(Sight translation by Certified Deaf Interpreter Mistie Owens)

At InDemand Interpreting, Certified Deaf Interpreters (CDIs) are offered as part of the ASL Interpreter team to ensure optimal language access for Deaf and Hard of Hearing patients. One common misconception is that a CDI only works with Deaf people who exhibit some level of language dysfluency, or any various breaks or irregularities that occurs within the flow of otherwise fluent speech, when in fact CDIs are beneficial to the interpreting team for a number of reasons beyond language dysfluency.

How does language dysfluency affect Deaf patients? 

Robyn Dean, an internationally recognized ASL interpreter for more than 25 years specializes in healthcare and advancing the practice of community interpreters, recently shared the following message on dysfluency:

“When a person is dysfluent for social or educational reasons, interpreters – hearing or Deaf interpreters – should seek to derive meaning, or to negotiate communication to the best of their ability. However, when a Deaf person is dysfluent for psychiatric or neurological reasons, deriving meaning from a message that does not inherently contain meaning – but instead contains important diagnostic information – can thwart the clinical goal.”

CDIs have native exposure to ASL and are accustomed to working with interpreters, and as a result, they are able to interpret in diverse settings, making them an asset to Deaf patients. With medical VRI, there are times when an ASL interpreter needs to partner with a CDI.

Additional scenarios a CDI is beneficial in the healthcare setting include:

  • Interpreting for monolingual ASL signers
  • Foreign born patients
  • Highly emotional/traumatic medical encounters
  • New diagnosis
  • Patient education (ie: diabetes education)
  • Traumatic pediatric encounters
  • Mental health encounters
  • Patients with physical limitation

Using CDIs has the potential to maximize the interpreting process well beyond language dysfluency. CDIs can function as highly effective resources to provide quality communication access for everyone involved.


A Deaf patient, without a history of language dysfluency, arrives for a routine appointment. While doing intake, the nurse learns that the patient hasn’t eaten for days and that her children were removed from the home. The patient becomes increasingly anxious, and the ASL interpreter is having difficulty maintaining the patient’s focus and communication is not effective.  This routine appointment rapidly becomes a highly emotional situation, and it seems the patient is in distress. The interpreter brings on a CDI for both source language support and cultural reinforcement. The presence of another Deaf person, and one that possesses the training and experience, quickly eases the patient’s apprehension. Though the patient is still experiencing stress, the patient is able to fully communicate and participate in her healthcare with the interpreting team and healthcare provider.

The above example demonstrates how an ASL interpreter and CDI can work in tandem to provide a better experience for both patient and provider – well beyond language dysfluency.

InDemand is at the forefront of providing CDI availability and use in the medical setting. InDemand sees the benefits of using CDIs as linguistic specialists and cultural mediators for the ultimate benefit of the patients so that they can fully participate in their own healthcare.