How to Communicate Better, and More Compassionately, With People With Hearing Loss

By Mary Florentine, Ph.D., Julia B. Florentine, and Michael J. Epstein, Ph.D. 

A trio of experts with both professional and personal connections to hearing loss share advice for better communication. 

They are a distinguished professor emeritus and expert in psychoacoustics (how humans perceive sounds); her daughter  who coaches communication skills and researches the link between language, language, and mental health; and an auditory scientist  who has investigated hearing better in background noise. 

Here they tell us what individuals with hearing loss say works and why these tips are effective.

“Look at me, and take your hands away from your mouth. Please don’t exaggerate your pronunciation.”

Many people have learned to use visual information from the mouth and facial expressions along with the sounds they receive to understand speech. The words “bother” and “father” sound very similar to people with hearing loss, but they look different when they are being said. The lips come together for “bother” to make a puff of air to start the word; the air coming through the mouth is continuous at the start of “father.”

Using these cues to understand speech is called “speechreading.” It used to be called “lip reading,” but we now know that we use more than information from the lips. Facial expressions also help.

Although there are excellent speechreading courses, some people learn to speechread on their own without formal training. Whether a person has had formal training speechreading or not, be sure that they can see your face.

Although many words can be speechread, others cannot. If you go to the mirror and say “mom, bomb,” in a natural manner and speed, they look the same on your lips. Speechreading can be helpful, but do not expect that someone can understand all speech 100 percent of the time using speechreading alone.

Many people exaggerate their pronunciation because they think it will make them easier to understand, but it can actually make it worse. Exaggerated pronunciation changes speechreading cues and may bring unwanted attention from others who can see you. Speak naturally. 

If you are eating while talking, make sure that you swallow the food in your mouth before you start to talk. Holding food in your mouth while talking will also change the speechreading cues. 

Don’t talk in the dark; good lighting is important. Don’t talk from the other room unless the listener can see through walls! And get their attention first, such as by asking “Can you hear me?” before speaking.

“If I do not hear you the first time, please repeat with different words.”

Some words are more difficult to hear than others. When a person with hearing loss misses a word, they often ask the speaker to repeat what they said. Most people will repeat the word that the person did not hear the first time.

If the listener does not hear the word again, some people continue to say the same word. Each time the word gets a little louder. This situation is extremely annoying to both the speaker and the listener.

If a person does not hear a word, it may be because the sound of that word might be especially difficult for them to process, and they do not have enough context to help them piece together the meaning. Saying the same thing with different words is a better strategy; it gives them another way to understand the message. If the word is an object and you both can see it, point or gesture. Writing or texting the word can be useful.

Even if you are having difficulty getting them to understand what you are saying, never give up and say, “Never mind.” You may think that what you have to say may not be that important, and you may be right. But the person with hearing loss wants to know what you said and is likely to feel left out. If you are having difficulty getting someone to understand, or you need to finish the conversation, it is better to say, “I’ll tell you later.” But if you say this, remember to tell them later or they will not believe you the next time.

The “I’ll tell you later” response can work well when the conditions for communication are bad or when you need time to think of a way to rephrase (and not just repeat) what you said.  

“Let’s try to limit or avoid background noise. I do not hear well in noisy environments.” 

It is difficult for people without hearing loss to understand the impact of background noise on a person with hearing loss. This is because they hear differently. People without hearing loss efficiently filter out unwanted noise, except when in the most extreme noise environments. People with hearing loss experience varying amounts of difficulty doing the same thing.

Every time we listen, unless we are in a sound-isolating chamber, we hear the sounds we want to hear mixed with sounds we do not want to hear. 

We usually get used to it and can tune out low-level background noises, such as the hum of a refrigerator or ventilation system fans. We can also tune out most other background noises, except when it gets very loud and/or really bothers us, like when a buzzing insect flies by.

People with hearing loss have difficulty separating out unwanted sounds. Most very low-level sounds are usually not a problem because they are not heard. Moderate and loud sounds that mix with speech can be a big problem. 

Noisy restaurants are always a problem, although there are ways to minimize the problem. You could go at a less crowded time, or ask for a quiet table away from the kitchen and the bar. If that doesn’t work, vote with your feet and go to another restaurant with better acoustics. You can look for reviews of quiet restaurants and even rate them yourself.

At home, you have more control over background noise. You can simply turn off the television or radio. If the person with hearing loss is watching television and you need to speak to them, ask them to put the television on pause or mute. If noise is coming from the hall, you can shut the door.

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Many other background sounds can occur at home. Don’t talk while washing dishes in the kitchen sink, using a food processor, or any other appliance that makes noise. Outside the home, you have less control over noise. It is usually best not to try to talk while walking outside on a noisy street and when you cannot face your conversational partner. Seek ways to limit background noise or wait until you are in a better environment to communicate.

We hope these strategies help facilitate better communication and engaging conversations for you and your loved ones.

