The link between hearing loss and dementia has been big news for the last couple of years. Because of this news, people seem to think if someone has hearing loss they’d better get hearing aids to keep from getting dementia. Also seen are giant ads using with information that scares people into buying hearing aids. This is wrong; this is people selling a product. The link between hearing loss and dementia is there, but by focusing on hearing aids only they are missing the bigger picture. Hearing aids are only PART of the answer.
Dr. Frank Lin, Otolaryngology, John Hopkins, has been researching the connection between hearing loss and dementia which you can find here. Lin says currently the main rehabilitative care being offered is hearing aids, and he goes on to say it’s not just about hearing aids, but ensuring people with hearing loss can communicate in all settings.
“Far more is involved.” – Dr. Frank Lin
I believe it’s the isolation factor that typically comes with hearing loss that causes dementia, and that idea comes from personal experience. My grandma didn’t have hearing loss, she had diabetes. She thought her life was over as she knew it, there was no more joy to be had. (Sounds like the hearing loss diagnosis?) Once a very active and social person, she withdrew from those activities, her friends, and she stayed home running errands for necessity only. Her mental health began to decline, slow at first, and later it picked up speed. It was frightening to witness and from then on I associated isolation with mental decline.
Twenty something years later, hearing loss and dementia were linked – and my first thought was social isolation. People with hearing loss tend to isolate themselves, as it’s a noisy world out there, and hearing devices are far from perfect. Audiologists hand out hearing aids, program them, reprogram them if needed, and people still struggle socially.
Even though hearing aids may have a noise reduction program for restaurants, separating the waitress’s voice though the clattering of dishes, background music and talk from other patrons remains difficult. Poor acoustics in these environments make the situation worse, reverberation confusing hearing aids/cochlear implants further. Not just words are lost but whole sentences. This is where people start bluffing because they just want it over with.
There’s a lot less of this confusion at home. Home is safer where the environment can be controlled. There are captions on the TV, books as easy friends, and embarrassing repeats can be avoided. It’s too risky in public, maybe that’s why my grandma stayed home. We aren’t given the proper tools and strategies to deal with this when they hand out hearing aids.
Another bummer is high dollar hearing aids can’t keep up in social venues such as theatres or at the movies. Dialog is lost in the booming background noises and/or overriding music. The dialog is delivered at a fast pace, just like some family functions. Conversation bounces around and by the time we figure out who’s talking, someone else is already speaking. This makes people with hearing loss feel left out, like an outcast in a sea of noise. They might resort to bluffing to give the appearance of fitting in, especially around people they know and love. Why? The words “never mind” or “I’ll tell you later” (which rarely happens) are also a dismissal. Maybe they were brave enough to ask for a repeat and then heard, “are your ears in?” We are shut out of the world communication.
Yes, we are wearing our hearing aids and they aren’t a magical fix. They are flawed, so repeats and certain accommodations will be needed. I’ve worn hearing aids for over 25 years now. For the first 16 years I thought something was wrong with me. I had expensive hearing aids, and I still had a hard time understanding speech. The feeling of inadequacy and the fear of judgement kept me socially withdrawn. What if I said something off the wall, again? Or maybe I’ll repeat what someone else already said, again. Easy street, in the short run, is to stay away from all dangerous situations.
Hearing aids do help and they have their place, but their limitations are not often discussed in full. If you’re lucky you run across someone knowledgeable about hearing loss, or happen to find the right book or article. It was a book for me and reading it, I finally understood why I hear the way I do and that hearing devices have their limits. What a relief to find out it wasn’t me after all, I’m just sorry it took me 16 years to learn that. It was freeing but anger soon followed. Why didn’t any one of the audiologists I had over the years tell me that? Why didn’t they offer me more support, isn’t that their job? After that I was on a mission to learn all I could about hearing loss and hearing aids. Here’s some of what I learned….
The big 3 of hearing aid limitations:
They only work well within 4-6 feet, after that their ability goes down.
If it’s a high frequency hearing loss, then hearing aids only replaces some hearing.
Even though digital hearing aids are better at masking some of the background noise, some noise is still overpowering for hearing aids. Bad acoustics can wreak havoc on hearing aids rendering them nearly useless.
How to conquer those limitations:
LEARN ALL YOU CAN ABOUT YOUR SPECIFIC HEARING LOSS.
