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 glistentraining.co.uk/book 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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