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     [This is a copy of a post sent to the Brain Injury Association of Oregon and to several national mental health and civil rights lists.  The author has exercised this role in several post-conviction arrangements with probation officers and other authority figures for cognitively impaired probation clients.  This role has been helpful in an increasing number of ADA disclosure and representation actions before employers, hearing officers, and case managers in a variety of adult community service agencies.]


     I am an independent disability advocate located in Portland, Oregon.  Over the past two months I have received several calls from different sources involving brain injured individuals requiring substantial assistance in working with community service agencies.  In all such cases, there has been a major communication breakdown resulting in delay or denial of benefits or rights ordinarily accorded to non-impaired persons.


     Most recently, I received a direct referral from the ADA coordinator of the Independent Living Resources Center in Portland to attend to a case involving a young adult client and the adult community justice system. His parents and his wife had been accepted during visits to a certain agency to act as his cognitive interpreters until very recently. They have taken turns accompanying him to regularly scheduled meetings.  Recently, all members were prohibited from accompanying him to these meetings.  This prohibition occurred exactly at the same time the agency official was handed a written notice from a family member that the young man was a person with a disability, and that he was invoking the protections due him under the ADA.  A major bone of contention since this person's first involvement with the justice system has been the system's blindness and denial that this person with a life-long history of organic brain disease is a person with a disability.


     I was called into the case by the ADA coordinator because of her knowledge that I work almost exclusively with cognitively impaired adults with non-verbal learning disability and autism.  On a number of occasions, I have acted as an ADA advocate with individuals' service providers, employers, school officials, and state and federal entitlement programs.  My role as advocate has not been challenged.  However, the role of advocate is different than that of an interpreter.  As an advocate, I have been authorized to speak on behalf of the client, and to conduct certain business on the client's behalf while the client is not present.  The role that I now seek to play is that of an communication assistant, an interpreter, acting in real time as a channel of communication between the client and an agency official.  I will not "speak for" the client, but rather assist the client in speaking for himself.


     In view of this recent situation, I have inaugurated the role of "cognitive interpreter" and this client who I represent without charge has said that he will allow me to assist him in understanding verbal and written communications to him, and in expressing himself precisely.  In this regard, I am to act as a conduit through whom communication in both directions may need to pass.  The specific nature of my service may consist of requesting that a speaker slow down, moderate his or her tone of voice, use a simpler vocabulary, and reduce their directions or requests to one-by-one sequential steps that will then be acknowledged in the clients own words or actions, or through my interpretation that he either does or does not understand what is being asked of him.  We have begun to arrange a signal system that allows him to express when his rate of understanding is being outpaced by a speaker or events, and to indicate when a sensory or other environmental factor or factors is causing him to become overwhelmed, initiating a "shut down."


     At those times, I will request that the communication directed towards him either cease or that it matches his pace of understanding.  It may be necessary for him to excuse himself or remove himself from an overly stimulating situation in order to recover his composure so that he may either continue or request a recess until such time as he is able to recover from neurobiological overload.  Other accommodations may include a request that these "official sessions" be recorded.  In the past, he has found it useful to use a tape recorder to refresh his memory in school and at work.  Upon completion of a full adult functional neuropsychological evaluation, the client may wish to share the results and recommendations of a forensic specialist with a person competent to conduct an assistive technology assessment.  I expect that some device to remediate or compensate for the client's short-term memory impairment may the recommended by the AT expert.  That device would then be recognized under the provisions of the Assistive Technology Act of 1988 and subsequent incorporating legislation.


     As an ADA advocate, I view each and every one of these accommodations as appropriate, given the nature of my client's specific documented impairments.  I may also be asked during these official visits to intervene as his ADA advocate to assert specific rights or provide information to an agency person that their uncorrected behavior or conduct may be in violation of Federal or state law in that the client's request for agreed-to or otherwise essential accommodation may not be honored at the time of my notice to them.


     I request input and suggestions with respect to this role.  It is my contention that the role of cognitive interpreter is every bit as necessary to persons who request such assistance as is the assistive role of an American Sign Language interpreter for a person who is hearing impaired to the point of requiring an interpreter, or a culturally sensitive and linguistically knowledgeable translator may be for a person not fluent in the primary language of communication in use in an agency setting.


     To my knowledge, there is no official recognition of the role of a true neutral to act as a cognitive interpreter.  This role is ordinarily undertaken by a member of the person's family or a person familiar with the individual who is impaired and has been accepted by that person to act in the capacity I describe above.  In this instance and perhaps in many instances known to the readers of this post such family assistance may not be readily available to persons with cognitive impairments.


     At issue is the competence, sensitivity, and understanding of the client's disability required of any such "cognitive interpreter."  The ethical and legal problems of a dual relationship--that of an interpreter as well as that of an ADA advocate deployed by the same person--should warrant discussion.  At a minimum, training, certification, and examination of the nature of informed consent should also weigh heavily in discussion of this role.


     I welcome a personal response to this request.  I also urge that my post be forwarded and widely circulated for the purpose of starting discussion about this issue.  Attorneys, ADA advocates, and forensic specialists are especially encouraged to respond.




Copyright Issues


This article is copyright, all rights reserved by the author, Roger N. Meyer.  It may be reproduced in single copy once for personal use, and in no more than ten copies total for educational purposes.  Fair Use is authorized for all purposes and under conditions established by US Statute and the International Copyright Convention, to which the United States is a signatory nation.  No person shall publish, distribute, copy, or by other means make this material available to others for purposes of personal gain or professional self-aggrandizement.  Individuals wishing permission to exercise other than fair use or limited distribution as outlined above must contact the author, in writing, and receive explicit written permission from the author prior to engaging in further use of this material.

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