How do you hear and why? Where do you fall on the speech banana and what sounds of speech do you miss? If your audiologist didn’t explain this to you, make an appointment right now and have him/her explain it to you. They owe you that. That way you know more of what you need to make communication easier on you and those around you. In fact, take your significant other with you so they too understand
FIGURE OUT WHAT YOU NEED TO MAKE COMMUNICATION EASIER.
So many people with hearing loss don’t know what they need so let me give you a starting list.
People need to be within 4-6 feet.
They need to get your attention first so you’re prepared to focus.
At all times they should face you when talking (you lip read some whether you know it or not).
Just those 3 rules will make communication easier on both parties. Create a habit together.
ADVOCATE FOR YOURSELF.
When you tell people what you need, you’re advocating for yourself. Woo-hoo! That’s a giant step forward and it’s absolutely okay to tell people what you need. The next step would be introducing yourself to new people with your needs. Here’s what I say: “I lipread.” (It gets them to face me pushing sound right at me and I can use lipreading in combination with my remaining hearing.) “I hear well enough to know you are talking but unless I’m looking at you I won’t understand much.” I’ve given them direction on how to communicate with me, there’s no guessing. If I don’t answer a question while looking down, I’m not rude, I didn’t hear/see.
USE ASSISTIVE LISTENING DEVICES (ALDs).
Hearing aids pair wonderfully with assistive listening devices (ALDs). While out in public look for the symbol, an outline of an ear with a slash/dots. Typically there are FM systems and if you’re lucky you’ll find hearing loops which are even better. There’s also live captioning, called CART (Communication Access Real-time Translation) and caption devices in theaters (CaptiView and Sony Caption Glasses). If the public venue’s devices don’t work well, be sure to let them know because you’re not only advocating for your needs but you’re also advocating for people with hearing loss who come after you.
LOOK FOR CLASSES ON HEARING LOSS.
Most states have a Deaf and Hard of Hearing Center/Commission and offer some form of help. Here in Utah we have Hard of Hearing Assistants in rural areas who go to senior centers (younger people are able to attend some) to teach classes, free. They teach lipreading, Living with Hearing Loss (based on Sam Trychin’s work), tinnitus, hearing aids 101 and slow paced sign language classes. Most states aren’t exactly like Utah but they should be able to offer some direction or support. Lipreading and the sign language classes helped me. I can use my lipreading ability in noisy situations such as restaurants, even taking my hearing aids out so the noise isn’t distracting me. I had my husband learn the ASL (American Sign Language) alphabet to help me when I’m stuck on words. I now have more tools at my disposal, helping me to be more successful in a variety of situations. If a state agency isn’t available, check for other resources such as college classes, local hearing loss support groups and online support (SWC is a great start with email lists and Facebook groups) and…
FIND YOUR TRIBE!
Find others with hearing loss. Find the role models who make themselves available to help others. Because they were once where you are, they can help you climb out of the isolation hole. The SayWhatclub (SWC) saved me twice in my life after big hearing drops; once in the late 90’s and again in 2009. Seek local support groups, and go to the hearing loss conventions each organization offers. SWC has an annual convention I can’t get enough of it, because I feel like I’ve come home. The conventions have given me something to look forward to, to learn from (every single time) and enables me to meet new friends and greet old ones. It’s socialization in my environment with people who know how to talk to me. All workshops are captioned and have hearing loops. It’s a world catered to me.
Hearing aids alone will not combat dementia. Audiologists need to expand their services, or at least point all clients in a direction where they can grow with hearing loss. I might believe ads about combating dementia with hearing aids AND rehabilitative services. What if all audiologists made themselves aware of state agencies for deafness and hearing loss? What if they passed out information on available hearing loss organizations to every client? What if audiologists offered mentoring services, someone with personal experience in hearing loss to help with questions, doubts and self-confidence? What if audiologist offices offered once a month talks on different aspects of hearing loss and communication? Only then would I believe they were focusing on the link between hearing loss and dementia.
Hearing loss is not the end; it’s just a matter of learning another way of doing things.
I look for hearing loss memes to post on our work Facebook page. Some are funny, some are true and some are way off base. Let’s take a look at memes.
This happens all the time with people who have hearing loss and there’s a variety of reasons. We can sense the other person’s agitation and we still didn’t hear it so we nod and let it go. Or someone is in deep denial still and afraid to admit they can’t hear.
