Communication and hearing impairment

1. How can hearing impairment affect interpersonal communication

Although in major society often the loss of sight is considered a much worse disability than the loss of hearing, in fact it is the other way around. Hearing is indispensable as far as human communication is concerned, and its loss always creates a huge social barrier. Children born deaf develop more slowly and their thinking and speech is always affected. Moreover, do not forget that hearing is an important sense of security, because it provides us with the ability to monitor our surrounding and assess threats in very wide areas (even where we cannot see), and is the only sense active even during sleep, too. That's the reason why warning signs like fire alarms, sirens, or alarm clocks, are mostly acoustic.

Levels of hearing loss

We can talk about:

• people with hearing impairment (slight, moderate, severe or profound - depending on decibels they can hear);
• people with hearing loss (nearly total - and total, which are also called deaf).

Types of hearin loss

• Conductive (when there is a problem with the Outer or Middle Ear which interferes with the passing sound to the Inner Ear; this can be caused by too much earwax, ear infections, etc., and in many cases, surgery and some types of hearing technologies can be used to treat this kind of hearing loss.).
• Sensorineural (when the hearing organ is damaged and it is necessary to strengthen the sound).
• Auditory processing (when a person cannot understand and louder voice is not helpful—in this case, we should rather speak more slowly, pronounce carefully, and allow the person to lip read).
• Mixed hearing loss (occurs when both Conductive Hearing Loss and Sensorineural Hearing Loss are present in one person).

For people who lost hearing during their lives, an important factor is if the loss happened before or after they began to speak (we talk about the prelingual or postlingual deafness - approx. before or after age 7 years).

What are the common symptoms of hearing loss

• A person asks others to repeat themselves;
• A person often say “what?” all the time, or he/she needs to be looking at someone to hear what they’re saying (reading their lips);
• A person turns the TV or music to a volume others find too loud;
• A person cannot have a usual conversation with others because he/she can't hear them well;
• A person has trouble hearing on the phone;
• A person has ringing in his/her ears (it is often thought to be a symptom of hearing loss or damage to the auditory system — and hearing loss and tinnitus very often go hand in hand).

2. Communication strategies for the Deaf and hard of hearing people

The Deaf refers usually to a person with hearing loss so severe that there is very little or no functional hearing, while hard of hearing person refers to one with a hearing loss where there may be efficient to use some auditory devices, such as a hearing aid or FM system, which provide adequate assistance to process speech).

Deafened usually refers to a person who became deaf later as a child or adult, and faces different challenges than a person who was born as a deaf.

Deaf, deafened, and hard of hearing individuals may use:

• hearing aids
• cochlear implants
• other assistive listening devices.

People with hearing impairment usually use various kinds of hearing aids (behind the ear, body worn, eyeglass aids etc.). These aids use analogue or digital technologies to strengthen the sound according to the indivdual needs.

Cochlear implant is an aid using completely different technology than hearing aids. Sound sensation comes from the sound that is converted into electric signals which directly stimulate the auditory nerve inside the cochlea. Cochlear implant helps people to hear who would, otherwise, be completely deaf. Auditory vestibular nerve must be intact, and so must auditory cortex in brain; the patient must have potential for development of speech and good enough intellectual abilities.

Communication strategies and rules

In communicatin they may:

• read lips
• use sign language (and sign language interpreters), and/or
• captioning (dactyl alphabet, subtitles...).

Try to learn a few of basic signs of American Sign Language:

Although there is not one international sign language (but only an International Sign System not widely used by the Deaf community), you can tra to learn some international signes here:

- or you may certainly find your own national sign language on the internet...

And now, try to suggest (and write down) a few of common rules for interpersonal communication with a hard of hearing person:

And now you can watch the video and check your suggestions:

3. What to do and what not to do...

When speaking to a person with hearing loss, you should keep the following rules and tips:

• Get his/her attention.
• Face him/her and stand close to him/her (between 2-4m) - and keep the eye contact.
• Have the light on your face and do not cover your mouth.
• Speak more slowly than usual (but not too slow!).
• Speak more loudly if it helps, but do not shout.
• Speak expressively and use your face, hand and body movements to follow your speech adequately.
• Use rather the well-known and frequented words and simple phrases.
• Make sure that a person understands the meaning of your speech.  
• Be ready to use a pen and paper (write words or short sencences, or you may draw some pictures).

On the other hand, we should not:

• touch this person on his/her back if he/she couldn't see us at first 
• talk to this person in a noisy and dark room (or environment)
• talk to this person from the oppocite corner of the room or turned back form him/her
• talk to this person while eating or with our lips covered by our hand or by the veil (mask) etc.
• talk to this person for a long time (more than about 30 minutes - after this time, the attention decreases significantly...).