Talk:Hearing loss

Corrections still needed

Multiple issues here:

1. Please review WP:MSH: on Wikipedia, headings are deaf repeated in sub-headings, and uppercase is avoided.

2. I have removed a lot of off-topic content and placed it on the talk page of the more appropriate article for such content (Sign language). There is more of same. On Wikipedia, wikilinks are used so that information can be written in the correct article and then linked to from other articles.

3. The entire section on "Communication barriers" should be moved, but I'm not sure what target article to move it to. It should also be rewritten to remove anecdote and generalities (I am hoping someone else has time to tackle this section, as the work needed is lengthy and will be time-consuming).

4. There is also a problem here that citations are added to the ends of entire sections, when at minimum, every paragraph should be cited.

5. Several sections are written as if the United States is the only country in the world and are in need of clarification and globalization. SandyGeorgia (Talk) 17:32, 20 November 2014 (UTC) rE: "The entire section on "Communication barriers" should be moved, but I'm not sure what target article to move it to..." Good points. I would agree that it is hard to find a better location--and thus it belongs squarely here. Haring loss IS a disability of communication barriers and thus this topic is absolutely integral to this page. I agree it needs re-writing and would be interested in helping. This section would be most helpful to most people to be up front. Hearing loss is a real equal opportunity disability that can affect everyone. More coping strategies listed would be interesting and helpful. Domaon (talk)domoan — Preceding undated comment added 22:51, 16 February 2015 (UTC)

Changes

• Not sure I see the point of changes "hearing loss" to "reduced ranges of hearing"? The former is more normal language.
• What exactly is this ref supporting [1] Seems a little spammy
• This sort of blog is not a suitable source [2]
• The most important thing about hearing aids is not that they are "FDA regulated medical" devices because they are not in more than 90% of the world. Please note that this is a global encyclopedia. Doc James (talk · contribs · email) 01:18, 6 January 2015 (UTC)

No comments yet? Doc James (talk · contribs · email) 21:24, 7 January 2015 (UTC)

By way of background, I work in R&D at a Big 6 hearing aid manufacturer. I consulted with our regulatory department. Nearly every country regulates "Hearing Aids" as medical devices. The U.S. and E.U. regulations are typically observed by other countries since they do not have the resources to produce their own. These regulations are enforced to a varying degree depending on the country and the country of origin for the devices. — Preceding unsigned comment added by Hearingreadyguy (talk • contribs) 21:36, 7 January 2015 (UTC)

Sure. If we are not going to go with "hearing loss" than we should also change the name of the article. Doc James (talk · contribs · email) 21:53, 7 January 2015 (UTC)

I don't think it is necessary to change the name of the article; hearing loss is a succinct identifier for the article. The distinction is that in certain context, it is appropriate to recognize that there are "changes" or "reductions in hearing" that may not constitute the definition of hearing loss, but which may trend towards one eventually. I regularly tell patients with borderline hearing loss configurations that while a hearing test/audiogram may not indicate a "Hearing Loss" diagnosis, that it is not to say that their hearing has not diminished from what it used to be to the point that they are aware of the changes. I was not making blanket changes, and I think if you look at the instances where I had, it does not take away from the article. Additionally, I added some valuable content and clarifications beyond these language updates. Hearingreadyguy (talk) 22:53, 7 January 2015 (UTC)

Yes there is both a technical cut off and a lay meaning. Hearing loss simply means any decrease in hearing to most people who speak the English language. Doc James (talk · contribs · email) 23:23, 7 January 2015 (UTC)

Hearing impairment encompasses "reduced ranges of hearing"; I don't see the need for that wording. SandyGeorgia (Talk) 15:38, 8 January 2015 (UTC)

Still, in terms of adhering to People-first Language, this article has room for improvment. (e.g. "A deaf or hard of hearing person can communicate over the phone with a hearing person via a human translator.")

It's great that a lot of people who sense changes in their hearing turn to wikipedia for information. It would be great to make it as user-friendly as possible, and the language that we use is a part of that.

I don't dispute that this is common and accurate language to use, but maybe it's time to modernize how we talk about this condition. "Hard of hearing" and "deaf" (except when speaking of the culturally Deaf) are labels that are, for many people, mental shortcuts that pull up stigma and baggage that triggers a grieving process which delays a person from seeking timely treatment. When possible, it should be kept functional like "reduction in hearing range" or, as Sandy suggests, "hearing impairment".

People are naturally adverse to "loss", so communicating the term "hearing loss" is best when the impairment is preventable or avoidable.

