HEARING AID 101Session 2

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info@fixmyhearing.com

Welcome to…

• HOW WE HEAR• REALISTIC EXPECTATIONS OF HEARING

AIDS• INTERPRETING HEARING LOSS• ADJUSTING TO HEARING AIDS

• DO’s/DON’Ts OF HEARING AIDS & BATTERIES• TROUBLESHOOTING TIPS

Last week we covered…

Any questions from last week??

Outline for Session 2:

• INFORMING OTHERS OF YOUR HEARING LOSS

• SPEECHREADING

• STRATEGIES TO IMPROVE COMMUNICATION

• APPROACHES TO COMMUNICATION

• HEARING PROTECTION DEVICES

• ASSISTIVE LISTENING DEVICES

Informing others of your hearing loss…

Informing others is an important consideration when you are thinking

about how to prevent or minimize communication

difficulties

Negative consequences can occur when you do not inform others of your hearing

loss. Others may interpret misunderstanding or lack of response as a

sign of:

UnfriendlinessLazinessUncooperativenessDodging responsibilityIncompetenceLack of social skillsAloofness

Examples of misunderstandings from not informing others of a

hearing loss…

BOSS: “Where’s that report I asked for? I needed it this morning!”

EMPLOYEE (HoH): “What report is that?”

CONSEQUENCES??

(HoH = Hard-of-Hearing)

(…continued)

DOCTOR: “I told you not to eat anything before coming in today!”

PATIENT (HoH): “I’m sorry, I’ll have to reschedule my appointment.”

CONSEQUENCES??

LADY 1: “Al (HoH) never looks at me or speaks to me when I see him at the board meetings.”

LADY 2: “Yeah, he’s the same way with me – very unfriendly.”

CONSEQUENCES??

How to Inform others about your hearing loss…

• There are ways of informing people that can lead to their cooperation & interest in communicating with you. However, there are ways that may dampen their enthusiasm to talk to you.

Examples (leading to undesirable results):HoH: “I’m sorry, I have a hearing loss and it’s very

difficult to communicate with me. I hope it won’t be hard for you. A lot of people don’t like to talk to me.”

HoH: “Speak up! I have a hearing loss. I don’t know what’s wrong with people, everyone mumbles these days!”

When informing others, try to avoid:

• Being apologetic

• Putting yourself down

• Expressing anger

• Being impolite

• Guilt-tripping

• Being defensive

• Once you inform others about your hearing loss, it is then important to inform them HOW to communicate with you in order to maximize understanding & prevent communication breakdowns

• Always remember, focus on what someone is doing RIGHT when they are communicating with you & PRAISE him/her for it. This will reinforce their behavior so they will continue it in the future.

What influences our understanding of speech?

• There are typically 3 factors…

1. Speaker Qualities

2. Listener Qualities

3. Environmental Factors

What are some qualities about a SPEAKER that can affect how well you

understand??

Speaker Qualities…• Voice loudness, pitch, & projection• Rate of speech• Clarity of speech• Monotone vs. emotionality• Amount of body language & facial expressions• Are they facing the listener?• Foreign accent• Beard/mustache• Other objects at the mouth• Relationship to listener

What about listener qualities?

Listener Qualities…• Amount of hearing loss• Use of hearing aids or assistive devices?• Attention level• Motivation to hear• Expectations• Emotional state• Fatigue• Distracting thoughts• Tension level• Speechreading skills

What about environmental factors?

Environmental Factors…• Background noise• Lighting conditions• Room acoustics• Distance from sound source• Distractions• Use of visual aids (& readability of visual

aids)• Angle of vision• Availability of Assistive devices

Keep in mind…

• If you are having difficulty communicating, try to determine if it is because of the speaker, the environment, or YOU as the listener.

• If the problem is identified, try to modify or change the situation for better communication

• Remember REALISTIC EXPECTATIONS of having hearing aids & hearing loss in those tough situations!

