As the grandmother of a bright and beautiful 13-month-old deaf baby who is about to undergo heart surgery, I gained firsthand insight into the challenges families face when it comes to language access during medical appointments. In the lead-up to my grandchild’s surgery, I’ve been struck by how often her language and communication needs as a young deaf child are overlooked by those caring for her in the hospital. While the medical team’s focus is on her physical health and well-being, her need for accessible language and communication is frequently forgotten—or not even recognized.
Through my professional work as an advocate for early language and education for families with deaf children, I’ve heard similar concerns from many families of deaf babies. However, nothing could have fully prepared me for experiencing this firsthand with my own family.
Families of deaf babies should not be left to shoulder the responsibility of advocating for their child’s language access and communication needs in medical settings. It is my hope that this article will serve as a reminder of the critical importance of making medical appointments fully accessible for deaf babies, particularly through the use of ASL-English interpreters. While I speak from my own experience with ASL-English interpreters, the core message of this article applies to providing interpreters in any signed languages, such as Mexican Sign Language (LSM), relevant to each family’s needs, ensuring medical settings are accessible for deaf babies and young children.
I urge the medical professionals working with infants and young children to view this not just a request, but a necessary action to provide the best care for all deaf children. I ask that those reading this article reflect on how we can work together with deaf advocates to create an environment where language is never a barrier to the health and well-being of any deaf infant or child.
I hope this article, with its focus on language accessibility, sparks meaningful conversations and leads to proactive changes that will ensure deaf babies, like my grandchild, receive the accessible medical care they deserve—care that respects their language and communication needs. Together, we can create an environment where language access is a priority, making a lasting and positive impact on the lives of families and deaf babies. I am confident that deaf babies, including my grandchild, will have a less traumatic experience in medical settings where language and communication are accessible. To foster accessible language and communication in medical settings for deaf babies, tips are provided below.
The Importance of ASL Interpreters for Deaf Babies in Medical Settings
Between 90% and 95% of deaf babies are born to hearing families. While many parents and caregivers understand the importance of American Sign Language (ASL) for early language development and accessible communication, they may be unaware of their legal right to ensure their deaf baby’s access to language with ASL-English interpreters, particularly in medical settings (Morina-Meyer, n.d).
A publication by Bridget Morina-Meyer on interpreting for pediatric clients highlights how uncommon it is for ASL-English interpreters to be present at medical appointments for deaf infants and young children. However, for those deaf infants who are fortunate enough to have deaf people in their lives who need an interpreter during these appointments, it’s an invaluable opportunity (Morina-Meyer, n.d.). They’re likely to gain important advocacy skills that will serve them throughout their lives.
The Need for ASL Interpreters During Critical Medical Procedures
When facing a serious medical procedure, such as surgery, the need for an ASL-English interpreter becomes even more urgent, regardless of the deaf baby’s age or proficiency in ASL. It is a common misconception to assume that, because the deaf baby knows only a few signs, there is no need for ASL interpreters at appointments. Having an interpreter present during the preoperative, operative, and postoperative phases can make a world of difference in ensuring the deaf baby’s safety, emotional comfort, and overall well-being.
These language access rights for deaf infants and young children are protected under the Americans with Disabilities Act (ADA) and the Rehabilitation Act (Section 504), empowering families to demand accessible language and communication during medical appointments. Families can advocate for their deaf child’s language access rights by requesting a qualified ASL interpreter, either in writing or verbally, at any point during medical procedures or appointments. Under the ADA, healthcare providers are legally obligated to provide reasonable accommodations, including interpreters, when necessary for accessible language and effective communication.
Advocacy and Legal Protections for Families of Deaf Babies
If families face resistance, they can contact the hospital’s Patient Advocacy or Legal Department or file a complaint with the U.S. Department of Health and Human Services (HHS). This ensures that language access is prioritized, protecting both the deaf baby’s well-being and the family’s ability to advocate for proper care.
In California, families can reach out to the nearest deaf advocacy agency funded by the Department of Social Services’ Deaf Access Program to receive advocacy services and support in securing interpreters for their deaf baby in medical settings. Click here for more information.
The Need for ASL Interpreters, Even for Babies Still Learning ASL
Misunderstandings and misinformation can arise when doctors and nurses speak to deaf babies as if they can hear, often using phrases like “good baby” or “you are so brave,” unaware that the baby is not accessing their spoken language.
There are also many misconceptions that medical professionals may have about deaf babies, such as assuming there is no need for an interpreter if the deaf baby isn’t looking at the interpreter or thinking it’s better not to use interpreters so the baby won’t learn about medical procedures and become scared (Bentley-Sassaman & Minor, n.d.). The general rule should be to treat deaf babies just like hearing babies in the presence of interpreters.
Some medical professionals argue that a deaf baby, knowing only a few ASL signs, does not need an interpreter. However, deaf babies, like hearing babies, have the right to effective language access and communication. Having ASL interpreters is essential, especially in critical moments like surgery when family members are not permitted in the room. This is vital for the deaf baby’s emotional comfort, safety, and communication with medical staff.
Creating Language Access in Medical Settings
Qualified interpreters experienced in working with deaf babies know how to create language access by using age-appropriate language such as “mommy,” “doctor,” “water,” “sleep,” “medicine,” and so on. With an ASL interpreter present, the deaf baby is not only exposed to language but can also feel more connected to the medical team.
It would also be beneficial if medical staff learned basic ASL, such as “good job,” “you are funny,” “want some milk?” and “you are now awake!”—to communicate directly with the baby. There are many ASL apps available to help medical staff learn basic sign language appropriate for deaf babies. Combined with professional sign language interpreters, this effort can make the hospital experience less intimidating, fostering a supportive environment for the deaf baby.
