Thursday, 21 November 2013

Communication Strategies -

Over 5% of the world population has a disabling hearing loss. ‘Deafness’ if by birth is also mostly associated with ‘muteness’ as most people who are born hearing impaired do not develop speech and language which is the most important form of communication. So how do you approach or communicate or make the communication easier for the person who is hard of hearing.

Listed below are certain strategies that one can use to help the hearing challenged to communicate effectively

Notice if the person is wearing a hearing aid or not. Strategies can be similar irrespective of whether the person is wearing an aid or not. Strategies can also be used with normal hearing person in difficult to hear situations such as in crowded or noisy situations.

If the person cups his ear or stands in a particular position showing his better ear to you, understand that he has a difficulty in hearing. The usual practice in such a case is to shout in the ears of the person. When it is not practical, following steps will aid in better communication.

a)      Position yourself in such a way that the person has good and clear view of your face. This means do not stand/speak with your back turned or from behind the door or from other room or from a distance or with an obstacle in between including your hands. Also make sure that there is appropriate lighting in the room. This is important because people who are hard of hearing or are in difficult to hear situations , rely more on our visual  information for example the facial expression to understand along with hearing. Speechreading or lipreading the syllables is also a normal part of communication as we try to get maximum information from the visual aspects of speaking e.g. for \u\ sound as in moon we round our lips.

b)      The second strategy is to reduce the background noise and loud sounds as much as possible. What is noise? Any unwanted sound in a situation is called noise. For example if the person is watching TV and there are few people talking behind interfering with the listening of TV, the noise in this situation is the speech. However if the person is listening to the people talking with the TV on, TV is the noise. Noise interferes with communication and even the modern digital hearing aids are not good with controlling the noise. Most persons with hearing impairment are not tolerant to loud sounds as well. Hence communication should be done if possible in a quiet environment to help the hearing handicapped. In simple words cut down all distractions.

c)       Get the attention of the person before you start your message. You can do this by taking his    name or patting him or by making sure he is facing you before you start your message. This will ensure that you will not have to repeat yourself and that the person has received the full message.

d)      Do not shout. Yes and that’s the way everyone communicates with the deaf. Instead of shouting or exaggerating speech you must speak slowly, clearly and naturally in a moderate pace so that the person can catch the sounds. Shouting leads to distortion of sounds and also sends a negative signal to the person. You may notice that a hearing impaired person may speak loudly. This is due to his hearing loss and inability to monitor his own voice. Also, if the person cannot understand certain words, it is better to rephrase/modify it. For example ‘Where did you buy this shirt from?’ and the person has difficulty catching ‘shirt’ you may just point with the finger to the shirt ‘where did you buy this from’ etc. Also use simple sentences while speaking instead of long and complex sentences.

e)      Make sure the person understood you. This can be done by asking the person to repeat indirectly. For example in a telephone conversation if you give an appointment you can ask the person to tell his appointment date or ask him if he got it right. You may also repeat it few times to make sure he heard it properly. Important messages can be given in written form as well to make sure the person understood and remembers. It is also a good practice to summarize the main points. Do not assume that the person understood you.

f)       Have a positive, patient, relaxed attitude towards them. Build a rapport to gain their confidence that you really understand their problem and are willing to help them. However do not over empathize with them talking about deafness etc. Treat them with respect and build their confidence so that it becomes a pleasant experience for them and they do not hesitate to seek help the next time.

g)      If the person does not use spoken communication, always ask them if they can communicate through sign language or by writing. You will be surprised to know that most of them can communicate by writing and you can try communicating by writing/ lipreading. In case you cannot find an interpreter try to understand simple signs and help them out if you can. However if there are important messages to be conveyed it is important you do it in a proper manner by taking appropriate help than just by trial and error with signs.

h)      In case of an emergency for example fire alarm / traffic horn etc. make sure you alert the hearing impaired person using visual information as well.


Useful resources:
1)      How to communicate with deaf people wiki how
http://www.wikihow.com/Communicate-With-Deaf-People
2)      Improving understanding with communication strategies  (on cochlear website)



Sunday, 10 November 2013

Hearing Aids: FAQs

Following are some of the frequently asked questions about hearing aids by my patients. Please go through it to get a general idea about hearing aids and how to choose one.

1. What is a hearing aid?
 A hearing aid is a small electronic device that can be worn outside or inside the ear by a person with hearing difficulties. The hearing aid basically amplifies or makes the sounds louder so that a person with hearing difficulty can communicate and listen normally.

 2. What are the different types of hearing aids
There are basically three types of hearing aids
1) Behind the Ear: All parts of the hearing are contained in a case that rests behind the ear. The case is inserted behind the ear using an ear mould and a tube. These come in different sizes and technologies.
2) In the ear: The hearing aid is contained in a case that fits directly in the ear. These are larger than canal hearing aids.
 3) In the Canal hearing aids: These aids are the smallest and fit into the canal of the ear canal. The style of the hearing aid depends on the hearing loss, the ear canal size and certain other factors.