Chelle:This article will not only help those who lipread, but it will help all hard of hearing people and the hearing people who communicate with them. You cannot talk to hard of hearing people the same way you do a hearing person. I realize you talk to more hearing people than you do hard of hearing people so it’s a habit of sorts, however, a few minor adjustments will help the hard of hearing a great deal.
Michele:Yes, we can all use pointers for better communication. Hearing people have various reactions when encountering someone who is different. Some are uncomfortable because they’re not sure how to accommodate someone with hearing loss to make themselves understood, while others seem to be more intuitive and mindful about what is needed and they accommodate automatically without anyone having to ask or inform.
Chelle:Even hard of hearing people are used to living in the hearing world and talking to hearing people. I’ve witnessed them forgetting the good rules of communication when talking to me. I volunteer for several hearing loss causes, go to hearing loss conventions, plus I work part time at the state Deaf and Hard of Hearing Center, so I’ve hung around with hard of hearing people over the last four or so years. My home life is, however, in the hearing world so when I started working and volunteering, it was hard for me to remember to switch to the different modes of communication. It became easier and after about six months I can now switch between modes easier and talking to people who are hard of hearing is habit now. If I can do this, you can too.
Michele:Attending my first SayWhatClub convention in Baltimore, Maryland in 2011 was an eye-opener. I found that I was terrible at giving the accommodation that I need myself. When you don’t know others in your real life with hearing loss, and you mostly communicate with hearing people, you are habituated to expect that everyone else can hear, just as a hearing person is. So, it does take some time and training to get into a new habit of communicating in a way that someone with a barrier needs, and we hope our tips help you do that. Chelle:Most hard of hearing people use some lipreading whether they know it or not. Lipreaders and hard of hearing people get stuck on a word, if not a string of words. That is the main frustration between hearies and the hard of hearing. We are trying our best to hear but our ears are broken. Maybe the hard of hearing person knows what to ask for, but many do not know or are afraid to be troublesome and ask straight out. If you are in doubt, ask the hard of hearing person, “What helps you understand me better?” In the meantime, here are some suggestions from Michele and me which also includes a few hints for hard of hearing people.
Michele:Chelle’s right, everyone lipreads to a certain degree, they are just not aware of it… the same way in which people with hearing loss are not aware of how much our hearing informs us in our everyday lives, until we talk to others in our shoes. Who would have thought being hard of hearing would complicate the use of elevators, indoor plumbing (we often leave water running), and driving a stick shift? Right again, Chelle, when in doubt, ASK! It’s not offensive for a hearing person to ask someone who is different how best to communicate with them, and it’s also not offensive for lipreaders to define what they need for understanding. Chelle:First and foremost, before speaking, get the person’s attention even if you are in the same room. Call their name, give a little wave and pause until their eyes are on you then start talking. Be within 4 to 6 feet when talking, as distance makes lipreading more difficult. If I’m too far away…My husband calls out ‘whoop’ in a tone he knows I can hear (such as when we are skiing) to get my attention.
Michele:Getting the person’s attention first is so important! If you don’t, then the lipreader is already behind and confused… they’re trying to figure out what the subject is, whether you’re telling them something, asking a question, or just interacting. Give the person with hearing loss as much info as you can right off the bat. Instead of starting in with a thought, say something like, “Hey, I want to talk to you about _______.” and then expand on the subject. If it’s a question, say “Can I ask you something?” Premise your conversation start as much as possible.
Don’t be rude while getting someone’s attention. Years ago, a dad on one of my kid’s soccer teams was very self-conscious at getting my attention, so he’d kick my foot when he wanted to talk to me. I was nice the first time I let him know there were better ways to get my attention, but eventually I had to tell him if he kicked me one more time I was going to deck him. If you’re unsure about how to get someone’s attention, ask them what they prefer. I guarantee no one will ever say “Oh, just kick me.” Chelle:Slow downa little but not too much, going slow motion distorts lipreading. On the flip side, talking too fast is hard to keep up with. There’s a happy medium in there somewhere. Take more time to enunciate. Some people don’t move their mouth much when talking, making lip-shapes harder to read. Ask your hard of hearing friend if this might be a problem. At a lipreading class, we all had a hard time understanding one particular lady. I caught her on the side once and confessed it was hard for us because she didn’t move her lips much. After that she worked on moving her mouth more to form the words and we could understand her better. *HOH people, it’s awkward to ask people to move their mouth more but it can help.
