The ear is divided in three parts: an external ear, a middle ear and an inner ear. Each part performs an important function in the process of hearing.

The external ear consists of the auricle and ear canal. These structures gather the sound and direct it towards the ear drum.

The middle ear chamber lies between the external and the inner ear and consists of an ear drum and the three small bones (ossicles): malleus (hammer), incus (anvil) and stapes (stirrup). These structures transmit sound vibrations to the inner ear. In so doing they act as a transformer, converting sound vibrations in the external ear canal into fluid waves in the inner ear.

The inner ear chamber contains the microscopic hearing and balance nerve endings bathed in fluid. Fluid waves initiated by movement of the stapes bone stimulate the delicate hearing nerve endings which in turn transmit an electrical impulse to the brain where it is interpreted as sound.

There are three types of hearing loss. Through clinical testing and examination your physician and audiologist will learn which type of loss you have and the severity of the loss.

Sensorineural (nerve) loss

A sensorineural loss occurs in the inner ear or along the hearing nerve (nerve VIII). This loss may be caused by infection, noise exposure, meningitis, ototoxic drugs, inherited conditions and unknown causes.

Conductive Loss

A problem in the outer or middle ear can lead to a conductive hearing loss. It may result from wax impactions, middle ear infections (otitis media), bony growth of the ear bones (otosclerosis) or birth abnormalities.

Mixed Loss

A person can have both types of loss at the same time.

Conductive losses are often, but not always medically or surgically correctable, while a sensorineural loss is usually not. The treatment for sensorineural, mixed and some conductive losses is the use of a hearing aid.

A sensorineural hearing impairment may result from disturbance of inner ear circulation or fluid pressure or from disturbances of nerve transmission. The most common cause of sensorineural impairment is an aging change in the nerve endings. This type of impairmentis not correctable but rarely leads to deafness.

The person with a nerve type hearing impairment may state that he can hear people talking but cannot understand what they are saying. An incrase in the loudness of speech may only addto his confusion. Speech is audile but not olcear to him. He usually hears better inquiet places and he may have difficulty understanding what is being said over the telephone. He will probably hearlow tones better than high tones and thereore, may find a man’s voice more understandable than a worman’s higher pitched voice. He may not hear a dorebell or the telephone ringing in another room.

A hearing impairment that is confined to one ear deproves a person of the ability to distinguish the direction of sound. He will also have difficulty hearing fromt he involved side and may find it difficult to understand in a noisy background or where the acoustics are poor.

Whenthisimpairment is conductive surgery will usually be possible to restore the hearing, givine a better aiditory balance. When the impairment is sensorineural, it is often possible to restore some of his balance through the use of a hearing aid.

In some instances an aid may be used on the impaired ear, bit in other cases it is necessary to use a CROS hearing aid.

A complete otologic examination by a competent ear specialist is necessary to determine what type of hearing impairment is present, Its probable cause and its treatment.

The treatment of choice may be remedial, preventive, medical, surgical or a combination of these. Each person with impaired hearing should have the benefit of adequate auditory rehabilitation.

A well rounded program of rehabilitation for persons with a hearing deficiency may include speech reading, auditory training, speech conservation and improvement, instruction in the use of a hearing aid and guidance in social adjustment. All aspects of the program do not necessarily apply to each individual with an impairment, but each individual may be helped through some of these methods.

The individual with a hearing impairment must, so to speak, stop, look and listen in order to hear and understand speech.

There are a number of factors that can significantly influence the communicating ability of the hearing handicapped. An understanding of some of the aspects of hearing impairment will prepare you to communicate more effectively with such persons

Speech reading. It is not uncommon for the person with impaired hearing to say, "I can’t hear a thing without my glasses." This expression is a sure indication that he relies heavily on speech reading. Many use speech reading without being aware that they have developed the skill. Over the years, the listener unconsciously compensates for his auditory impairment by obtaining visual clues of speech from the lips and facial expressions of the speaker.

