The discrepancy between hearing impairment and handicap in the elderly: Balancing transaction and interaction in conversation

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Abstract
Many seniors adapt their conversation to compensate for hearing loss. They may talk more to reduce listening demand, or pretend to understand rather than repairing conversation to recover unheard or misheard information. Such adaptations may differentially affect the transactional and interactional functions of discourse. Clinicians and researchers must appreciate the ‘normal’ bounds of these adaptations. The relationship between auditory and conversational function was explored in a case study of one 80‐year old woman with moderate hearing impairment who had little communication handicap in everyday life but often pretended to understand. She conversed with an audiologist in favorable and unfavorable listening conditions. Comprehension was measured using free and recognition recall, and conversational behaviors were analyzed. Recall was influenced more by the cognitive and emotional‐social engagement of the senior than by auditory status. The findings illustrate how the interactional function of conversation was maintained and how it supported the informational function.