Talking With People With Hearing or Speech Problems

Holidays are a time for visiting. My own very large, boisterous extended family includes nephews and neices with physical and cognitive limitations, older people with serious hearing problems, and folks who hear fairly well, but process information slowly.

We aren't unusual. According to the American Speech and Language Association: "Hearing loss affects approximately 17 in 1,000 children under age 18. Incidence increases with age: Approximately 314 in 1,000 people over age 65 have hearing loss and 40 to 50 percent of people 75 and older have a hearing loss."

So if you're talking to someone over 65, the odds are good that they will have trouble hearing. Many more people - including many younger folks - have had strokes or other brain injuries that make it hard for them to hear, process language, or speak. And some people just stutter.

Holidays are a time for sharing stories and good times together. Don't let speech and hearing problems stop you.

Tips for Talking. I want to share this video. It was put together by Laura, a 27 year old who was hit by a drunk driver 5 years ago and had a stroke. She's aphasic, meaning she has problems processing language and speaking.

She provides simple tips for talking to people like her. Many of the same tips help people who are hard of hearing, who stutter, or who have other language processing problems. Heck, I think they might help for almost all of us.

Speak at a slow and normal pace.

• As Laura illustrates, many people talk to people with hearing or speech problems too slowly, as if they cannot understand. This can feel very condescending and can be boring for both speaker and listener.
• Because they do not get the quick verbal responses or are nervous, some speakers can also talk too quickly, going from topic to topic as if they were speaking to themselves.
• Although Laura does not mention it, inflection provides important cues about what words you are using and what you are trying to communicate. When speaking slowly, don't lose the ups and downs in your voice!

Say one thing at a time.

• At the end of his life, my father was classified as 'mentally confused'. He was very much himself, but had trouble thinking quickly or weighing too many things at a time. But given a choice between two options, he could choose easily.
• Say one thing and stop. Give your listener a chance to respond. If you go on without pausing, people who have a hard time composing answers won't know which part of what you've said to respond to. In addition, this also gives people a chance to ask for more information if they missed something you said.

Don't shout or talk down to people.

• Speaking clearly and annunciating is helpful. It is not the same as shouting. A hearing or speech problem does not mean the person is stupid. Enough said.

Talk in a quiet place.

• Background noise is a killer. It is hard for people with normal hearing to follow a conversation when there is a lot of background noise. It is impossible for someone who has trouble hearing the difference between p's, b's, and d's and has a hard time distinguishing vowels.
• Turn off the music. I love music and it lends a festive mood. My family always has the TV on when everyone is together (don't ask). But this is not the place to talk to someone who can't hear. It's not the place for you to hear someone who doesn't speak clearly. Want to chat? Go to the kitchen. Sit in a bedroom. Find a quiet spot.
• Turn ON closed captioning. Watching TV as a group? If you turn on closed captioning you can turn down the volume and people who don't hear well can still share in the fun.
  

It can help to ask Yes or No questions.

• If the person has problems speaking, make it easy for them to respond. As Laura illustrates, don't give a long list of choices, do it one at a time to make it easy to respond. For example, there are ten different items at the buffet where you are collecting food for your aunt. Instead of listing everything and asking what she wants, make it easier. List what they have. Then ask, one item at a time, which she wants. Do you want herring salad? Ham? With mustard? There is white, rye, or whole wheat bread. Woudl you like white bread? Rye? Whole wheat?

Wait for an answer.

• Laura doesn't say this, but you can see this in her first clip. When you ask a question, wait for an answer. Sometimes it takes someone a while to figure out what you said. Sometimes it takes a while for someone to begin to answer. My son tends to stammer and it can take him a long time to compose an answer before something starts to come out. (Once you start him, you can't get him to stop.) Because of that, people tend to ask him a question, then talk on before he answers. Don't do that. Wait. It can be worth it.

Watch for understanding.

• Use visual cues (and ask!) if you are speaking at a good clear pace. If you see their eyes glazing or they nod but don't seem to respond to specifics of what you've said, they may not be able to hear you. I realized one reason my father-in-law was telling long, rambling stories that seemed unconnected to other conversation was that he couldn't hear what we were saying. By telling a story, he could be part of the conversation without having to hear.

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• My sons have low rumbly voices. When they talk to their grandparents, they need to talk a bit higher and articulate clearly to be understood. They speak loudly enough, but not clearly enough. I don't rumble, but I do the same thing. Speak as if you were having a private conversation in a noisy room.

A Day of Listening. When I was in high school, my now mother-in-law urged me to talk to my grandmother and write down some basic geneological information. Now geneology interested me nt at all. But I never regretted the four hours I spent talking to Oma that night. I learned about her childhood and how she was forced out of school in the fourth grade. I heard about the day her brother died, and how she worked in her father's tavern, mopping out the back alley when the outhouse overflowed. I learned how she accidentally wound up alone in America at 16 not speaking the language and meeting my grandfather. I heard about them losing all their money during the bank closures of the 1920's. I learned about obstetric care and birth control in the 1930's. I learned about how much she and my grandfather cared for each other and for my mother.

The holidays are a great time to talk. The veterans of World War II are dying. As are their wives and sweethearts. What was it like to be in the country when almost every able bodied man between 18 and 40 was overseas? What was it like growing up during the Great Depression? Or the 50's? Or during the Civil Rights movement or in the days of segregation? Ask.

Some simple changes can make it easier to have those conversations - and much simpler ones. Speech and hearing problems can be among the most isolating of disabilities. Take the time to listen.