Michele:Even hearing people know what it’s like to not understand fast talkers, mumblers, and those who do not enunciate well or who have a thick accent. Give what you would like others to give you in conversation—a slower but normal pace, no overly exaggerated lip movements, and clear enunciation while speaking from your diaphragm. Example: My oldest son can be a mumbler and I have a heck of time lipreading him, but when he’s reading literature out loud to his girlfriend I can understand him perfectly because he’s projecting and focusing on enunciation more. So, I asked him, “Can you please talk to me as if you’re reading literature aloud, I can understand you so much better in that voice?”
It’s also okay to tell someone when they are not a good lipreading subject. You’re telling them because you want understanding, not because you’re trying to criticize. However, people can be offended if you come across as blaming them. Practice at putting people at ease while asking them to adjust their speaking for success. Example:“Your accent is lovely, but it makes my ability to lipread a little harder… if you could go a bit slower that would help.”; or “I love that you’re such a passionate and animated speaker, but when you turn your head while talking or motion with your hands in front of your face I have a hard time following you. Looking me in the eye while you are speaking is helpful.” If someone has told you that you are hard to lipread, don’t take it personally and go watch yourself speak in the mirror in your normal delivery; then concentrate on improving your lip movements for better understanding. Can you see the difference?
Chelle:Nice addition Michele, thank you.
My next item is to rephrase rather than repeat. There’s nothing worse to a hard of hearing person than someone who repeats it all in exactly the same way all three times. There’s the same rise and fall of tones with certain words exaggerated in exactly the same way. Instead say it a little differently; either shorten what you said, find a different word or lengthen the description to give more clues. Take the stress/exaggeration off words and say them in a normal tone of voice. *HOH people, we need to learn to ask for a rephrase instead of a repeat. *Also, tell people the parts you heard so they will only say what you missed, it might help.
Michele:Yep, repeats often don’t work. Say it in a different way and add more where appropriate. However, remember, we are all different and some feel that less is better and like to stick to basics, so it is best to ask each person what they find helpful.
Don’t Use Contractions or one word sentences
I tell my family “No one-word answers and don’t use contractions!” If the answer is “yes” or “no” then use it in a sentence—”No, I am not.” vs. “Yes, I am.” changes up the syllables… people don’t realize how we lipreaders really are grabbing onto every little detail of what we do hear to help us figure out conversation. We are sudoku masters of conversation—filling in what’s known and eliminating possibilities through reason, except lipreading is harder and we have to do it fast enough to keep up with each new thing that is said.
And, don’t restrict use of these tips to the person with hearing loss, practice them with everyone you are talking to in a group, as the person with hearing loss is trying to follow and lipread everyone so they can interject and participate in the group conversation. Plus, applying these tips to all of your conversations will help you become a much better communicator with everyone. I even do this with my granddaughter when we play “Go Fish”… if I don’t have the card she asks for I say, “No, I do not have a ______, go fish.” She started out just saying a simple “yes” or “no” to my asking for a card, but now she speaks in full sentences like I do, but sometimes I have to remind her.
Adding more words is what I prefer. My husband might have mentioned he was going to town earlier in the day (maybe I heard him, maybe I didn’t?), and then later he will say something out of the blue like “Are you going with me?”, and I’ll have to figure out where “with me” is… it would be much better if he said “I’m getting ready to leave for town, are you going to go with me?” Talk in whole thoughts and use more describing words to make sentences clearer and to give them more meaning.
Noun before pronoun please
The other big thing I come up against is someone using a pronoun right off the bat. Generally, a pronoun should follow the word it refers to, so you shouldn’t use a pronoun until you’ve used the noun first unless you intend to leave your listener in suspense. Yes, I’m a grammar whore, but also it makes lipreading and understanding harder when you start off referring to someone or something without naming them/it first… not only do we have to follow what is said, we also have to figure out who I, me, mine, you, yours, his, her, hers, we, they, or them might be. Or, what that, this, those, or these is referring to. It becomes too much. Repeating a whole phrase when you’re not getting one word is really irritating, and that’s why a person with hearing loss needs to tell people what they need if they don’t get it on the first repeat—“Say that in a different way, please, and be more descriptive.”
