remained after statistically controlling peripheral performance; conversely, the parafoveal and peripheral group performance equivalencies remained after controlling central identification accuracy. These results suggest that, in the absence of auditory input, reduced central attentional capacity is not necessarily associated with enhanced peripheral attentional capacity or with flattening of a general attention gradient. Our findings converge with earlier studies suggesting that a general graded trade-off of attentional resources across the visual field does not adequately explain the complex task-dependent spatial distribution of deaf-hearing performance differences reported in the literature. Rather, growing evidence suggests that the spatial distribution of attention-mediated performance in deaf people is determined by sophisticated cross-modal plasticity mechanisms that recruit specific sensory and polymodal cortex to achieve specific compensatory processing goals.

Collaboration With Deaf Communities to Conduct Accessible Health Surveillance.

INTRODUCTION: Populations of deaf sign language users experience health disparities unmeasured by current public health surveillance. Population-specific health data are necessary to collaboratively identify health priorities and evaluate interventions. Standardized, reproducible, and language-concordant data collection in sign language is impossible via written or telephone surveys. METHODS: Deaf and hearing researchers, community members, and other stakeholders developed a broad computer-based health survey based on the telephone-administered Behavioral Risk Factor Surveillance System. They translated survey items from English to sign language, evaluated the translations, and filmed the survey items for inclusion in their custom software. They initiated the second Rochester Deaf Health Survey in 2013 (n=211). Analyses (conducted in 2015) compared Rochester Deaf Health Survey 2013 findings with those of the Behavioral Risk Factor Surveillance System with the general adult population in the same community (2012, n=1,816). RESULTS: The Rochester Deaf Health Survey 2013 participants' mean age was 44.7 (range, 18-87) years. Most were deaf since birth or early childhood (87.1%) and highly educated (53.6% with ≥4 years of college). The median household income was <$35,000. The prevalence of current smokers was low (8.1%). Nearly all (93.8%) reported having health insurance, yet barriers to appropriate health care were evident, with high emergency department use (16.2% with two or more past-year visits) and 22.7% forgoing needed health care in the past year because of cost. CONCLUSIONS: Community-engaged research with deaf populations identifies strengths and priorities, providing essential information otherwise missing from existing public health surveillance, and forming a foundation for collaborative dissemination to facilitate broader inclusion of deaf communities.

Dimensions of Deaf/Hard-of-Hearing and Hearing Adolescents' Health Literacy and Health Knowledge.

Deaf and hard-of-hearing (D/HH) adults have lower health literacy compared to hearing adults, but it is unclear whether this disparity also occurs in adolescence. We used the Health Literacy Skills Instrument-Short Form (HLSI-SF), Short Form of the Test of Functional Health Literacy in Adults (S-TOFHLA), Comprehensive Heart Disease Knowledge Questionnaire (CHDKQ), and newly constructed interactive and critical health literacy survey items to quantify D/HH and hearing adolescents' health literacy. We adapted and translated survey materials into sign language and spoken English to reduce testing bias due to variable English language skills. Participants were 187 D/HH and 94 hearing college-bound high school students. When we adjusted for age, gender, race/ethnicity, school grade, and socioeconomic status, D/HH adolescents demonstrated weaker general and functional health literacy and cardiovascular health knowledge than hearing adolescents on the HLSI, S-TOFHLA, and CHDKQ (all ps < .0001). Standard health literacy or knowledge scores were associated with several interactive and critical health literacy skills (all ps < .05). D/HH adolescents who reported greater hearing-culture identity, having hearing aids, experiencing better hearing with assistive devices, having good quality of communication with parents, and attending hearing schools at least half of the time had higher functional health literacy (all ps < .025). Those who reported English as their best language and attending hearing schools at least half of the time had higher cardiovascular health knowledge scores (all ps < .03). Results suggest that interventions to improve D/HH adolescents' health literacy should target their health-related conversations with their families; access to printed health information; and access to health information from other people, especially health care providers and educators.

A wavelet based algorithm for the identification of oscillatory event-related potential components.

Event related potentials (ERPs) are very feeble alterations in the ongoing electroencephalogram (EEG) and their detection is a challenging problem. Based on the unique time-based parameters derived from wavelet coefficients and the asymmetry property of wavelets a novel algorithm to separate ERP components in single-trial EEG data is described. Though illustrated as a specific application to N170 ERP detection, the algorithm is a generalized approach that can be easily adapted to isolate different kinds of ERP components. The algorithm detected the N170 ERP component with a high level of accuracy. We demonstrate that the asymmetry method is more accurate than the matching wavelet algorithm and t-CWT method by 48.67 and 8.03 percent, respectively. This paper provides an off-line demonstration of the algorithm and considers issues related to the extension of the algorithm to real-time applications.

Community participatory research with deaf sign language users to identify health inequities.

