Which of the following is not effective when communicating with a hearing impaired patient?

How can I better communicate with someone with a hearing loss?

Hearing aids are beneficial in many situations. However, there are some listening events where hearing aids alone cannot provide enough benefit. In those situations, communication partners can help the person with hearing loss be more successful in hearing. Remember, communication involves at least two individuals: a talker who sends the message, and a listener who receives the message. You, as a member of this communication pair, can improve the conversation by following a few simple strategies.

Gain attention

Gain the listener's attention before you begin talking, for example, by saying his or her name. If the person with hearing loss hears better from one ear, move to that side of the person. Also consider touching the listener's hand, arm or shoulder lightly to gain attention. These simple gestures will prepare the individual with hearing loss to listen and not miss the first part of the conversation.

Maintain eye contact

Face the person who has the hearing loss. Make eye contact. Your facial expressions and body language add vital information to the message being conveyed. For example, you can "see" a person's excitement, joy, confusion or frustration by watching the facial expressions or body language.

Keep hands away from face

When talking, try to keep your hands away from your face. You will produce clearer speech and allow the listener to make use of those visual cues by keeping your mouth and face visible.

In addition, most listeners can improve their perception by watching the talker’s face – also known as speechreading. Speechreading helps to improve speech perception. Many sounds can been seen that are hard to hear. For example, the sound /s/ is very difficult to hear but easily speechread. It is important to not over exaggerate your talking, talk with food in your mouth or chew gum when talking to a person with hearing loss. Keep in mind that heavy beards and moustaches can also hide your mouth.

Speak naturally

Speak distinctly, but without exaggeration. You do not need to shout. Shouting actually distorts the words. Try not to mumble, as this is very hard to understand, even for people with normal hearing. Speak at a normal rate, not too fast or too slow. Use pauses rather than slow speech to give the person time to process speech. Give clues when changing subjects or say “new topic."

Rephrase rather than repeat

If the listener has difficulty understanding something you said, repeat it once. If they are still having difficulty find a different way of saying it. Use different words with the same meaning. For example: “I am going to the grocery store." Repeat once and then rephrase. “I am going to the supermarket," If he or she did not understand the words the first time, it's likely he or she will not understand them a second time. So, try to rephrase it. Another option is to ask what the person did not understand and just repeat that phrase or word. For example, "grocery store" is what was not understood, so just repeat those words "grocery store."

Talk away from background noise

Try to reduce background noises when talking. Turn off the radio or television. Move to a quiet space away from the noise source. When going to a restaurant or making dinner reservations, ask for a table away from the kitchen, server stations or large parties.

Good lighting is important

A person with hearing loss can speechread to assist in hearing so lighting on your face is important. When in a restaurant or other social gathering, sit where there is good lighting so that your face can be more easily seen. Poor lighting may cause shadows on the face of the talker. Conversely avoid sitting with strong lighting coming from behind, such as through a window, as that will cause difficulty looking into the bright light.

Use an app to translate from spoken word to written word, or use texting

There are numerous apps that can be downloaded that can allow you to speak into a smart phone and have your words show up on the screen for the person with hearing loss to read. One such app is called Dragon. The use of texting is also an efficient use to supplement communication.

Effective communication with a qualified person who is deaf or hard of hearing is communication that allows the person an equal opportunity to participate in, and enjoy the benefits of, a service, program, or activity.

What laws apply to effective communication for people who are deaf or hard of hearing?

Section 504

Section 504 of the Rehabilitation Act of 1973 (Section 504) forbids public and private entities that receive financial assistance from any federal department or agency (“covered entities”) from excluding qualified individuals with disabilities or denying them an equal opportunity to receive program benefits and services.

ADA

The Americans with Disabilities Act of 1990 (ADA) protects individuals with disabilities in employment, state and local government services, public accommodations (most private offices and businesses), transportation, and telecommunications.

Who is protected under these laws?

These laws protect qualified individuals with disabilities:

• Has a physical or mental impairment that substantially limits one or more major life activities (such as hearing, speaking, sleeping, thinking, learning, working or the operation of a major bodily function)
• Has a record of such an impairment
• Is regarded as having such an impairment

To receive services, education, or training, qualified individuals with disabilities must, with or without reasonable modifications, meet the essential eligibility requirements for the specific service, program, or activity.

Examples:

• A 40-year old person who is deaf would not be a qualified individual with a disability for a program limited to people over 65.
• A 7-year old child who is hard of hearing would probably be a qualified individual with a disability for a vaccination program that is provided to all school-age children.

What are auxiliary aids and services?

Auxiliary aids and services may be:

• qualified interpreters*
• note takers
• transcription services
• written materials
• telephone handset amplifiers
• assistive listening devices
• assistive listening systems
• telephones compatible with hearing aids closed caption decoders, open and closed captioning
• text telephones (TTYs)
• videotext displays, or other effective methods of making aurally delivered** materials available to individuals who are deaf or hard of hearing

* "Qualified interpreter” means an interpreter who is able to interpret effectively, accurately, and impartially, both receptively and expressively, using any necessary specialized vocabulary.

** “Aurally delivered information” means information that is delivered through sound, including through speech, intercoms, telephones, recorded messages, loudspeakers, alarms, etc.

What should I do if I need auxiliary aid or service?

As soon as possible:

• Let the entity know that you are deaf or hard of hearing
• Ask for the auxiliary aid or service you think you need (interpreter, notepaper, etc.)

Who decides on the aid or service?

The covered entity is responsible for ensuring that effective communication happens.

Generally, the entity should consult with you and give primary consideration to fulfilling your request. They may use a substitute if the alternative also provides effective communication. If an auxiliary aid or service is needed, the entity must provide it free of cost, after considering:

• How many people are participating in the communication and their individual characteristics
• The particular situation or context and the nature, length, complexity, and importance of the communication
• Whether a fundamental alteration of the program or service or would result in an undue burden. This decision must be made on a case-by-case basis.

Example Scenario:

A person who is deaf went to the doctor’s office to have a blood test. The doctor knew that the visit would be very short and that there would be very little communication during the visit. After consulting with the individual, the doctor determined that an interpreter was not needed, and that writing notes and gestures would be effective for this patient in this situation. For the next appointment to discuss the results of the blood test and to talk about treatment decisions, the doctor provided an interpreter. In making these decisions, the doctor consulted with the individual, thought about the needs of the individual, the circumstances, the importance, nature, and complexity of the communication, and whether providing an interpreter would constitute an undue burden under the law.

What if I think the communication is not effective?

You can tell the service provider if you think the communication is not, or will not be, effective. You should tell the provider why you think it is not effective.

Example Scenario:

A deaf parent of a child in a Head Start program requested a meeting with the Director to talk about problems with her child’s teacher. The Director asked a teacher who was a close friend of the child’s teacher to serve as an interpreter. The parent told the Director that she thought an outside interpreter should be obtained because the interpreter might not be able to remain impartial.

When communicating with hearing

Which of the following techniques will improve communication with a deaf patient?

When communicating with a patient with a visual impairment you should?

When communicating with a person who has a speech impediment or impairment you should do all the following except?