Many take formal training from tutors who are specially prepared in this area. Whatever the means of acquiring the skill, it is helpful to all hearing handicapped to be able to view the face of the speaker. The speaker who absent-mindedly covers his mouth, chews gum, or sucks on a pipe during a conversation deprives the handicapped listener of valuable visual information that could enhance his understanding. Poor speech habits not only negate the lipreading skill of the listener but also introduce distorted speech sounds. On the other hand, overly precise lip movements are to be avoided because exaggerated mouthing also result in speech distortion. Lip readers have learned to interpret normal speech movements.

Attention. Relatives of the hard of hearing have been heard to say, "Oh, he hears when he wants to hear". Sometimes a person is able to hear and understand without apparent difficulty. However, his "good hearing" is often the result of an ideal listening situation in which he was communicating at a short distance, with an articulate speaker, in the absence of noise. Attempts to communicate in noise or with poor articulation or from another room in the house will often end in failure.

The hearing handicapped expend an enormous amount of energy in an effort to sift out the important clues of speech. Their attention to the task of hearing requires concentration.

Modulated Voice. A very loud voice that is further amplified by a hearing aid becomes distressing and sometimes painful to the hearing aid user. If a person seems to hear but not understand, shouting will not help matters. It also is wise to remember not to drop the loudness of your voice at the end of a sentence.

Enunciation. One must speak with care while at the same time not exaggerating the words. Overdoing one’s enunciation also leads to distorted speech. Remember that the listener will not understand all the sounds even when they are properly articulated. Faulty enunciation will further reduce his understanding.

Rate. Rapid speech is very difficult for the hard of hearing to understand. Spoken words last only a fraction of a moment. The brain must quickly identify each group of sounds in a word and assign a meaning. If groups of sounds (words) are run together or any single sound is distorted or omitted by fast speaking, then the listener’s understanding is affected. Because spoken language is so transient, the listener has only a short time to identify each word. Frequently, the hard-of-hearing give the wrong answer to a question-not because they don’s know the answer but because they have misinterpreted the question.

Speech clues. Poor speech discrimination (inability to understand words) is the major handicapping aspect of hearing impairment. Because the meanings of many words are lost or misinterpreted by the hard of hearing, the speaker can be helpful by offering as many clues as possible to establish the meaning of a conversation. By using several different words to express the same thought, the hard-of-hearing listener is provided with additional clues as to the context of speech. For example, instead of saying, "Would you like to see the paper?" - you might say, "The Gazette; would you like to read the news paper?" You will notice that the loss of some of the more important words is less critical when there are other to indicate the same idea. However, the misinterpretation of the single word, "paper" in the first sentence results in a complete breakdown of communicating that particular idea.

Hearing impairment is a complex handicap. The task of adjusting to one’s handicap can be eased by remembering a few simple rules. Get the hard-of-hearing persons attention and enunciate clearly and speak loudly enough. Do not speak rapidly. Above all - be patient.

Speech reading is a skill that enables a person with impaired hearing to better understand conversation by attentively observing the speaker.

All of us, whether we have a hearing impairment or not, employ the senses of sight as well as the sense of hearing in ordinary conversation. We find it easier to comprehend if we can watch the speaker’s facial expressions, lip movements and gestures. A stuffy of the fundamentals of Speech reading will make conversation less of an effort and therefore more pleasant for both the speaker and the listener.

Speech reading has limitations. For example, when the distance between the speaker is great or when there is faulty lighting or defective vision, one may not always be able to see the speaker’s lips enough to speech read adequately. Some persons have beards, hold their hands over their mouths or smoke as they talk, making speech reading difficult if not impossible.

It is important that the hard of hearing person acquaint his family, close friends, and associates with his problem so that they may avoid needlessly increasing the difficulty of speech reading. The speech reader must, so to speak, "stop, look and listen", in order to understand what he hears. It is helpful to point this out to family and associates so that they will get the hard of hearing person’s attention before speaking.

The hard of hearing must recognize characteristics of the English language. Many sounds and many words look the same on the lips. Look into your mirror and say the following pairs or groups of sounds and words: F, V; P, B, M; beef, meat, meat; shoe, chew; few, view. Each pair or group of letters and words looks the same on the lips.