Speechreading

• Often referred to as “lipreading” but actually uses numerous clues surrounding the process of communication. These clues include:– Observing whole body language (in addition

to “reading” the lips)– Synthesizing the person, the environment, &

various situational clues– Considering the topic & context of the

communicative event

Speechreading…

• It is an acquired skill which requires practice in order to use the eyes to combine visual clues with residual hearing

• It does not assure perfect understanding, it is an AID to assist the sense of hearing

• It is used in conjunction with hearing aids to maximize understanding

• It enables many individuals to follow a conversation with confidence who would otherwise be at a standstill

Rules for Speechreading…• Observe the speaker carefully – note total

expression, not just the lips• Observe the seating arrangement in the room (and

lighting) & then seat yourself across from the speaker

• Determine as soon as possible what the topic of conversation is (even if you have to ask)

• Look for ideas rather than single words• Relax. Do not strain while you are speechreading. • Keep abreast of current events so you may enter

into conversations• Keep informed of friends’ interests & new

developments so you may easily converse

Rules for Speechreading (cont)…

• Inform your friends you are hard-of-hearing & studying speechreading

• Don’t be afraid people will think you are staring at them while you are speechreading

• Don’t bluff! Ask people to rephrase if you do not understand.

• If you do not understand, repeat what you did get from the conversation

• PRACTICE…PRACTICE…PRACTICE!!!

Critical factors for Speechreading…

1. DISTANCE: 3 to 6 feet is the best distance between the speaker and the listener.

2. LIGHTING: The light should come from behind the listener and shine on the speaker’s face, without a glare.

3. DEGREE OF VISIBILITY OF SOUNDS: Because some sounds are not very visible, you will not be able to lipread every word in most sentences

Communication Strategies

1st strategy…ANTICIPATORY STRATEGIES

Strategies used to PREVENT a communication breakdown from happening

TAKING CONTROL OF YOUR ENVIRONMENT!!

What does it involve?

• Anticipating topics of conversation & associated vocabulary

• Anticipating sequence of dialogue• Anticipating questions you might ask or be

asked• Knowing information you want to acquire• Instructing the talker• “Engineering” your environment to

enhance communicative performance

Exercises in Anticipatory Strategies…

• Predict what might be said:

– You are going to the dentist

– You are going to the auto-repair shop

Let’s practice more ways to implement anticipatory strategies…

Communication Strategies

2nd strategy…REPAIR STRATEGIES

Strategies used after a communication breakdown has occurred

Approaches used by an individual when he/she has not understood a message AFTER they have implemented anticipatory strategies

What does it involve?

• Using specific vs. nonspecific repair strategies

Specific repair strategies – Providing explicit instructions to your communicative partner about HOW to repair the breakdown

Nonspecific repair strategies – Simply indicating lack of understanding

*Repeat all or part of the message

*What?

*Rephrase the message *Huh?

*Elaborate the message *Pardon?

*Simplify the message

*Indicate the topic of conversation

*Confirm the message

*Write the message

SPECIFIC REPAIR STRATEGIESNONSPECIFIC REPAIR

STRATEGIES

Important to know…

• Nonspecific repair strategies are the most commonly used repair strategies but are the LEAST EFFECTIVE

• The hearing-impaired listener is placing the entire burden of the miscommunication back on the speaker

• Those using nonspecific repair strategies are more likely to be perceived unfavorably by others in communicative situations

Exercises in Repair Strategies…

The Communication Problem

How to ask for help

You understood only part of the message (“…got back…vacation…flew”)

?????

You couldn’t see the speaker’s mouth

?????

The person was speaking too fast

?????

The person’s speech was too soft

?????

Stages in Repairing a Communication Breakdown

Detect a Communication Breakdown

Choose Course of Action

Use Repair Strategy

Disregard Utterance

Bluff

Consequences of your course of action…

• If you choose to… Disregard Utterance or Bluff – You may be

considered insensitive, uninterested, &/or inattentive

Use a repair strategy – You can Communicate!

