Archive for the 'About Hearing Loss' Category
March 17, 2008
This blog owes its existence to my starting formal lip reading classes, closely followed by a very basic sales training program. I have exaggerated things slightly for emphasis (blogger’s licence ?) but I believe the concepts are as sound as any other aspect of popular psychology. While hearing impaired people are amongst their regular friends and acquaintances, these people make allowances for any possible perceived “rudeness”. The effects discussed only really come seriously into play when meeting strangers, particularly if there are important things at stake. I will try to avoid ‘he’ and ’she’, as in most instances the effects apply independently of the gender of both the ‘reader’ and the ’subject’.
A good way of making someone feel really uncomfortable during a conversation is to spend a lot of time looking at their face, but never making eye contact. The middle of the forehead and the throat area are particularly effective for this. The mouth is obviously very potent as well. It has the added complication that many women will worry about some imagined make-up or facial blemish, and will either start to cover their mouth or not relax until they have checked in a mirror.
As the mouth is very close to the eyes, it is very easy to try to compensate for this by making frequent eye contact. Unfortunately this is a strong sign of at least good friendship, possibly even attraction or affection. This is perhaps not always welcomed by strangers, so the answer is to look away as often as possible to try to maintain only normal levels of eye contact. The problem can be heightened by a tendency to place yourself nearer to the subject than normal, to hear better. This again is only really tolerated by a subject if the person is a close friend (note the significant adjective). In the case of a stranger it constitutes at least over familiarity, perhaps even aggression. We must always read the person, as well as the lips, and try to find some mutually acceptable compromise.
We are told that the best position for lip reading is with reader and subject facing each other. Yet “face to face” is quite rightly synonymous with antagonism. If coupled with invasion of personal space it is aggressive, and pictures of boxers “facing off” at weigh-in are common before a big fight. Very close, face to face and trying to “stare the opponent down”. Sound familiar? Ninety degrees between the bodies is a far more useful working alignment.
The same applies to seating at table. Pub lunches are a popular low key form of entertaining customers, yet can be very difficult to stage. The recommended alignment would be both sitting on the same side of a longish table. Under normal circumstances that puts you both tactically “on the same side” as well as literally. In my case though the tendency would be to sit too close to the subject, spend a lot of the time with my head noticeably turned to gaze at the subject’s face and making too much eye contact. Not good! Again ninety degrees on a smaller square table is far preferable. Lighting continues to be difficult, the preferred situation for reading again being very uncomfortable for the subject, with a good light shining on their face (into their eyes?). There are other informal protocols about seating customers comfortably, which can very often run contrary to reading requirements. On several occasions I have apologised to important contacts if I couldn’t discretely manipulate a suitable seating arrangement. I have never found explaining why I wanted to change the positioning to be a drawback, especially when coupled with “because I want to be as sure as possible of what you are saying”
Acknowledgement of authority can be a major problem, particularly with eastern cultures. I have been shown respect by a person lowering both their head and voice when speaking to me. Unfortunate. I far prefer the approach often shown by ex-military personnel, rarely any need for guesswork there. The reverse problem arises when a reader talks with a superior. Unexplained reading would certainly be considered very disrespectful in some cultures. Even in European ones, high ups can be uncomfortable with it, perhaps interpreting it as over familiarity by a subordinate.
One last point at the end of a long blog. Readers would do well to consider what they themselves look like while they are reading. I find some situations very difficult and tiring, and professional colleagues have warned me that my natural expression under these conditions is somewhere between a frown and a scowl. Again not good social practise.
As a summary then. If I had an appointment with a perfect stranger, and I wanted to ensure my best conversation conditions, as regards accurate exchange of information. The subject would have their face well illuminated and I would be directly facing, looking at the lips only. Our faces would be unusually close together and I would be scowling slightly.
If that didn’t make us instant friends, I suppose I could always try the thumb screws. 
February 15, 2008
Until I started on this blog I could never work out a really good way of answering this question. The true answer would be considered rather rude, so I tend to fudge it. I don’t think people would like to be told bluntly “Yes, but most people have no idea what that actually means”. The better answer, that has just come to me, would be “Everyone does! I rely on it a lot more than normal, but not as much as some.” It really boils down to how you think of lip reading – as some kind of special academic skill, or a day to day means of communication. Most people ‘read’ or react sub-consciously to body language, and everyone recognises facial expressions such as sadness, laughter, surprise etc. It’s only one very small, involuntary, step further into reading lips.
In the days before audiometry was widely available (producing the charts shown earlier from controlled electronic sound signals), specialists were skilled in assessing the patient’s situation from their own test routines. I haven’t had one in recent years but they may still do them. The specialist would say single words or phrases at varying loudness and distance, from various parts of the room, face on / profile and even back turned. In many respects it was a test of total speech recognition rather than purely a hearing test. I only realised this during one of the lengthier assessments. I repeated the number the specialist had said, but felt compelled to add, helpfully “but only because I’m reading you”. We actually got on very well, considering that some specialists could be very ‘haughty’ in those days. His answer was a mixture of amusement and resignation “And just what do you think I’m testing?”
During a couple of infections, when I thought that my hearing was deteriorating very fast, I asked specialists if I should try formal lip reading classes. On both occasions the answer was basically “You won’t learn anything, you already read pretty well, easily as well as you need to.” It’s that last phrase that is important.
