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 lip read. This may be a conscious learning process, by attending lip reading classes, or a sub-conscious process, whereby watching the shape of others' mouths is a subliminal way of checking what is 'heard'.

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

Using Gestures

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 lip reader often has no idea of the context of the conversation.

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 lip reader 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.

Lip Reading Classes

Local authorities often offer lip reading classes to people who are losing their hearing, or who have already become deaf. These provide a lot more than just the skills needed to learn to lip read. People suffering a gradual hearing loss are often very frightened once they realise they may soon have no useful levels of hearing left to them. They frequently become more and more isolated as they no longer follow conversations around them - they may become withdrawn. The classes offer 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.

Lip Reading Pitfalls

Profoundly deaf people may become extremely proficient at lip reading, 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 end of a conversation if the person talking turns away from the listener, and then subsequently finishes 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 on board.

Occasionally something quite simple will be said to a lip reader, 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 a word or phrase looks, to the lip reader, exactly like a completely different word or phrase (and therefore with entirely different meaning). If you are a lip reader 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 lip reading 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 lip reading - it is speaking in a manner that makes lip reading easier. 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. 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 lip reader 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 person who is deaf or hard of hearing is counter-productive. When you shout, your face shows expressions of anger and looks cross - even if you are not. It is almost impossible to shout while 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 lip reader 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 lip reader is still not able to understand you, then try changing the words you are using.

• 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.

• Large moustaches and beards which obscure the lips will make lip reading impossible. Strong accents can also be confusing for a lip reader to interpret.

These general tips are aimed at 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 themselves 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 Regulations, 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 caused a lot of them to lose their hearing⁴, and many became experts at lip reading by default.

Comedian Les Dawson made this part of his act, and when talking about 'private' or 'embarrassing' subjects reverted to over the top lipspeaking. It was not called lipspeaking though - it was referred to as 'mouthing'.