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It is estimated that approximately 50,000-60,000 Competent to Stand Trial (CST) evaluations are conducted every year in the United States (Skeem, Golding & Berge, 2018; Bonnie & Grisso, 2000). CST cases encompass a wide range of diagnoses including psychotic disorders, mood disorders, psychosis, and substance disorders. CST cases may also involve defendants with an intellectual disability, cognitive disorder, as well as defendants who are Deaf or Hard of Hearing (HoH). Longstanding concerns regarding language and communication barriers raise questions regarding a defendant’s ability to assist in their own defense as well their due process protections. In the recent past, there have been efforts to reform the CST and restoration process. This presentation will discuss these recent reform efforts, including the creation of competency dockets, and discuss the implications for Deaf defendants.