Group Conversations

Overcoming Problems with Group Conversations for Children with Hearing Loss 

by Jay R. Lucker, Ed.D., CCC-A/SLP, FAAA, and Anne T. Molloy, Psy.D.

One concern parents often bring to professionals is that their children with hearing loss have few friends or find themselves left out of social situations, especially groups of children.  Significant challenges with group communication become more  obvious as children transition into their teen years—middle and high school. Many professionals tell parents this is due to the hearing loss, which makes social interactions difficult.  But hearing loss may not be the only reason.  One factor may be that children with hearing loss have not learned how to advocate effectively for themselves in group social situations.

Children with hearing loss often shy away from group communication situations hoping that no one will ask them a question or insist that they join in on the conversation.  In contrast, they usually find it comfortable communicating with only one person at a time, especially when that person is a close friend who has learned how to communicate effectively with them. When teens reach middle and high school they find significant challenges with group communication.  Rather than being part of a group, these teens often state that they prefer to be alone or with one other person having a conversation.

Parents, and even professionals, attribute these group communication challenges to the difficulties these children and teens have because of their hearing loss.  This is true, but the presence of the hearing loss should not be an excuse to avoid participating in group conversations.  Self-advocacy skills are important for children with hearing loss.  Children who may expect that someone will always be there to intervene for them in communication situations they find difficult may grow up not knowing what to do in order to communicate successfully in these situations.

When we think about how we teach children with hearing loss how to communicate, we usually do so in a one-on-one situation.  If this instruction occurs in a group format, the leader of the group tends to speak directly to each individual child and controls the communication so that only one person speaks at a time. In the real world when children and teens interact, this is not the way communication and interaction occur.

If you think about a situation in which you could not understand a person, such as on a cell phone with a bad connection, wouldn’t you let the person on the other end of the conversation know why you are having difficulty understanding what they are saying?  Similarly, we need to teach children with hearing loss to inform others about their difficulties communicating and understanding without embarrassing themselves.

A goal that must be included in the child’s educational plan and speech-language/communication therapy provided for children with hearing loss is to teach them self-advocacy skills for dealing with group conversations.  These advocacy skills need to be taught to children and practiced in group conversations long before they are teenagers so that they can lead successful lives communicating with their peers when they reach that important age of peer interaction starting around upper elementary school and particularly in middle and high school.  These advocacy skills should be socially appropriate and not embarrassing to the child with hearing loss. The following are self-advocacy skills we have used successfully in our clinical work with many children who have hearing loss.

Many children with hearing loss may feel uncomfortable revealing their hearing loss and communication challenges to others.  Yet, what they do not realize is that most people with whom they will interact throughout their lives do not understand the impact of hearing loss on communication. Children with hearing loss typically grow up with parents, teachers and others who eventually learn how to adapt to the child’s hearing loss and thus modify how they communicate with the child. For example, parents of children with hearing loss automatically face and remain facing the child when speaking with the child in order to provide needed visual cues for speechreading. Thus, when these children meet another child at the playground or at school, they might expect that the child will also face them and continue to face them while speaking with them. The children with hearing loss do not realize that the other child may have absolutely no understanding of hearing loss and what a child with a hearing loss requires for successful communication. In teaching children with hearing loss to self-advocate, the first thing a child with a hearing loss needs to learn is that most people they meet will not know that they have a hearing loss and will not understand how to successfully communicate with them. This is true not only for other children they meet but also for adults with whom they come in contact. Children with hearing loss need to understand how to explain to others that they have a hearing loss and that they may have difficulties communicating with others, and especially with understanding what they are saying. Children with hearing loss also need to learn how to explain to others their strategies for successful communication, such as, “Please face me when you speak with me. What you are saying is important.  I need to see your face when you speak in order to understand what you are saying.”  Presenting a statement in this manner lets the other person know that you are interested in and want to understand what that person is saying.

Another strategy is to teach children with hearing loss to tell other people that they may periodically summarize what they think they understood in order to ensure that they are following the conversation. Again, the focus is that the other person’s conversation is important and the child wants to be sure he/she understands what was said.  Then, during the conversation, the child has to learn how to summarize what other people say.

A third strategy is for the child with hearing loss to let others know that he or she has difficulty realizing when the topic of the conversation has changed. The child needs to ask others to state that the conversation has moved to a new topic and to let him/her know what the new topic is. In educating others about this need, using wording such as, “I really want to follow what you are saying, so let me know if you change topics so I can follow along.”

The major theme in all of these strategies is to teach the child with hearing loss to focus on the importance of the other person’s conversation and the desire to follow what that person is saying. People tend to be more receptive and understanding when the requested accommodation focuses on them and not the need of the person asking for the accommodation. This is especially true for young children and teens who tend to be somewhat self-centered, especially during conversations.

In the beginning, these self-advocacy skills should be taught and practiced in one-on-one interactions where it is easier to begin applying these advocacy skills in everyday conversations. Once the child has learned to do this on a regular basis, it is easy to use these strategies during group conversations. These skills can be taught by therapists working with the child—speech-language pathologists, psychologists or educators such as teachers of the deaf and hard of hearing. The focus is to help people, especially in group situations, understand the needs of the person with hearing loss until they get to be familiar with that person. However, even if they are very familiar, it is not a bad idea to teach the teen to remind the people in the group, “Remember please, I really want to join in the conversation, but I have a hearing loss.  So, please……” giving some key things needed for successful communication.

It is important that we develop self-advocacy skills in our children with hearing loss as early as possible. Waiting until problems get out of hand before introducing such skills may be too late. At such times, the child or teen may become negatively emotionally involved and will not want to admit the hearing loss and instead opt to avoid group communication situations altogether. The key is to start as soon as possible, using wording that is appropriate to the child’s age and self-understanding of hearing loss. In the end, the child will feel more comfortable in and be more successful during group communication situations.

Source: Volta Voices, November/December 2014