How “Clear Speech” Helps Those with Hearing Loss

As audiologists at Cleveland Hearing & Speech Center, we are best known for rehabilitating hearing loss.  However, we don’t stop at evaluating your hearing.  We care about communication.  When you come to one of our audiologists for a diagnostic hearing evaluation, we discuss with you your lifestyle and your communication needs.  We talk to you about how your specific hearing loss impacts your ability to communicate in a wide range of listening environments.  Just as important— we work with family, friends, and other communication partners to help them better understand how to communicate with a loved one who has hearing loss.  During May – Better Hearing and Speech Month – we want to discuss how Clear Speech can lead to better hearing.  The following strategies can help you improve your communication with family and friends who have a hearing loss.

What is Clear Speech?

Clear Speech is a method of speaking in which the speaker makes a concerted effort to express every word, sentence, and idea in a very precise, accurate, and deliberate way.  When you practice Clear Speech with a friend or family member, you don’t shout at them or speak in unnatural ways – like exaggerating sounds, or speaking in a monotone or “sing-song” voice.  Rather, you speak slowly and clearly at a slightly elevated – but not strained – volume.  It is a way of conveying your message in a clear, purposeful way to help a person with a hearing loss better understand what you said AND avoid the need for repetition.

What is the goal of Clear Speech?

Hearing loss impairs communication by filtering out certain speech sounds, so the individual with hearing loss only hears a portion of the sounds spoken to them.  Different types and degrees of hearing loss filter out different speech sounds and different amounts of speech information.  The goal of Clear Speech is for the communication partner to employ good speech techniques to help the individual with hearing loss to compensate for the speech sounds filtered out by their hearing loss.

How can I practice Clear Speech?

  • Articulate sounds precisely and accurately
  • Speak more slowly
  • Take clear pauses between phrases and thoughts. This gives the individual with hearing loss time to process key ideas before you continue with your thoughts.
  • Increase volume – but only slightly, and avoid speaking where you are straining. When you strain to speak loudly, you are distorting your speech sounds and the way your lips are moving (thus impairing visual lipreading cues).

Examples of Clear Speech:

You may be reading this thinking “I speak clearly, what more can I do?”  What many people don’t realize, though, is that English speakers actually don’t speak very clearly – even when we think we are!  We often blur words together and blend speech sounds of neighboring words in a sentence.  Take a look at the following examples of typical spoken English and the transformation into Clear Speech (Kricos, 2005).

  • “She leffer the store onabus”
    • Using Clear Speech, the speaker would say – at a modestly elevated vocal volume – “She left for the city   on a bus.”  The pauses give the individual with hearing loss time to process what has been said – and to understand the meaning of key ideas before the speaker adds further detail.  Also Clear Speech avoids blending of sounds like “leffer” in this particular example.
  • “The kids ‘r swim’n inthepool.”
    • The Clear Speech version would be: “The kids     are swimming    in the pool.”  Once again, strategic pauses in key places help the individual with hearing loss to follow ideas in the sentence.  Also, by not blending words and sounds together, you make your ideas more easily understandable to a family or friend with hearing loss.
  • “Yermother’ll haftagotothe denistomorrow”
    • With Clear Speech, you would say “Your mother will have to go to the   dentist tomorrow.”  Words like “hafta” are common in spoken English, but they are difficult for the individual with hearing loss.  With Clear Speech, you avoid familiar sayings like this to make sure your speech is clear and understandable.  It may take some effort to avoid speaking like this, but if you do, you may avoid having to repeat yourself!
  • Another Clear Speech tip is to take a pause before and after very important words in a sentence. For example, if you want to ensure an individual with hearing loss hears the correct name in a sentence, take a pause before and after saying the person’s name.  The same goes for any very important word in a sentence.

Other Communication Strategies:

In addition to Clear Speech techniques, there are numerous strategies for improving your communication with friends and family members with hearing loss.  Below are some ideas:

  • Make sure you get the individual’s attention before speaking. This could mean saying his/her name and waiting until he/she makes eye contact with you.  Or it could mean gently tapping the person on the shoulder.
  • Don’t try to communicate from different rooms in the house! We hear this one a lot  when see patients.  We know it may feel more convenient to try shouting from another room, but individuals with hearing loss can’t communicate this way!
  • Reduce background noise and distractions when communicating. Background noise is very detrimental for individuals with hearing loss.  Even background noise that you perceive as soft may make speech understanding more difficult for an individual with hearing loss
  • Make sure the individual with hearing loss can see your face. Speak face-to-face with good lighting.  Visual cues help a lot!
  • If an individual with hearing loss asks for repetition, consider using different words/phrasing when you repeat. Some words are difficult for an individual with hearing loss to hear, so repeating in different words may help.
  • Check for understanding.  When expressing ideas, you may need to step back to check that the listener is on the same page before continuing on with other ideas.
  • Most importantly, be patient! Listening with a hearing loss is hard work.