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This is excerpted from “How to Talk to People With Hearing Loss,” available at and also previously appeared in the Summer 2019 issue of Hearing Health magazine. Mary Florentine, Ph.D. (far left) is a Matthews Distinguished Professor Emeritus at Northeastern University in Boston. Julia B. Florentine is the director, coach, and trainer at Glisten Training, which she founded, based in theU.K. Michael J. Epstein, Ph.D., is an auditory scientist, writer, filmmaker, and musician.

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Retired Hockey Star Mark Messier Fundraises for Hearing Research

By Lauren McGrath

Hearing Health Foundation (HHF) was thrilled to join this year’s Cantor Fitzgerald Relief Fund Charity Day on Wednesday, September 11, 2019 in New York City.

The annual philanthropic event “turns a tragic day into one that is positive and uplifting by helping others.” On Charity Day, Cantor Fitzgerald and and its affiliates GFI Securities and BCG generously donate the day’s brokerage revenues to the participating nonprofit organizations, each of which is represented by a celebrity representative. 

From left: HHF Board Vice Chair Paul Orlin, Retired Hockey Pro Mark Messier, CEO Timothy Higdon

From left: HHF Board Vice Chair Paul Orlin, Retired Hockey Pro Mark Messier, CEO Timothy Higdon

HHF was fortunate to have local athletic favorite Mark Messier serve as its charismatic and energetic celebrity ambassador. National Hockey League Hall of Famer Messier ended his 25-year professional playing career in 2004 before taking on leadership roles with the New York City team. Sporting a NY Rangers t-shirt, Messier was a familiar and friendly face and name to the staff and clients at GFI Securities and BCG Partners, where he graciously volunteered his time on Wednesday.

Messier was accompanied by Board of Directors Vice Chair Paul Orlin and CEO Timothy Higdon, and his participation marked HHF’s seventh year of participation.  

“Mark did an exceptional job engaging folks on the trading floor and over the phone. I was impressed by his positive demeanor and compassion, and I am so grateful that he could give up part of his day to make more hearing loss research possible.”

The Cantor Relief Fund was originally established to aid the families of the Cantor Fitzgerald’s 658 employees who perished in the World Trade Center attacks. The Fund has since expanded to support victims of terrorism, natural disasters, and emergencies, wounded military personnel, and other charitable causes, including HHF. Since its 2001 inception, Charity Day has raised $159 million globally.

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Estrogen’s Role in Hearing and Protecting Against Hearing Loss

By Christopher Geissler, Ph.D.

While the anatomy of the inner ear does not vary much among individuals, differences in hearing and hearing loss in men and women are well documented. A recent review of these differences by Benjamin Z. Shuster, Didier A. Depireux, Ph.D., Jessica A. Mong, Ph.D., and Ronna Hertzano, M.D., Ph.D., a member of the Hearing Health Foundation’s Hearing Restoration Project, appeared in the June 2019 issue of the Journal of the Acoustical Society of America. 

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Surveying the existing literature, the authors summarize what is known about estrogen’s role in protecting against or lessening the effects of hearing loss. Estrogen is a hormone present in all human beings but in higher levels generally in individuals who identify as female. 

Documented sex differences include better outer hair cell function and more prominent auditory brainstem response in women. Women also have lower rates of hearing loss than men, and men also experience declines in hearing more rapidly than their female counterparts. 

There is substantial evidence that estrogen plays a role in these differences, which is unsurprising, given that sex hormones are often behind physiological differences between the sexes. Studies demonstrate that estrogen helps determine hearing ability and can protect hearing over time. 

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But despite ample evidence of estrogen’s role in hearing, scientists are still not entirely sure how it works. Further research on estrogen and hearing will help scientists develop treatments for age-related and noise-induced hearing loss. 


A better understanding of estrogen’s role in hearing and differences between the sexes is also important because, as the authors point out, “a large sex bias still exists in many aspects of hearing research,” which means that studies that involve only men or that do not account for sex at all could lead to the development of treatments that will be less effective for women.

Christopher Geissler, Ph.D. is Hearing Health Foundation (HHF)’s director of program and research support. Ronna Hertzano, M.D., Ph.D., is a member of HHF’s Hearing Restoration Project consortium based at University of Maryland School of Medicine.

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Our Impact Invigorated: HHF Visits the NIDCD

By Timothy Higdon

In my role as CEO of Hearing Health Foundation (HHF), most of my time is spent liaising with the individuals who make our groundbreaking work possible—scientists, volunteers, Board members, and donors—from our New York City office. I was fortunate to recently step away from my typical routine to witness the excitement of hearing and balance science at the National Institutes of Health (NIH) on Wednesday, August 21. 

This educational visit was organized by the Friends of the Congressional Hearing Health Congressional (FCHHC), the coalition co-founded by HHF that supports the policy interests of the Congressional Hearing Health Caucus (CHHC), a bipartisan group to committed to increasing hearing health care.

