Falling on Deaf Ears: Social Workers' Attitudes about Deafness, Hearing Loss, and Deaf Cultural Competence

Background and Purpose: Inaccessible healthcare, including primary medicine, counseling, and other social services have been found to be associated with low health literacy and high rates of mis or underdiagnosed medical and mental illness in d/Deaf populations. Current research suggests that d/Deaf people experience major gaps in access to healthcare and social services. Reasons for these gaps have been attributed to caregivers’ medical (deafness is a disease) rather than cultural (deafness is a culture) attitudes about deafness and lack of experience serving d/Deaf populations. Few studies have directly assessed the relationship between these factors and competence among social workers to begin to understand these gaps. This cross-sectional study aims to better understand factors contributing to low access to social services by examining the relationship between social workers’ attitudes, experience with d/Deaf populations, and competence working with d/Deaf communities.

Methods: We surveyed 115 social workers using a 45-item questionnaire that measured social worker’s attitudes, competence, experience working with d/Deaf populations along with relevant demographic characteristics. Social workers were recruited via a LISTSERV email to NASW Louisiana Chapter subscribers. Data was analyzed using Chi-Square tests and one-way ANOVAs to examine relationships between attitudes, competence, experience, and demographics such as race, gender, hearing identity, social work education and licensure.

Results: Among respondents, most (71.1%) social workers surveyed held attitudes on the cultural range of the spectrum while 28.7% were on the medical range. Most rated their competence working with d/Deaf clients as mostly beginning (40%), while 35.7% indicated moderate and 16.5% advanced competence. The majority of respondents reported never to rarely working with d/Deaf clients (64.3%). We found a significant relationship between social workers attitudes to deafness and self-reported competence, [χ²(1, N=115) =8.88, p=0.003]. Additionally, more experience with d/Deaf clients was associated with higher competence [F (5, 109) =3.7, p= 0.004]. Demographic characteristics were not significantly related to attitudes or competence, with the exception of gender--women had more cultural attitudes towards deafness. Similarly, professional characteristics such as licensure, workplace, and occupation were not related to attitudes, competence or experience. Education about d/Deaf and hard of hearing clients in MSW program was, however, found to be significantly related to competence [c2 (2, N=115) = 14.2, p<0.000].

Conclusions and Implications: Findings indicate that social workers who are more competent to serve d/Deaf clients have first, had experience with d/Deaf people, second, received education about d/Deaf issues, and third hold sociocultural attitudes towards deafness. This suggests that increasing education on d/Deaf community concerns during MSW programs could better equip social workers to competently serve d/Deaf people. By training social workers to be more culturally competent when working with d/Deaf clients we can begin address the higher instances of misdiagnosis, higher mortality rates, and low health literacy associated with deafness. Future research could examine the relationship between disability and competency to serve d/Deaf populations.