CyraCom Language Services Blog

Back To Blog

Using Certified Deaf Interpreters (CDIS) to Communicate with the Deaf

Published on June 01, 2015 by Victor Collazo

Using Certified Deaf Interpreters CDIs

Certified Deaf Interpreters (CDIs) are interpreters who, while being Deaf themselves, have been trained to interpret for Deaf patients who may have a limited knowledge of American Sign Language (ASL). If a patient is not fluent in ASL and uses a mixture of gesture/home signs or have a psychological or physical challenge preventing them from using ASL, a CDI would work with an ASL interpreter to facilitate communication between the Deaf patient and the hearing individual.

When CDIs are Necessary

Many people assume that all Deaf people are fluent in only ASL. However, depending on the individual’s schooling and their environment, they could have been exposed to ASL, ESL (English Sign Language) or home signs. While of course ASL is the formal language of the Deaf community and has its own distinct syntax and grammar, other variations of communication in the Deaf community have cropped up over the past few hundred years.

So, what about Deaf individuals who cannot or choose not to use ASL, such as the Oral Deaf community? These individuals use oral speech to communicate and are sometimes trained to use lip-reading (though difficult, with only about 30% accuracy) to communicate.  Writing back and forth is also another way of communicating with deaf individuals.  Because ASL is a visual language and differs in its syntax and grammar with that of English, writing back and forth can be a challenging way to communicate. Additionally, Deaf individuals that have recently immigrated to the United States may still use their home countries’ sign language, as well as basic ASL to communicate. Depending on the educational background or sign language exposure, some of these deaf individuals may even use “home signs.”

“Home signs” are signs that have been invented within a household in order to help with deaf communication between hearing and deaf family members. This occurs frequently in hearing families that have one Deaf child, since most members of a hearing family never learn ASL. As a result, home signs will differ from family to family. For example, see below for the ASL sign and home sign for “white”.


Certified Deaf Interpreters“White” in ASL


Certified Deaf Interpreters

“White” in a home sign

The process for a non-fluent Deaf patient and an English-speaking healthcare provider conversation

So how does the process work, if the CDI is Deaf too? In scenarios where a CDI is needed, there will be a total of two interpreters, a hearing ASL interpreter and a Certified Deaf Interpreter, facilitating the conversation between patient and healthcare provider.  The ASL interpreter will take the words of the physician and interpret it into ASL for the CDI interpreter, who then takes that information and interprets it for the Deaf patient in a way that they can understand.


1. English speaker to hearing ASL interpreter

2. Hearing ASL interpreter to Certified Deaf Interpreter

3. Certified Deaf Interpreter to patient

The opposite process is the same. The patient will sign to the CDI, who then interprets into ASL for the ASL interpreter. The ASL interpreter then takes that information and interprets it into English for the hearing healthcare provider.


4. Patient to Certified Deaf Interpreter

5. Certified Deaf Interpreter to hearing ASL interpreter

6. Hearing ASL interpreter to English speaker

Best Practices for When to Use CDIs and How to Hire One

I recently attended the National Symposium on Healthcare Interpreting at St. Catherine’s University in St. Paul, Minnesota, where one of the panelists said that their organization makes sure that they have a CDI for each and every Video Remote Interpretation (VRI) call. In other words, having two interpreters for each VRI call.

There is no doubt that CDIs play an important role in bridging the communication gaps that may occasionally exist between hearing and Deaf individuals, but it can become expensive to use two interpreters for every call. However, if your hospital were to find a cost-effective system that would allow the use of CDIs, it would undoubtedly work to strengthen the interpreting experience for both Deaf patients and hearing interpreters alike.

Regardless of whether you decide to use CDIs for every VRI call, CDIs are a valuable resource in the event that a Deaf patient does not communicate well in ASL and needs an interpreter.  RID (Registry of Interpreters for the Deaf) has a standard practice paperthat provides more helpful information on the uses of a CDI and why there are sometimes an essential part of the interpreting role. If you would like to hire a CDI, visit RID’s website or speak with a local ASL agency for more information.

Deaf and Hard of Hearing