“Hearing people can be so mean” noted one of my patients during a session. We were talking about a reaction that she sometimes experiences when she asks an acquaintance "What did (s)he just say?" Questions intended to help someone understand what is being discussed are sometimes perceived by typically hearing friends as being overly probing. The young woman discussing this issue was born deaf and she remembers often asking for help by asking such questions. She prefers paying the price of being judged by some people as having bad manners to being out of the loop.
Others with hearing loss may experience similar conflicts. We expect people to be more sensitive, considerate, and aware of the difficulties people are encountering but too often even friends and family fail to appropriately respond. Professionals sometimes use the "earplugs experience" as a demonstration of what it’s like to have hearing loss. In reality, the experience of being deaf or hard of hearing is so much more complicated. It sounds trivial to ask people with hearing loss to simply explain their needs to friends and others around them. But they may not know where to start because of the lack of understanding regarding what it means to be deaf.
This post is about self-advocacy and the importance of people with hearing loss being proactive about explaining the difficulties they encounter as well as their needs as people who are deaf or hard of hearing people. This includes anyone with hearing loss, regardless of the technology they use.
My comments and recommendations are drawn from many years of working with adult CI recipients and learning about their experiences and interactions with the "hearing world." These are topics that should be explained when practicing self-advocacy and educating your friends and family about your needs as someone with hearing loss.
· The influence of a noisy environment. Did you know that many people with typical hearing think that a noisy environment has no impact on the ability of someone with hearing loss to hear? It may be assumed that people with hearing loss cannot hear the background noise. Clarification is needed. Noisy environments make hearing and understanding even more difficult for people with hearing loss compared to people with typical hearing. In order to gain the same level of speech understanding, people with hearing loss need a better signal to noise ratio (e.g., the difference between the noise and the speech needs to be greater, favoring the speech level). Though people with typical hearing can often understand speech when speech signal level is the same as the noise level (or even a bit softer), people with hearing loss generally cannot understand speech unless the volume level is significantly higher than the noise. Knowing that would enable others to understand:
o Why you're asking them to turn down the TV volume
o The need to not sit near the air conditioning or to a working dishwasher when having a conversation with you
o Why you are encouraging friends and family to choose quiet restaurants
o Why you are often too busy or have other plans when invited to events in noisy places. Assistive Listening Devices (ALDs) that require your friends/ family/colleagues cooperation can be extremely helpful since they may provide you with a better signal to noise ratio by decreasing the level of the surrounding noise and increasing the level of the speaker's voice. It's important to note that during many daily situations, noise levels are too high for people with hearing loss meaning that they are forced to lose a lot of the auditory information and invest a large level of effort in trying to compensate for their limited auditory perception.
· The influence of the number of speakers in a conversation. As the number of speakers increases, the ability of deaf and hard of hearing people to follow the conversation decreases. People with hearing loss may not be able to rely solely on auditory information and may need visual cues (e.g., speech reading). In a conversation with more than one person, person may need to locate each speaker visually in order to supplement what he is hearing with speech reading. When people are not speaking one-at-a-time, understanding may be impossible. Having visual cues to supplement the auditory signal becomes even more important when a conversation is taking place in a noisy environment. Knowing that would let your friends understand why:
o You prefer to meet with a group of friends in a bright place and not in a dark one
o You need to position yourself such that you are able to see all of the speakers’ faces
o You are asking people to remove their hands from their face while talking
o Overlapping conversations leave you out of the loop.
· The amount of effort that's required for keeping up with the conversation. Many people with typical hearing are unaware of how exhausting it can be for someone with hearing loss to follow a multi-speaker conversation in a noisy environment. You can read about listening fatigue in my previous post https://www.acialliance.org/blogpost/1334356/311879/Listening-Effort-and-Fatigue-Part-1
· Dealing with communication gaps and misunderstanding. Did you know that many people with typical hearing believe that speech reading replaces what someone with typical hearing perceives via listening alone? People sometimes believe that deaf and hard of hearing people have a unique ability to derive the whole meaning of what has been said by focusing on a speaker's face. Clearly this is false belief that should be addressed. It is not possible to completely perceive speech sounds in the absence of hearing them. People with typical hearing are not aware of the various strategies deaf and HOH people use in order to understand speech based on incomplete auditory input. They do not know that in order to understand whether somebody said "doll" or "tall" you need to use linguistic context since speech reading alone would not be helpful in recognizing which of the words were spoken. People with typical hearing are often not aware of the fact that people with hearing loss do a lot of guessing. For example, they might need to guess the name of a person they were introduced to because they did not perceive it completely; they might guess what had been said in conversation with more than one person since they might miss some of what had been said. They might smile and nod in the wrong places. These are typically done daily, and such guesses may lead to misunderstanding.
As people with typical hearing are exposed to a lot of auditory information—without even knowing they were listening to it—much of this information may not be perceived by a person with hearing loss. Parents of young deaf children are usually instructed by professionals to mediate the environment for their young children in order to:
· Encourage their listening skills
· Expand their knowledge and curiosity
· Improve their orientation and their sense of involvement.
Many of these young children continue to seek this kind information as adults, reaching out to their friends, colleagues, spouses and relatives.
When your friends better understand the challenges you face, they are likely to be much more cooperative and helpful when you ask: "What did (s)he just say?"