Deaf people who use American Sign Language (ASL) are medically underserved and often excluded from health research and surveillance. We used a community participatory approach to develop and administer an ASL-accessible health survey. We identified deaf community strengths (e.g., a low prevalence of current smokers) and 3 glaring health inequities: obesity, partner violence, and suicide. This collaborative work represents the first time a deaf community has used its own data to identify health priorities.

Non-verbal IQ is correlated with visual field advantages for short duration coherent motion detection in deaf signers with varied ASL exposure and etiologies of deafness.

Studies have reported a right visual field (RVF) advantage for coherent motion detection by deaf and hearing signers but not non-signers. Yet two studies [Bosworth R. G., & Dobkins, K. R. (2002). Visual field asymmetries for motion processing in deaf and hearing signers. Brain and Cognition, 49, 170-181; Samar, V. J., & Parasnis, I. (2005). Dorsal stream deficits suggest hidden dyslexia among deaf poor readers: Correlated evidence from reduced perceptual speed and elevated coherent motion detection thresholds. Brain and Cognition, 58, 300-311.] reported a small, non-significant RVF advantage for deaf signers when short duration motion stimuli were used (200-250 ms). Samar and Parasnis (2005) reported that this small RVF advantage became significant when non-verbal IQ was statistically controlled. This paper presents extended analyses of the correlation between non-verbal IQ and visual field asymmetries in the data set of Samar and Parasnis (2005). We speculate that this correlation might plausibly be driven by individual differences either in age of acquisition of American Sign Language (ASL) or in the degree of neurodevelopmental insult associated with various etiologies of deafness. Limited additional analyses are presented that indicate a need for further research on the cause of this apparent IQ-laterality relationship. Some potential implications of this relationship for lateralization studies of deaf signers are discussed. Controlling non-verbal IQ may improve the reliability of short duration coherent motion tasks to detect adaptive dorsal stream lateralization due to exposure to ASL in deaf research participants.

Cortical locus of coherent motion deficits in deaf poor readers.

Samar and Parasnis [Samar, V. J., & Parasnis, I. (2005). Dorsal stream deficits suggest hidden dyslexia among deaf poor readers: correlated evidence from reduced perceptual speed and elevated coherent motion detection thresholds. Brain and Cognition, 58, 300-311.] reported that correlated measures of coherent motion detection and perceptual speed predicted reading comprehension in deaf young adults. Because deficits in coherent motion detection have been associated with dyslexia in the hearing population, and because coherent motion detection is strongly dependent on extrastriate cortical area MT, these results are consistent with the claim that hidden dyslexia occurs within the deaf population and is associated with deficits in MT. However, coherent motion detection can also be influenced by subcortical deficits in both magnocellular and parvocellular pathways. To confirm the putative cortical locus of coherent motion perception deficits, we measured contrast thresholds for detecting the direction of movement of drifting sine wave gratings in the same participant group as [Samar, V. J., & Parasnis, I. (2005). Dorsal stream deficits suggest hidden dyslexia among deaf poor readers: correlated evidence from reduced perceptual speed and elevated coherent motion detection thresholds. Brain and Cognition, 58, 300-311.], under stimulus conditions that selectively biased for input from the subcortical magnocellular and parvocellular pathways, respectively. Contrast thresholds were not related to reading comprehension performance under either the magnocellular or parvocellular conditions. Furthermore, the previously reported correlations among reading comprehension, coherent motion thresholds, and perceptual speed remained significant even after contrast thresholds and non-verbal IQ were controlled in partial correlation analyses. In addition, coherent motion detection thresholds were found to correlate specifically with a reading-IQ discrepancy score, one commonly used indicator of dyslexia. These results provide direct psychophysical evidence that the previously reported deficit in coherent motion detection in deaf poor readers does not involve subcortical pathway deficits, but rather is associated with a cortical deficit likely involving area MT. They also strengthen the argument for the existence of hidden dyslexia in the deaf adult population.

Dorsal stream deficits suggest hidden dyslexia among deaf poor readers: correlated evidence from reduced perceptual speed and elevated coherent motion detection thresholds.

Prelingual deafness and developmental dyslexia have confounding developmental effects on reading acquisition. Therefore, standard reading assessment methods for diagnosing dyslexia in hearing people are ineffective for use with deaf people. Recently, Samar, Parasnis, and Berent (2002) reported visual evoked potential evidence that deaf poor readers, compared to deaf good readers, have dorsal stream visual system deficits like those previously found for hearing dyslexics. Here, we report new psychometric and psychophysical evidence that deficits in dorsal stream function, likely involving extrastriate area MT, are associated with relatively poor reading comprehension in deaf adults. Poorer reading comprehension within a group of 23 prelingually deaf adults was associated with lower scores on the Symbol Digit Modality Test, a perceptual speed test commonly used to help identify dyslexia in hearing people. Furthermore, coherent dot motion detection thresholds, which reflect the functional status of area MT, correlated negatively with reading scores in each visual quadrant. Elevated motion thresholds for deaf poor readers were not due to general cognitive differences in IQ but were specifically correlated with poor perceptual speed. With IQ controlled, a highly reliable right visual field advantage for coherent motion detection was found. Additional analyses suggested that the functional status of dorsal stream motion detection mechanisms in deaf people is related to reading comprehension, but the direction and strength of lateralization of those mechanisms is independent of reading comprehension. Our results generally imply that dyslexia is a hidden contributor to relatively poor reading skill within the deaf population and that assessment of dorsal stream function may provide a diagnostic biological marker for dyslexia in deaf people.

