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Issues Related to the Communication Environment

This section addresses the needs of people with hearing loss. For issues related to communicating in ASL, see the Understanding Deaf Culture tab and Communication Environments: Using Interpreters. Note that some women use a combination of interpretation and speech reading or other methods of communication. Sometimes this is because neither method is sufficient for the survivor, especially if she is not fluent in American Sign Language.

A survivor with functional limitations related to hearing will have specific communication needs.  Meeting those needs requires an open process in which the survivor is encouraged to identify the best path.

Providers need to learn the lay of the land in communication technologies. Various communication technologies can assist the process, but these technologies require advance attention and a technology’s effectiveness will vary for each person.

In a state of crisis, a survivor should not be expected to self-advocate about her communication requirements.

Examples of Problems

  • The survivor knows that by moving to another location she can see the provider more clearly and avoid the sound of the fan.  When the survivor asks if they can re-situate, the provider explains that the seating is arranged for both people's comfort.  The survivor accepts the providers’ authority and defers to it, but cannot hear much of the information being conveyed.
  • During a support group, the facilitator makes no effort to make sure that people only speak one at a time. The person with a hearing limitation loses track of who is saying what.

Suggested Solutions

  • Consider having a collection of visual aids for the topics you discuss with survivors. Visual Aids have been developed for people with cognitive issues or people who are speech-impaired for use with communication boards. Pictography can be adapted from such aids, so that your services have a collection to assist communication in any number of situations where clarity of communication is your upmost concern. See Addressing Individual Needs : Cognitive Abilities & Limitations.
  • Writing notes is not an effective communication strategy during medical examinations. It should only be used when the survivor wants to use it. During a sexual assault examination, a woman may suddenly decide to use a different communication strategy. Her anxiety may limit her ability to discriminate speech and she will require extra time to make sure communications are correct. Use visual aids as described above.
  • The best strategy during any communication is to honor the individual’s preferences for communication, even if she changes her preferences, or it takes extra time.
  • If the survivor is deaf in one ear, she may need you to sit to one side.
  • Shouting distorts speech. It is a hindrance not a help. It also sends a visual signal that is potentially threatening.
  • Always face a person with hearing loss so that she can deduce what you are saying from listening and speech reading simultaneously. Make sure your face is illuminated in order to increase the clarity of your face. Do not sit with your back to a window or a bright light. Eliminate as mush glare as possible. The contrast will make your face appear dark. Hearing Loss Web explains “The goal is to illuminate the speaker with a soft, uniform light that does not promote shadows.”
  • Notice background noise when you are speaking, and stop speaking. Repeat anything that was said during an interruption. Repeat the information as often as the survivor requests. The provider, in this case, is in an easier position to recognize when accommodations are needed.
  • Avoid obstacles in front of your face, like your hand, a mug, a pen.
  • Avoid having things in your mouth like gum or food.
  • Be conscious of looking away from the person because she may think the conversation has ended.
  • Speak at a moderate pace. Speak naturally, but clearly.
  • The Massachusetts Eye & Ear Hospital recommends:
    • If a person has difficulty understanding some particular phrase or word, try to find a different way of saying the same thing. Rephrase rather than repeat the original words over and over.
    • Avoid sudden changes of topic.
    • Don't drop your voice at the end of sentences.
  • Hearing Loss Web advises,“Chances are pretty good that the person with hearing loss knows what works and doesn't work for them. They may want to sit at a certain table at a restaurant, have certain people sit in particular places, or have discussions in a specific place. They have good reasons for these choices, even if they can't explain them. If you want to promote communication, accommodate their environmental requests.”
  • Some people are caught between languages and never fully learn American Sign Language or English. Pictorial approaches with plain language may help. Universal design ideas used for people with cognitive limitations are helpful in these circumstances to facilitate the communication of visual and textual information. In addition to the the Understanding Deaf Culture tab and Communication Environments: Using Interpreters, see Addressing Individual Needs : Cognitive Abilities & Limitations.
  • Group meetings or support groups should make every effort to have only one person speak at a time.
  • There are assistive listening devices that are FM systems or a similar type transmitter in which the provider wears a transmitter and the survivor receives the information (or vice versa if the provider requires one). They are available at RadioShack and other audio equipment vendors. They require that the person speaking be comfortable with personal space – as the receiver will need to be close to the attached transmitter as well.
  • In a shelter environment, if a survivor arrives without assistive technology (either because of a quick escape or because it has been destroyed), there is the potential to get an assistive technology loan. The purpose of loan programs is for a person to test what works best using 30-day trials.
  • Amplification devices for a telephone help a person with partial hearing loss.
  • TTYs are used by people who have profound hearing loss or who are Deaf. It is cheaper to buy a telephone with an integrated TTY than purchase a separate machine. Accommodation plans should include how to train all staff and volunteers who use the phone line how to use the TTY as well as future trainings as staff and volunteers turnover, or they need a brush-up of skills. Shelters should place a TTY at a private location for use by survivors.
  • TTY’s are only for the most severe hearing limitations (as well as speech limitations). For everyone else there is a range of communication technologies to learn about. Despite rapid changes in the quality and availability of assistive technologies, well-developed resources make it easy to learn about other options. 
  • Consider the range of technologies that increase access to your services. See Assistive Technologies for Communication under Creating Welcoming Environments: Communication.