We learned about the latest federally-funded advancements in hearing and balance disorders in a tour of the labs at NIH’s National Institute on Deafness and Other Communication Disorders (NIDCD) Intramural Research Program at the Clinical Center in Bethesda, MD. The nation’s largest hospital devoted to clinical research, the center is one location where the NIDCD supports and conducts research on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language with an annual budget of $474 million. 

Members of the FCHHC in the Clinical Center. Photo by Nichole Westin, American Cochlear Implant Alliance.

Members of the FCHHC in the Clinical Center. Photo by Nichole Westin, American Cochlear Implant Alliance.

NIDCD Scientific Director Andrew J. Griffith, M.D., Ph.D., and clinician-scientists Carmen Brewer, Ph.D., and Clint Allen, M.D., hosted a presentation and tour. Griffith noted the importance of animal models in his overview of the hearing and balance functions, a nod to our Hearing Restoration Project’s work with birds, fish, and mice to identify biological cures for hearing loss in humans.

I was very impressed by the state-of-the-art facilities, especially the vestibular testing booth that is used to evaluate hearing and balance patients. Eye movement is observed while the chair or walls of the booth spin rapidly, helping doctors to understand how conditions like vertigo or Ménière's disease are affecting the patient.

The support that is given to patients in clinical trials also inspired me immensely. Clinical trials recruitment can be challenging, but the NIH has a national reach with a database registry for interested patients. The NIH helps with relocation expenses for the patient to minimize disruption while necessary care is provided.

I am tremendously excited by the strong relationship HHF maintains with the NIDCD. The NIDCD’s newly appointed Director, Debara Tucci, M.D., is an alumnus of our Emerging Research Grants (ERG) program and Council of Scientific Trustees. Many of our ERG recipients subsequently qualify for funding from the NIDCD and other constituent institutes of the NIH at the rate of $91 for every $1 invested by HHF. My visit to the NIH was a meaningful reminder of the impact our scientists make at the federal level, while demonstrating that much more work must be done to better the millions who live with hearing and balance conditions. 

How wonderful it was to spend the day with so many individuals committed to hearing health. I look forward to continuing our relationships with the NIDCD and the FCHHC to advance our vision of a world in which people can live without hearing loss.

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Staying Vital

By Lauren McGrath

My father is an avid concertgoer who turned 61 in February, and I’ve been trying for more than two years—since I joined the team at Hearing Health Foundation (HHF)—to convince him to get his hearing tested.

I do not know whether or not my father has an identifiable hearing loss, but I know that a person of his age should take extra precaution for his ears. The World Health Organization advises: “If you are beyond the age of 60, work in a noisy environment, or have frequent exposure to loud noises, an annual hearing check is recommended.”

Lauren and her father at a music festival in Athens, Georgia.

Lauren and her father at a music festival in Athens, Georgia.

As an adult, I have had my own hearing tested twice, first with an audiologist at the Center for Hearing and Communication in New York City, and later over the phone using an automated system. Though I have never experienced difficulty in conversations or noisy spaces, I appreciated that these non-intrusive tests provided reassurance my hearing falls within the typical range. If a loss was identified, I would have been equipped to seek treatment immediately.

“Hearing tests are quick, easy, and painless, Dad,” I persist, but he’s still adamant about not getting one of his own, despite being generally proactive in other areas of his health. As we now know, ignoring a hearing loss can result in additional serious medical issues affecting the whole body, including cognitive decline and dementia, falls, social isolation, and depression.

With my ongoing support (read: badgering), I expect my father will take my advice in the near future. But most of the U.S. adult population does not have someone in their life checking up on their hearing health unless they are already treating a known hearing condition. 

Because the importance of healthcare is still severely underappreciated, I’m immensely grateful for the “Hear Well. Stay Vital.” campaign. This awareness initiative launched by the Hearing Industries Association (HIA) in early 2019 has as its objective to encourage more people—starting with baby boomers, like my dad—to check their hearing annually and take appropriate action with the results. 


“Hear Well. Stay Vital.” is centered on the preservation of our passions. The campaign website states: “We all have passions that inspire us, hobbies and interests that energize and make us feel like our true selves. Singing. Tennis. Dancing. Motorcycling, Yoga. Pottery. Hiking. Gardening. Traveling. Socializing. This concept is designed to capture those passions and help people understand that to stay vital and preserve their passion, they need to manage their hearing health. So, get a hearing wellness check annually and stay true to yourself.” 

HIA was largely inspired by a 2016 report by the The National Academy of Sciences, Engineering, and Medicine onHearing Health Care for Adults: Priorities for Improving Access and Affordability.” One recommendation of this report, to which HHF Board of Directors member Judy Dubno, Ph.D., contributed, calls for improving publicly available information on hearing health. 

“Hearing health and routine hearing checks do not receive the attention directed to other health issues. Many people can cite statistics relative to their unique health, such as height, weight, heart rate, cholesterol, vision and more. But not hearing,” says Kate Carr, president of HIA. 