Creating a Safe and Accessible Medical Environment for Deaf Babies
A hospital environment can be intimidating, with needles and machines. Without access to language and communication, the deaf baby may experience additional stress. Ensuring that ASL interpreters are available allows for a smoother transition through preoperative preparation, surgery, and recovery—minimizing disruptions to the baby’s language access and development.
Accessible language and communication in medical settings are about more than the number of words or signs a deaf baby knows—it’s about ensuring the baby understands their surroundings, expresses their needs, and feels secure. Even if the baby is still learning ASL, it remains their primary means of communication. Ensuring access to this language, particularly in high-stress environments like hospitals, is essential for preventing unnecessary emotional and cognitive strain.
The Impact of Language Access on the Baby’s Well-Being
Early exposure to sign language is a crucial intervention in preventing developmental delays for deaf infants (Spellun & Kushalnagar, 2018). Continuous access to signed language, even in hospital settings, supports cognitive development while fostering a sense of security and understanding in what can be a stressful environment. In medical settings, ASL-English interpreters ensure communication is accessible for everyone, especially the deaf baby, providing comfort and consistency during high-stress moments.
Since a deaf baby may struggle to express discomfort or pain as effectively as an older child, interpreters help convey any signs—whether a look of distress or a specific gesture—to the medical team. This ensures effective pain management and prioritizes the baby’s comfort. Surgery can be a terrifying experience for both the deaf baby and their family, making clear, accessible communication crucial for the baby’s safety. ASL interpreters ensure the medical team understands the deaf baby’s needs in real-time, allowing for swift and appropriate responses, particularly when family members cannot be in the room.
When the deaf baby feels anxious or disoriented, interpreters alleviate these challenges by facilitating clear communication. Before surgery, for instance, the baby is surrounded by a medical team focused on providing the best care—an effort that can only be fully realized with shared, accessible language. ASL-English interpreters bridge language and communication gaps, ensuring the baby, medical team, and family interact in a clear, reassuring, and supportive manner.
Post-Surgery Support
After surgery, ongoing access to language and communication through interpreters remains crucial. As the deaf baby wakes, they may experience discomfort or confusion, and being able to express these feelings is vital. ASL-English interpreters facilitate communication between the baby and medical staff, whether they’re signaling pain, fear, or a need for comfort. This ensures that parents and caregivers can effectively advocate for the baby’s needs, knowing their child has full access to language. Continuously having interpreters present throughout the healing process alleviates stress and burden on the family, allowing them to focus on their child’s recovery with peace of mind.
Video Remote Interpreting (VRI) is Not Recommended for Deaf Babies
Video Remote Interpreting (VRI) is not recommended for deaf infants and young children because interpreters often rely on subtle cues, like facial expressions and body language, to understand and respond—cues that can be difficult to pick up through a screen. In-person interpreters, on the other hand, can see and respond to these cues directly, making language access and communication much more effective. It’s also important for interpreters working with young children to have special training, such as knowledge of child development, adapting sign language for infants, and creating a welcoming and engaging environment for the baby or young child.
Having in-person ASL-English interpreters allows parents and caregivers to focus on advocating for the baby’s medical needs without worrying about their deaf baby’s language and communication access. Providing interpreters for deaf infants empowers families to better support their deaf baby. It also sets a precedent for language access and establishes long-term expectations for medical professionals caring for their deaf child..
Final Thoughts
In the face of a serious medical procedure, including major surgeries for deaf babies, language and communication should never be a barrier. Even though the baby is still learning sign language, ASL-English interpreters ensure that the child’s needs are met and that they remain emotionally supported throughout the process.
Dr. Peter Hauser, a researcher, pointed out the critical importance of early language access: “If deaf infants and toddlers aren’t given the chance to access language early in life, they’ll face language deprivation, which impacts their education… This includes health education, directly affecting their health knowledge and literacy” (World Federation of the Deaf, 2018, para. 6).
Whether during surgery or in recovery, having ASL-English interpreters helps families and the medical team work together to provide the best care possible for the deaf baby. Most importantly, it ensures that the deaf baby’s language and communication needs are respected, helping them feel safe, valued, and understood during a challenging time.
References
Morina-Meyer, B. (n.d.). Interpreting for a pediatric client – Medical setting. CCBC Pressbooks Hub. https://opencontent.ccbcmd.edu/interpreting/…medical-setting
Spellun, A., & Kushalnagar, P. (2018). Sign language for deaf infants: A key intervention for a developmental emergency. Clinical Pediatrics (Philadelphia), 57(14), 1613–1615. https://doi.org/10.1177/0009922818778041f
World Federation of the Deaf. (2018). The deaf gap in healthcare. https://wfdeaf.org/news/deaf-gap-healthcare/
About the author:
Julie Rems-Smario, Ed.D.
In 2021, Dr. Julie Rems-Smario graduated from the Ed.D. program at California State University, East Bay. She currently serves as an Education Programs Consultant for the Deaf Education Unit at the California Department of Education, where she is also the co-coordinator of the California Early Hearing Intervention and Detection program known as LEAD-K Family Services. In 2007, she was recognized by CNN Heroes and E-Women Network for her work with DeafHope, a nonprofit that supports Deaf survivors of domestic and sexual violence. Dr. Rems-Smario is also a co-founder of CoFusion Group, which engages in abolition work to address inequities in the educational system. www.cofusiongroup.org