Everyone will appreciate that those who are deaf or partially deaf use all sorts of visual clues to understand what is being said to them. Profoundly deaf children these days are often taught through the medium of sign-language, but those who lose their hearing in later life¹, or who have some residual hearing often learn to lipread. This may be a conscious learning process, by attending lipreading classes or a sub-conscious process, whereby watching the shape of others' mouths is a subliminal way of checking what is 'heard'.

Profoundly deaf people may become extremely proficient at lipreading, so much so that occasionally the speaker may be completely unaware that the person being spoken to is actually deaf. Deaf people are in danger of missing extremely important pieces of information - such as car horns, fire alarms and doorbells. In speech they may lose the ends of a conversation if the person talking turns away from the listener, and then subsequently ended the conversation with a vital piece of information - the deaf person will not have any idea that there was anything further they needed to know. Likewise the speaker will not realise their message has not been taken fully onboard.

The purpose of this Entry is to understand some of the problems that a person with hearing loss faces and how lipreading may help.

How does Lipreading Work?

Try turning the sound down on the TV. Watch the lips of a newsreader who you know speaks slowly and clearly. You will soon realise that you have no idea what the subject matter of the news item is - unless there are subtitles or information rolling across the bottom of the screen to match the photographs behind the newsreaders head. In real life a deaf lipreader often has no idea of the context of the conversation - so for instance if you were talking about the price of eggs in a supermarket and then suddenly spotted a friend over the shoulder of the deaf listener and said something like 'Oh there's Mrs Brown from next door' - the lipreader would find this change of subject hard to follow, without some helpful visual clues. So, as well as just needing to read your lips, the deaf person needs some helpful hand gestures, good facial expressions and occasional physical touches to show in which direction to look.

Example: Touch the person's shoulder and point over it in the required direction. Raise your eyebrows to emphasise 'Look' and nod at the same time.

Lipreading Classes

Local authorities often have lipreading classes which are offered to people who are losing their hearing, or who have already become deaf. They offer a lot more than just the skills needed to learn to lipread. Often someone is very frightened once they realise they may soon have no useful levels of hearing left to them. Frequently a person with gradual hearing loss becomes more and more isolated as they no longer follow conversations around them - they may become withdrawn. There is an element of support from meeting others in the same boat.

The teacher may be skilled in the use of hearing aids and offer practical advice, possibly being able to provide essential batteries and help on their maintenance. He or she will also likely provide some explanation of how the ear works and some other problems a deaf person might be experiencing - such as vertigo² or tinnitus³.

Lipreading Pitfalls

Occasionally something quite simple will be said to a lipreader, who will nod and agree - but in fact has misunderstood entirely. This happens when the speaker has said something which has been read wrongly, usually because two words or phrases look exactly like something else entirely. If you are a lipreader yourself, you should pay attention to situations where this might be likely and repeat what you think you interpreted back to the speaker. In this way you will soon discover whether you are both talking about the same thing.
If you are the speaker you should be attuned to finding different words to say that mean the same thing. It is no good repeating yourself more than once or twice. Be prepared to use gestures and good facial expressions to amplify what you are trying to say.

Example: There's a leak in the bathroom. (difficulty with the word 'leak') Change the words completely for instance to:

There's *water* on the floor in the bathroom - we have a flood.

The biggest problem with lipreading is with sounds that are made inside of the mouth, such as 'c' 'g' 'h' and so on. 40% of speech falls into this category. Also the sounds 'p' and 'b' look absolutely the same. Try saying these numbers silently in front of a mirror and you will understand the problem facing a person with hearing loss.

Example: 'eighty-six' and 'sixty-eight'

Lipspeaking

Lipspeaking is the converse of lipreading. Family members and friends of the hearing impaired should aim to make any conversations as easy to follow as possible; the following suggestions may prove helpful.

It is impossible to read someone's lips if they speak too rapidly or mumble indistinctly. So, for this reason you should try very hard to face the listener and make your mouth work a bit harder than normal. It is not necessary to raise your voice. In fact if the lipreader is skilled you can lipspeak without using your voice at all. Most hard of hearing or slightly deaf people benefit from the approach of lipspeaking, as they will have naturally started to use their eyes more to help them understand spoken language as their hearing slowly deteriorated, in this case your voice should be used at a normal volume, or just very slightly raised. However, do not over-exaggerate the words, as this will distort the shape of your mouth, you should be aiming to speak normally, but a lot more clearly. The easiest advice to follow is to talk a more slowly - don't 'gabble'.

Shouting at a deaf or hard of hearing person is counter-productive. When shouting your face shows expressions of anger and looks cross - even if you are not. It is almost impossible to shout whilst smiling. If you shout loudly at someone who has difficulty in hearing you, they may well interpret this as you being annoyed with them.

In a situation where there is a lot of background noise, and a passerby asks a question, it is often left to the friend of the deaf person to repeat this to them in lipspeak to enable complete understanding of what is going on. Don't forget, the lipreader is not stupid - just unable to hear as well as the majority. Don't 'dumb-down' the language, this would be patronising.

If you find you are repeating yourself more than two or three times, and the lipreader is still not able to understand you, then try changing the words you are using.

Other tips to remember are to position yourself so that light is falling on your face - preferably with the person with hearing loss having their back to the window or light source.

It is also worth pointing out that large moustaches and beards which obscure the lips will make lipreading impossible. Strong accents can also be confusing for a lipreader to interpret.

These general tips are aimed for casual conversations within the home or the family. However there are professionally trained lipspeakers who are available for formal occasions, such as hospital appointments, business meetings and conferences, further and higher education or court appearances. In this case the services of a neutral professional acting to aid the deaf or hard of hearing person may be essential in a situation where it would be very difficult to read someone's lips directly. Further information about lipspeaking and the training available for this career path is available from the Association of Lipspeakers.

Other Places Where People Read Each Others' Lips

Cabin Crew on flights - as it is impossible to make yourself heard from one part of the aircraft cabin to another you will notice that they use a form of shorthand gestures and lipspeaking to each other to pass requests along the cabin

In Cotton Mills - before the days of Health and Safety, factories such as this were extremely noisy places and often the workforce was unable to communicate above the din. Very often too, the extreme noise cause a lot of them to lose their hearing⁴, and many became experts at lipreading by default. Comedians such as Les Dawson made this part of his act, and when talking about 'private' or 'embarassing' subjects reverted to over the top lip-speaking. It was not called lipspeaking though - it was referred to as 'mouthing'.