HHF is a partner in the campaign, along with the Academy of Doctors of Audiology, the American Academy of Audiology, the American Cochlear Implant Alliance, the American Speech-Language-Hearing Association, the Hearing Loss Association of America, and the International Hearing Society.

HIA encouraged a major push during May’s Better Speech and Hearing Month to garner awareness. As of August, PSA videos were distributed to more than 3,000 network stations across the U.S. The PSA videos are in the top 10 percent of more than 1,000 videos tracked by Nielsen. 

“Anyone can join in this effort to improve hearing health,” Carr says. The campaign website hosts videos and a social media guide for free download and distribution. 

I’m hopeful that education will continue to increase and, one day, hearing tests will be perceived as important as dental cleaning and vision checks. 

Music is my dad’s passion. He sees an average of 40 concerts each year (with earplugs, of course), and his CD and record collection totals over 3,000. I want him, and individuals at risk of hearing loss, to preserve their ability to enjoy what they love to the fullest.

For more on the “Hear Well. Stay Vital.” awareness campaign and free shareable resources, see

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Katelyn and Solenne

By Timothy Higdon

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You know well what it means to live with hearing loss: It can be lonely, scary, or frustrating. It can make us struggle to access the things — and the people — we love the most.

I know these feelings, too. In the U.S. Army, I was exposed to equipment, demolitions and weaponry without wearing hearing protection, and today I live with a bilateral hearing loss.

I cannot thank our supporters enough for making critical hearing and balance research possible. Having only recently joined Hearing Health Foundation (HHF), I already this generosity and enthusiasm for better treatments and cures so inspirational.

Support from private individuals is especially critical given how government funding for hearing loss research is so low relative to its burden on Americans.

Sisters Katelyn, 12, and Solenne, 11, of Connecticut, are among the tens of millions of individuals who benefit from advances in hearing loss research. Both girls were born with severe to profound hearing loss but showed no benefit from hearing aids. They have both since received cochlear implants (CIs).

Their mother, Genevieve, is grateful that Katelyn and Solenne are able to attend a mainstream school and thrive. Katelyn plays lacrosse and violin, while Solenne plays basketball and sings in the school chorus. Both girls take sailing lessons in the summer.

But Genevieve and her husband, Brian, know well that more advancements in technology and medicine will benefit their daughters, other children, and adults. Because there are limitations to CIs and hearing aids, the long-term objective for HHF is to provide far better quality hearing discovered through research.

Please make a contribution today to bring us closer to permanent hearing loss cures. Your generosity can make possible more scientific discoveries we — our veterans, parents, our children, spouses, friends — urgently need. 

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Breaking Stereotypes: Hearing Loss in the Media

By Alexander Chern, M.D.

Last summer’s blockbuster film “A Star Is Born” brought hearing loss into mainstream media. What has the entertainment industry done since? 

Friend: This is my friend Ally.

Ally: Oh, my God! Hi.

Jackson: Hi. Hey. 

Ally: I thought that might be you.

Jackson: What’d you say?

Ally: I thought that might be you.

Jackson: That’s me.

Ally: So why are you in here hon?

Jackson: Sorry?

Ally: What brings you here?

Jackson: Oh I was playing right around here tonight. I’m a musician.

This exchange stood out to me while watching “A Star Is Born,” the blockbuster film from the summer of 2018 about a hard-drinking, seasoned rock star, Jackson (played by Bradley Cooper), who discovers and falls in love with a struggling artist, Ally (Lady Gaga). 

This scenario is familiar to most people (with or without hearing loss)—sometimes we miss a few words here and there when having a conversation in a noisy environment, such as a loud concert or a cocktail party. But something felt strange about this scene; this type of situation rarely happens in a movie, let alone twice in one scene, because movies are scripted. 

In most movies, any imperfections of daily life are often erased from movie dialogue so that everyone seems perfect—and this includes the ability to hear. As a resident physician in otolaryngology–head and neck surgery (also known as ear, nose, and throat surgery, or ENT) and as a person with hearing loss, I suspected there was something more to this than meets the eye. Several scenes later, my hunch was proven correct when we learn that Jackson suffers from hearing loss and tinnitus. 

Bradley Cooper and Lady Gaga in “A Star is Born.” Credit:    Peter Lowe   , Flickr.

Bradley Cooper and Lady Gaga in “A Star is Born.” Credit: Peter Lowe, Flickr.

When Jackson visits a hearing specialist (a cameo by William Slattery III, M.D., an otolaryngologist from the House Ear Clinic in Los Angeles, and Cooper’s actual ear doctor), they discuss Jackson’s hearing loss and the importance of using in-ear monitors to protect his hearing while performing. In the next scene, Jackson adamantly refuses to use hearing protection when performing at loud rock concerts, and he later explains that his struggles with hearing and tinnitus began when he was younger. His hearing worsened throughout his career as a musician, suggesting he likely has noise-induced hearing loss from exposure to loud sounds, a common occupational hazard in the music industry. 

