Coping with hearing loss - how to identify factors in communication problems

I was doing some web surfing looking for hearing loss coping skills and this section of an article from the paper Coping with Hearing Loss hit home for me:

Coping with Hearing Loss

Samuel Trychin, Ph.D.

from Seminars in Hearing -- Volume 18, Number 2, May 1997, pp 77-86

What people who are hard of hearing say when they are not able to understand what someone else is saying is of critical importance in their ability to successfully cope with hearing loss. My observation is that people who are hard of hearing mostly say things like, "Huh?," "What?," "Would you repeat that?," "I'm sorry!," "Excuse me?," "I didn't get that," or "I didn't understand you." These are all ineffective responses to a communication problem because they do not contain any information about what needs to be done to resolve the difficulty. The speaker is informed that a communication breakdown has occurred, but has no clue as to what to do to solve the problem. Put in this situation, many people may opt for ending the conversation or for ignoring the hard-of-hearing person if it is a group discussion. Then, the person who is hard of hearing will probably blame the hearing loss, when in fact it was their ineffectual response that produced their being shut out. A much better response to a communication breakdown would be to offer a solution to the problem, that is, "Please slow down" (or "Face me when you speak" or "Raise your voice a little"). This provides the speaker with something concrete to do to be better understood and increases the probability that they will continue the conversation. Unfortunately, many people who have hearing loss and their family members are unable to identify the causes of communication breakdowns and need to be taught to do so.

Speaker, environment, and listener factors interact with hearing loss and cause or exacerbate communication problems. Family members, supervisors, co-workers, friends, and people who are hard of hearing themselves need to understand how these factors operate in communication situations. Otherwise, faulty attributions about someone's failure to understand are made and relationships are too frequently damaged as a result. For example, a frequent complaint of family members is, "I don't understand the variability in his ability to understand me; sometimes he understands everything I say and other times nothing. This is very upsetting for me." This confusion often leads to the statement, "He can understand me when he wants to" or "She has selective hearing."

The reason that people experience this kind of confusion is that they do not know the specific causes of communication breakdowns, that is, the speaker, environmental, and listener factors. Speaker factors include such things as not speaking clearly, speaking too rapidly, or speaking too softly. They also include other characteristics of the speaker, such as, foreign accent, distracting mannerisms, and beards or mustaches that obscure the lips. Environmental factors include background noise, lighting conditions, and acoustics. They also include factors such as visual or auditory distractions, ventilation, and seating arrangements. Listener factors include facts about the individual's hearing loss such as severity, type and onset characteristics. They also include the listener's ability to pay attention, emotional status, and distracting body sensations or thoughts. A major goal of the training is to enable people to identify these factors when they occur. Once people are able to identify the specific causes of communication problems, they are in a better position to suggest solutions to them. These factors and suggestions for reducing their effects are discussed in greater detail in Staying in Touch (Trychin & Albright, 1993).

Problem is, this article doesn't go any further in providing ways to identify these problem factors in communication and how to relay to your conversation partner how best to communicate in certain situations. I'm going to try to get this book from the library. If I get it, I'll update with tips on how to identify communication problems and suggest solutions.