December 21, 2016

Communication Strategies

I was taking a walk with my friend the other day after a yoga class. Sadly, our favorite coffee shop is near the “L” train so our conversation kept getting interrupted and I found myself struggling to hear. It’s times like these I sympathize with my hearing-impaired clients. The increased amount of effort needed to hear in noisy environments takes the enjoyment out of the conversation. It’s not that I can’t hear, I’m just unable to understand the words when the train flies by.

The loss of clarity in speech is the number one complaint from clients. Rarely does someone tell me they can’t hear, but rather most of my clients’ say they can hear fine… they just can’t understand. (Spouses and kids mumbling comes in as a close second!)

Why is that? It comes down to simple anatomy. The cochlea, the snail-shaped organ of the ear, was formed with high frequency hair cells at the entrance, followed by mid-frequencies and ending with low frequencies at the top. Think of the entrance of the cochlea like the entrance to a carpeted room—the carpeting at the entrance becomes worn much faster than anywhere else in the room.

Typically, when we lose our hearing it starts in the high frequencies and slowly progresses to the mid and low frequencies. Voiceless consonants are located in the high frequencies. Think “s”, “sh”, “f”, “th”. These sounds tend to be at the beginning and end of a word whereas vowels and voiced consonants occur in the low and mid frequencies. The low frequencies give us the sense of volume in speech.

Someone with a typical sloping hearing loss will hear fine (low frequency volume) but lose the clarity (high frequency voiceless consonants) in speech. This gradual sloping loss also occurs slowly so those with hearing loss do not realize it’s happening. They feel their difficulties are due to the environment or the person speaking. If people went from hearing to sudden hearing loss overnight, they would be calling their doctor for an urgent appointment. When it occurs gradually we tend to not notice until others point it out which brings us to the third most common complaint: my spouse and kids think I can’t hear.

Discrimination is the ability to clearly understand what is said. Problems with discrimination are common for various people whether they have hearing loss, wear hearing instruments or have normal hearing. So what’s the solution? Hearing instruments are a great start for those with hearing loss and we can all benefit from good communication strategies. Successful communication only works if everyone involved in a conversation are using good communication strategies.

The following is a list of communication strategies meant to help ease communication:

  • Face the person you are speaking with. Positioning yourself in good lighting and on the same level as the person you’re talking to accomplishes two things; it directs your voice to the listener and it allows the listener to use visual cues. Most people cannot lip read entire sentences but can pick up some cues from what is seen—the eyes help fill in what the ears are missing.
  • Stay in the same room when talking. If you’re not in the same room, you’ve already forgotten the first strategy. Being in separate rooms means you’re more likely to shout while communicating. This not only distorts speech signals but also limits the sounds that reach the listener. Some sounds in speech—think “s”, “sh”, “f”, “th”—do not travel far. Imagine these sounds as a feather; no matter how hard you throw the feather it doesn’t go very far. However, vowel sounds would be like a baseball that can be thrown quite a distance. This results in speech sounding muffled. Even a hearing instrument cannot help in this situation as it can only amplify the sounds that reach it. Still don’t believe me? Try shouting the “th” sound.
  • Speak clearly, slowly, distinctly—but naturally—without shouting or exaggerating mouth movements. Shouting not only distorts speech but it changes how you form the word on your lips, therefore making speech reading more difficulty. Just slowing down helps the listener separate the words. If you’re listening to someone speaking quickly and you miss a word, it is hard to pick up the next one as you are not hearing the end of one and start of another; the words get jumbled together. If you speak slowly, the person listening to you might still miss a word but they can pick up again right away at the next word. Many times we can miss a word or two and still understand what was said.
  •  Start your conversation by using the listeners name. Why? Think about the last time you were out and heard your name. You may not have heard or paid attention to anything else that was said around you, but as soon as you heard your name you suddenly focus in on the conversation. Saying someone’s name gets their attention. Otherwise, you may be halfway through a sentence before the listener realizes you’re talking to them.
  • When you need to repeat, try to use a different word. If the listener is having trouble understanding it could be that the word is unfamiliar, it’s difficult to speech read or the sounds in the word are not being heard due to hearing loss. Simply changing the word might make it easier for the listener to hear. Remember, those airy sounds are hard to hear. If you said “we were heading east” you could change it to “we’re driving toward the lake.” Just rephrasing can help.
  • Location, location, location. If the listener has a better ear than the other, sit on that side. If you are going to a restaurant, pick a slower time of day so there is less noise. If that is not possible, pick the quietest spot. Sitting with your back to the noise and putting the person you want to hear up against the wall is helpful. It also means you are on the perimeter of the noise rather than in the center of it. If a high back booth is available, take it! The back of the booth will help to soften the noise.
  • Reduce background noise. If you are in a restaurant, pick the quietest spot (see above). If you are at home, you have more control. Mute the television and talk during commercials, or better yet turn off the television and radio when talking. Don’t try to carry on a conversation while you have the water running, washing dishes, etc. Limit the noise in your environment so the speech can come through more clearly.
  • Inform the listener when the topic has changed. Sudden changes in a topic occur frequently in social situations. Just knowing the topic helps as you will know the types of words that might be said. A switch from talking about food to politics has a completely different set of vocabulary. If you think the conversation is about restaurants, you might think the speaker said, “did you hear about their Chai tea?” when actually she said, “did you hear about their rioting?”
  • Get it in writing: If you know you have discrimination problems, get all important numbers in writing. Whether it is a phone number, price or any other important figure ask for it in writing. One wrong number in a phone number makes it invalid.
  • Pay attention. If the listener looks confused, pause and ask why. If you are the listener, focus your attention on the speaker and put away other distractions like your phone.
  • Take turns speaking! Avoid interrupting when someone is speaking.

Practicing good communication strategies is not hard. Yet these minor changes will immensely improve the flow of your conversations.