3 Approaches to Communication: Different approaches to situational

breakdowns can affect the success of communication

1. Passive: Withdraws from conversation, frequently bluffs & pretends to recognize speech, avoids social interactions & group gatherings in order to avoid communication difficulties.

= Poor Communication

Approaches (cont)…

2. Aggressive: May blame others for misunderstanding, shows hostility, acts belligerent, has an overall bad attitude.

= No Real Communication Exchange

3. Assertive: Respects the rights of their communication partners but at the same time expresses their own needs & emotions. Takes responsibility for managing communication difficulties, but in a way that is considerate of their communication partner.

= Good Communication Exchange

Being assertive means…

Willing to act in one’s own best interestAble to stand up for one’s selfWilling to exercise personal rights & not deny

the rights of othersWilling to admit to having a hearing problemWilling to explain the problem to other people

if or when appropriateAble to suggest specific ways to improve

communication

The Scenario…

You and Rich are driving to Santa Fe. You decide to stop at a rest area. You park the car. Rich just said something about a new route you will take, but the map is in front of his face.

Passive, Aggressive, or Assertive??

• Without having heard him, you say, “Whatever you think is best Rich.”

• You pull the map out of his hands & throw it at him.

• You explain to Rich that you were unable to hear him, the map obstructed your view, & ask him to repeat what he said.

Communication Guidelines for Hard-of-Hearing Listeners. A Summary…

1. Pick the best spot to communicate by avoiding areas that are poorly lit & very noisy.

2. Do not bluff!3. Pay attention to the speaker.4. Provide feedback that you understood or

failed to understand.5. Look for visual clues to what is being said.6. Anticipate difficult situations & plan how to

minimize problems.

Cont…

7. Tell others how best to talk to you. 8. Provide feedback to speakers by saying

how well they are doing. 9. Try not to interrupt too often.10. Arrange for breaks if discussions or

meetings are too long.11. If necessary, ask for written clues.12. Set REALISTIC GOALS about what you

can expect to understand

Communication Guidelines for Speakers. A Summary…

1. Get the person’s attention before you speak.

2. Speak clearly & at a moderate pace.

3. Don’t shout.

4. Avoid noisy backgrounds.

5. Rephrase when you are not understood.

6. Give clues when changing the subject

Cont…

7. Use facial expressions & gestures. 8. Be patient, positive, & relaxed. 9. Do not put objects in front of your face.10. Do not put objects in your mouth (gum,

food, cigarettes)11.When in doubt, ask the hard-of-hearing

person for suggestion to improve communication.

12.The person who begins a conversation must go TO the listener.

A little about hearing conservation…• It is extremely important to protect one’s hearing in

loud environments even if a hearing loss is present.

– Your RESIDUAL HEARING is very important to your communicative abilities & needs to BE PROTECTED!!

Ear protection should be worn if excessive sound:Causes ringing in the earsCauses a temporary reduction in hearing abilityMakes communication by speech difficult/impossible

Cont…To protect your hearing…Ear protectors should be pliable & fit each

ear tightly (cotton is NOT adequate)

Ear protectors may work loose & need to be reseated periodically

Cont…

To protect your hearing…

Plugs/muffs do not cause infection but should be kept clean

Ear protectors make it easier to understand speech in noisy situations

Custom ear protection is an alternative to the everyday insert foams (ask your hearing care professional about options for you)

The best ear protector is the ONE THAT IS WORN!!

Assistive Listening Devices…

• Usually used in specific situations (church, theatre, public hall, TV) when hearing aids are either insufficient to permit good communication or undesirable to the listener

• Includes:– Alerting devices– Telephones– TV devices– Personal Communicators– Large Area Assistive Devices (i.e. FM systems)

Examples…

Ask your hearing care professional about ELI!

More assistive/alerting devices…

Please let your hearing care professional know about the assistive/alerting devices

YOU are interested in!

Questions

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info@fixmyhearing.com