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Hearing Loss Treatment: Beyond Hearing Aids

Listening and Communication Enhancement (LACE)

What is the first thing you do after you receive a new hip? Start physical therapy! After you receive your new hip, you have to learn to use it again. After you receive your new hearing aids, you have to learn to listen again.

No matter how good your hearing aids are, they can only provide audibility. In other words, hearing aids get sounds into your ear; how your brain uses those sounds is not related to your hearing aids. It is a function of your processing and listening skills. Listening and Communication Enhancement (LACE) is a software program you complete at home on your computer. It is “physical therapy” for your brain. Completion of this program has proven to improve listening skills up to 40%.

Communication Strategies

When someone in the family has a hearing loss, it affects the entire family. Hearing loss is invisible; it is easy to underestimate its impact. Many people believe hearing aids will solve their loved ones’ problems entirely. While they certainly improve quality of life, hearing can still be particularly difficult in challenging conditions, such as from a distance, in background noise and in poor acoustics. Below are some communication strategies for both the listener and the communication partner that may significantly reduce conversational difficulties.

Don't try to hide your hearing loss

Listener: Acknowledge your hearing loss so that people will be more likely to look directly at you when talking and speak clearly when addressing you. If your conversation partner knows that you have hearing difficulties, there will be fewer misunderstandings if you do not respond appropriately or if it appears that you are ignoring them.

Communication Partner: If someone you are conversing with wears hearing aids and/or tells you that she has a hearing loss, do not shout or exaggerate your mouth movements. Just speak clearly, a little bit slower and a little bit louder. Pausing between phrases will help the listener have time to process what you are saying.

Use hearing assistive technology

Listener: If you own hearing aids, by all means wear them. If you don't, check with your hearing healthcare professional to see what's new in hearing aid technology that would make your communication flow more easily.

Communication Partner: If you see that the person you are conversing with is having difficulty communicating and they do not use hearing aids or other assistive technology, encourage them to get help.

Polish your concentration skills

Listener: Pay extra attention to the talker and try to hone your listening skills. This may be especially difficult for new hearing aid users, who may have spent several years "tuning out" during conversations, movies, lectures, or religious services because of difficulties hearing. Watch the talker's mouth instead of looking down. Try to concentrate on the topic of conversation, even if you are missing a few words or phrases.

Communication Partner: Realize that it can be a strain for people with hearing difficulties to listen for long periods of time. Try to appreciate that folks who have to pay extra attention during conversations will often tire more easily than other listeners, and may want to go home earlier than you do from parties, family dinners, and other group events.

Be prepared

Listener: Anticipate difficult listening situations and plan ahead. If you're dining out with friends, for example, suggest going at a time that is not likely to be busy, recommend a restaurant that you know is relatively quiet, and familiarize yourself with the restaurant's menu, which can often be found online. Going to a bowling luncheon banquet? Try to arrive early so that you can pick a seat at the table furthest from the noisy kitchen, and choose to sit with your back to a brightly lit window so you can reduce glare. Be as prepared as you can to minimize listening difficulties.

Communication Partner: When accompanying a friend or family member to an event that is likely to be a difficult listening situation, think of ways ahead of time to minimize communication problems. For example, if you are going to a lecture together, try to arrive early so that the two of you can get a good seat, up close to the podium. Engage beforehand in conversation about the lecture topic as a way of perhaps anticipating what the lecturer will say. If you are hosting a social event and know that someone who is attending has a hearing loss, strategize as to how you might reduce problem situations. Perhaps you could choose a relatively quiet restaurant and ask to have a private, carpeted room for your event.  The efforts you take to plan for a "noise-free" event will probably actually benefit ALL of your guests.

Use effective clarification strategies

Listener: Avoid saying "Huh?" or "What did you say?" when you have heard at least part of what the speaker was saying. Instead, try saying something like "I know you said you are talking about the new house you are building, but I didn't catch where you said the house is located." This way, the talker does not have to repeat everything that was said.