If you suspect a friend or family member has hearing loss, we want to help!  The above tips are a general guide for communicating with a friend or family member with hearing loss, but only a diagnostic hearing evaluation performed by a licensed audiologist can provide individualized recommendations.  Call Cleveland Hearing & Speech Center at 216-231-8787 to schedule a consult with one of our experienced audiologists.  In the meantime, we encourage you to practice Clear Speech with friends and family members who have hearing loss.  This month, better speech is better hearing!



How to Respond to Communication-Related Tantrums

by Megan Ahlman, M.A. CCC-SLP at Cleveland Hearing & Speech Center

Communicating can be frustrating for both parents, and toddlers!  Toddlers often know what they want, but are not yet able to express their wants accurately to caregivers.  Communication breakdowns happen when toddlers point or whine, sending an unclear message to the adult they’re communicating with.

Remember – it’s normal for toddlers to communicate this way!  Toddlers are exposed to new words every day, and they need to hear and try new words many times before using them consistently.

But, when tension builds and frustration mounts due to a communication breakdown, toddlers may completely lose their cool!  Your toddler may cry, scream, run away from you, shut down, or even hit and pinch when you offer comfort.  Toddlers can become overwhelmed with their emotions, which can turn into a full-blown tantrum.

Toddlers also learn how to push limits as their need to experience independence grows.  As toddlers attempt to make their own decisions – open the refrigerator, dress themselves, decide they want to go outside to play – communication breakdowns may occur.  This can be exhausting and irritating for parents, who feel frustration with their toddler’s growing desire to do things on their own.  Again, remember- this is a normal behavior for toddlers!

How should a parent respond when a toddler can’t communicate what they want?
Here are a few tips to keep in mind:

Don’t Take It Personally

Every parent can remember a time when their child pushed the limits.  Toddlers constantly gauge what they can (and cannot) get away with.  The playground, kitchen table, and grocery store are only a few places where they may test their boundaries.  It’s important to remember that toddlers are impulsive and easily swayed by their emotions.  As they attempt to control the world around them, their actions may seem defiant.  In reality, children are learning what is (and is not) allowed.  Remind yourself that your child is learning, and maintain your patience rather than viewing his actions as a personal attack.

Respond Consistently

Show your child that you are not affected by their behavior.  Dealing with a tantrum and emotions that are running rampant can quickly become challenging, but remember to keep your composure.  You are the parent, and you are in charge.  Do not allow your child to control a situation by using their emotions to get your attention.  Parents may become embarrassed when their child throws a tantrum, but it’s a normal part of toddler’s growth of their emotional knowledge.  Respect their emotions, but don’t give in.  Respond calmly- don’t threaten or punish your child for feeling strong emotions.  Instead, recognize their feelings, and help your child work through their emotions.  Tell your child what you would like for them to do.  Instead of saying “No, don’t throw the ball in the house!” say “I see you’re angry.  We throw balls outside.  Please go outside so you can throw it.”

Remove The Pressure – Accept & Listen

When a child is trying to tell you something, he may feel pressured to use words to say what he wants.  Parents can remove this pressure by accepting the means of communication their child is using.  Let your toddler point or gesture.  Using words can be hard for toddlers, so they should be encouraged to communicate with others in a comfortable way.  Using gestures is still a good way for your child to get his point across, and gestures can be combined with sounds for emphasis.  If your child is trying to use words, you may hear approximations, distorted or shortened words.  This is expected for toddlers, and parents should encourage the use of approximations even though they may be difficult to understand.

Give your toddler time to get his message across.  Slow down the pace of the interaction, and continue the conversation in an un-hurried way.  If your child is attempting to use words, make sure you take time to truly listen to what your child is saying.

Model How You Want Them To Talk

You may hear a lot of “No, no, NO!” from your toddler, especially when you’re trying to help them and figure out what they want!  Toddlers may not have the words to ask for a favorite toy, a snack, or to go to the bathroom.  In order to help your child and avoid a potentially exasperating situation, model the way you would like your child to ask for things during play or daily routines.  Saying “my turn” while pointing at your chest may encourage your child to point to his chest when he wants something.  You can say “I want cereal.  Do you want cereal?”  Then, help your child ask appropriately, modeling “I want…”  If your child is using approximations, encourage them to keep talking by taking your child’s approximations and modeling the correct way to say it.  For example, if you child says “doo,” parents can reply “Oh, you want juice!”  If your child says “doe ow-sigh” while pointing to the door, model “Go outside!  I see you pointing.”