My 2 cents Hearingreadyguy (talk) 00:46, 11 January 2015 (UTC)

Just be sure that your usage of deaf/Deaf is consistent with the consensus reached in the RfC on the matter and the broader principles of Wikipedia policy on the matter from which it was drawn; "Deaf" can only be used in extremely narrow contexts. From your wording, you may well follow this distinction already, but I recommend looking at that RfC anyway, because the conclusions are very nuanced. Snow talk 04:41, 11 January 2015 (UTC)

I am happy to go with "hearing impairment" rather than "hearing loss" but do not see a significant difference. Doc James (talk · contribs · email) 04:47, 11 January 2015 (UTC)

On that point, I tend to agree. Clearly both terms have a broader common usage and also various more refined technical definitions in particular contexts. For our purposes here, I think both could used interchangeably without confusion to the reader, with notes on nomenclature where appropriate. Certainly the vast majority of readers will be able to parse these meanings, but to whatever extent editors here prefer one over the other, it's not particularly worth arguing over. Snow talk 04:57, 11 January 2015 (UTC)

confusion in section on myths

Several or most of the examples in this section are in fact corrections of common wrong ideas and don't even mention the myth, which was so confusing i renamed the section, but it still needs to be rewritten. --Espoo (talk) 22:04, 11 April 2015 (UTC)

I searched for lists of Deaf myths, and discovered one common set that is used repeatedly in websites for Deaf people and/or run by Deaf people. These same myths were covered in the sign language class I took. For the moment, I have reformatted the existing list as an unordered (bulleted) list in in the Myth: Fact: format one commonly sees. I did not make any actual changes to the content, just the way it is presented. However, I do intend to expand the list and verify the refs, updating as needed, later./Bruce/ [aka Slasher] 02:17, 9 August 2015 (UTC) — Preceding unsigned comment added by Brucewh (talk • contribs)

Texas School for the Deaf picture

What, frankly, is the point of a picture of the 'Texas School for the Deaf' that shows us nothing but a nondescript gateway, a lot of trees and a big stretch of empty, badly maintained roadway? It might as well be the entrance to a cemetery anywhere in the world, and it tells us nothing whatever about hearing loss, except as proof - but where's the proof? - that Texas does in fact (as one would hope!) have a school for the deaf.213.127.210.95 (talk) 18:26, 29 October 2015 (UTC)

Hearing loss = hard of hearing?!

'Hearing loss, also known as hard of hearing....' is absurd - you can't 'suffer from hard of hearing', and you can't 'be hearing loss'.213.127.210.95 (talk) 18:26, 29 October 2015 (UTC)

You can be hard of hearing or have hearing loss. Doc James (talk · contribs · email) 03:49, 30 October 2015 (UTC)

I agree with you, IP, and I even proposed a simple way a couple of weeks ago to resolve the mis-phrasing, but Doc James seems to prefer it the way it is. General Ization ^Talk 03:54, 30 October 2015 (UTC)

We have refs that support [3] Doc James (talk · contribs · email) 03:58, 30 October 2015 (UTC)

I don't see anything at that page that supports the phrasing that appears in the lead. No one is arguing that people with hearing loss can't be described as hard of hearing, but one is a noun (referring to a medical condition), the other an adjective phrase (describing a person). They should not be equated in the first sentence, as the IP has (and others have) pointed out. It's simply wrong grammatically and, frankly, sounds ignorant (which is why people keep bringing it up). General Ization ^Talk 04:03, 30 October 2015 (UTC)

They have similar meanings and they are what this article is about. Doc James (talk · contribs · email) 04:38, 30 October 2015 (UTC)

Doc James, no-one is disputing that they have similar meanings. But the terms are used differently in a sentence. One could say "Bob is hard of hearing", but not "Bob is hearing loss". Similarly, one could say "Hearing loss can cause loneliness", but not "Hard of hearing can cause loneliness". So "Hearing loss, also known as hard of hearing" just doesn't work. I've restored General Ization's wording, modified a little. Adrian J. Hunter^{(talk•contribs)} 10:26, 30 October 2015 (UTC)

communication barriers = social psychology, not hearing

Moving article section here pending disposition. I propose moving it to Social psychology article or Speech (intelligibility) article.

