Importance of social fluency in hearing healthcare

Our human need for social connections is strong. As hearing care professionals, addressing social fluency can make it easier for your patients to understand the link between hearing well and maintaining social connections.

A husband and wife take a leisurely stroll through their neighbourhood, marvelling at the vibrant colours of the autumn leaves as the season change.

“The colors of the leaves have such beautiful hues”

“Who is Hugh? I don’t think I’ve met him. I did get a chance to catch up with Paul though. He’s going on a cruise next summer”

“Look up, look at the leaves. The seasons are changing and the trees are absolutely beautiful”

“Yes, it is a beautiful day darling”

Following a gentle pat on the hand, they retreat into their own worlds, struggling to maintain meaningful conversation—a scene characteristic of the challenges many with hearing loss face in fluent communication that usually falters into a familiar pattern of disconnected exchanges.

Social connection: A fundamental human need

At the core of human existence lies the innate desire for social connections; about feeling connected, understood, and included in social settings.  The need for social connection in humans is so strong that a lack of it can lead to profound implications to health.1

Looking at Maslow’s hierarchy of needs (see Figure below) once the basics of physiological and safety needs have been met, at the base of Maslow’s pyramid, there comes the need for love and belonging. Love and belongingness encompass the emotional requirement in humans for interpersonal connections, affiliation, a sense of connectedness, and inclusion within a group.2 Additional work conducted by Bowen in 2021 builds on Maslow’s five categories of needs and reframes it to even include communication as a core need of human beings, which without, social relationships would be impossible and could not exist.3

Figure: Maslow’s hierarchy of needs

Beyond speech understanding: Emotional need for social fluency

While speech understanding is a critical aspect of hearing care, there’s an equally important emotional need for social fluency.

Social fluency: Ability to function and be proficient in social situations.
Conversational fluency: Ability to engage in conversations smoothly and effectively.

The importance of social engagement and conversational fluency cannot be overstated in the realm of hearing care. It’s about more than just hearing words; it’s about feeling confident, comfortable, and natural in social interactions, it’s about empowering individuals to fully participate in life’s social moments with confidence and ease.4

This emotional aspect often drives decision-making, as people seek solutions that not only meet their functional needs but also enhance their overall quality of life. However, research suggests that psychosocial support is infrequently provided in audiology clinical practices and can impact not only on the psychological and emotional well-being of our patients but can have a broader impact on a range of physical and cognitive functions.4

The role of decision theory

Research reveals that emotions constitute potent, pervasive, predictable, sometimes harmful and sometimes beneficial drivers of decision making. Decision theory, a framework of how choices are and should be made, tells us that emotions can influence judgments and choices.5

This insight is crucial in understanding why addressing emotional needs is key to convincing potential patients and driving earlier adoption of hearing aids. By emphasizing the importance of social engagement and conversational fluency, hearing care professionals (HCPs) can resonate with individuals on a deeper level and guide them towards optimal hearing solutions sooner.

Phonak’s commitment to holistic hearing care

Phonak recognizes the integral role of social engagement and conversational fluency in enhancing social fluency and enhancing life with hearing aids. That’s why they provide comprehensive training programs like ECHHO (Enhancing Cognitive Health through Hearing Optimization) as well as guidelines on integrating social-emotional well-being into clinical practice.6  

This training equips HCPs with the tools and knowledge to integrate cognitive and socio-emotional elements of well-being into their counseling conversations. By addressing the holistic needs of individuals, Phonak ensures that every interaction is not just about hearing better but also about living better.

To learn more about the ECHHO training program, we invite you to visit our website.

To access the social-emotional well-being and adult hearing loss: clinical recommendations guideline, click here.


  1. Martino, L., Pegg, J., and Frates, E. P. (2015). The connection prescription: Using the power of social interactions and the deep desire for connectedness to empower health and wellness. American Journal of Lifestyle Medicine, 11(6). 466-475. doi: 10.1177/1559827615608788.
  2. McLeod, S. (24 Jan, 2024). Maslow’s Hierarchy of Needs. Simply Psychology. Retrieved from, accessed April, 2024.
  3. Bowen, B. (2021). The Matrix of Needs: Reframing Maslow’s Hierarchy. Health, 13, 538-563. doi: 10.4236/health.2021.135041.
  4. Bennett, R. J,. Barr, C., Cortis, A., Eikelboom, R. H., Ferguson, M., Gerace, D., Heffernan, E., Hickson, L., van Leeuwen, L., Montano, J., Preminger, J. E., Pronk, M., Saunders, G. H., Singh, G., Timmer, B. H. B., Weinstein, B., & Bellekom, S. (2020). Audiological approaches to address the psychosocial needs of adults with hearing loss: perceived benefit and likelihood of use. International Journal of Audiology, 60(sup2). 12-19. doi: 10.1080/14992027.2020.1839680.
  5. Lerner, J. S., Li, Y., Valdesolo, P., & Kassam, K. S. (2015). Emotion and decision making. Annual Review of Psychology, 66, 799–823.
  6. Timmer, B. H. B., Bennett, R. J., Montano, J.,  Hickson, L., Weinstein, B., Wild, J., Ferguson, M., Holman, J. A., LeBeau, V., & Dyre, L. (2023).  Social-emotional well-being and adult hearing loss: clinical recommendations.  International Journal of Audiology. 1-12.

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