Hearing loss is both underrepresented and misrepresented in the media, which frustrates many of us who actually have hearing loss. When hearing loss is represented in the media, it is often in connection with aging—individuals who are hard of hearing have typically been depicted as elderly, isolated, and disabled individuals who are dependent on others. Other media representations of hearing loss focus on Deaf culture; television shows like “Switched at Birth” and “The Society” and movies like “A Quiet Place” and “Wonderstruck” represent individuals with deafness, but are not necessarily relatable for all individuals across a wide spectrum of hearing loss. 

In contrast, Cooper’s character in “A Star Is Born” is a famous, still-young music celebrity who does not meet the typical stereotype of someone with a hearing loss. As the movie progresses, we watch Jackson struggle with his hearing loss and its impact on his self-image as he continually refuses to have his hearing treated or protected while exposed to loud music onstage. 

Though Jackson’s struggles with his hearing are not the main focus of the movie, this subplot also reminds the public that this condition not only affects the elderly—young people can have hearing loss, too. One in five young adults ages 20 to 29 reportedly has trouble hearing. And fewer than 16 percent of individuals ages 20 to 69 who could benefit from wearing hearing aids have actually used them. 

I can relate to Jackson’s struggle to reconcile his image with his hearing loss. Even though I am currently an ENT physician-in-training, pursuing a career that helps treat people with hearing loss, I spent almost 10 years of my life while in college and medical school refusing to wear my hearing aids when I certainly could have benefited from them. As a young person with a hearing loss (I am 29), I made life harder for myself for no good reason other than what I felt was society’s perception of people with hearing loss.  

The media is the fastest and most cost-effective way to raise awareness and eliminate stereotypes, promote inclusion of individuals with hearing loss, and reduce the perceived stigma that is still ingrained in our society. Doing so will also help us fight the hidden epidemic of hearing loss, which is both highly prevalent and severely undertreated. 

Credit: Disney Studios

Credit: Disney Studios

Not so long ago, people persisted in using terms such as “deaf and dumb,” “deaf-mute,” and “hearing impaired” to refer to these individuals. Such terms reflect the unconscious biases people have against such individuals who struggle with hearing, which, in part, prevents them from seeking treatment. I believe those who work in entertainment—writers, producers, and directors—should take the artistic responsibility to portray individuals with hearing loss in an accurate, authentic, and diverse way. 

In addition, the frequency of individuals with hearing loss portrayed in the mainstream media needs to more accurately reflect its real-life prevalence. According to the National Institute on Deafness and Other Communication Disorders, about 20 percent or 48 million Americans report some degree of hearing loss. Normalizing hearing loss and fighting stereotypes will also require the entertainment industry to show us more characters with hearing loss wearing modern, digital hearing technology. We also need more character development, storylines, and subplots about hearing loss, not to mention actors, directors, and writers affected by this condition who are best able to tell such stories. Diverse media representation will be crucial in raising awareness and educating the public about hearing loss. 

I recently saw “Toy Story 4,” the latest installment of Pixar’s iconic “Toy Story” series that began decades ago, in 1994. I was thrilled to see the creators of the movie took a big step toward inclusivity when they featured a young child wearing a cochlear implant with a bright green processor. (It’s in an early scene when Bonnie goes to kindergarten for the first time and meets her classmates.) 

I remember, as I am sure many of us do, what it felt like to be made fun of for wearing hearing aids as a child—it was embarrassing. For many, this perceived stigma is often a barrier to obtaining treatment for their hearing loss. Wearing hearing aids makes us feel different, and not in a positive way. Glasses, a medical device seen as part of everyday life for many people, used to be stereotyped as being worn by nerdy kids without any friends. However, glasses are now considered fashionable and stylish—many individuals wear glasses even if they do not have vision loss. 

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There is no reason why having hearing loss treated with hearing aids or cochlear implants should be perceived any differently than having vision loss treated with glasses, especially nowadays when wearing name-brand headphones or earbuds or other accessories on the ear is commonplace. Though there is still a long way to go in raising awareness, breaking stereotypes, and making hearing loss hardly anything different in the media, that little boy in “Toy Story 4” rocking his bright green processor marks an important first step. 

Alexander Chern is a second-year ENT resident physician at NewYork Presbyterian Hospital, Columbia/Cornell.

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Net Gains

By David Pierce

In 1979, captioning was in its infancy on broadcast television. Services were provided by Caption Center (which had been doing it since 1972) and National Captioning Institute, which was launched in 1979 to serve as competition to Caption Center. Only a few television series were being voluntarily captioned, as Federal Communications Commission captioning regulations did not yet exist. 


Also that same year, Silent Network was launched in Hollywood to provide broadcast television programming for viewers who were deaf and hard of hearing using sign language, open captions, and full sound on broadcast and cable. The word “SILENT” is an acronym: “SIgn Language ENTertainment.”

