Open‐class repair initiations in conversations involving middle‐aged hearing aid users with mild to moderate loss

Abstract

Background To manage conversational breakdowns, individuals with hearing loss (HL) often have to request their interlocutors to repeat or clarify. Aims To examine how middle‐aged hearing aid (HA) users manage conversational breakdowns by using open‐class repair initiations (e.g., questions such as sorry, what and huh), and whether their use of repair initiations differs from their normally hearing interlocutors. Methods & Procedures Eighteen 45–64‐year‐old adults with acquired mild to moderate HL participated in the study. The participants were videotaped in everyday interactions at their homes and workplaces and in clinical encounters with hearing health professionals. Interactions were transcribed and open‐class repair initiations of participants with HL and their interlocutors were identified using conversation analysis. The frequencies of initiations were analyzed statistically between the groups, and the contexts and structure of repair sequences dealing with communication breakdown were analyzed. Outcomes & Results Before acquiring HA the participants with HL reported intense use of open‐class repair initiation. After HAs were acquired, there was no statistically significant difference in the frequency of open‐class repair initiations between HA users and their interlocutors. The most common means for open‐class repair initiation in the data was interrogative word mitä (‘what’). Vocalization hä (‘huh’), apologetic expression anteeksi (‘sorry’) and clausal initiations (e.g., ‘what did you say’/‘I didn't hear’) occurred less often. Open‐class repair initiations emerged in contexts where they typically occur in conversation, such as topical shifts, overlapping talk and action, background noise, and disagreements. When used, open‐class repair initiations most often led to repetition by the interlocutor, which immediately repaired the conversational breakdown. Long clarification sequences with multiple repair initiations did not occur. Conclusions & Implications Participants with mild to moderate HL using hearing amplification initiate open‐class repair similarly to their normally hearing conversational partners when the frequency, types, contexts and structure of repair are considered. The findings diminish the stigma related to HL, HAs and the use of open‐class repair. The findings suggest that HA amplifies hearing successfully in everyday conversation when the level of HL is mild to moderate. However, the evidence for the benefit of HAs remains indirect.

Cocktail-party behavior: dynamics of conversation and (mis)communication in noisy environments

“…Importantly, our reporting of communication breakdowns is also a robust and direct metric for assessing real-world conversational difficulty during interactive communication. Previous studies have reported that incidental noise captured during otherwise quiet recording sessions (e.g., newspaper rustling, cooking) were more likely to result in a communication breakdown [36,43,44]. Here we systemically showed the impact of increasing background noise levels on communication breakdowns during interactive communication.…”

“…Indeed, it is well documented that listeners 'let it pass' [73] to not interrupt conversational flow and rely on context to recover the intended message, and also employ nonverbal communication such as head and body movement and facial gestures (e.g., 'freeze look' [74]) to signal communication breakdown. It is also the case that our sample contained instances of communication breakdowns that transpired not because of SNR problems related to the background noise level, but rather due to the mismanagement of turn-taking (still a potential speech intelligibility problem) and/or rapid topic shifts [44,75].…”

“…comprehension when understanding goes awry, OIRs temporarily disrupt primary conversational goals in pursuit of rectifying missed communication [39]. OIRs are well documented for individuals with hearing loss (i.e., populations with intrinsic acoustic-perceptual limitations [40][41][42][43][44]). Not surprisingly, suspending conversational flow through repeated communication breakdowns can lead to unpleasant social interactions [39] and conversational avoidance [45], as well as severe limitations to social engagement and reduced rates of participation [46].…”

Combined effects of age and hearing impairment on utterances and requests for clarification in spontaneous conversation and a referential communication task

“…However, in their study, the interaction took place in a background of noise, whereas in the present study, the task was conducted in a quiet room. Furthermore, studies based on analysing naturally occurring conversation in everyday life have shown that non-specific requests for clarification are regularly used by people who are hard of hearing (Pajo, 2013;Laakso et al, 2019), so it is likely that their relative infrequency in the present study relates to the optimal conditions (one-to-one conversation in a quiet room) in which the testing took place.…”

“…However, Laakso et al. (2019) investigated non‐specific requests for clarification in middle‐aged adults with mild to moderate acquired hearing impairment and interlocutors without hearing impairment, finding no difference in frequency of their use between the two groups.…”