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The Medical Minute: How to communicate with someone who doesn’t hear? Just ask them.

Edith Dong, an extern in Audiology at Penn State Health Milton S. Hershey Medical Center, sometimes forms a bond with patients few of her co-workers can ever completely understand.

When someone is nervous about or unsure about their hearing loss, they can find comfort with the extern. Dong actually knows what it’s like. She doesn’t regurgitate secondhand descriptions from a manual. She’s lived it.

Dong knows about silence.

In addition to studying audiology at Gallaudet University in Washington, D.C., she’s had profound hearing loss ― she doesn’t understand voices and only the loudest noises register ― since she was 10 years old. To her colleagues, family and friends, deafness is not a disability and she isn’t suffering from anything. Deafness is just another trait among the million or so ingredients that make up Dong.

Like 30 million people in the U.S., Dong learns, communicates and lives her life without sound. Others like her don’t make up one group or make use of one kind of communication. In fact, Dong asked that the article refer to everyone as “D/deaf or hard of hearing”– encompassing both those who identify themselves as part of the Deaf community and those who don’t.

The characteristic is one of many reasons why she’s so good at her job, says Jill McClelland, manager of audiology at Penn State Health, who works with Dong nearly every day.

“I can think of one patient in particular,” McClelland said. A pediatric patient was worried about putting cochlear implants on her ears. “Edith really made a big difference by letting her see that she wears hers, and it’s not hurting. Not only did it help that little patient, but it also helped the parents whenever they had questions.”

At Penn State Health, Dong holds conversations by using American Sign Language and multiple interpreters who accompany her during work. A Philadelphia-area native, she’s worked in various clinical and education settings throughout the east coast. Every place is a little different. Penn State Health is one of the good ones, she says.

“Everybody’s been very accommodating and understanding,” she said. “I feel very comfortable here.”

For one thing, McClelland and a handful of her colleagues have experience with American Sign Language.

That’s a rarity, Dong said. Most of the clinicians she’s encountered don’t sign besides those she has encountered at Gallaudet.

“In my opinion there’s not a lot of audiologists that sign,” McClelland said. “When I was doing my training, I was specifically told not to because it goes against what the audiology training is for.” That’s changing, she said.

Though sign language is an invaluable tool to those who need and use it, you don’t have to know it to have meaningful and important conversations with someone who needs assistance with sound.

While communicating with someone who doesn’t hear you might seem daunting to hearing people who aren’t used to it, people with varying degrees of deafness around the world are integral parts of workforces, schools and social circles where understanding and making themselves understood is no problem.

All it takes is a little planning and empathy.

Ask the them about their communications needs

“Listening to the D/deaf or hard of hearing person is important,” Dong said. “Make sure that you’re advocating for them.”

McClelland says it’s a learning process and not everyone communicates the same way. “It’s not going to be the same for the next person with whom I communicate with hearing loss,” she said.

Dong usually works with two interpreters at a time. Kendra Barlet is with her every day and several other interpreters work with her on a rotating basis. Her college arranged for them to be there.

Other people with different levels of hearing loss communicate in entirely different ways.

Make sure you maintain eye contact with the person with whom you’re speaking, even if they’re working with an interpreter. “Make sure you’re looking at their face to make sure things are being explained clearly,” Dong said. Don’t look at the interpreter, so the person you’re addressing understands you’re talking directly to them.

Visual resources can also be helpful, she said. Offer written instructions or pictures of objects that require a lot of complicated description can help clarify key points.

Other tips

The Deaf-Hearing Communications Centre offers several recommendations to help make the exchanges easier:

  • Do not yell or talk loudly and do not mumble.
  • If you use written communication, make sure you are understood.
  • Do not over emphasize your facial expressions or lip movements as this can reduce communication.
  • If the person prefers to use speech-reading, speak normally and avoid speaking too slow or too fast.
  • Avoid excess background noise.
  • Be patient and relaxed.
  • Take advantage of technology by typing back and forth on a computer screen, using email, instant messenger or text messaging.


“You will see a variety of different technology devices and supports regarding sign language interpretation for the Deaf community,” Dong said. “But it would be better to have in-person interpreters.” It’s the same as any conversation you might have with a hearing person. Over the phone or text or video conferencing, key ideas and information become lost when you aren’t in the same room.

That said, in today’s high-tech, socially distanced world, technology is there to help. “Just the progression that’s happened over time with technology – especially with COVID – has made things easier,” McClelland said.

Online video conferencing offers transcription services. Cell phones can be set to vibrate to alert a someone who can’t hear a ring tone about an incoming message. DIGLO offers a wealth of products to help with communication between hearing and non-hearing people, from surgical masks that offer a window on the wearer’s lips to devices that flash when your doorbell rings.

Communication becomes easier the more you do it and eventually becomes second nature, Dong said.

“Treat people the way that you want to be treated,” she said. “They don’t need special treatment – they just want to be treated like other people. We do everything the same as hearing people.”

“Being in the Deaf community doesn’t mean you’re lacking,” McClelland said. “It means there’s a communication difference. You can certainly be a whole person, even if you’re hearing differently.”

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The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.

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