The ASL Alphabet can help. Just signing the first letter of a word can clarify the difference between two words that rhyme.
Chelle:Learn the American Sign Language (ASL)alphabet at the very least. Many hard of hearing people are familiar with it and if not, you can both learn. Go to www.lifeprint.com to learn the ASL alphabet. Then if that one word stumps the hard of hearing person you can start spelling it with your fingers. Most of the time you won’t have to spell the whole word, just the first two or three letters. It’s extremely helpful and can be used anywhere, any time. This works great for spelling out names too. People who are hard of hearing have the toughest time getting names right (Was it Terri or Cheri?). It helps them to remember the names too. But go slow! We are not fast fingerspelling readers generally.
Michele: I’ve known how to fingerspell since early childhood, as my deaf grandmother taught my sister and me. It was the only sign language she knew. We used it often to aid communication when Grandma would get stuck by what we were saying. My kids (daughters, not so much sons) are good to use fingerspelling with me when I get stuck on a word, especially when introducing someone. I’ve been wanting to at least learn PSE (Pidgin Signed English is a combination of American Sign Language (ASL) and English), sometimes called CASE (Conceptually Accurate Signed English), as I notice how much it helps when I’m talking with someone who uses it.
Chelle: I also suggest learning the ASL numbers too because hearing numbers can be hard and numbers can be so important; was that 15 or 50? It comes in handy for addresses and phone numbers too.
Gestures can aid communication and sink words in faster than repeating. It might feel awkward at first but after a while it becomes second nature and can be quite entertaining. Use facial expressions as needed too. ASL and the Deaf community use a lot of expression while communicating and I think the the Hard of Hearing community could benefit from that as well.
Michele: I love gestures, and because I began losing my hearing in childhood I’ve always been the recipient of some sort of gesturing. In my immediate family we even have family sign language for things/words we use a lot. Think of playing charades and what you can do to help your team make the right guess for the win!! It works the same with gesturing for someone with hearing loss.
Chelle: Here are some other things that make lipreading harder; smiling too much. When I get around other hard of hearing people I tend to smile a lot because I’m so happy to be within in my tribe. I think this might have made it hard for Michele to lipread me at first. While I teach lipreading classes we get to laughing and smiling (I try to make it fun) then I end up covering my cheeks with my palms and wiping the smile off my face before continuing. Michele: <laughing> I had forgotten that I used to have such a hard time lipreading Chelle, and I think she might be right, smiling lips impede lipreading ability. I’m probably the opposite… over many years, I’ve concentrated so hard to enunciate and project my voice, in order to keep my speech clear, that I tend to come across pretty serious at times, especially if I’m meeting someone for the first time, though I’m sure I do my share of smiling while talking.
My best grade school friend told me once, “You were so serious and studious at school, but outside of school you were funny, cheerful and full of laughter,” and I think that’s why, I had to try so hard in school to keep up and stay on top of what the teacher was saying that I looked serious much of the time.
Don’t talk with your mouth full of food or while chewing on a pen
Chelle: Fingers, hands or items such as a pen or pencil in front of the mouth make it really hard to lipread. Chewing gum, or eating in general, is distracting. It’s hypnotizing, in a warped way, watching the wad of pink go around so focus on the lips is lost. When the person is eating, it’s the same except we are waiting to see if food comes flying out at us too. *Don’t be afraid to ask people to spit out their gum or candy, or lower their hands from their mouth.
Michele:Anything covering or distorting a person’s mouth will be a distraction. I’ll add: Braces, facial oddities, bad teeth, etc. These things are hard to mention without offending, but I have done it successfully, though I’d probably never tell someone their bad teeth are tripping me up. Just yesterday I explained to a young girl at a concession stand, “Braces really wreck my lipreading skills, so I’m struggling here, but that’s not on you, it’s on me. Lipreading doesn’t work 100% of the time,” always said with a smile. Chelle: Seeing is hearing, the eyes are the ears. Make sure there is good lighting to make lipreading easier. It may create ‘atmosphere’ to dim the lights but it will also bring communication to a halt or isolate the hard of hearing person. *As a hard of hearing person, do not be afraid to ask people to turn up the lights or switch places so their face isn’t in the shadows. Start it with humor, “I can’t hear in the dark, can you…” Everyone has laughed and turned the lights back up for me. *Both the hearing and Hard of Hearing can ask for lights to be turned back up at bars or restaurants when this happens too. Usually the business will accommodate the request.
