How to Treat Frum Patients

Levi A. Reiter, Ph.D.
What to Know When Treating Orthodox Jewish Clients
Audiologist Levi A. Reiter shares some simple advice that can make or break interactions with Orthodox Jewish clients.

By Bridget Murray Law

Growing up in mostly secular Marine Park, Brooklyn, Levi Reiter practiced Judaism, and his middle-class family kept a kosher home. But he wanted more—a deeper understanding of the religion’s Chassidic foundations and teachings. So, while pursuing a PhD in experimental psychology at the University of Rochester, he delved into Chabad Chassidic philosophy and the writings of Rabbi Menachem Mendel Schneerson.

He and his wife began practicing—and raised their five children in—Orthodox Judaism. And, after earning his audiology certification, Reiter signed on as professor of speech, language and hearing sciences at Hofstra University. During his 33 years there, he’s made his mark investigating the link between ear suction, such as that produced by kissing, and various hearing disorders.

He’s also written and performed the rap song “Say What?” to popularize audiology among students. And he’s sought to boost audiologists’ sensitivity to cultural differences among clients. As a private practitioner on the side, Reiter sees a hugely diverse clientele and, of course, knows just how to cater to those who are Orthodox Jews. What insights can he share with other audiologists serving this population, which numbers about 1 million nationwide? We talked with him to find out.

From the perspective of Orthodox Jewish patients, what is one of the biggest challenges they may likely encounter when working with a non-Orthodox provider?

The only real challenge is nonessential, unnecessary touching between males and females. Touching an Orthodox client during the actual audiological examination is perfectly acceptable because it is necessary, but touching somebody in greeting is not. This is a biggie because, for example, it wouldn’t be appropriate for a male to extend his hand to shake the hand of a female Orthodox patient when saying “Hi.” She might shake his hand, but she won’t feel good about it. And the same is true if a female audiologist shakes the hand of a male patient. He might shake it, but he won’t be happy.

There is no biological basis for this. It’s about modesty and respect for individuality.

How do you know that person is Orthodox?

There are some telltale signs: A man will wear a head covering: a yarmulka (kippah) or hat.

A woman will be in modest dress. She could look very chic, but she won’t be showing her collarbone, her sleeves will cover her elbows, and her skirt will be below the knee. You don’t see too many women dressed this way these days. So the dress could be a tip-off, or the patient may come out and say, “By the way, I’m Orthodox, and I don’t shake hands.”

I was on the NBC “Today” show recently, discussing ear-kiss syndrome, and I wondered if the anchor woman would shake my hand. But she had done her research and didn’t. Otherwise, I often will just kind of give a nod to stave it off. I don’t want to embarrass folks, but I’ve become pretty good at getting out of it.

What are some key ways for a non-Orthodox provider to put an Orthodox client at ease?

It’s very simple. Don’t try to shake hands and act normal.

What is the biggest mistake a non-Orthodox audiologist could make when treating an Orthodox client?

If the patient is a married female, then her hair will be covered, usually with a sheitel, which is a wig. It looks beautiful, like real hair, but it’s not for attractiveness. It’s esoteric and exoteric. It’s a spiritual thing because a married woman’s hair is special. So if the patient is an Orthodox woman, assume she’s wearing a wig, and this is very important when removing the headphones during hearing testing. If the headphones are over the wig, and you’re not aware, you could pull the wig off, which would be quite embarrassing to the woman, as well as to the audiologist. So what I do is to carefully spread the headphones out from the ears before pulling them up and off.

You’ve been involved in making programmable hearing aids—those that fit into the small part of the ear—more appropriate for the Sabbath. Explain how they are (were) not appropriate for Orthodox populations.

During the Sabbath, you are not supposed to turn a circuit off or on, and this pertains to hearing aids because they are electrical. So, if you are Orthodox, you cannot change the hearing aid settings, preprogrammed by the audiologist, during the Sabbath or Jewish holidays. But it’s easy to accidentally hit the button that changes the settings. So my contribution was to develop a hearing aid where the settings program button can be disabled and re-enabled before and after the Sabbath or, say, a three-day holiday.

You worked with the company Persona Medical to create the “Emet” hearing aid, which allows you to preselect one setting for an extended time. What type of feedback have you had on this device?

In theory the idea is great and we’ve made progress, but there are various technical problems, so for now the project is suspended. But we’re now discussing other ways of dealing with the same problem. I’m looking for an innovative company to work with on new and related ideas.

Are there other audiology devices or assistive technology that could be adjusted to be more Orthodox-friendly?

A couple of hearing aid companies are working on technology that enables the hearing aid to literally change its own setting just by sensing the environment and sound levels surrounding the wearer. This technology is out there.

Your audiology rap “Say What?” has been super popular with your students. Do you use it or other similar types of tools to teach them about the role of culture in treatment?

I now have 18 different audiology songs and raps, like ones about auditory pathologies, diagnoses, treatments, and one called “First-Year Student in the AuD Program Blues.” And I’ll be putting out the CD “Say What?” that will be very multicultural with the songs sung in different accents and dialects and featuring all different styles like reggae, calypso, gangsta and Yiddish. It’s a way to teach about audiology and culture and get students’ motivation up at the same time.

Bridget Murray Law is managing editor of The ASHA Leader.
[email protected]

Levi A. Reiter, PhD, CCC-A, is professor of speech, language and hearing sciences at Hofstra University and a member of the Long Island AuD Consortium. He is an affiliate of ASHA Special Interest Group 6, Hearing and Hearing Disorders: Research and Diagnostics. He also holds a rabbinical degree from Ayshel Avraham Rabbinical Seminary in Monsey, N.Y.
[email protected]