• Strongly disagree - First, it would have been polite to wait for a consensus here before moving it out of the article. I understand you were being bold, but it doesn't hurt anything to leave it in the article pending consensus. If someone is looking for issues related to communication barriers and hearing loss, they will not look in "Social psychology" (it's far too broad) and very unlikely that they will look at speech intelligibility. Speech intelligibility and hearing loss are only tangentially related. Many people with speech problems do not having hearing loss, and many people with hearing loss do not have problems with speech. If you move this information out of the article you are removing a huge amount of very relevant and useful information and making it very difficult for the average reader to find it. Leave it. By the way, I do think the section needs a lot of cleanup, possibly shortening and with better sourcing. Sundayclose (talk) 15:52, 14 November 2015 (UTC)

Communication barriers

The most predominant forms of communication barriers originate from one's own personal self and they are directly the result of the hearing loss condition. These barriers are associated specifically with speech and language. In terms of speech, hearing loss has an effect on speech sound production, for example distortion caused by the omission of various letters from words. The pitch of their voice may sound too high or low and their volume may be louder or quieter than is intended. Resonance of voice is also affected, as it can be hypernasal or denasal. Prosody, which represents the patterns of stress and rhythm in the voice, will often become irregular. As a result of such changes to speech, the receiver during a conversation is likely to deem the communicator's speech unintelligible. The placement of improper stresses on syllables makes it more difficult for the receiver to clearly perceive and hear the intended words. Three major problems in terms of language are present for those with hearing loss. First, there are problems with language formation, where individuals may overuse nouns and verbs and they may improperly place words within a sentence. Second, the actual content of the language is troubling, for example the interpretation of synonyms and antonyms. This results in a limited vocabulary. The third major problem is associated with Pragmatics, which includes the inability of individuals to recognize that a message has been delivered to them, therefore resulting in inappropriate questions being asked. All of these speech and language barriers make it difficult for those with hearing loss to control their own speech and understand what others have to say, therefore making it quite hard to hold a conversation altogether.

Family

The communication limitations between people who are deaf and their hearing family members can often cause difficulties in family relationships, and affect the strength of relationships among individual family members. It was found that most people who are deaf have hearing parents, which means that the channel that the child and parents communicate through can be very different, often affecting their relationship in a negative way. If a parent communicates best verbally, and their child communicates best using sign language, this could result in ineffective communication between parents and children. Ineffective communication can potentially lead to fights caused by misunderstanding, less willingness to talk about life events and issues, and an overall weaker relationship. Even if individuals in the family made an effort to learn deaf communication techniques such as sign language, a deaf family member often will feel excluded from casual banter; such as the exchange of daily events and news at the dinner table. It is often difficult for people who are deaf to follow these conversations due to the fast paced and overlapping nature of these exchanges. This can cause a deaf individual to become frustrated and take part in less family conversations. This can potentially result in weaker relationships between the hearing individual and their immediate family members. This communication barrier can have a particularly negative effect on relationships with extended family members as well. Communication between a deaf individual and their extended family members can be very difficult due to the gap in verbal and non-verbal communication. This can cause the individuals to feel frustrated and unwilling to put effort into communicating effectively. The lack of effort put into communicating can result in anger, miscommunication, and unwillingness to build a strong relationship.

Community

People who have hearing loss can often experience many difficulties as a result of communication barriers among them and other hearing individuals in the community. Some major areas that can be impacted by this are involvement in extracurricular activities and social relationships. For young people, extracurricular activities are vehicles for physical, emotional, social, and intellectual development. However, it is often the case that communication barriers between people who are deaf and their hearing peers and coaches/club advisors limit them from getting involved. These communication barriers make it difficult for someone with a hearing loss to understand directions, take advice, collaborate, and form bonding relationships with other team or club members. As a result, extracurricular activities such as sports teams, clubs, and volunteering are often not as enjoyable and beneficial for individuals who have hearing loss, and they may engage in them less often. A lack of community involvement through extracurricular activities may also limit the individual’s social network. In general, it can be difficult for someone who is deaf to develop and maintain friendships with their hearing peers due to the communication gap that they experience. They can often miss the jokes, informal banter, and "messing around" that is associated with the formation of many friendships among young people. Conversations between people who are deaf and their hearing peers can often be limited and short due to their differences in communication methods and lack of knowledge on how to overcome these differences. Deaf individuals can often experience rejection by hearing peers who are not willing to make an effort to find their way around communication difficulties. Patience and motivation to overcome such communication barriers is required by both the hearing impaired and hearing individuals in order to establish and maintain good friendships.