The speech reader must determine from the context of the sentence which word is being used just as the normal hearing person must depend upon the context to tell which of two or more words that sound the same are being used. For example, in the sentence, "The boy has a vacant stare in his eye," "Boy sounds the same as "Buoy"; "Stare" sounds the same as "stair" and "eye" the same as "I", but the listener has no difficulty selecting the words intended and understanding the meaning conveyed from the context.

The hard of hearing person should be aware that it is impossible to see certain words on the lips and therefore he will continuously need to fill in "gaps" in words and in sentences. Look in your mirror again and say the following sounds: k, g, n, I and t. It is impossible to see these sounds on the lips because they are formed in the mouth and at the back of the throat. Two-thirds of al sounds in the English language are not visible on the ips. Because of the difficulties presented by sounds, the speech reader is encouraged to follow the context or thought of what is being said, rather than to try to lip read each word.

The hard of hearing person can also help himself by being keenly aware of the rhythm of conversation. A change in rhythm is a definite aid to understanding what is being said. Pauses between words and between sentences, stress and inflection, all affect what the speech reader sees and should convey different meanings to him.

Say the following sentences in a mirror or have someone speak them to you. Note the differences in meaning even though the sentences contain the same words.

1. Yes, I heard you tell him.
2. Yes, I heard you. Tell him.
3. Yes, I heard. You tell him.

Did you notice that the sentences look different on the lips because of the differences in pauses and in stress?

To master speech reading one must acquaint himself with the "setting" of a given situation. For instance, if the hard of hearing person is invited to a gathering, he should find out as much as possible about the occasion to give himself a background for speech reading. Who will be present? What are the names of some of the persons who are likely to attend? What are the interests of this particular group? What are they most likely to discuss as a group or individually?

If the hard of hearing person is on the alert to "size up" situations, speech reading will be easier for him wherever he goes. If a motorcycle policeman approaches after you have gone through a red light, it should be obvious to you what he is going to say. Similarly, you can anticipate the remarks of a salesman behind the counter or of a repairman who has just arrived to repair the radio or television. When you enter a group conversation that is already in progress, ask a friend what the discussion is about. It is frequently said that the persons with defective hearing have an "extra mile to go". It is certainly true in the sense that they need to be forever on the alert for whets going on.

The person who is learning to speech read, learning to use a hearing aid, or both should have the help of a professional person trained to each of these skills. This help is usually available at the Speech and Hearing Clinics of various universities. The Adult Division of the Board of Education in most large cities sponsors speech-reading classes for adults. In Los Angeles and in other large cities, the Veterans Administration provides classes in speech reading and auditory training for veterans. Your neighborhood school may be able to direct you to the services of a teacher who is trained in these special skills and who is able to arrange for private tutoring.

Many books on the subject of impaired hearing are available at public libraries. Unfortunately, one cannot read one of these books, and become a speech reader. With the help of family and friends, however, it is possible to use at home the practice lessons in speech reading contained in some of these books. Professional help can then be supplemented with a member of the family.

You may have certain communication problems that cannot be solved by the use of a hearing aid or by speech reading. These problems may involve the use of the telephone, radio, and television and the inability to hear the door chime, telephone bell and alarm clock.

Special instruments have been developed to solve these problems. They are available either through AT&T Service Center or your hearing aid dispenser. Installation of the radio and television devices maybe performed by your television repairman.

The telephone represents an important avenue of communication and one that offers the hearing handicapped considerable difficulty.

Many hearing aids provide a telephone switch. Moving the switch turns of the aid’s microphone and activates what is called an "induction coil". The telephone receiver is placed in contact with the case of the hearing aid to amplify the conversation without picking up distracting noises.

The induction coil telephone pick up on current hearing aids has been effective with AT&T or Bell System telephones in the past. All telephones manufactured after January 1, 1991 are compatible with hearing aids. It should be stated on the side of the box.

