Adding a Certified Deaf Interpreter (CDI) for More Effective Communication


Sight translation by Mary Luczki.

Working with Deaf patients requires the use of nationally certified interpreters, preferably those with extensive medical interpreting experience.  However, there will be times when a hearing certified interpreter will only be one part of the linguistic team needed to support a Deaf patient. The other half of that linguistic team may be a Certified Deaf interpreter (CDI)  who “has an extensive knowledge and understanding of deafness, the deaf community, and/or Deaf culture which combined with excellent communication skills, can bring added expertise into both routine and uniquely difficult interpreting situations.” (source: We’ll explore when a CDI might be necessary and the benefits to routinely adding them to medical encounters.

When To Use a CDI:

American Sign Language (ASL), like English, has its own idiosyncrasies, dialects and unique applications that aren’t always accessible to non-native users. Deaf people are native users of ASL, therefore they have an intimate understanding of the language and can be a critical part in bridging the communication gap. The following circumstances describe a Deaf patient that might benefit from the use of a CDI:

  • Patient uses non-standard signs that often originate from their family; often called “home-signs”
  • Patient uses atypical signs from a particular region, culture, ethnic group or age group
  • Patient has minimal language skills
  • Patient uses a foreign sign language
  • Patient is Deaf-blind or has limited vision
  • Patient has communication traits that are unfamiliar to a hearing interpreter


How To Use a CDI and a Certified Interpreter:

When a patient arrives and the medical provider has already arranged for a CDI and a certified hearing interpreter (via VRI or onsite), the process is rather simple. The CDI and the hearing interpreter work collaboratively to ensure that all communication is conveyed successfully. The providers look and speak to the Deaf patient while the hearing interpreter interprets what is being said to the CDI. The CDI then interprets to the Deaf patient. When the Deaf patient responds to the medical providers, the Deaf patient will sign to the CDI and the CDI will then interpret what the patient said to the hearing interpreter who then in turn interprets to the provider. The following visual helps illustrate the process.

CDI Graphic

The process might take a few extra moments than when working with a hearing interpreter alone. However, the benefits and assurances that the patient has full understanding and opportunity to participate in their health care is worth the extra time and effort.

The Benefits of Using a CDI:

It is important to note that the use of a CDI doesn’t diminish the skills, training and experience of a hearing interpreter. Rather, an experienced interpreter will be able to identify a patient that needs a CDI and be confidant that the addition of a CDI is what is best for the patient. Just as a doctor knows when he needs to bring in a specialist, an interpreter knows when to call for a CDI.

There are fantastic benefits to using a CDI that can have positive results for all parties involved:

  • Reduced misunderstandings and confusion for the patient when navigating their health care, diagnosis, and treatment plan
  • Reduced visits to the ER and urgent care as a result of misunderstanding their health care/treatment plan
  • The CDI and hearing interpreter can work together to ensure their interpretations are accurate
  • Increased opportunities for health care literacy and follow through with physician recommendations
  • The Deaf patient can communicate in their native language with a CDI without trying to accommodate the language skills/abilities of the hearing interpreter

Medical providers are legally required to provide effective communication for their patients and, depending on the patient, effective communication may involve the use of a CDI. Hearing interpreters and CDIs, whether onsite, via VRI, or a combination of both can all work together to provide the best, most effective and efficient means of communication resulting in successful medical encounters.

Video Remote Intepreting for Deaf and Hard of Hearing Patients

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