When Louder isn’t Always Better: Tips for communicating with someone who is hearing impaired


Communicating with someone with hearing loss is often very frustrating for all parties.   The inability to hear normally and effectively communicate leads to emotional consequences such as a loss of self-esteem, social isolation and a lack of participation in social settings. While there is currently no cure for sensorineural hearing loss, hearing devices prove a powerful and life changing tool.

While I (and most of my colleagues and patients) regard hearing instruments as “tiny little miracles”, simply wearing hearing aids alone may not be enough to maximize communication.   Both the listener and speaker should understand that in order to receive the most benefit from hearing aids, there are additional strategies that can be employed concomitantly.

The Hearing Loss Association of America (HLAA) recommends three core points to maximize communication with a person who is hard of hearing: set the stage, get the point across, and establish empathy with the audience.

When setting the stage, the HLAA recommends facing the listener directly, spotlight your face (avoiding backlighting), avoid noisy backgrounds, get the listener’s attention before initiating speech, and ask how you can facilitate conversation (often the listener knows just what to recommend!).  When the acoustics are poor, emphasize visual cues.

The HLAA outlines several pointers on how to best “get the point across”.  First, don’t shout. Speaking louder doesn’t necessarily result in a clearer acoustic signal.  The ideal way to deliver your message is by speaking at a moderate pace, clearly, without overemphasizing words. Use facial expressions or gestures when appropriate and don’t hesitate to rephrase if you are not understood. Finally, remember the hearing impaired rely heavily on visual cues. Chewing, facial hair such as a heavy beard or mustache, or turning your head while speaking may not result in communication breakdowns for someone with normal hearing but may cause interruptions for a hard of hearing listener.

To establish empathy with your audience the HLAA recommends being patient.  Speak directly to the hard of hearing individual (not about him or her to another person), show respect and maintain a sense of humor, stay positive and relaxed.

Even with the best intentions however, communication breakdowns are bound to occur.  If your listener did not appropriately understand what you said, try repeating the message noting your delivery speed. If your message was still not understood try rephrasing the message. If “that’s right” was not understood try, “that is correct.” Another approach is to repeat a key word to indicate the topic of conversation. If “Sue came home” was not recognized try, “Sue. Sue is home.” Simple alterations in word choice and order often have a significant impact on your intelligibility.

In summary, when communicating with individuals with hearing loss , share in the responsibility of effective communications.  While there are certainly strategies for the hearing impaired listener to maximize communications (a topic for a later post), exercising some of these strategies can yield a positive impact on your relationships.


Stefanie Wolf, Au.D.

Doctor of Audiology
Audiology of Nassau County
165 North Village Avenue
Suite #114
Rockville Centre, NY 11570
(516) 764-2094

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Johnson, C., Danhauer, Guidebook for Support Programs in Aural Rehabilitation. Singular Publishing Group, San Diego,1999.
Montano, JJ. and Spitzer, J.B. (Eds.) Adult Audiologic Rehabilitation Plural: San Diego (2009).
Tye-Murray, N.: Foundations of Aural Rehabilitation Singular: San Diego (1998).

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