Volume control handset. This telephone handset is equipped with a thumb operated wheel which to adjust the loudness of an incoming message. Available through AT&T Service Centers.

Telephone Amplifier. This unit is a pocket size battery operated amplifier that is useful to the hearing impaired person who uses different telephones. It can be carried in a purse or pocket and simply clips on to most telephone receivers.

Telephone device for the deaf (TDD). The telephone-teletype system is another method of communication for the profoundly deaf that permits the two-way transmission of typewritten messages over telephone lines. The deaf person who wishes to make a telephone call to someone with similar telephone equipment places, the handset in a special cradle and dials the number. A monitor light flashes to signal when the phone at the other end is busy, ringing, or when someone answers. After contact is made a conversation can be typed back and forth between the two parties, offering a printed record of the messages. There are several devices available and they vary in cost. They may be purchased at AT&T Service Centers or through Michigan Hearing Center (MHC).

Michigan Bell Relay Service. Allows the deaf person to dial an operator and communicate with the operator by TDD, te operator contacts the party the deaf person wishes to communicate with (ie: doctor’s office, repairman, etc.) And relays the message for the deaf person. There is no additional charge for this service.

Signal bells. Some hard of hearing persons have difficulty hearing the door chime or the telephone bell. The problem of hearing a particular signal may be solved by either amplifying the signal or by substituting it with another sound that can be easily heard. For example, one may find help by substituting a lower pitched buzzer for the door chime or bell.

Buzzer. This telephone signal substitutes a buzzer-like sound for the usual ringer. It is preferred by many hearing impaired persons who have adequate hearing acuity for low frequencies. Available through AT&T Service Centers or MHC.

Extra strength signals. In addition to bells of different pitch, are alarms of extra loudness, such as gong, bells and horns to signal the ringing of the telephone. Although these signals are designed to be heard in a very noisy environment, they are adaptable to home use. Available through AT&T Service Centers or MHC.

Auxiliary control device (Signalman). This unit signals the ringing telephone by activating a flashing lamp. Substituting a visual clue for the auditory signal is particularly helpful to the severely hearing impaired. Available through MHC.

Sonic Alert. The inability to hear a sound originating in another part of one’s home poses another problem for the hearing impaired. One can improve his reception of a specific sound such as a door chime or the cry of a baby by installing this special switch. The switch converts sound into either visual or vibratory impulses. Lamps or vibrators are wired from the sound sensing apparatus to various rooms throughout the house. For example, the sensing device is placed in the baby’s room. When the baby cries, lights will flash throughout the home.

Automatic waking devices. The device consists of an electric clock into which is built or plugged into a bedside lamp, buzzer, or vibrator, depending on the preference of the user. The buzzer can be placed under the pillow while the vibrator is attached to the bed frame. At a preset time, the clock activates the alarm signal. It is the light and the vibrations that awaken the sleeper.

Electronic stethoscope. This instrument consists of a standard stethoscope to which a modified hearing aid amplifier is attached. The user adjusts the volume control and frequency response to his requirements. In this way, the hard of hearing physician and nurse can hear faint body signals that otherwise would go undetected.

Amplified earphone. This device permits the whole family to enjoy radio and television. It is attached to the set and the hard of hearing viewer adjusts tone and volume by controls situated at his chair.

Loudspeaker. This unit is also connected to the television and the speaker placed conveniently next to the hearing impaired listener’s chair. Your radio and television repairman can provide and install a suitable amplifier and when coupled to a loudspeaker or headset will provide adequate amplification.

Private radio TV listener. This inexpensive item may be obtained from Radio Shak.

Wireless TV Amplifier. The Sennheiser wireless amplifier unit consists of an infrared transmitter and a binaural receiver. Several infrared receivers may be used with a single transmitter. This unit produces good distortion free sound.

Desk Model Amplifier. Some persons prefer to use a small transistorized auditory trainer that is equipped with earphones. This type of amplifier offers greater fidelity than the average hearing aid. These devices permit other household members to listen in comfort while the sound is amplified for the hearing impaired listener.

