In January, 1999, I learned that what I'd always thought of as a "severe" hearing loss had tipped over into functional deafness in my right ear. I sent out a letter to family and friends about this, which contained a lot of information on how to help a hearing-impaired person. I then tried looking for similar information on the Web and didn't find it.
I'm therefore putting up this page to explain step-by-step how best to have a conversation with a hearing-impaired person. I've tried using catchy phrases to identify each of the points to make it easier to remember (send questions and comments to email@example.com):
What about sign language?
Dealing with phone calls
Note: a lot of people prefer "hard of hearing" instead of "hearing-impaired", so you'll need to find out what each person wants.
One "noise" that may not be apparent to you is when you're outside and there's a lot of gusty wind. Not only can the wind rattle small objects, but it can actually generate noise in a hearing aid, just like a whistle. (You can also notice this effect if you're talking to someone who's using a cell phone in the wind.)
This is even more important in a group situation. In general, it's easier for hearing-impaired people to listen to people they know well because they know the typical speech patterns for those people; however, that knowledge can't be used until the speaker is identified.
A slightly different aspect of attention is that it's a lot easier to follow a conversation if the subject matter is known. For example, it's a really bad idea to start a conversation by saying, "Terminator is the best movie of all time." A better way would be, "Do you know the movie Terminator? It's the best movie of all time." The key points are to use some padding words at the beginning to let the impaired person get up to speed and to use a subject word ("movie") to focus the contextual cues before you start giving details.
Finally, if you change the subject, make sure to do so explicitly.
Some hearing-impaired people have a preferred ear. If so, the rule changes to line of sight from your mouth to the impaired person's good ear. Sitting on that person's "bad" side is almost as bad as not facing them. If you see someone constantly swiveling her head, you might want to ask if there is a preferred ear.
Make sure that nothing obstructs your mouth: don't wave a fork in front of your face, don't rest your chin on your hand, and so on. Another aspect of this is make sure that your face is in the light and not backlit (backlighting shadows your face).
Keep your mouth empty of food, gum, or other obstructions (unless your name is Demosthenes).
Whispering can be a particular problem for hearing-impaired people. The problem with whispering is that it heavily aspirates everything, and the noise of the breath drowns out the words in addition to decreasing the clarity of the consonants. It's much better to speak normally, but as quietly as possible.
Note: "speaking slowly" is not the same thing as drawing out each word. Make sure that you pronounce each word normally; the pause between each word should be about half as long as a "comma pause". If you're familiar with music, you might think of it as speaking in staccato, but without the hard "break".
Even if you break this rule on all other occasions, make sure to follow it saying a person's name or reading an address or phone number.
Be particularly careful if you tend to say "yeah" and "nah" a lot. The vowel is identical, so it can be difficult to distinguish the two if you mumble the consonant. Better to use "yes" and "no", extending the "s" to make it clearer ("yesss").
If this isn't clear, consider taking a class in acting or singing; classes on public speaking can also help.
If you're talking to a large group of people (e.g. making a presentation), make sure to use the microphone if available. You still need to project because you need to hold the mike several inches way from your mouth to avoid amplifying your breathing sounds. If you take questions from the audience, make sure to repeat the question before answering unless there are microphones for the audience.
This obviously doesn't apply to names and addresses, but those are short enough that you can spell things out with a phonetic alphabet. It doesn't have to be the standard aviation set if you don't know it; just use easily understood words that start with the letter (such as "sally" for "s" and "jack" for "j") -- the most important is distinguishing between "m" and "n", usually "Mary" and "Nancy".
If the person you're talking to repeats what you said to make sure she got it right, just say "yes" or "correct." If you repeat yourself, the other person will assume she heard wrong.
If you're interested in learning more about sign language, take a look at the American Sign Language Resource Site.
Phone calls only exacerbate the problems for hearing-impaired people.
Fortunately, your phone tax dollars pay for captioned phone calls;
that used to require a TDD/TTY, but phone captioning has moved into
the Internet Age with captioned phones and captioning in the browser
(and even mobile phones) from
Conference calls add yet another layer of difficulty, because there's no visual cue to identify the speaker. Add triple difficulty with the lousy sound common to speaker phones; consider using IM instead, or at least having each person dial in from an individual phone.
DVD Movies with Captioned Features
Guide to Captioning
Letter to Dr. Sacks explaining that amusia from cochlear implants is not due to technological limitations of cochlear implants
A Guide to Assistive Technology for Deaf People covers technologies useful for all hearing-impaired people
Hearing Simulator demonstrates what it's like to have a hearing loss (requires Flash plug-in).
Strategies for communication between the hearing and the hearing-impaired (I found this link after writing my own piece)
Assisting Residents Who Are Hearing Impaired (Another page similar to mine, this one gives more background on the hearing process)
Hearing Exchange is a site devoted to providing a lot of resources specifically for hearing-impaired people, rather than hearing and deaf (or mostly deaf).
Listen Up! (lots of good info, though aimed more at parents of hearing-impaired children)
HLAA (Hearing Loss Association of America)
The Spoon Theory is about managing time/energy when you have a disability (it's from a person with lupus, but I have to deal with similar issues)
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