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I grew up in a hard of hearing family, so issues related to hearing loss and communication difficulties are very near and dear to my heart. I understand how difficult it is to communicate with a hard of hearing person who doesn’t wear hearing aids or his or her hearing aids aren’t functioning properly. Depression, isolation, and anxiety are common among the hard of hearing population.

Effective Communication Strategies for Hard of Hearing People

I hope these communication tips will be helpful for the health care professionals as well as family and friends of hard of hearing people. Please remember that hearing loss isn’t just an individual problem, it is also a family and community problem as well. We all have to work together for an effective communication with the hard of hearing people (HOH).

Decrease the distance between you and the listener.
This is the single most effective way to increase understanding. Moving a little closer can make a big difference.

Don't eat, drink, or chew gum while speaking with someone who has hearing loss.

During conversation, turn off radios, television and other distracting noise sources.

Wait until passing noise subsides. While walking down the street, don't ''talk over'' the noise of the passing cement mixer. Wait until it's out of range.

Save important conversations for quiet environments.
Scout out good places. Know which restaurants are quiet and which are noisy. Know which areas of a restaurant are better than others. Avoid the kitchen, cash register, and reception area. Look for restaurants with lots of soft fabrics and upholstery rather than hard surfaces.

Be sure the listener is ready to hear you. Listeners need a moment to focus because understanding speech requires more concentration for them than for you. To better understand this, think of listening to someone with a thick accent. It's much more difficult to understand the first few words if you are unprepared to listen. For best communication, the speaker and listener should be 3 to 6 feet apart.

Face your communication partner so they can see your entire face and your hand and body gestures. These all provide valuable cues and can help fill in for sounds they are not getting. Try to avoid bushy mustaches or other facial hair that obscures the lips. Avoid shadows.

Lighting should be above or in front of you, not from behind you. Don't stand in front of the window while talking to a person with hearing loss. As discussed earlier, they need to observe facial expressions and body gestures. This is particularly important if the listener is further away, as in a classroom.

Face the person with hearing loss and speak directly to them so the volume of your voice doesn't fluctuate. Turning away from someone while talking significantly decreases the volume of your speech and makes it much harder for them to hear you.
Talking into the cupboard while getting the cereal or looking down while reading the patient’s file is even worse. Try not to talk while moving around so you offer consistent loudness and constant visual cues.

In summary, please DO NOT:
• Talk rapidly
• Enunciate poorly and in a quiet voice
• Speak with food in your mouth
• Turn away from the listener
• Speak with your head in the cupboard or from another room or from more than
6 feet away
• Change topics abruptly, without cues or transitions
• Use unusual or unfamiliar words
• Speak when there is significant background noise present
• Speak in poor lighting

Speak louder and enunciate clearly, but don't exaggerate sounds and please, don't shout! Exaggerating distorts sounds, and shouting can be very disruptive to the Hard of Hearing (HOH) person for two reasons: First, the HOH person, depending on the degree of hearing loss, may dwell in silence where ambient sounds we take for granted are severely reduced or absent. A sudden loud sound can be startling. Second, there is a reduced listening comfort range between what can be heard and what is uncomfortably loud for people with sensorineural hearing loss.


Rephrase, don't repeat. Vary the words. Some words are more difficult to understand than others and some are more difficult to lip-read than others.

Introduce topics clearly. For example, ''Dad (pause), I want to talk about your trip to Florida'', rather than ''What time is your flight?'' If you are discussing a complex topic, good organization and clear transitions will aid understanding. This is critically important and it relates to the way we listen and absorb information. If we're prepared, it goes more smoothly.

​Be sensitive to signs of confusion or uncertainty.

In group conversations, try to have one person speak at a time. The person who is about to speak should provide a subtle visual cue such as a hand gesture. The HOH person can't understand one voice over another and needs to be facing the speaker for maximum clarity. In formal settings, such as book clubs, the leader should indicate who is to speak by pointing and saying his or her name.

Arrange people and furniture to create the best listening environment. In the living room, seat the HOH person away from the kitchen and away from noisy areas. Be sure
he or she is sitting with the noise behind him or her. In a restaurant, choose booth vs. chairs (if available). Ask for a quiet environment or a corner table & let the HOH person sit with their back toward the wall. Sit away from the kitchen or the entry door. Be sure you are facing the HOH person & don’t talk with your mouth full. Slow down the rate of your speech.

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