Many people tend to forget about the difficulties that deaf children encounter, as they view the deaf child differently from a deaf adult. Deaf children grow up being unable to fully communicate with their parents, siblings and other family members. Examples include being unable to tell their family what they have learned, what they did, asking for help, or even simply being unable to interact in daily conversation. Hearing impaired children have to learn sign language and to read lips at a young age, however they cannot communicate with others using it unless the others are educated in sign language as well. Children who are hearing impaired are faced with many complications while growing up, for example some children have to wear hearing aids and others require assistance from sign language (ASL) interpreters. The interpreters help them to communicate with other individuals until they develop the skills they need to efficiently communicate on their own. Although growing up for deaf children may entitle more difficulties than for other children, there are many support groups that allow deaf children to interact with other children. This is where they develop friendships. There are also classes for young children to learn sign language in an environment that has other children in their same situation and around their same age. These groups and classes can be very beneficial in providing the child with the proper knowledge and not to mention the societal interactions that they need in order to live a healthy, young, playful and carefree life that any child deserves.

Lee Meyerson, a Professor of Psychology at Arizona State University created three adjustment patterns that can help adults with hearing loss. The first one is to remain withdrawn into your own self. This provides a sense of safety and familiarity which can be a comforting way to lead your life. The second is to act "as if" one does not even have hearing loss. A positive attitude will help people to live a life with no barriers and thus, engage in optimal interaction. The final and third pattern is for the person to accept their hearing loss as a part of them without undervaluing oneself. This means understanding that one is forced to live life with this disability, however it is not the only thing that constitutes life’s meaning. Furthermore, many feel as if their inability to hear others during conversation is their fault. It's important that these individuals learn how to become more assertive individuals who do not lack fear when it comes to asking someone to repeat something or to speak a little louder. Although there is much fatigue and frustration that is produced from one’s inability to hear, it is important to learn from personal experiences in order to improve on one’s communication skills. In essence, these patterns will help adults with hearing loss deal with the communication barriers that are present.

Workplace

In most instances, people who are deaf find themselves working with hearing colleagues, where they can often be cut off from the communication going on around them. Interpreters can be provided for meetings and workshops, however are seldom provided for everyday work interactions. Communication of important information needed for jobs typically comes in the form of written or verbal summaries, which do not convey subtle meanings such as tone of voice, side conversations during group discussions, and body language. This can result in confusion and misunderstanding for the worker who is deaf, therefore making it harder to do their job effectively. Additionally, deaf workers can be unintentionally left out of professional networks, informal gatherings, and casual conversations among their collogues. Information about informal rules and organizational culture in the workplace is often communicated though these types of interactions, which puts the worker who is deaf at a professional and personal disadvantage. This could sever their job performance due to lack of access to information and therefore, reduce their opportunity to form relationships with their co-workers. Additionally, these communication barriers can all affect a deaf person’s career development. Since being able to effectively communicate with one's co-workers and other people relevant to one's job is essential to managerial positions, people with hearing loss can often be denied such opportunities.

To avoid these situations in the workplace, individuals can take full-time or part-time sign language courses. In this way, they can become better able to communicate with the hearing impaired. Such courses teach the American Sign Language (ASL) language as most North Americans use this particular language to communicate. It is a visual language made up of specific gestures (signs), hand shapes, and facial expressions that contain their own unique grammatical rules and sentence structures By completing sign language courses, it ensures that hearing impaired individuals feel a part of the workplace and have the ability to communicate with their co-workers and employer in the manner as other hearing employees do.

Health care

Not only can communication barriers between deaf and hearing people affect family relationships, work, and school, but they can also have a very significant effect on a deaf individual’s health care. As a result of poor communication between the health care professional and the hearing impaired patient, many patients report that they are not properly informed about their disease and prognosis. This lack of or poor communication could also lead to other issues such as misdiagnosis, poor assessments, mistreatment, and even possibly harm to patients. Poor communication in this setting is often the result of health care providers having the misconception that all people who are hearing impaired have the same type of hearing loss, and require the same type of communication methods. In reality, there are many different types and range of hearing loss, and in order to communicate effectively a health care provider needs to understand that each individual with hearing loss has unique needs. This affects how individuals have been educated to communicate, as some communication methods work better depending on an individual’s severity of hearing loss. For example, assuming every hearing impaired patient knows American Sign Language would be incorrect because there are different types of sign language, each varying in signs and meanings. A patient could have been educated to use cued speech which is entirely different from ASL. Therefore, in order to communicate effectively, a health care provider needs to understand that each individual has unique needs when communicating.