3. Why is wearing a hearing aid important?
 Hearing impacts all domains of our life including communication, safety, entertainment and social well being. Hearing loss affects your day to day communication and a long term hearing loss may cut you off from social activities affecting general well-being. Hence obtaining hearing aids is important to enjoy the day to day sounds and speech for improved quality of life.

 4. How do I know if I need hearing aids?
 If you think you struggle to listen to normal conversation or day to day sounds, miss out on words, needs to constantly up the TV volume, consult your ENT specialist or physician who will refer you to an Audiologist to test your hearing. The specialists will be able to find out the type and degree of your hearing loss and decide whether your hearing loss can be treated medically or surgically or you need to go for hearing aids

 5. Who should I consult for my hearing aids?
After you get your hearing tested, your ENT specialist will be able to suggest if going for hearing aids is the most suitable option and then refer you to back to the Audiologist. An Audiologist is a professional specialized in dealing with hearing loss and hearing loss management. The Audiologist will help you choose the appropriate model based on your hearing loss and your listening needs and expectations.

6. How do I choose my hearing aid?
 Based on your degree and type of loss as well as your lifestyle, listening needs at home and work, leisure activities, style preference and your expectations, Audiologist will provide you necessary information to help you choose your hearing aid. He/ She will also let you try the aids depending on the preferred model and answer all your queries that will enable you to decide in choosing your hearing aid. Remember your answers are important in deciding the style and features of the hearing aid.

7. What is the cost of a hearing aid?
Like other electronic devices the price of a hearing aid will range from several 100 dollars (Few thousand Rupees ) to few thousand dollars (to few lakh Rupees). The price of the hearing aid is based on the style and its features. The cost alone is not a determining factor. You must consider the features and what a hearing aid can and cannot do as hearing and a hearing aid is a basic day to day need.

 8. Should I go for 1 or 2 hearing aids?
If you have hearing problem in both ears wearing two hearing aids are recommended as two aids will give more natural way of sounds to the brain. Hearing from two ears will help you locate where the speech or sound comes from and to hear from a distance, hear in a group, in noisy situation and for better overall hearing.

 9. Why are hearing aids so expensive?
 Modern hearing aids use the digital technology wherein they have a mini computer chip which can process different sounds differently. Hearing aid costs are based on the technology, durability, personalization costs, features of the aids, manufacturing and marketing costs and hence vary from manufacturer to manufacturer. Your Audiologist will help you choose an aid considering all factors.

 10. Can I buy hearing aids online?
A hearing aid is a complex device and not just an amplifier. It is very important to get your hearing tested by a professional Audiologist. An Audiologist can help you choose the most suitable aid for you and let you try it before ordering. The hearing aid has to be digitally programmed according to your loss and you may require to make few visits, adjustments, and requires information on subsequent care and maintenance. Hence the hearing aids ordered online cannot be ‘personalized’ to your loss and needs

11. Will the use of hearing aids cause my hearing loss to be worsened?
 A hearing aid is not a ‘cure’ for your hearing problem and it cannot restore normal hearing. The hearing aids will help you hear and communicate better in most situations and studies have shown that wearing a hearing aid can keep the nerves from the ear to the brain active. An appropriately programmed hearing aid will not worsen your hearing loss.

12. What is the average life of a hearing aid?
Hearing aids usually come with a warranty of 2 years. However if taken proper care and maintenance a hearing aid can last longer. Usually as the hearing worsens adjustments can be done in the same hearing aid. Behind the ear aids have more range compared to inside the ear hearing aids.

13. What are the subsequent care and maintenance required?
Like any other electronic device, daily care and maintenance of hearing aids are essential like keeping it away from water and moisture, cleaning of wax and regular care and servicing. These are relatively simple and your Audiologist will guide you at the time of purchase.

14. Once I invest on the hearing aids what are the subsequent costs?
 After purchasing the aids, subsequent charges are that for the batteries, repair charges if damaged, fine tuning or adjustment charges and in the purchase of accessories. These vary depending on the model, usage and care and maintenance taken.

15. How can I use my telephone/TV with the hearing aid?
 Hearing aids have features like telecoil that can be activated to speak on the telephone. Most hearing aids now have Bluetooth connectivity which can be connected to your phone , TV or PC via an additional device which will make hearing through other devices easier.

16. What all should I ask my Audiologist before buying a hearing aid?
 Keep the following in mind when you buy a hearing aid
-Your listening needs
-Useful features
 - Outweigh Cost vs Technology
-Trial of aids before purchase
 -Warranty, extended warranty and insurance policies if any
 -Servicing, repair , readjustment services, follow up services- availability and costs.

17. Can I get the same hearing aid as my friend?
There are several hearing aids available in different styles and features. The hearing loss and needs vary from person to person. Hence, you must consider your hearing loss and needs before purchasing the same aid as something that has worked well for your friend may not work for you. Similarly, if a hearing aid has not worked for your friend does not mean it may not work for you as well. Best way is to get professional advice from a professional.

Hope these questions helped you get a basic idea about hearing aids and how to choose a hearing aid. Contact for more details: shijitha.c@gmail.com.