Provide Choices

Toddlers are developing independence and may become upset if they feel like they’re being ordered around.  You may be able to “trick” your toddler into thinking they are in charge of a situation by offering them choices.  Asking the question “What do you want for breakfast?” may result in an answer like “Cupcakes!” or simply no response if your child doesn’t have the vocabulary to answer you with what he wants.  Instead, phrase your question as a choice, saying “Do you want cereal or eggs for breakfast?”  This allows your child to still feel in control, while ensuring they will make an appropriate suggestion and avoid frustration.

Offer an Alternative Activity

If your child’s tantrum becomes out of control, take a break from the activity or reason for the communication breakdown.  Remove your child from the situation and remain close to them, in case they attempt to communicate with you.  Try going for a walk, eating a snack, or sitting quietly together.

Toddlers expect their parents to know exactly what they want at all times, and sometimes parents do!  Avoid situations in which you know your child may be primed for a communication breakdown.  For example, if you schedule a doctor’s appointment during your child’s typical nap time, you’ll likely experience an emotion-laden toddler who is difficult to communicate with.
These tips may help parents keep their cool while helping their child through a communication-related tantrum.  If parents find that they are unable to understand their toddler’s verbalizations of their wants and needs more than 50% of the time, a licensed speech-language pathologist (SLP) may be able to help!  SLPs can help parents learn strategies to make communicating with toddlers easier, and ultimately less frustrating. If you have questions or concerns about your child’s speech or language development, contact the Cleveland Hearing & Speech Center at 216-231-8787.


Developing Social Skills in Young Children

Social skills are the ways we use our language skills in social situations. Social communication is important in developing effective interpersonal skills and is critical to various aspects of our daily life. Social skills are important in childhood and adulthood. What is the relationship between social skills and speech-language skills/disorders?

Navigating social interactions is one of the most complex tasks in which human beings participate. Social communication involves many psychological systems, such as visual and auditory perception, receptive and expressive language and problem-solving skills. These systems develop throughout childhood into adulthood and are influenced by our personality (nature) and the environment and interactions around us (nurture). When these systems do not function properly, social exchanges may not go smoothly. For example, a child with a language deficit affecting social communication may not be able to understand or respond to verbal or nonverbal social cues such as when to end a conversation or how to change topics during discussion.

There are many different types of social skills deficits. Some examples include children with Autism Spectrum Disorders (ASD), who tend to have deficits in understanding another person’s perspectives. Many individuals with ASD do indeed desire social involvement; however, these individuals typically lack the necessary skills to interact effectively. Children with the hyperactive and impulsive subtypes of Attention-Deficit/Hyperactivity Disorder (ADHD) tend to have poor impulse control and social problem-solving skills. Socially anxious children are overly cautious, in part due to fears of what others will think of their actions, which may result in avoiding social situations.

Research presented at the 2007 meeting of the Society for Research in Child Development by a team of Michigan State University researchers indicate that a child’s social skills at age 3 could predict his or her future social and academic performance. Important social skills in early childhood include emerging abilities to manage feelings and behaviors, recognize social cues from others and engage in positive interactions with peers.

Young children who experience problems with social-behavioral adjustment often have co-existing deficits in early language and literacy skills. These deficits may compound the challenges they face and place prospects for success in school and in positive social relationships at risk (Bos, Coleman, & Vaughn, 2002; Hinshaw, 1992; Kaiser, Car, Hancock, & Foster, 2002; McGee, Prior, Williams, Smart, & Sanson, 2002; Tomblin, Zhang, Buckwalter, & Catts, 2000).

What do social skills include?

Social skills include:

  • using eye contact
  • greeting others
  • taking turns in conversations
  • starting and ending conversations appropriately, not abruptly
  • staying on topic or appropriately changing topics
  • using the correct tone of voice for the situation
  • using the appropriate facial expressions and hand gestures
  • sending the message as it was meant (e.g., was it a joke or a request or a way to disagree)

How are social skills evaluated?

Evaluating a child’s social skills is best done by observing a child in a variety of contexts or having the caregiver report about their skills, as well as some formalized testing and checklists. A speech-language pathologist (SLP) will observe a child during a speech-language assessment and record his/her responses. These responses are then reviewed and analyzed for accuracy and appropriateness of each of the skills listed above. The SLP may also ask the parent to complete a checklist of skills the child has demonstrated or to describe difficulties the child has when interacting with others.