Communication Partner: When the listener has missed something you said, try repeating what you said one time, using clear (but not exaggerated) speech. If the person still does not understand, try rewording. For example, if the person did not understand you when you said, "It's not polite to boast", repeat it once, then reword your sentence to "It's not nice to brag."

Try to determine the source of your difficulty

Listener: Practice analyzing WHY you are having difficulties with a particular talker, then make specific requests, politely of course. Does she have a soft voice? Rather than saying, "Say again?", try asking her to "speak a little bit louder please". Does he speak too fast? Ask him to "please slow down a bit so my ears can keep up with what you are saying". If she has turned away from you while talking, don't say, "I didn't hear you." Instead, use a specific request such as "Please face me when you speak." If she is talking with her hand over her mouth, say "Could you please put your hand down so I can see your face" instead of "I can't make out what you're saying."

Communication partner: The best way to speak clearly for people with hearing loss is to face them, speak a little bit more slowly, a little bit more loudly, and with natural voice intonation. Try not to cover your mouth when you are talking as it prevents your partner from taking advantage of visual cues.

Verify what you think you heard

Listener: If you have the slightest doubt that you understood a message correctly, confirm the details with the talker. It could save you some embarrassment or complications later.

Communication partner: When giving directions, such as where and when to meet for a meeting, ask your partner with hearing loss to repeat the information.

Accentuate the positive

Listener: Use positive words when you need help from your communication partner, such as "Could you please speak a bit louder?" instead of "You're going to have speak louder if you want me to understand you."

Be assertive

Listener: Politely let your communication partner know what you need to make the conversation flow more easily. At a group meeting, for example, if everyone is talking at once, suggest that only one person at a time talk. If you are on a conference call, suggest that each participant identify himself or herself when they say something, such as "This is Pat. I think we should have the fundraising event on a weekend."

Communication partner: If the person you are talking with indicates that she have a hearing loss and needs you to speak a bit louder or a bit slower, try to accommodate her needs without exaggerating. The accommodations you make will enable the conversation to flow more easily for both of you.Communication partner: When the listener with a hearing loss asks you to say something a little bit louder, take it as a compliment! It means she really wants to understand what you are talking about.

Listen with your eyes, not just your ears

Listener: Watch the speaker's face. Although less than 50% of the English language is visible on the lips, you can still get a great deal of help by picking up visual cues on the speaker's face.  Body language and facial expressions can also speak volumes.

Communication partner: The listener may benefit tremendously by being able to watch you as you speak. Be sure to not cover your mouth with your hands, a restaurant menu, etc., so that the visible features of speech are available.

Sometimes it's okay to break the rules

Listener: Sure, your mother told you to "Never interrupt," "Don't buck the line," and "Wait patiently until it's your turn to speak." However, picture this scenario: you are at a busy airport, waiting at the gate, and after a loudspeaker announcement that you couldn't understand, half the people waiting with you start running to another gate. Despite what your mother taught you, don't feel that you must wait in the long line of people waiting to talk to the gate agent. Simply go to the head of the line and say "Excuse me, I don't mean to break into the line but I could not hear the announcement that was just made and wonder if you could repeat it for me so I don't miss my connection."

Communication partner: It's important to understand that what may seem like rudeness on the part of your friend or family member is simply an effort to let you know as soon as possible that he is having communicating difficulty. For example, if he stops you in the middle of your description of your recent trip to the Rockies, just to ask you to speak a little slower, don't think of him as being impolite or not interested. Quite the opposite, he may be indicating that he wants to hear about your travel experiences but can understand your story better when you use clearer speech. So take it as a compliment, not as poor social skills.

Go easy on yourself

Listener: Be patient, with yourself, with your family and friends, and with people you encounter throughout the day. Don't blame yourself or others for your difficulties. Just keep trying to use the tips provided here and stay positive, even when the going gets tough. Some days will be more difficult than others but a cheerful attitude can work wonders for getting through the tough times.

Communication partner: Keep reminding yourself that although it may be difficult for you to converse with someone who has a hearing loss, it is even a greater challenge for that person, given the many difficulties encountered during a typical conversation. Be patient.