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Lip Reading

The visual component of speech communication is referred to as "lip-reading" or "speech-reading." Speech-reading is the preferable term because it is closer to what actually occurs-which involves processing much more visual information than lip movements only. It is too often an overlooked aspect of the aural rehabilitation process. Speech-reading is routinely utilized by both normally hearing and hearing impaired individuals to enhance understanding of spoken language.

It is important to understand that speech-reading is typically learned without any formal instruction. As infants/toddlers begin developing language receptive skills, the visual component is learned as is the auditory component: by observation, modeling, replication, repetition and so forth. Most youngsters can correctly understand and use fairly complex language rules long before the rules have been formally explained to them in school.

Speech is a dynamic, ongoing and fleeting signal that must be processed by the brain in real time. It does not lend itself to lengthy analysis. One may use primarily auditory cues, visual cues or a combination of the two (which is the most common). There are other cues that are utilized such as linguistic cues, "set" (or expectation), situational, gestural, or supra-segmental aspects of speech including stress, intonation, etc. In short, there are many cues that may be and are used to facilitate understanding of spoken language. Most often, this array of cues produces redundancy in the message that is fortuitous in the event that we are unable to pick up some of the other critical cues and they make speech comprehension possible in a wide variety of situations. The more of these cues that are absent, the greater will be the difficulty in understanding what is said.

Each individual relies to greater or lesser degree on each of these varied speech comprehension cues. Thus, if an individual who has not developed good use of visual cues develops significant hearing loss, his inability to effectively draw upon those visual cues will make the hearing loss an even greater problem than it would be if he effectively utilized them.

The challenge for people who develop hearing loss is to more effectively utilize the visual cues available to them to enhance speech understanding. This is true for people who obtain/use hearing instruments as well as those who do not. You will understand more, by taking advantage of the visual cues, even if you have hearing instruments with all of the latest wrinkles. Most frequently, the combined use of hearing instruments and of visual cues results in the best outcomes.

So, how do you go about enhancing speech-reading ability? This reminds me of the story of the centipede who managed very nicely with his many legs until, one day, a grasshopper asked him how in the world he figured out which leg to put forward when. As the centipede delved deeper and deeper into an analysis of how he did this, he found himself totally immobilized. The lesson is, that you probably do not need any special lessons in speech-reading. You already know how to do it, you just need to avail yourself of those cues by looking at the person who is speaking to you and helping them to understand that you won't have to ask for repetitions as often if they will get your attention and look at you when they speak. Once you work at this consistently for a few weeks, it will become habit-second nature. Unlike with written language, you cannot simply stop someone's speech at will or turn back the page, look at the last sentence again or whatever. You either get the message on the first pass or you don't. And, you know that you quickly use up your quota of "Huhs" and "Whats."

It is important to dispel some common myths about "lip-reading." Contrary to what some old spy movie might suggest, it really is not possible to understand much of anything across a football stadium with a telescope. If all you have are the visual cues, you are often left high and dry. The reason for this is that many speech sounds have no distinctive visible cues because they may be formed in the back of the mouth. Others look alike. For example, the sounds of "p," "b," and "m" are visually identical. Generally, the combination of remaining hearing (usually better for lower frequencies) and utilization of visual cues (most helpful for those sounds that are dependent on adequate high frequencies hearing) results in the ability to get much more than could be understood based on the defective hearing or on visual cues alone. Taking advantage of available visual cues is a tremendous help whether or not you use hearing aids. When hearing aids can enhance hearing, the combination of hearing aids and speech reading produces much better results than either approach alone.

I do not advise you to inform people that you "lip read" because, in an effort to be helpful, they often exaggerate their lip movements in such a way that you get less than if they spoke naturally. On the other hand, it is helpful for you to inform your communication partners that you have a hearing problem and that it helps if they get your attention and look at you throughout the conversation. You might even point out the "payoff" to them for doing this ".so I won't have to ask you to repeat so often." Remember to stop what you are doing and look at the speaker.

In cases where hearing loss develops before the acquisition of speech, special training in the use of visual cues can be very important.

In any event, if you would like further information about or assistance with speech reading, consult with your audiologist.