Although there are specific laws and rules to govern communication between health care professionals and people who are deaf, they are not always followed due to the health care professional’s insufficient knowledge of communication techniques. This lack of knowledge can lead them to make assumptions about communicating with someone who is deaf, which can in turn cause them to use an unsuitable form of communication. Acts in countries such as the Americans with Disabilities Act (ADA) state that all health care providers are required to provide reasonable communication accommodations when caring for patients who are deaf. These accommodations could include qualified sign language interpreters, CDIs, and technology such as Internet interpretation services. A qualified sign language interpreter will enhance communication between a deaf individual and a health care professional by interpreting not only a health professional’s verbal communication, but also their non-verbal such as expressions, perceptions, and body language. A Certified Deaf Interpreter (CDI) is a sign language interpreter who is also a member of the Deaf community. They accompany a sign language interpreter and are useful for communication with deaf individuals who also have language or cognitive deficits. A CDI will transform what the health care professional communicates into basic, simple language. This method takes much longer, however it can also be more effective than other techniques. Internet interpretation services are convenient and less costly, but can potentially pose significant risks. They involve the use of a sign language interpreter over a video device rather than directly in the room. This can often be an inaccurate form of communication because the interpreter may not be licensed, is often unfamiliar with the patient and their signs, and can lack knowledge of medical terminology.

Aside from utilizing interpreters, healthcare professionals can improve their communication with hearing impaired patients by educating themselves on common misconceptions and proper practices depending on the patient’s needs. For example, a common misconception is that exaggerating words and speaking loudly will help the patient understand more clearly. However, many individuals with hearing loss depend on lip-reading to identify words. Exaggerated pronunciation and a raised voice can distort the lips, making it even more difficult to understand. Another common mistake health care professionals make are the use of single words rather than full sentences. Although language should be kept simple and short, keeping context is important because certain homophonous words are difficult to distinguish by lip-reading. Health care professionals can further improve their own communication with their patients by eliminating any background noise and positioning themselves in a way where their face is clearly visible to the patient, and suitably lit. The healthcare professional should know how to use body language and facial expressions to properly communicate different feelings.

References

tone

This article contains a lot of vernacular and colloquial phraseology, as if it were written for a magazine instead of a concise scholarly encyclopedia article. Scholars are dry, pithy and use precise technical diction. Much of the text needs to be redrafted accordingly, though it reads passably ok as casual reading.Sbalfour (talk) 19:59, 14 November 2015 (UTC)

We are writing for a casual / general reader. We are NOT writing for a PHD scientist. That group has a lot of great sources already. Doc James (talk · contribs · email) 15:43, 15 November 2015 (UTC)

prodigious reorg

I've given this disorderly article a systematic and scholarly presentation by restructuring the level 2 sections and level 3 subsections, adding many of each, and redistributing the text appropriately beneath them. The text now is a bit fragmented as well as anemic, but I've not lost any, it just seems that way because the deficiencies and omissions now stick out. Th article could easily fill a book, and we can't cover everything here - here are at least a dozen highly relevant main articles articles associated with the section and subsections where further info can be found. It is in that sense a top-level, or topical article, though it should be comprehensive in scope rather in depth. The tone of the text as well as completeness remain large issues.Sbalfour (talk) 20:43, 14 November 2015 (UTC)

Please follow WP:MEDMOS. We are not supposed to be writing in point form. We are supposed to be writing in prose not point form. Please do not create empty sections. Best Doc James (talk · contribs · email) 15:47, 15 November 2015 (UTC)

Textbook of Clinical Pediatrics source issues

This is an article about hearing loss, not pediatrics. Except for statements unique to childhood, it's dubious to cite this book for support of statements related to adult hearing loss, especially since most hearing loss in adulthood is due to advanced age. Also, only one citation with page number (Epidemiology subsection/paragraph) is provided, though the citation is used in 8 places. It's virtually impossible to verify the other 7 uses of the source to support individual statements scattered thru the text of the article. But it's even worse: one passage I did manage to locate in the book was found with a text search, i.e. the statement, short though it was (12 words), was so closely paraphrased that it must be considered to be copy/paste. Since the 7 non-page numbered instances of this ref are unable to be verified and dubious anyway, I'm deleting them. Without page numbers, it's also impossible to verify copyvio, so I'm going to have to leave the article text in place (hope and pray).Sbalfour (talk) 18:40, 11 December 2015 (UTC)

Which text was copied? Please provide it word for word here. Doc James (talk · contribs · email) 09:43, 13 December 2015 (UTC)

Prevention efforts from WHO

Have added "Other effective preventive efforts include immunisation against measles, mumps, and meningitis, efforts to prevent premature birth, and avoidance of certain medication."

The source is a 2016 document from the World Health Organization. There is a statement that this source is not compliant with WP:MEDRS which is strange. User:Dicklyon can you clarify? Doc James (talk · contribs · email) 19:06, 3 March 2016 (UTC)

WHO [4] is a very good source--Ozzie10aaaa (talk) 19:17, 3 March 2016 (UTC)

References