Communication problems of hearing impaired people

COMMUNICATION PROBLEMS OF HEARING IMPAIRED PEOPLE

DISCUSSION LED BY:
Asha Yathiraj, All India Institute of Speech and Hearing,
Manasagangotri, Mysore – 570 006, India.
Ph: 0821-514449, fax: 0821-510515,
Email: root@aiish.ernet.in

General

• World-wide, deafness is a misunderstood disability, because of the low incidence of the problem (0.1% of the population).
• It is relatively invisible and most deaf people hear something, even though what they hear may not carry any meaning.
• Some deaf people may have understandable speech while others do not.
• It is not universally understood that most deaf people have normal intellectual capacity. Many deaf people are mistakenly diagnosed as having mental retardation, stubbornness, delayed speech and language development, or learning disability.

Education of deaf children

• Considerable disagreement exists concerning the extent to which deaf children should be educated alongside hearing children. Those in favour of integration, inclusion or mainstreaming argue that educating deaf children within classes of hearing children is less expensive, provides them with normal models of speech and language, and decreases the stigma by fostering better understanding between deaf and hearing children. In the rebuttal, advocates of special schools point out that deaf children do better socially in segregated settings, they receive education tailored to their special needs from skilled, specially trained teachers, and, when deaf children are in an otherwise hearing classroom, there is too often little meaningful communication.
• There is considerable controversy on methods of teaching communication to deaf children. One group advocates teaching sign language as the first language and the language of the majority hearing culture, that is, reading and writing, as the second. The other approach is a bi-lingual one, which emphasises bi-lingual education of deaf children.
• Sign language plays a critical role in the lives of most deaf people. Sign languages differ from each other just as spoken languages do.

Hearing aids

• Hearing aids must be custom fitted.
• Ear moulds are plastic devices which connect the hearing aid to the ear canal.
• Without a properly fitting ear mould, the hearing aid will squeal with an annoying feedback.
• Ear moulds are made from impressions of the outer ear, and no two ears are alike. Particularly in young children, ear moulds have a limited life because they must be replaced periodically as the ear grows and changes shape.
• Hearing aids usually do not work well in noisy environments, because the amplified sound is painful and the deaf person is unable to sort out the sounds.
• It is also not commonly understood that classrooms for deaf students should be acoustically treated to reduce echoes.

COMMUNICATION PROBLEMS OF HEARING IMPAIRED ADULTS

Types of hearing problems present in adults: 1. Conductive hearing loss 2. Sensori-neural hearing loss 3. Mixed type of hearing loss.

1. Communication problems of people with conductive hearing loss are difficulty in hearing soft and moderately loud sounds and difficulty in understanding loud speech.
   Interventions for this kind of hearing loss are medical/surgical interventions and audiological interventions.
2. Communication problems of people with sensori-neural hearing loss are that they may have problems in hearing soft to very loud sounds, depending on the degree of hearing loss. They may hear speech but may have difficulty in identifying what is spoken.
   Interventions for sensori-neural hearing loss are the use of hearing aids, assistive listening devices and cochlear implants, speech reading and use of communication strategies.
3. Communication problems with mixed hearing loss are problems in hearing soft to very loud sounds, depending on the degree of hearing loss. They may hear speech, but may have difficulty in identifying what is spoken.
   Interventions vary depending on the problem into any of the methods listed earlier.

ENHANCING THE HEARING OF HEARING IMPAIRED ADULTS

Anticipatory strategies

1. Inform the speaker about your hearing problem before you start a conversation.
2. Select a seat next to the speaker.
3. Request the speaker to turn towards the source of light, so that his face is visible for speech reading.
4. Choose a quiet place to talk, so that the hearing aid does not pick up noises.
5. Practice to anticipate vocabulary used in usual conversations.
6. Remove visual obstructions that cover the lips of the speaker.
7. Request the speaker to speak naturally without exaggerating the lip movements, so that speech reading is not difficult.
8. Ask a nearby person to inform the change in topic during a conversation by cueing when the topic gets changed.
9. Ask the members of a group to take turns in speaking when there is a group conversation.
10. Obtain back-ground notes in advance if you can.
11. Improve knowledge about current topics of interest and topics that are often conversed.

Repair strategies to clarify the message

1. Request the speaker to repeat when the conversation is not understood (part of the message, key word, full message).
2. Request the speaker to speak slower for speech reading.
3. Request the speaker to speak louder.
4. Request the speaker to rephrase.
5. Request the speaker to clarify.
6. Request the speaker to summarise.
7. Request the speaker to spell the word that is not understood.
8. Request the speaker to avoid speaking with objects like a pipe in the mouth, to facilitate speech reading.
9. Request the speaker to point to the objects if there is also a visual cue (also write the words).
10. Request the speaker to gesture when communicating a message.