How are social skills disorders treated?
Social skills disorders are best treated in a group setting to provide a variety of partners and situations to practice learned skills. Our groups provide direct instruction through a variety of teaching techniques that include modeling, role-play activities, coaching and games. Group lessons address specific goals identified for the group members, such as paying attention to others, holding a conversation, understanding turn-taking, interviewing, problem solving of daily issues, compromise and self-evaluation. A successful group includes plans for generalization and maintenance of newly learned skills outside the training environment. We use group activities to create opportunities to practice real-life skills, and homework is assigned to increase the generalization of skills beyond the group session. Parents and teachers should be involved to ensure carryover of skills to natural settings.

Social skills options at Cleveland Hearing & Speech Center (CHSC)

CHSC is able to design a social skills group based on a client’s age and skill set.  Please contact Barbara Choudhury at (216) 325-7532 or Linda Lange at (216) 325-7531 for more information.

Why Communication Matters

Only through communication can human life hold meaning.– Paulo Freire

Kids talking in group -

Welcome to the blog for Cleveland Hearing & Speech Center (CHSC). As the premier provider of hearing, speech-language and deaf programs, services and advocacy, CHSC will keep you updated as to the latest information, tips, resources, research and more related to all things communication-based. If you are wondering how important the gift of communication can be – consider these

Top 10 Reasons Why Communication Matters

Cleveland hearing & Speech Center (CHSC) is dedicated to our vision – a community where everyone communicates effectively. The choice as to the form communication takes is a personal one.  Hearing and speaking are the most common forms of communication. Some people may use American Sign Language (ASL) Still others may choose captioning or lip reading. Communication by definition is the transmitting of, or interchange of, thoughts, opinions, or information by speech, writing, or signs. But, without question, the loss of the ability to communicate can mean loss of quality of life.

Without the ability to communicate you…

  1. wouldn’t be able to get a job. All jobs – from ditch-digger to CEO – require the ability to convey information. Your effectiveness at work, including interpersonal skills, is rooted in your approach to communicating with people. Hearing what is being said by the client; conveying goals to your team; listening to your boss’ instructions; understanding your objectives – all require your ability to communicate effectively.
  2. wouldn’t be able to signal for help. You finally got to take that trip to Italy – only to find yourself lost in a strange town. How can you ask for help? Being unable to communicate a need can be scary, especially in unfamiliar surroundings.
  3. wouldn’t be able to learn. Who doesn’t love curling up with a good book? Reading, writing, and ‘rithmatic all require the ability to understand the meaning of letters, words and numbers. Literacy is tied to communication, as is all learning.
  4. wouldn’t be able to manage a bank account. Keeping your checkbook balanced may seem like an ongoing challenge – but imagine if you had no understanding of the complexities of deposits, withdrawals, and other bank-related formulas. The same is true of other complex issues – legal documents, contracts, warranties.
  5. wouldn’t be able to express your ideas or feelings. As recent politics showed us – people have strong opinions and ideas about what they want for themselves, their families, their futures. Everyone wants to feel their opinion matters. But first, they need to able to communicate that opinion.
  6. wouldn’t be able to socialize. Statistics show that people with hearing loss, aphasia (loss of language), or other communication challenges, tend to withdraw more and more from social situations. This creates a downward spiral where they feel  lonely and depressed. Statistics show that socializing with friends, family and groups not only keeps the brain sharp but improves overall health and wellbeing.
  7. wouldn’t be able to explain a problem. When the car engine starts making that weird noise, or the faucet won’t stop dripping – it’s time to schedule maintenance. This requires the ability to find the appropriate source of help, communicate the issue and arrange for repair.
  8. wouldn’t be able to call or text a friend. It’s true that communication isn’t always verbal – and texting is a form of communicating. But if you were both deaf and blind and had not been given alternate methods of communicating – you might never experience the simple pleasure of a friendly chat.
  9. wouldn’t be able to live independently. As we’ve mentioned, without the ability to communicate and understand complex ideas such as banking, living independently would be nearly impossible. Add to that the inability to navigate a bus schedule or pay utility bills and you would feel completely dependent on others for your life’s needs.
  10. wouldn’t be able to say “I love you.” Although hugs and kisses convey as much heartfelt meaning as the words “I love you” – it is not always possible to express feelings in a physical way, and not every relationship is a physical one. Communication is the greatest gift we have and can give to each other.

Most of us take our ability to communicate effectively for granted. Unless or until something changes our ability, we pay very little attention to it. But knowing that services and programs exist to help those who need it – when they need it – is key to the mission of Cleveland Hearing & Speech Center. Whether it is the family whose infant did not pass its hearing test at the hospital, or the child who stutters, or the stroke survivor who needs speech therapy, or the Deaf individual who needs an American Sign Language interpreter, or the Baby Boomer who is beginning to notice a hearing loss – these and many others find the help they need at CHSC.

If you or someone you know has a communication issue, please contact us for further information. We are happy to help you get the answers you need. You will find us at or call 216-231-8787.