Michele:Seeing is hearing for anyone with hearing loss. I explain this to my 5 year-old granddaughter, “If Mim can’t see you, she can’t hear you,” and she understands. I think I get better accommodation from her than some of my adult family members. I’m always torn about lighting in some situations, as I don’t want to take away from others if the low-lighting is intended to create a mood, but I do often point out that I can’t hear if I can’t see clearly. You really have to gauge each situation and decide those instances where you want to ask for the lights to be left on. However, if you’re lucky, some wonderful friends and family do step in for you, and that lessens what can seem like a burden of always asking to be accommodated—I admit, sometimes I feel like a killjoy. Example: My husband and I did a houseboat trip with several other couples from high school. Late nights on the water were nice, with the lights down low, over dinner, but if the lights were turned off I wasn’t part of the conversation. I didn’t feel I could assert my need for light the first night. Turns out I didn’t have to, a good friend stepped in when someone turned down the lights, saying “Michele needs the lights on to hear.” I was so grateful for an intuitive friend.
However the person who turned the lights down at dinner was up on the deck of the boat with me later that same evening, star-gazing and chatting away, just the two of us. After about five minutes of non-stop talk, he paused, and I said in a joking tone, “Mike, you’ve gotta know that I have no idea what you’ve been saying. I really am deaf.”
The above is a perfect example of how some friends get it and you never have to mention your hearing loss to them again, while others can’t remember that you can’t hear from one moment to the next.
The one area I’m not shy about is backlighting, which is a lipreader’s nemesis. I always ask to switch places so the people I’m with are not backlit. I’ll even tell wait staff they are backlit and ask them to move to better light so I can lipread them better, and I’ve never had anyone refuse or react negatively.
Which brings up another point: The necessity of people with hearing loss constantly having to remind others about what they need. If someone you know has a hearing loss and lipreads, and they’ve taken the time to explain how best to communicate with them, it’s likely that those things will also aid you in all of your conversations and exchanges, so try to remember and practice them. If you see the lipreader only occasionally, they will be more understanding when you don’t remember their instruction, vs. someone they see every day. And another thing: The person you know with hearing loss is likely the only person you communicate with who is different. For the person with hearing loss, you are one of many that they need to ask for accommodation from every single day, and it does get tedious to have to constantly remind the same people over and over about what they can do to facilitate better communication with us.
We get weary.
Chelle: An example that encompasses a little of all of these strategies happened just the other night on our patio with my husband and another couple. I got stuck on a word while the conversation was aimed at me with laughter (not about my hearing). Instead of bluffing, I fessed up, “I’m missing the one word.” Nothing was making sense because of the one missing word. I looked to my husband who made a “G” for me with his fingers. He didn’t spell out anymore, maybe because we were with others or he was stuck spelling at the moment, so I was still stuck. Our friend said it a couple of more times it was still not visible/audible for me. He grabbed his shirt (gesture) and still made no sense; his shirt was blue, not green. I looked back at my husband who added another word and I got it! “Under garmet,” and I got it. They were saying garment. There was no frustration between us, they saw how hard I was trying and the kept going until I got it. It took all of us to make it work, no one was left out or frustrated and we all got to laugh.
Michele:Good example, Chelle, that demonstrates how a lipreader’s mind works. I think it’s really useful to share these examples of good practices that work in real life. It’s the best way I know of to help others who want to be more successful lipreaders and communicators identify areas where they can improve.
People often ask me how I lipread so well, and I’m not sure how to explain something that I’m hardwired to do? How do you explain something you learned while not even being aware you were learning it? Collaborating on these lipreading articles forces me to think more about what makes lipreading successful and useful for me, which, in turn, helps both hearing and hard of hearing gain a better understanding of lipreading and its potential.
Chelle: We’re happy to bring more basic lipreading techniques to light and much of it is sound sense rather than only seeing shapes on lips (which we’ll get to later). Teaching speechreading in Utah has helped me focus more on what it takes to make it happen. I’ve probably been doing it the same way Michele has (only not as well she does) for a number of years. Focusing on all the elements that go into lipreading has bumped me up to the next level where I’m a little better and I realize that advocating for myself is a good portion of what it takes. Michele and I make a good team because we’ve both been lipreaders for decades, and we want to share what we know and learn with others too.