The importance of British Sign Language
BMJ 2024; 384 doi: https://doi.org/10.1136/bmj.p2615 (Published 28 February 2024) Cite this as: BMJ 2024;384:p2615Linked Editorial
The NHS is failing deaf people
My son failed his newborn hearing screening, but further tests told us he was able to hear. Throughout the next two and a half years he was frustrated a lot of the time and relied heavily on routines. He had no speech and huge delays in understanding. Not long before he turned 3, an audit of our paediatric audiology department found many children had been misdiagnosed, and further testing found him to be profoundly deaf.
We quickly started to learnBritish Sign Language (BSL), which has given our family the ability to have unabridged communication. We finally all speak the same language.
No way of communicating
After several months we made the painstaking decision to get cochlear implants for our son. We saw it as a tool to allow him access to sound, but agreed we would all continue to use BSL as it had become the language we used to communicate.
After his cochlear implant surgery, I saw my small glassy eyed boy through the windows before they rolled him back into the ward, where my husband and I were anxiously waiting. Our 4 year old son, with heavy bandages around his head, was visibly confused and upset. A staff member told us they couldn’t understand him as he’d been signing to themwhen he woke up from surgery. He had been asking for me, his mum, but none of the staff knew any BSL to understand orcomfort him. The thought of him asking for me and no one understanding broke my heart.
Deaf culture
This wasn’t an isolated experience. I found the whole journey from diagnosis to implant difficult because of the lack of deaf awareness. We had concerns about the impact of implants on our son’s place in the deaf community, but we felt these were often dismissed in healthcare settings.
“Deaf culture” is a huge part of the deaf community. It includes not seeing deafness as a disability, and instead viewing it with positivity and pride. Healthcare professionals sometimes saw deafness as something to cure, and we found this very challenging. I think staff having more understanding of deaf culture would have allowed them to empathise with us more and it would have made the process so much easier. It would have also undoubtedly made the experience better for my son.
BSL versus implant
On numerous occasions I was told that BSL would be either unnecessary or that it would be a hindrance to my son in acquiring speech. We were presented with a false dichotomy: BSL or cochlear implants. Since his “switch on,” we were encouraged to use visual aids instead to help him connect sounds and concepts. We decided that BSL was more appropriate than a basic communication system for us, and he is coming on leaps and bounds. For him, having a full language also means ensured communication when processors don’t work or when listening fatigue forces a hearing break.
BSL is a hugely important, relevant, and accessible way to communicate for many deaf people. Healthcare professionals knowing some basic BSL and about deaf culture would go a long way in bridging the gap between deaf and hearing communities, and would be especially useful for families like mine.
What you need to know
Knowledge of BSL is important for anyone working in healthcare
Understanding deaf culture helps support and inform parents and carers of deaf children
It doesn’t have to be either BSL or hearing devices—it can absolutely be both
Education into practice
How could you improve the experiences of deaf patients within healthcare?
When and where could you learn the basics of BSL to best communicate with patients or families affected by deafness?
Footnotes
Competing interests: KA is a member of Families failed by Lothian Audiology Action Group.
Provenance and peer review: commissioned; not externally peer reviewed.