The following appeared in an article in the Telegraph 23/11/2006 (Hitler Home Movies Telegraph Link ) “The technology that has allowed the dialogue to be reconstructed is called ALR — automated lip reading — and has been developed by Frank Huber, a speech recognition expert. The computer recognises shapes that lips make, turns them into sounds and matches these to a dictionary.” (NB The “dictionary” must have been phonetic, not the ordinary kind) It’s a pretty good definition of lip reading. You can appreciate how one could program a computer to do it, particularly on a film of a limited number of individuals that could be run over and over again, with unlimited time allowance. Humans in normal conversation have to attempt the same process in a much shorter time scale with very limited resources. So basically we cut corners. If we can simply hear, that is the preferred path. In areas of difficulty we will get extra clues from reading. If we know the speaker well we may use a restricted dictionary of their favourite words or phrases.. Similarly the topic or even the mood of the conversation allows other short cuts to the right kind of words. At conversational speed you don’t have the luxury of working everything out from first principles. You either see/hear the phrase first time or you don’t. Practise is everything, it can be tremendously difficult and tiring and people naturally only learn to do it as well as they need to.
You will appreciate the difficulty in the question now. If I turn my hearing aids off I will probably read a bit better than a person with regular hearing, but nowhere near well enough to carry out a normal conversation. I have never been forced to learn to that level of skill. On the other hand if I wore my aids but with a blindfold my “hearing” of speech would deteriorate considerably. Like the old (but very valid) chestnut “Wait till I put my glasses on, I’ll hear you better”!!
I did actually go to a series of reading classes at the age of about 40. Essentially the specialists were right, of course, and I learned very little of practical value. What I did learn was the basic theory behind what I had been doing instinctively since the age of three. In a way I had been learning to see/hear for most of my life. The others on the course benefited much more, and had been forced onto what might be called an accelerated learning curve by circumstances. A minority of various ages had been rendered deaf suddenly. The majority were, say, early sixties upwards and starting to struggle with age related deafness, after a lifetime of perfectly good hearing. In such cases some sort of formal schooling and practice in reading is well worth considering, rather than just “picking it up as you go along”. Classes are usually provided free, or at very low cost, by local authorities.
After my last blog about ‘Hearing Strategy’ and possibly trying to conceal a hearing loss, one might be forgiven for thinking that lip reading was a fairly secretive way of dealing with things. It is however very difficult, and I have seen it reported that even good readers can only be positive of about 35% of what they see. The rest is guesswork. So, again, reading is just one tool to be used in conjunction with other techniques to get as many clues as possible for the crossword.
One thing I didn’t realise until I got a little more involved in body language and psychology etc (ie basic sales training ) was just how antagonistic and uncomfortable intensive lipreading can be for the subject being read. I will cover this later but, again, there is a very strong case for letting the subject know exactly what you are doing and, perhaps more importantly, why.
February 8, 2008
We have established by now that hearing loss is not exactly the same for everyone, nor is there a single best way of dealing with it. Most readers will have gathered that I personally tend to meet problems head on, and in a fairly open and reasoned manner. It’s a way that has worked for me, but is perhaps not for everyone. I think that it is worthwhile, though, for anyone affected (when they are ready to face up to it) to have a quiet think and try to work out rationally which is the best way for them personally.
All strategist seem agree that “doing nothing” can actually be very effective, always provided that the decision has been arrived at for valid reasons and is not just a “cop out”. Remember also that all strategies need reviewing from time to time, particularly if they are not producing the desired results. People should also be aware that this blog refers mainly to speech, which I believe is the major concern for most people.
It shouldn’t be forgotten that tonal hearing and “noise recognition” in general can be very important to some people. Musicians are an obvious case. Doctors using stethoscopes and car mechanics listening to engines are less obvious but just as valid. We are all to some extent dependant these days on alarm sounds of various kinds, telephones, door bells and smoke alarms etc. Even for non-mechanics the first indication that something is starting to go wrong is “it doesn’t sound right”. All these points could play a part in decision making, depending on the individual’s circumstances.
Below, I have tried to separate thoughts into three general divisions, demonstrating them by describing the opposite extremes, essentially covert versus overt. The divisions are for illustration only as they are all every much interrelated in real life. However more specific blogs to follow will also develop these general ideas.
How much do you really need to hear? Chatting is a very basic social function. The fact that you are doing it is very often at least as important as what is being said. Some people develop techniques that allow them to be very good social chatters, while having only an outline understanding of what has actually been said by others. At the opposite extreme, most responsible jobs leave no scope at all for vague understandings or guesses.
How important are cosmetics? Like glasses, hearing aids are sometimes considered to detract from a person’s looks. The ultimate response to this is not to wear them at all. The more usual one is to use them but to go to extreme lengths to conceal their existence. Not usually very successful in the long run. At the opposite end of the scale very little regard is paid to the looks of the instrument, the main consideration being its functionality and suitability for the job.
How confident are you of others? Self explanatory this. Basically, do you want to “go it alone” or are you prepared to prompt others into making life a little easier for all concerned?
To the surprise of absolutely no one who has been following this blog, my strategy is to be very open on each of these questions. I don’t expect there to be many more readers in exactly my position. In fact the first instinct of people finding themselves with a hearing loss is to be quite secretive about it.
One of the main reasons for me attempting this blog is to perhaps persuade people there are some real advantages in being at least a little bit more open and proactive about their hearing loss. The other major reason is, of course, is to give readers with “normal” hearing some insight as to what hearing loss is all about.
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