It was a pioneering time for accessible television, and the general public was being exposed to captioned and sign language programming on a national basis. Silent Network was founded by Hollywood veteran Sheldon I. Altfeld and Kathleen Gold. Gold’s daughter, Julianne, was born deaf, and became a Broadway actress appearing in the original Tony Award–winning production of “Children of a Lesser God.” The founders identified the need for actors and producers who were deaf and hard of hearing to have a place to work, and the network was formed to fulfill that goal. 

The network’s first program, “Sign of Our Times,” aired on NBC in 1979 during a prime-time slot and was hosted by comedian Norm Crosby. The response was overwhelming, and the network expanded its offerings to broadcast, cable, and satellite. By 1995, it was a full network airing 24 hours a day, 7 days a week. Around the same time, when broadband internet was relatively new and serving low-resolution streaming video, it was one of the first 24/7 networks to stream its live satellite signal to the internet simultaneously.

Silent Network cofounders Sheldon I. Altfeld and Kathleen Gold with comedian Norm Crosby during the production of "Sign of Our Times" in 1979.

Silent Network cofounders Sheldon I. Altfeld and Kathleen Gold with comedian Norm Crosby during the production of "Sign of Our Times" in 1979.

Over the years, as it earned several Emmy Awards and other accolades, Silent Network weathered ongoing changes in the media landscape but eventually ran into financial difficulties. It entered into economic hibernation in 2000 when the network went off the air via satellite. However, with the advent of over-the-top (OTT) television, which allows content creators to stream their products directly to consumers, the network relaunched in 2017. 

Along with Silent Network and its sign language programming, a new network called Access Network was launched in 2018, providing open captioned and language-free programming for the general public and deaf, hard of hearing, and people learning English as a second language. The language-free content can be viewed by anyone around the world, with strong visuals relaying the story instead of spoken word. In 2019, as part of its 40th anniversary celebration, Silent Network launched a second OTT network for Roku players and TVs, free to Roku subscribers. 

In the network’s long history, it has experienced different owners, resulting in several changes to the network’s name. In recent years, the network reverted back to its original name of Silent Network by the current owners—my wife Robin Byers-Pierce, and me. 

As the network’s longest-standing alumnus and profoundly deaf, I was involved with several aspects of the network over a 32-year period as it underwent various incarnations. I currently run the post-production and master control operations of the network at our two locations in Texas. Robin, also a longtime alumnus who is hard of hearing, handles editing, captioning, and interpreting work for the network.

Herb Larson (left) and Lou Fant (center) with actor Lou Ferrigno on the set of Silent Network's long-running series “Off-Hand.”

Herb Larson (left) and Lou Fant (center) with actor Lou Ferrigno on the set of Silent Network's long-running series “Off-Hand.”

With the network’s large archive of 15,000 programs, videotape preservation and restoration work is a regular practice in order to preserve the content for the benefit of future generations. Most broadcast videotape has a shelf life of between 20 to 35 years (dependent upon proper storage conditions), so it is a ticking time bomb for the older programming. Our film and video preservation company, Davideo Productions, performs the restoration work.

The network’s content is varied to target different age groups and constituencies. On a new service called Access Community, which is part of Access Network, professional content providers can contribute their own unique programming in sign language. Viewers who are hard of hearing, especially senior citizens who lost their hearing later in life, seem to gravitate toward the open captioned programming on Access Network, especially classic films and television shows. People for whom English or sign language is not a native language can enjoy the language-free programming that has no dialogue. 

New content is added to both Silent Network and Access Network on a weekly basis. Robin and I are proud to carry on the network’s legacy of accessibility and inclusion. 

For nearly 35 years, David H. Pierce has worked in all aspects of television programming and production and has a long list of production credits. A writer and advisory board member for this magazine in the 1980s, Pierce is a managing partner of Silent Network. A certified sign language interpreter since 1976, Robin Byers-Pierce owns Specialty Interpreters and is a partner at Silent Network. For more, see,,, and

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How to Plan for the Cost of Hearing Care


Out of the estimated 48 million Americans living with some degree of hearing loss, only one in five wears hearing aids. The main reason? Cost. And these aren’t the only costs associated with hearing loss. Over the course of a lifetime, healthcare fees can add up to tens of thousands of dollars—or more. Here are tips to help you budget and plan for these expenses.

Find a health insurance plan tailored to your needs.
Hearing aid devices usually range from $1,000 to $4,000 each and may require replacement roughly every five years. Many insurance companies do not provide full or even partial hearing aid coverage. Currently, only 22 states require insurance companies to provide hearing aid coverage for children, and only five states have provisions that include coverage for adults. Government healthcare programs such as Medicare offer little to no coverage, with the breadth of coverage varying from state to state for Medicaid. 

If your current health plan does not cover hearing aids, an accredited insurance broker or agent can help you identify a plan that will work best for your situation and location. Make sure your agent represents several major insurers to ensure they are not incentivized toward selling you a specific plan.