Hearing dog programs have been developed to train and provide dogs for qualified individuals. Applicants who have severe to profound hearing loss, 18 years or older, who do not have hearing people living with them may apply for a dog. The dogs are not trained as guard dogs but are trained to alert the individual to specific sounds such as alarm clock rings, doorbell and knock on the door, ringing of the telephone, a baby’s cry or a smoke alarm. The dog trainer will spend 5 to 7 days of the training program with the dog in the recipient’s home. This enables the dog to make the transfer from the trainer to its new guardian who then becomes the sole authority figure to the animal.

If interested contact the United Way.

A hearing aid is an amplification system. Acting as an artificial ear, the hearing aid amplified sounds which the human ear may no longer perceive at the normal level. It uses the persons remaining hearing to the best of its ability. The hearing aid does not restore hearing to perfection. It is an assistive listening device.

Every hearing aid contains the same basic components.

Microphones detect the incoming sounds such as voices.

This control is to adjust the incoming sounds. They can be adjusted louder or softer. The volume is usually changed when entering different listening situations. In most instruments an on/off switch is incorporated into the volume control.

The battery compartment is where the batter is located.

The receiver transmits sound from the hearing instrument in to the ear canal.

A smallhole in the hearing aid that reduces a "plugged up" feeling in the ear. It allows the ear to "breathe" and receive sounds naturally.

A circuit is the mechanics inside of the hearing aid.

The portion of the hearing instrument that is located in the canal. It houses the receiver and the vent.

Some models have internal controls. The audiologist can adjust these trimmers for specific needs of the user. This can be done in the office.

In the ear (ITE) hearing aids are available in three basic sizes: full shell, concha/half shell and canal. The size of the hearing aid chosen is dependent on several factors. These factors are severity of hearing loss, user’s preference, wearer’s dexterity and cost. Not all people are candidates for in the ear hearing aids. This can be due to the severity of loss and amount of power needed in the hearing aid.

People with hearing losses ranging from mild to severe can be considered for this mode.. This is the most versatile in the ear hearing aid. It is the largest type. The full shell aid covers the entire ear opening. The battery size is 13 and has a life of approximately 243 hours. This aid uses the least amount of batteries of all in the ear aids. The full shell instrument is the easiest to operate due to the larger controls. Persons with dexterity and/or sight deficiencies should consider this model. The full shell model is also the least expensive.

The concha or half shell instruments is appropriate for mild to moderately severe losses. It is the most popular model. It is the mid size in the ear hearing aid. The concha aid does not cover the entire portion of the outer ear as does the full shell model, only the bowl portion, the controls and battery are smaller than the full shell instrument. Battery size on this type is a 312 and lasts approximately 175 hours. It is in the middle range of the price scale

The canal aid is appropriate for persons with a mild to moderate hearing loss. This is the smallest aid available. It fits in the canal portion of the ear and very inconspicuous. The battery size is a 312 or 230 and lasts approximately 75 hours. This model ranks the highest in terms of difficulty to operate, due to the small size and fragility of the device. Several versions of this aid are available. The canal aid is the most expensive of all in the ear hearing aids.

A behind the ear aid is connected to the ear by an earmold. The behind the ear hearing aid is considered the most durable but less flexible than in the ear hearing aid. The behind the ear hearing aid is mainly worn by persons having severe losses. However, they can be used for all forms of hearing loss.

Digitally controllable and programmable hearing aids are the most recent advanced in hearing health care industry. Through the use of computer technology these hearing aids can be programmed to precisely fit one’s hearing loss. Digital technology allows more accurate control of the sounds being delivered to your ear. The digital hearing aid is currently available in a behind the ear and in the ear model.

