Communication Strategies Training Introduction to Audiological Rehabilitation

Training Content Communication problems associated with hearing loss Facilitative strategies Repair strategies Communication styles

Program Considerations Length of training sessions Group vs individual Gender Age of individual(s) Life stage Culture Motivation Specific communication difficulties

Communication Strategies Training Model Stage 1 Formal Instruction Stage 2 Guided Learning Stage 3 Real World Practice

Stage 1– Formal Instruction Provide information about various types of communication strategies and appropriate listening and speaking behaviors Stage 1 Formal Instruction Lecture Tutorials Handouts Workshops Discussion Presentation

Stage 2– Guided Learning Individuals use conversational strategies in a structured setting Stage 2 Guided Learning Modeling Role- playing Focused attention Scenarios Continuous Discourse Tracking Drill Activity

Stage 3– Real-World Practice Individuals practice new skills or behaviors in everyday environment Stage 3 Real-World Practice Diaries Calendars Worksheet Assignments

Short-term Training Materials approach –providing materials, brochures, etc. Dr. Sam Trychin Audiology Awareness SHHH (Hearing Loss Association of America)SHHH ALDA John Tracy Clinic Beginnings for Parents GoHear Consumer Handbook on Hearing Loss and Hearing Aids Hear Again Publications Dr. Ross HearingVision (Norm Erber)HearingVision Arthur Boothroyd HearingLoss Web Short Tutorials –brief tutorial on communication strategies

Short Tutorial Example (Formal Instruction) W=watch the talker’s mouth, not his eyes A=ask specific questions T=talk about your hearing loss C=change the situation H=acquire health care knowledge Montgomery, 1994

SPEECH (Formal Instruction) S = spotlight your face –Keep face visible, distance, same room P = pause slightly while speaking –Moderate rate E = empathize and be patient –Be patient, utilize facilitative and repair strategies E = ease their listening –Gain listener attention, ask for communication solutions C = control the circumstances –Manage environment H = have a plan –Use appropriate communication strategies for situations

Training Communication Partners Empathy Organized messages Comprehension Repair strategies Facilitative Strategies Clear Speech

TOPICON (Guided Learning) Each participant independently examines a list of topics and indicates a topic of interest or familiarity One participant or instructor selects a topic for conversation The two participants engage in a brief conversation during which the instructor monitors the discussion assesses the conversation Participants and instructor discuss the discourse, fluency considering avoidance resolution of difficulties

Example TOPICON Topics babieselectronicswriting poetry dancingcave exploringantique furniture cheese barbecues friends gossipcats newspaper ads computersbest recipesgoing fishing shopping tennis last weekend astrology saving money house renovation televisionsailing recent illness beer the theatre going to work

TOPICON Evaluation Clinician and the client discuss what happened during the conversation, for example: –What are the advantages/disadvantages of discussing a familiar/unfamiliar topic? –What happens when both people know little about the topic? –Who talked more during the conversation? Why? –Who asked more questions? Why? –What was the general direction of "information flow"- to/from the client? –Which factors resulted in disruption/fluency during the conversation? –Which clarification requests/strategies were applied (in)effectively

Continuous Discourse Tracking (Guided Learning) A talker reads a passage of text, phrase-by-phrase, to a listener After each phrase has been delivered, the listener attempts to repeat the phrase verbatim If there are errors, the talker repeats or paraphrases until the response is word-for-word accurate Performance is measured in number of words of text repeated correctly per unit of time The sender coaches the receiver on use of repair strategies

Continuous Discourse Tracking Purpose: Increase speech recognition skills Increase utilization of contextual cues Improve coping skills –Use of repair strategies Improve conversational fluency –Word per minute rate

Continuous Discourse Tracking Novels Readers Digest Books Newspapers Audiology speech materials (Everyday Sentences, etc.) Listening to tapes Kid Trax