Plan and budget to cover your healthcare costs.
Plan for three types of expenses: fixed monthly premiums to your insurance company; routine out-of-pocket expenses (e.g., hearing devices); and unexpected costs (e.g., emergency room visits). In addition, make sure you understand all the costs included with your health plan, including deductibles, copays, co-insurance, and the out-of-pocket maximum. Once you’ve identified all these expenses:

Add up the cost of your fixed premiums and routine out-of-pocket expenses. Divide the total by 12 and aim to save that amount each month. 

Open a separate medical emergency fund. You’ll want to start saving enough to cover your deductible and eventually, your plan’s annual out-of-pocket maximum. Consider opening a high-yield savings account, as they often have no fees and no minimum balance and offer higher returns than a typical savings account. 

Ask your employer whether you’re eligible for a Health Savings Account (HSA) or Flexible Spending Account (FSA), both of which allow you to make tax-free contributions to save for medical costs. You may be able to use HSA or FSA funds to pay for hearing aid devices and hearing aid batteries. One key difference is that HSA funds automatically roll over from year to year, while FSA accounts have a use-it-or-lose-it provision. 

If you’re raising a child with hearing loss, consider developing an estate plan to help ensure they are financially secure.
A financial planner or estate planning attorney can help you navigate this complex topic and develop a plan tailored to your financial situation as well as to your child’s needs. A trust, for example, can ensure your child’s inheritance is carefully managed according to your wishes. If your child is eligible for Medicaid or Supplemental Security Income (SSI), a special needs trust will ensure that he/she will remain eligible for federal benefits. 

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The costs associated with hearing loss can be overwhelming, but you don’t have to navigate them alone. A trusted financial professional can help you plan for these expenses or ensure your loved one’s costs are taken care of after you’re gone. 

Matthew Phillips is a wealth adviser at Trilogy Financial, a privately held financial planning firm with advisers across the country. Based in Corona, California, Phillips partnered with RISE Interpreting and California Baptist University to deliver American Sign Language–certified translation, workshops, and other services to better serve his clients. For more, see This article originally appeared in the Spring 2019 issue of Hearing Health magazine. For references, see

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Family Ties

By Ava Finnerty

Ava’s mother, Sonia, had a hearing loss but never disclosed it to anyone.

Ava’s mother, Sonia, had a hearing loss but never disclosed it to anyone.

My mother Sonia, born and raised in Wales, was the first person I knew with a hearing loss. She concealed it for many years. In my adolescence and young adulthood, I came to learn of her hearing loss, my grandmother’s, and, eventually, my own.

During World War II, my mother served in the Women’s Air Corps in Britain, where it was her duty to (wo)man the barrage balloons on the White Cliffs of Dover. It was there she met and married my father, John Jessen, a U.S. Army Sergeant preparing for D-Day. During the war she gave birth to my oldest brother, and then they both emigrated to the U.S. in 1946 to reunite with my father.

My parents moved to a veterans housing project in Bayonne, New Jersey, to raise our family. My mother was a very private person who largely refrained from sharing her medical issues with my two brothers, my sister, and me. I have a vague memory of her having some kind of ear surgery in the early 1950s, when I was 5 or 6 years old, but I did not receive an explanation. 

Every time we went swimming, my mother plugged her left ear with a large wad of cotton and covered her head with a bathing cap. She told us she had a “hole” in her ear that needed to be protected from water. Incidentally, my mother helped tend bar at my father’s parents’ bar, The Viking, before becoming pregnant with me, but I later learned for certain her hearing loss was not caused by noise.

A Family Inheritance

A strict parent, my mother believed “children should be seen and not heard,” so I thought she often remained silent in response to my questions on purpose, and not because she literally could not hear me. It was only when I was a teenager that my mother told me the truth about her hearing. She had a severe hearing loss, but she did not treat it. Her small group of friends likely provided some support for her untreated condition.

My mother inherited her hearing loss from her mother, Bessie, who was profoundly deaf. Grannie still lived in the small Welsh village of Pontypool, where I visited her occasionally, first when I was 20, before my own hearing loss had been identified.

Shown with extended family, Ava (second from right) traces her roots to Wales through her mother Sonia.

Shown with extended family, Ava (second from right) traces her roots to Wales through her mother Sonia.

Grannie was a voracious writer—I suppose by necessity, because she did not wear hearing aids. She was keenly in touch with her surroundings, able to sense vibrations and read lips adeptly. Relying heavily on her vision, she was more cognizant of others’ facial expressions and body language than most with typical hearing. 

At my wedding Grannie impressed me with her grace as a dancer, using the feelings of the bass and drums to move rhythmically. She was a strong and confident woman who’d grown resilient living as a mother and grandmother with a hearing loss during World War II. 

