Mask-wearing and physical distancing have become essential safety measures in the pandemic. But for people who rely on lip-reading and facial expressions to communicate, the increased use of facial coverings can lead to even greater isolation. 

Face coverings over the nose and mouth can decrease the volume of the speech by up to 12 decibels, which makes it hard for listeners with normal hearing to understand, never mind for people with hearing loss.

Individuals with hearing loss may struggle to communicate basic needs at work, with friends and family, or even when  ordering a coffee. Add in a global health crisis and the stakes take on a quality of life urgency.

“If patients lose the ability to communicate, they lose the ability to participate in life,” says Dr. Nicole Laffan, an audiologist, speech-language pathologist, and assistant clinical professor in the Department of Communication Sciences Disorders in the Bouve College of Health Sciences.

In the Speech-Language and Hearing Center in the Behrakis Building, Laffan routinely saw audiology patients for hearing evaluations, hearing aid fittings and repairs, and aural rehabilitation. The pandemic brought an abrupt end to those services.

“I felt like not only did my access to these audiology patients just end. But their ability to get the care they needed would get lost, and they would be cut off,” she says.

Laffan and other staff members in the center tried to continue caring for their patients by making how-to videos, conducting virtual calls to teach patients and family members how to fix hearing aids, and even provided house visits.

However, more needed to be done. Laffan worried about the new barriers that the pandemic created for individuals with hearing loss, especially the elderly who were at risk for isolation and depression. 

And then an idea was born.

Laffan decided to compile all her communication tips and resources into one presentation to share with others who work with the hearing-impaired. The presentation describes how to improve virtual communication by using assistive listening devices, phones with captioning, smartphone apps that change spoken language into text, and techniques to advocate for oneself when spaced apart.

Among her pointers are:

• Be as specific as possible regarding what you missed (e.g., I heard you up until the word “movie;” What did you say before the word “cookie?” Did you say “tall” or “fall?”);
• Ask people to write down what they are saying for you to read; 
• And ask them if they would be comfortable taking their mask off if you agree to remain masked while keeping a six-foot distance.

The tips have been well-received by several state government agencies and universities.

“I wanted to let you know I have shared it with my leadership to enhance their awareness and understanding,” wrote an employee from the Connecticut State Department of Education.

It was a high school trip to Ecuador that first got Laffan to think about a career in the medical field as a channel to improve the lives of others. She went on to earn a Bachelor’s in Communication Disorders from Boston University and a Dual Master’s degree in Speech-Language Pathology and Audiology from Northeastern before obtaining a Doctor of Audiology degree from A.T. Still University in Arizona.

Today, she has her dream job.

The Speech-Language and Hearing Center allows her to provide discounted hearing aids through a foundation called the Guild, saving thousands of dollars for patients in need.

In addition, the department offers free hearing loss training sessions, known as aural rehabilitation, to teach patients about hearing loss, environmental modifications, lip and speech reading skills, and repair strategies. 

When a message is not understood, the blame is often placed on the listener. But Laffan says that both the speaker and the listener have an equal responsibility for making sure that the message comes through.

“It’s my job as the speaker to be able to say: What can I do to fix it? Should I rephrase the question? Should I say it louder? Should I say it slower?” she says.

“Right now you’re nodding,” she tells an interviewer over a video call. “You’re showing me that you’re comprehending what I’m saying. You’re smiling. I’m not saying anything that’s disturbing to you. That’s information that the sender of the message gets.”

When the sender perceives that the message was not received by the listener, it is the sender’s job to try to repair it, Laffan adds.

She recommends simple communication tips such as speaking in the same room, facing each other, turning down background noise, calling the listener’s name to gain attention before speaking, and sharing the topic so the listener can make a better guess on words that were missed.

“The profession of audiology and speech-pathology is such a helping profession. And every day, I just feel blessed that I’m able to try to make a little difference in someone’s life.”

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