Appropriate services for the deaf and hard of hearing, sometimes referred to as “culturally affirmative approaches,” are those services that entail specialized knowledge in working with this population.  Specialized knowledge includes appropriate skill and training in the language, culture, and community values of the deaf and hard of hearing population.  Such a specialized skill set requires years of specific training that focuses on accommodating to the health care needs of this population. There are ethics codes and laws that stipulate that when there are culturally appropriate services available to a specific minority population that requires a specialized skill set, provisions should be made to provide the individual with such service.