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 1Formal Instruction

Stage 2Guided Learning

Stage 3Real World Practice

Stage 1– Formal InstructionProvide 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

GuidedLearning

Modeling

Role-playing

Focused attention

Scenarios

Continuous DiscourseTracking

Drill Activity

Stage 3– Real-World Practice

Individuals practice new skills or behaviors in everyday environment

Stage 3

Real-WorldPractice

Diaries

Calendars WorksheetAssignments

Short-term Training• Materials approach

– 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

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

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

TOPICON EvaluationClinician 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