Group Aural Rehabilitation session three

This session focuses on anticipatory communication strategies. You and your group members will discuss how preparing ahead, using reminders, and avoiding negativity can help them plan for tricky communication situations.


  • Review repair strategies
  • Introduce anticipatory strategies
  • Group activity: The 15 Things Exercise

Review repair strategies

In the previous session, you introduced group members to repair strategies for managing communication breakdowns. Take a few minutes to review the ideas that group members shared. It may be useful to show the flipchart from the last session.

Introduce anticipatory strategies

There are certain communication situations that people with hearing loss always know will be challenging: Noisy restaurants, large gatherings, and outdoor activities are just a few examples. Anticipatory strategies are plans of action people can have in mind before a situation occurs. Work with your group members to make applying anticipatory strategies a natural part of their day to help them prevent communication breakdowns.

Prepare ahead

Ask group members to write down one or two upcoming events where they anticipate having communication difficulties. Then have them consider what factors are within their control: Can they choose the location of where they are meeting someone? Can they request a table or a seat where it will be easier for them to hear? Are they attending an event in a building that has a hearing loop? Will someone be attending with them that can help fill in any communication gaps?


People with hearing loss can help their communication partners by agreeing on different signals to use as reminders. For example, rather than interrupting a friend or spouse to let them know that they’re speaking too quickly, they can use their agreed upon code to remind them to slow down. Ask group participants to provide suggestions for such signals, such as lightly tapping your chin.

Avoid negativity

Anyone can be a bit negative. For people with hearing loss, having to ask people to repeat themselves frequently or feeling out of the loop of a conversation can be tiring or frustrating. If a person with hearing loss repeatedly says that they are having trouble understanding, their communication partner may misinterpret this as negativity.

If a person with hearing loss takes an unconstructive approach – for example, saying something broad like “I can never understand what you’re saying” – it sounds like the person with hearing loss is blaming whom they’re talking to. This might make their communication partner defensive and less likely to modify their behavior.

A person with hearing loss can head off the problem by requesting help using more positive terms before the communication breakdown occurs. Simply qualifying requests with “would you,” “it would help me,” “please,” and “thank you” will both make the communication partner mindful of their behavior and take some of the stress off of the situation for both parties.

Group activity: The 15 Things Exercise

The 15 Things Exercise is a useful way of stimulating problem-solving within the group.

Sam Trychin uses 15 Things Exercise to address a participant's communication challenge.

  1. Have a group member – either a person with hearing loss or a communication partner – identify a problem they have experienced or are anticipating.
  2. State the problem in objective, measurable terms. For example: "George does not go out in public since his hearing has worsened. I would like him to go out to a restaurant with me and another couple. When we go out, I want him to understand most of what is being said and enjoy himself."
  3. Go around the room and have group members identify at least 15 different things that could be done to help solve the issue. Ask each member individually to share an idea. Encourage the group to keep sharing even after 15 suggestions have been made; it’s not uncommon for a group to brainstorm 25 or 30 suggestions.
  4. Write down every suggestion. It’s important that you create an open environment that encourages creative thinking. Ask participants to withhold criticism or negativity; if someone's suggestion is criticized, other group members will be less likely to offer one.
  5. Give the list to the person who shared the problem and ask them to select the suggestions that seem best to them. Ask the individual to try the suggestions and to report on the results in the next session.