Hearing loss and communication
There are three outcomes when we attempt conversation.
(1) It can be heard and fully understood;
(2) it can be misheard and only partly understood or;
(3) it may not be heard at all which can lead to partial or full misunderstanding.
Hearing-impaired people, while many hear most of the sound, can still miss out on the message because they cannot hear certain sounds while others are muffled. What can be done to improve understanding?
Rowena Vnuk told me of her experience. “My hearing loss is severe enough to need a hearing aid so I have difficulties hearing speech and therefore I do not always fully understand the intent of the conversation. Although with the help of my hearing aid I am able to hear a range of sounds, including speech sounds, I may not hear particular sound frequencies that make certain vowels or consonants clear. This can make it difficult for me to understand speech. But not only that, the way I understand it may also be different from other hearing-impaired people because they hear different sounds of speech to me.
“Unfortunately, I come across many people who try to compensate by shouting. But shouting simply ‘misses the point’. My hearing aid is powerful enough to pick up sound in the speech range, but it cannot make up for sound frequencies I am physically unable to hear. It’s up to me, I guess, to explain that shouting does not help and explain that I hear particular sounds and not others. (But sometimes this seems just too hard.)
“My hearing has declined very, very, slowly. Recently, I came to understand that a slow decline in hearing usually results in a decline in speech quality, potentially causing additional communication issues. For instance, my hearing loss is not uniform across all speech frequencies so I am losing the ability to hear some speech sounds more than others. I can no longer hear the ‘s’ sound very well, a sound which often comes at the end of a word and I must imagine this sound when I’m lip reading and speak this sound from memory when I need to.
“Research shows that over time, we all have a tendency to speak as we hear and this often results in the loss of word endings as well as a decline in resonance. Because we aren’t getting the feedback we don’t hear the changes in our speech and eventually, through lack of use, we could even become unable to use our mouth, tongue, chest, and other organs to give clear speech. Consequently, a hearing-impaired person’s voice can become flat, monotonal and nasal in quality. (Unfortunately, even though I am aware, I have been told my voice now has some nasal qualities because I cannot properly hear myself speak.)
“When unable to hear at all, sometimes a person can’t tell if they can be heard. This causes problems as we continually check our own voice, often shouting, so that we get our message across.”
Rowena, lists a number of strategies she uses to make sure she is communicating correctly.
“Always ensure you:
• can see the other person’s face, particularly if you can lipread or speechread
• position yourself so that anyone speaking to you does not have light behind their faces
• reduce background noise such as turning off the radio or television
• avoid situations where more than one person is speaking at the same time
• ask the speaker to repeat the sentence particularly the first few words which often contain the subject (Paraphrasing can be used, but is less effective, and may take longer to get the message across)
• repeat back the whole sentence if you need to check you heard correctly
• tell people that shouting doesn’t help
• use alternate means of sending a message when voice quality or other reasons stop a message being sent accurately (eg write it down)”
Recommended further reading:
Kaplan, H., Bally, I., Garretson, C. (1997). Speechreading (2nd edition), Washington D.C, Gallaudet University Press (Chapter 4 is most relevant to this topic and this reference is much more reader friendly).
Lloyd, L. L., Fuller, D. R., & Arvidson, H. H. (Eds.). (1997). Augmentative and Alternative Communication: a handbook of principles and practices. Massachusetts: Allyn and Bacon. (Very technical)
This article is written by Rowena Vnuk and Felicity Bleckly. The purpose of this information to help people manage and live with their hearing loss. However, this information is intended only to provide a perspective on matters of interest and to enable people to seek other advice; information found in these essays are not definitive, and thus readers should seek other advice where necessary. For the purposes of BellaOnline website, I give Felicity Bleckly permission to publish this information on the BellaOnline deafness site.
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This content was written by Rowena Vnuk & Felicity Bleckly. If you wish to use this content in any manner, you need written permission. Contact Felicity Bleckly for details.