Helping People Use Communication Strategies

By Louise Hickson

This article is a part of the November/December, Volume 34, Number 6, Audiology Today issue.

When asked to contribute an article on teaching communication strategies, I thought long and hard about this topic. It raised a critical issue for me about how adults with hearing loss successfully use strategies in everyday life—it’s about how they learn and not how we teach.

Most of the adults seen in hearing-health-care practices have developed a slow and steady hearing loss over many years. They have been communicating in certain ways all of their lives. However, their means of communication does not work as it used to, and they miss parts of conversation, have to ask for repetition, and feel left out of conversations they used to enjoy. Hearing-health-care professionals must remember that fixing communication issues may not be obvious to our patients. 

As audiologists and hearing-health-care practitioners, we all have learned about certain strategy lists and may wonder why clients do not know what to do and why, when we give them a handout with the list. They do not simply apply the strategies as soon as they leave the clinic. 

I used to think the same until we did a research study that showed that, although adults improved their knowledge of communication strategies after receiving such a list, this did not mean they applied them in conversation (Wilson et al, 1998). This occurs because increasing knowledge is simply not enough to change behavior. We may know that eating too many sweets is bad, but stopping is another matter altogether.

Helping adults with hearing loss to use communication strategies requires a collaborative, problem-solving approach and not a lecture on what to do and what not to do. It is about working alongside clients and their families to help them learn how to self-manage the communication challenges they face. Fundamentally, this is how aural rehabilitation programs work. 

Our Active Communication Education (ACE) Program is an evidence-based intervention, with outcomes showing improved communication ability and quality of life for both adults with hearing loss and their significant others (Hickson et al, 2006, 2007; Oberg et al, 2014; Rivera et al, 2020). The program runs for five weeks (two hours per week) and has been translated into many languages. The Spanish translation, developed in Chile, also is included on the website (Rivera et al, 2020). 

Any adult with hearing loss can benefit from learning strategies, and it does not matter if they use hearing devices or not.

The program features five modules:

1. Identification of communication needs
2. Conversation in background noise
3. Conversation around the house
4. Communication with difficult speakers
5. Listening to other signals, including public address systems