Following a visit to your physician and hearing test you will make a hearing aid evaluation appointment. At this appointment an audiologist will discuss your type of hearing loss, expectations of improvement, available options and prices of hearing aids. When a decision is made on the most appropriate type of hearing aid needed, audiometric measurements and an impression of your ear canal are taken. You will make an appointment in three weeks to receive the hearing aid. This service is a hearing aid orientation. The audiologist will explain and demonstrate how your hearing instrument operates. Fit and internal controls are also checked and set at this time. A two week conformity or follow up session is scheduled. This return appointment is to answer any questions or concerns you may have and to make sure the patients’ expectations are met. The audiologist might make some adjustments on the aid at this time.

Hearing aids are returnable/refundable within the thirty day trial period required by law. Return/refund policies will be provided in writing at the hearing aid evaluation. Most hearing aids are warrantied for loss, damage and repair up to 1 year.

Whatever the type of hearing impairment, it is important to follow a planned program of "learning to use the hearing aid" The ease or difficulty of hearing will vary depending on the loudness of background noises, the distance of the listener from the source of sounds, the clarity of speech or of music and the lighting (which may enhance of may interfere with lip reading). Practice exercises will help to prepare the wearer to use his hearing aid in widely different situations.

Thirteen recommendations for learning to use a hearing aid for maximum benefit are described in the following paragraphs.

Your hearing aid amplifies noise as well as it amplifies music or speech and you may be disturbed temporarily by background nose. Concentrate on listening for all of the normal household sounds that you hear. Once you can identify background noises, such as the hum of the refrigerator, the roar of an electric fan, the clinking of dishes, or the slamming of doors, the noises will tend to be less annoying and distracting to you.

Do not attempt to set an endurance record or to wear the aid at first during all of your waking hours. If you are tired and fatigues after using the aid for an hour or two, take it off. Let the way you feel be your guide. You can, over a period of several weeks, gradually lengthen the amount of time you wear the aid.

Talk about familiar topics; use common expressions, names, or a series of numbers for practical purposes. After a few days of practice with one person in a quiet environment try a different listening exercise. Turn on the radio or television and with this auditory distraction try to understand your companion’s speech.

The importance of listening carefully and of concentrating on what is being said cannot be overemphasized, but do not worry if you miss an occasional word. Normal hearing persons miss individual words or parts of sentences and unconsciously "fill in" with the thought expressed. (Keep your eyes on the face of the speaker. Speech reading is a very great help as a supplement to the hearing aid)

If your initial experience with the aid is unsatisfactory, remember that you are leaning new habits, or rather, relearning old habits in a new setting. Normal hearing persons are aware of background noises too, but have learned to push them out of conscious awareness. As you will learn to discriminate between noise and speech and to identify various background sounds, you also will be able to ignore extraneous noises just as persons with normal hearing do.

Localization of sound (the determination of the direction from which the sound comes) often presents a special problem to wearers of hearing aids. One exercise that helps to develop directional perception is to relax in a chair, keep your eyes closed, and have someone speak to you form different places in the room. Each time your helper changes his position, attempt to locate him through the sound of his voice along.

At first, hearing aid users tend to set the volume control at a level too low for efficient listening. Louder sounds need not cause discomfort. By a very simple procedure you may, over a period of time, increase your tolerance for sound. While you are listening to one speaker or to your radio or television in your own home gradually turn up the volume control of your hearing aid until the sound is very loud. When the loudness is uncomfortable, very slowly turn the volume down to a more comfortable level. After a period of practice you will find that your comfort level has increased considerably.

Prepare a list of words, which differ in one sound only. For example:

Have your helper pronounce these words slowly and distinctly. Watch the lip movement closely while you carefully listen for the differences in similar pars of words. Then try to discriminate the words by listening alone.

A good exercise in listening is to have your companion read aloud from a magazine or a newspaper while you follow along with your own copy of the reading material. At irregular intervals your reader should stop and have you repeat the last word read.

You will find that it is more difficult to carry on a conversation with three or four persons than it is to talk to one. Concentrate mainly on the individual who is talking the most.