Deaf college students' attitudes toward racial/ethnic diversity, campus climate, and role models.

Deaf college students' attitudes toward a variety of issues related to racial/ethnic diversity were surveyed by contacting all racial/ethnic minority deaf students and a random sample of Caucasian deaf students attending the National Technical Institute for the Deaf (NTID), Rochester Institute of Technology; 38% completed the survey. Although racial/ethnic groups similarly perceived NTID's commitment and efforts related to diversity, they differed significantly on some items related to campus climate and role models. Furthermore, the racial/ethnic minority groups differed from each other in their perceptions of campus comfort level, racial conflict, friendship patterns, and availability of role models. Educational satisfaction was positively correlated with campus comfort level; both correlated negatively with perception of discrimination and racial conflict. Qualitative data analyses supported quantitative data analyses and provided rich detail that facilitated interpretation of deaf students' experiences related to racial/ethnic diversity.

Deaf adults without attention deficit hyperactivity disorder display reduced perceptual sensitivity and elevated impulsivity on the Test of Variables of Attention (T.O.V.A.).

The Test of Variables of Attention (T.O.V.A.; R. A. Leark, T. R. Dupuy, L. M. Greenberg, C. L. Corman, & C. L. Kindeschi, 1996) is a continuous performance test used widely to help diagnose attention deficit hyperactivity disorder (ADHD) in both hearing and deaf people. The T.O.V.A. previously has been normed only on the hearing population. The T.O.V.A. performance of 38 prelingually and severely-to-profoundly deaf young adults and 34 hearing young adults who did not have ADHD was examined in this study. Deaf and hearing participants did not differ on the T.O.V.A. omission variables. However, deaf participants had significantly lower d' scores than hearing participants, indicating reduced perceptual sensitivity to the distinction between target and distractor stimuli. Consistent with the existing literature on attentional reorganization in the deaf population, this result was interpreted as indicating a deafness-related reduction in attention to centrally presented stimuli. Deaf participants also showed 2 to 3 times more commission errors than hearing participants and displayed a higher incidence of anticipatory errors. These results suggest a deafness-related increase in impulsivity at the time of response initiation. Beta score analysis confirmed that deaf participants adopted an overall less conservative (more impulsive) response criterion that contributed to their total elevated commission errors. However, a portion of the commission errors was secondary to their reduced d', not to increased behavioral impulsivity. Separate factor analyses of the standard T.O.V.A. variables revealed highly similar factor structures for deaf and hearing participants, indicating similar construct validity of the T.O.V.A. for both groups. The evidence for increased inattention and impulsivity in a non-ADHD deaf sample are interpreted in the context of an adaptive attentional reorganization due to deafness. Along with the factor analytic results, these considerations suggest that separate T.O.V.A. norms must be developed for the deaf population to avoid overdiagnosis of ADHD in deaf individuals.

Deaf poor readers' pattern reversal visual evoked potentials suggest magnocellular system deficits: implications for diagnostic neuroimaging of dyslexia in deaf individuals.

Deafness and developmental dyslexia in the same individual may jointly limit the acquisition of reading skills for different underlying reasons. A diagnostic marker for dyslexia in deaf individuals must therefore detect the presence of a neurobiologically based dyslexia but be insensitive to the ordinary developmental influences of deafness on reading skill development. We propose that the functional status of the magnocellular visual system in deaf individuals is potentially such a marker. We present visual evoked potential (VEP) evidence that adult deaf poor readers as a group display magnocellular system deficits not observed in deaf good readers. We recorded pattern-reversal VEPs to high- and low-contrast checkerboard stimuli, which primarily activate the parvocellular and magnocellular pathways, respectively. Principal components analysis of these VEPs produced a time-ordered sequence of three early components that displayed interactions between reading skill and stimulus contrast across multiple scalp recording sites. Deaf poor readers displayed an abnormal absence of contrast-sensitive VEP responses at occipital sites during early visual processing (75 ms poststimulus), whereas deaf good readers showed the expected early contrast-sensitive occipital VEP responses. Over the subsequent 225 ms, the occipital VEP behavior of deaf poor readers closely approximated that of deaf good readers. The VEPs of deaf poor readers were apparently characterized by delayed responses to low-contrast stimuli compared with deaf good readers. Our results provide the first neurobiological evidence that developmental dyslexia exists within the deaf population and is associated with the same underlying magnocellular system deficit that has been observed in hearing dyslexics. Direct neural imaging of the status of the magnocellular visual system in deaf individuals may eventually provide differential diagnosis of developmental dyslexia in the deaf population.