Support from Communication Partners Flashcards
Is there pain associated with age-related HL?
Not physical pain, but there is often emotional and psychological pain
Is communication participation in both planning and AR rehabilitation protocols highly beneficial?
Yes
Establishing formal AR goals helps the CP to understand the impact of the loss, provides them with strategies to avoid/repair communication breakdown, facilitates coping skills and shows the importance of their role in rehabilitation
What is a third party disability?
A disability of family members due to the health condition of their significant other
Describes a range of activity limitations and participation restrictions experienced by CPs
Stress of lifestyle changes, communication difficulties, and emotional consequences
What are the AR goals for the CP?
Identify the impact of the HL on the CP
Understand the activity limitations and participation restrictions that result from the HL and its impact on the PHL and CP
Acknowledge that both parties are partners in communication with an important stake in improving outcomes of the treatment
Realize they have a shared responsibility in managing the HL and treatment approach
Does CPs support for PHL make a significant different in coping and living with hearing loss?
Yes
However recognizing strategies to support improved communication may not be intuitive
What are the steps of goal setting for partners?
Step 1 - PHL and CPs identify key listening situations that both parties want to improve (doesn’t have to be done in the office - have a tool prepared to provide them with instructions, shifts the focus away from technology)
Step 2 - the audiologist uses open-ended questions to let each party to reflect on their experiences while considering the others POV (what challenges do you experience bc of your HL and what challenges do you think your CP is facing bc of your HL)
Step 3 - Have the couple discuss the problems they experience together (can be done outside of the office)
Step 4 - create a set of achievable goals for each respective problem
Step 5 - the PHL, CP, and audiologist brainstorm ideas and tactics to achieve these goals
Should be create and maintain record of the plan to track PHL and CP?
Yes, it is recommended
So you can check in with them
Ida Institute: Goal Sharing for Partners
Phonak FOCAS
What are some ways you can bring awareness to the CP on the activity limitations and participation restrictions the PHL faces?
Use concrete examples to help the CP understand the impact of the loss on audibility (sentence with HF sounds redacted)
Use a speech banana and have them cross out the sounds that cannot be heard
Give them an unfair hearing test (simulate different types of HL)
What are some important counseling points for the communication partner?
It’s possible to hear a voice, and still have difficulty understanding some words (hearing loss distorts signals, so speaking louder won’t always make words clearer, every hearing-impaired person has difficulty understanding in background noise, reverberant, echoey environments cause as much difficulty as noise)
Hearing loss causes people to be sensitive to loud sounds (speak clearly and slowly)
Trying to understand all day takes effort and is exhausting
What are some topics to discuss with CP?
Accents
CP looks away or hand covering mouth
Facial hair
Mumbling/too soft
Too loud
Mannerisms, gestures, facial expressions
Too fast/too slow
Chewing gum/food
Exaggerated lip movements
What are some valuable instructional topics for CPs?
Explain that communication breakdown increases as stress and anxiety levels rise
Explain that auditory fatigue can lead to social withdrawal
Explain limitations associated with lipreading tasks
How can the CP help the listener?
Get PHL attention before talking
Move closer to PHL and face them
Use facial expressions and gestures
Inform the listener when the subject changes
Don’t speak while chewing, or when mouth is covered
Stay patient, positive, and relax (communication breakdown happens despite the best of intentions, a sense of humor helps tremendously to accept that and try a different strategy)
Should we help the CP understand the importance of rephrasing?
Yes
It increases the chance that critical sounds will be heard
Can practice rephasing be an activity in an AR group?
Yes
Provide a list of complex sentences
Ask the CP to rephrase a sentence you provide:
Restate the sentence in a simpler way
Restate it using two sentences
Restate the most important word
Completely rephrase the sentence
How much do clear speech methods improve speech understanding?
About 17%
Is simply asking a speaker to “speak clearly” effective in eliciting clear speech?
No
Research showed a 45 minutes intervention training session yielded changes in more speech parameters, more stable changes, and better speech recognition
What does clear speech do?
Improves intelligibility for both normal hearing and hearing-impaired individuals
In quiet, noise, and reverberant environments
How should you teach clear speech?
45-minute training session
Explain the Clear Speech concept
Create learning exercises to help participants identify (hear) the elements of Clear Speech on their own
Provide informational handouts explaining the differences b/w conversational and Clear Speech
Create a series of Clear Speech practice exercises that increase in difficulty
What are critical elements when using clear speech methods?
Well articulated (aka enunciate - lengthen vowel sounds and release of stop bursts)
Speak slightly slower
Speak slightly louder (5-8 dB)
Add stress to key words
Briefly pause after saying key words
Pause at appropriate linguistic boundaries
Sentences with simple grammar
Sentences are produced naturally and not in a staccato or exaggerated fashion
What is level one clear speech training?
Review common communication breakdowns
Provide sentences to the group
Mark where the pauses are in a sentence and underline the stressed words
*Just pay attention to the pauses and stress
What is an alternative to level one?
Clear speech bingo
Participants listen for key words while the facilitator read a passage
They add a bingo chip every time they hear a stressed key word
More difficult: Participants identify key words while listening to a scripted conversation (video)
What is level 2 of formal clear speech training?
Create activities for participants to practice use of Clear Speech strategy in a structured manner:
In sentences
In short paragraphs
In simulated conversations
*Pair them up and practice
*Ask them to reflect on the practice
What do you do after level 2?
Group practice with paragraphs
Have the listeners take notes to see if they can get the gist of the passage
Listener can stop the speaker at any time and use an instructional strategy to clarify what was heard
What is formal clear speech training level 3?
Practice using structured interviews
The speaker plays the role of the interviewee
They choose a place they visited and respond to questions using Clear Speech
The listener asks the following questions, using message tailoring questions and instructional strategies when clarification is needed (questions that leave to conversational answers)
What is clear speech training level 4?
Practice use of Clear Speech in the real world (schedule a daily clear speech practice time)
Set a timer for 20 minutes and practice Clear Speech
Increase by 10 minutes until 1-hour daily practice
The goal is for Clear Speech use to become a habit
What is the communication partners role?
Advocate and offer support by helping others understand communication strategies
Let people know speaking slower and only slightly louder is helpful
Remind a group that only one person should speak at a time
Sit next to them & have them turn to you to share the punch line if it’s missed
Share the topic of conversation when they join a group or if the topic changes quickly
Before a family gathering, share some tips and tactics to help foster more successful communication
Is it ok for both the PHL and the CP to slip up?
Yes
People may forget, and that’s ok
Get back up on the horse and try again
Stay positive
A sense of humor helps
Patience really helps
Relax/breathe and enjoy the fine company, even if you do not catch every word
