Group Aural Rehabilitation session four

The goal of this session is to introduce the group to two practical techniques that will help them improve their communication. 

Agenda

• Follow-up on last session
• Introduce clear speech methods
• Group activity: Practice clear speech methods
• Introduce tips for lipreading
• Lipreading exercises 

In the last session, the group went through the 15 Things Exercise. Ask group members if they tried out some of the ideas that came out of this exercise and what they learned from this experience.  

Introduce clear speech methods

Clear speech is a method where the speaker talks slightly slower and louder, uses frequent pauses, and enunciates speech sounds more clearly. It is not exaggerated speech, but rather a style of speaking that is adopted intuitively by many talkers in difficult communication situations. For example, clear speech is often used when conversing in noisy or reverberant environments or when talking to non-native language speakers.

One of the keys to living well with hearing loss is for participants to learn how to educate the people they frequently communicate with about clear speech. Research has indicated that people (including young children) can be taught to produce speech that is much more easily understood by people with hearing loss.

Ask the group to try out the following exercises:    

Exercise 1

Say the sentence: “The ship left on a two week cruise.” This is the target sentence, the sounds we aim to produce. 

In a normal conversational speaking voice, this sentence would probably sound more like this: “The shiplef ona twoweecruise.” 

Some of the vowels are missing: the “t” at the end of “left” disappeared, and the “k” of week became merged into the “c” of “cruise.” 

In a clear speech style, the sentence would be: “The ship left__on a two__ week cruise.” 

The vowels sound the way they are supposed to, the “t” at the end of “left” has reappeared, and natural pauses are inserted after “left,” “two,” and “week.”

Exercise 2

Target sentence: “We were looking for a white truck to buy.” 

In conversation: “We’re lookin for a whitruck tabuy.” 

In Clear Speech: “We were looking for a white truck to buy.” 

The bolded words are the key words that need to be stressed, after which you should insert natural pauses to emphasize the natural breaks in the sentence. You will also notice that no words are merged (e.g. we’re) as in the conversational version. Nor are any words or sounds dropped.

Exercise 3

In the following sentences we have bolded key words that you need to emphasize. By emphasizing the key words and by breaking the sentence down into natural phrases, each speech sound becomes very distinct. Practice these sentences in clear speech. Be sure to express every sound: 

“Who ate the last piece of cake?” 

“Please send that letter in the mail.” 

“The rooster ran all over the barnyard.” 

“The dog was waiting in the car.”

“The ballerina looked lovely in a pink and white outfit.”

Exercise 4

Read the following sentences out loud. Underline keywords and break them into natural phrases: 

“Ice cream was all over the child’s face.” 

“We could see the snowy peaks in the distance.” 

“The sun is just coming up behind the trees.” 

“Father used a ladder to get on the roof.” 

“We held a birthday party on a sunny day in the park.” 

“His castle sat high upon the wooded hill.”

Exercise 5

Turn to the person sitting next to you and discuss the following topics for two or three minutes. Remember to concentrate on pronouncing every sound in every word clearly and naturally. Do not exaggerate. Do not rush. Use lively inflection. Keep in mind that you want every single part of your message to be understood. 

• Give directions to the local library. 
• Describe how to make a pot of tea. 
• Describe the last family holiday. 
• Describe the different towns or homes in which you have lived. Each time, ask the other person whether all the speech was clear and easy to understand. Also ask whether your voice sounded natural.

These exercises were adapted from a brochure titled “Communication Is a Two-Way Street.”

Introduce tips for lipreading

Lipreading is a useful technique, regardless of one’s degree of hearing loss, to better understand what a talker is saying. People with hearing loss naturally employ this strategy, as do people with normal hearing in difficult communication situations. This part of the program is meant to introduce the skill to the communication partners in the room and have everyone practice together. 

Describe what lipreading is and review ways to get the most out of it, such as:

• Ask people to face you directly when speaking to you so that you can watch the talker’s lips, facial expressions, and body language. This may give you supplemental information regarding the talker’s tone and message.
• Whenever possible, choose well-lit settings so you can better see the lips and expressions of those that you are communicating with. 
• In a group setting ask your spouse, partner, family member, or close friend to clue you in on the topic at hand, so that you have some context regarding what is being said. For example, you might hear, “Who put the blue cows in the room?” But if someone informed you that people are talking about bathrooms, you can conclude that the talker must have said: “Who put the blue towels in the bathroom?”

Have people pair up. Ideally Person One should be a person with hearing loss. If possible, Person Two should be the communication partner that they came with them, though this is not essential. Explain that Person One will start as the talker and Person Two will start as the listener/lipreader. Person Two’s goal is to write down as many objects as they can recognize while lipreading.

Exercise 1

Person One says out loud to Person Two: “This group of objects has to do with a vacation. Each time I will say ‘When I go on a vacation I will need…’” Repeat this phrase out loud.

Now, mouth the phrase but do not speak: “When I go on a vacation I will need my suitcase.” Repeat it again, silently. Give Person Two a few seconds to write down what they think the object at the end of the sentence was. 

Continue the exercise by using the same carrier phrase, but replacing the object at the end. You can have these objects written down on a handout for the talker, or as flashcards with images:

“When I go on vacation I will need…”

• Suntan lotion
• My beach towel
• Plane tickets
• My swimsuit
• Hotel reservations
• My phone charger

Person One: reveal the full list of objects. 

Facilitator: Ask participants how many objects they got correct. 

Exercise 2

Now Person Two is the talker, and Person One lipreads with the goal of writing down as many objects as they can recognize while lipreading.

Person Two says out loud to Person One: “This group of objects has to do with gardening. Each time I will say ‘When I do the gardening I will need…’” Repeat this phrase out loud. 

Now, mouth the phrase using clear speech, but do not speak: “When I do the gardening I will need my gardening gloves.” Repeat it again, silently. Give Person One a few seconds to write down what they think the object at the end of the sentence was. 

Continue the exercise by using the same carrier phrase, but replacing the object at the end. You can have these objects written down on a handout for the talker, or as flashcards with images:

“When I do the gardening, I will need…”

• A shovel
• Flower seeds
• Fertilizer
• My boots
• Flower pots
• A watering can
• My gardening cushion

Person One: reveal the full list of objects.

Facilitator: Ask participants how many objects they got correct. 

If time allows, here are additional exercises:

“When I make cookies, I will need…”

• My apron
• A measuring cup
• Chocolate chips
• A large mixing bowl
• Sugar and flour
• Baking pans
• A cooling rack

If your group is looking for a challenge, try this exercise containing words with “sh” or “ch” or “j”:

“Each time I will say ‘In my bag I have…’” 

• Some chocolate
• Chopsticks
• A cheese grater
• A potato masher
• A lemon juicer
• A jar of jam
• A hair brush

These lipreading exercises were adapted from Gloria McGregor’s Lip Reading Practice. 

Remind people that the more they practice lipreading, the easier it will get. You may choose to have a discussion with the group regarding whether the people in the room that have had a hearing loss for a long time have found the activity easier than those in the room that don’t have a hearing loss or have a very recent hearing loss.