A Gradual Process

My own difficulty hearing came on so gradually it was hard to notice. But I do remember vividly the day I realized the difference between my left and right ears. I was then a parent of three young children, living in Bayonne in a two-family house with my mother. I was cooking while cradling the phone between my right shoulder and right ear. 

At one point in the conversation I switched the phone to my left ear and realized I could not hear what was being said. Despite this realization, I compensated for some time, relying on my “good” ear for conversation. It is truly amazing what a person can get accustomed to not having!

Around this time I could tell that my hearing loss was affecting my work. I was well into my career as a high school English teacher. At first, I attributed my inability to understand my students to their mumbling or mouth-covering. But, as the problem worsened, I knew it was me, not them. Only later did I learn my colleagues thought I was aloof because I would not acknowledge their greetings!

I developed a meaningful relationship with my mother, incidentally, during the onset of my own hearing loss. She and I cared for my father, helping him with home kidney dialysis every other day, and formed a very close bond. After his death, we spent many hours talking together, and I told her about the difficulty I had hearing my students.

Even though I knew of my mother and my grandmother’s hearing loss, I had concluded I had a buildup of earwax in my left ear. My husband Joseph, who was the chief echocardiography technologist for New York Hospital, was able to refer me to an audiologist at New York Weill Cornell Hospital. 

There I learned I had almost no earwax buildup—but I did have a significant hearing loss. I was diagnosed with a 78 percent loss in my left ear and a loss of close to 30 percent in my right. 

Successful Surgery

My left ear’s hearing loss was due to otosclerosis, an abnormal growth of bone in the middle ear. Otosclerosis is commonly thought to be inherited but its causes remain unclear. Scientists cite measles infections, stress fractures to tissue surrounding the inner ear, and immune disorders as possible causes. My doctor noted my otosclerosis was accelerated by my pregnancies, and research has since suggested this is possible.

I had a successful stapedectomy on my left ear, a surgical procedure that replaces the stapes bone with a prosthetic device so the bones in the middle ear can again vibrate in response to
sound and hearing is restored. The procedure was minimally uncomfortable but did cause severe vertigo, which I was able to control with medication. 

In the late 1980s, my mother finally chose to pursue hearing aids but wore them rarely because they emitted a very high-pitched sound. Later in her life, she stopped wearing them completely. Since we shared the two-family home, my family and I always knew what Grandma was playing on her television or radio upstairs at maximum volume. And we lost count of the number of times she shouted “whadjasay?!” to my father.

Mom became increasingly withdrawn. She never wanted to go out on dinner dates or socialize with friends. Only in recent years, after her passing, have I come to understand this preference for isolation.

Over the decades that followed, the hearing in my right ear slowly diminished and I found it increasingly difficult to manage at social events. I wanted to undergo a second stapedectomy, but the audiologist told me this wasn’t recommended. 

I was fitted for hearing aids instead. The audiogram showed a moderate hearing loss in my left ear and a severe loss in my right with difficulty hearing low frequencies in both. No wonder I could not hear the deep-voiced young men speaking in class!

The audiologist asked if I wanted access to sounds at 180 or 360 degrees. I said 360 because I wanted to hear what my students were saying behind my back. I always told my students that although I wore hearing aids, they needed to speak clearly and be aware that I sometimes surprised myself by what I was able to hear. I specifically told my students to never say “never mind” if I asked them to repeat themselves or speak up, but to repeat and rephrase what they said.

Vigilant About Hearing Well

Ava (middle) and her two daughters.

Ava (middle) and her two daughters.

This was in 2011, when I was 62 years old, and I’ve vigilantly worn my hearing aids since. The devices have, for certain, added to my quality of life. They are not perfect, but I consider them an absolute necessity if I want to hear my grandchildren and other family members. I am a music lover, play-goer, and movie fan. And had I not begun wearing them, I surely would have retired from my teaching career earlier than I wanted to. 

I supplement my hearing aids with simple requests and tools. I have no problem telling someone, “I don’t hear as well as I would like to. Could you say that again?” I retired in 2014, after 42 years of teaching high school English, and then was elected to be a Bayonne Board of Education trustee in 2015. During our meetings I prefer to sit at or near the head of the table to read the lips of the person speaking. 

I use closed captions at home watching television. When I babysit, I often go to my grandchildren’s bedroom doors to check on them because I am not sure if they are crying. I love baby monitors that not only light up but also have video for me to easily check. 

Both my daughter and daughter-in-law are aware of the genetic predisposition for otosclerosis. In fact, my daughter thinks that her 16-year-old daughter may have some hearing loss. My advice to her was to pay attention—but also that there is a great distinction between “hearing” and “listening,” especially when it comes to adolescents! 

Ava Finnerty lives with her husband Joseph in New Jersey. A retired English teacher, she serves on the Bayonne Board of Education as a trustee. Their adult children are Kristen, also an English teacher; Jill,
a music teacher; and Sean, a U.S. Navy veteran who served in Iraq. This article originally appeared in the Summer 2019 issue of Hearing Health magazine. For references, see

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