1. Communication Strategies Training Chapter 9
Introduction to Audiological Rehabilitation

2. Training Content Considerations
Communication problems associated with hearing loss
Facilitative strategies
Repair strategies
Communication styles
Assertiveness training
Self-efficacy

3. Self-Efficacy
Self-efficacy: confidence that a person has for performing a particular task AR self-efficacy: beliefs patients have about their abilities to manage difficult communication situations

4. Self-Efficacy
Can influence person’s willingness in activities and conversations
Can influence the efforts persons will invest into completing an activity, the time devoted to an activity or challenge

5. Bolstering Self-Efficacy
Master experience: direct experience in a successful communication interaction
Multiple practice experiences
Vicarious experience: direct observation of others succeeding in communication interaction
Watching others succeed in interaction
Verbal persuasion: Explaining or telling how to manage communication challenges
Didactic training, feedback, involving others
Emotional arousal: emotional reactions in response to communication interactions
Relaxation or breathing activities

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

7. Question
Communication Training consists of how many stages: 1 2 3 4 5

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

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

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

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

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

13. 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

14. 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

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

16. 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

17. Example TOPICON Topics
babies electronics writing poetry
dancing cave exploring antique furniture
cheese barbecues friends
gossip cats newspaper ads
computers best recipes going fishing
shopping tennis last weekend
astrology saving money house renovation
television sailing recent illness
beer the theatre going to work

18. 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

19. 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

20. 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

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

22. KidTrax

23. Active Communication Education (ACE)
Group training program to help people over the age of fifty with HL to become more effective communicators in everyday life.
program offers guidance and strategies that will help to:
Improve the person’s communication abilities
Reduce the hearing difficulties experienced
Improve the person's quality of life.

24. Active Communication Education (ACE)
The facilitator asks participants to consider: What hearing/communication difficulties do you experience in everyday life as a result of your HL?
The facilitator asks each participant to state one difficulty only.
The facilitator writes each difficulty on a board.
Group members state one difficulty at a time until all difficulties are recorded.
The facilitator leads a discussion to clarify the difficulties and pulls together any difficulties that are similar.
Each group member given three Post-It notes with 3, 2, or 1 on each. Participants asked to place the sticker labeled rating each difficulty.
Facilitator gives score of 3 to the difficulties labeled 1, a score of 2 to the difficulties labeled 2, and score of 1 to difficulties labeled 3.
The difficulties with highest scores become topics in sessions that follow.

25. Adult Benefits of Training
Good patient participation
Change in communication strategies
Change in perceived hearing-related disability

26. Children Benefits of Training
Increased responsibility for initiating and managing repair
Better matching of strategy to situation
Greater variety of strategies used
Improved assessment of partner’s viewpoint

27. Communication Training Considerations
Can empower persons with HL
Persons vary in willingness to participate
Some are incapable of changing
Some lack metacommunication skills to examine conversational styles and monitor their interactions