Communication and Hearing Loss

Effective communication is fundamental for human connection. Hearing loss can be a barrier that leads to communication breakdown and feelings of isolation. With a better understanding of hearing loss and communication strategies, we can improve our communication with those who are hard of hearing.

Types of Hearing Loss
There are three types of hearing loss: conductive hearing loss, which involves the outer and/or middle ear, sensorineural hearing loss, which involves the inner ear, and mixed hearing loss, a combination of conductive and sensorineural hearing losses. 

Conductive hearing loss is the result of a problem within the outer ear (the ear canal) and/or the middle ear, such as wax impaction, middle ear fluid, ear infection, obstruction/foreign body in the ear canal, perforated ear drum, and Eustachian tube dysfunction. This type of hearing loss is typically treated without the use of hearing aids as the cause of the hearing loss can often be treated (e.g., antibiotics, wax removal).

Sensorineural hearing loss is the most common type of permanent hearing loss. In this type of hearing loss, sound reaches the inner ear, but it is either not relayed to the brain or the brain is unable to interpret the signal. This can be the result of damage to the inner ear or auditory nerve, which can be caused by aging, illness, ototoxicity from medications/drugs, genetics, head injury, or vocational/environmental exposure to loud or constant noise.

People with hearing loss may hear speech as distorted or muffled and have increased difficulty hearing in background noise. Often our natural reaction when speaking to someone with hearing loss is to increase our volume. However, some people with hearing loss have increased sensitivity to loud noises or continue to hear the incoming signal as distorted. There are many other things we can do to improve our communication with partners who are hearing impaired to reduce risk of communication breakdown.

Modify the Environment Reduce the distance between you and the listener. Ensure the environment has good lighting and reduce environmental background noise. Position yourself near the listener’s better ear. Be mindful of this at restaurants, medical appointments, and other social settings.

Starting the Conversation Once you have the listener’s attention, maintain eye contact and keep your mouth and face visible within necessary masking precautions. Provide context clues, such as the conversational topic or key words, to begin the conversation.

Your message Speak slowly and clearly. Supplement your speech with gestures. Write down information. Check in frequently with your communication partner to ensure he/she is understanding. It is best not to assume, as this can lead to communication breakdown and misunderstandings. Watch your partner’s facial expressions. You can also ask the listener to repeat information back to you to ensure understanding.

If you or someone you know is experiencing hearing loss, consult your primary care physician. Early detection is important. Audiologists provide identification, assessment, and treatment of people with hearing loss. Speech-language pathologists provide aural rehabilitation to help people adjust to hearing loss and optimize quality of life by reducing the impact of hearing loss on communication, participation in activities, and daily life.  

Katelyn O’Neill, MS, CCC-SLP, is a speech-language pathologist at SVMC Outpatient Rehabilitation  in Bennington and at SVMC Northshire Campus in Manchester Center. Both practices are part of Southwestern Vermont Medical Center in Bennington.