After you have adjusted fairly well in your own home to background noise and to conversation with several people at once you will be ready to extend the use of your aid to the super market, church, theater, and other public places. Turn the volume low to reduce the impact of unfamiliar background noise; do not sit under balconies; move about indifferent areas of the auditorium or theater until you find a section or a seat where you can hear well. Dining out may present special problems to the hearing aid user, so ear your first meals in public in a quiet restaurant with carpeted floors and draped windows. Avoid noise cafeterias. As your tolerance for noise increases you will find it easier to experiment with increasingly noise environments.

Lipreading will help you in general communication with others; consider it an important supplement to the user of the hearing aid. Although lipreading has many limitations, some words cannot be seen on the lips and some words cannot be distinguished from each other, lipreading combines with a hearing aid is often more satisfactory than is either alone.

If your hearing loss is not especially severe, you will probably be able with a little practice, to use your hearing aid with the telephone. Place the receiver end of the telephone next to the microphone of the hearing aid. In some hearing aids an induction coil is an integral part of the aid, and the cordless portion of the telephone is placed in contact with the case of the aid. Getting used to the placement of the telephone and getting used to listening in this manner requires practice. It is suggested that you arrange to have a friend telephone you at a certain each day for several days to help you become accustomed to the telephone procedure with the hearing aid.

There is no magic in adjusting satisfactorily to the use of a hearing aid. It requires practice and an application of the common senses steps discussed above. Do not expect perfection. Accept limited successes as signs of your progress. Different persons will learn at different rates. Some individuals, perhaps because of the severity of their loss or because of the nature of their hearing impairment, may require many weeks to learn to use the aid; even then they may never have a completely satisfactory adjustment. Others will find that the adjustment entails only minor problems and will be wearing the aid without any great difficulty within a few hours.

The prime objective in wearing a hearing aid is to bring about more nearly normal communications in every day life. To achieve this goal, speech reading is almost always required. For maximum benefits, lipreading rehabilitation should accompany the practice training in using the hearing aid.

SUMMARY

1. A complete otologic examination is necessary to determine what type of hearing impairment is present, its probable cause and recommended treatment.
2. Hearing is the natural and normal way to understand speech. If your hearing can be improved by medical or by surgical means, or through he use of a hearing aid, this should be done.
3. Whatever the type of treatment carried out, rehabilitation is essential if you are to gain maximum benefits from treatment.
4. Be determined to master speech reading. Making a hobby of it. It will help in every conversation.
5. Make every effort to relax. Do not strain either to hear, or to see speech. Strain causes tension and makes lipreading much more difficult. A combination of hearing and seeing, under relaxed condition, enables persons with impaired hearing to understand most speakers quite well.
6. Do not expect to understand every word in a conversation, but follow along with the speaker. As you become familiar with the rhythm of the speech, key words will emerge and you will be able to understand the complete thought.
7. Try to stage manage the situation to your advantage. Lighting is important. Avoid facing a bright light and avoid having a shadow on the speaker’s face. Six feet is an ideal separation from the speaker; at this distance his lip movements, facial expressions and gestures can be readily observed.
8. Maintain an active interest in people and events in your community and intimate social circle. You will be able to follow discussions more easily.
9. Remember that conversation is a two way affair. Do not monopolize a conversation in an attempt to direct and control it. On the other hand, do not let is pass by without participating. Take an active and interested part whenever possible.
10. Be particular about your speech. A hearing impairment of long duration may bring about changes in volume as well as in articulation and voice quality. These changes must be prevented where possible and corrected when indicated. A pleasant well modulated voice is a great asset.
11. A friendly sympathetic interest in other people and in their problems can do much to smooth one’s own path.
12. The education of the public is your responsibility and mine alike. You cannot help others to understand your problem if you conceal it from them. Do not hide the fact that you wear a hearing aid, or that you depend on speech reading to understand conversation. By letting others know about your problem you can make communication easier for you. It is only through mutual acceptance and through understanding of the problems of persons with impaired hearing that the "outsider" can be expected to adjust to the needs of the speech reader. Without this understanding the "outsider" may unintentionally add to the problems of the speech reader.
13. Always keep in mind that the success of your auditory rehabilitation is largely dependent on you, your attitude and your acceptance of your problem.