Improving communication in the home

A guide to helping your clients embrace communication strategies that lead to enhanced communication. It promotes Family-Centered Care and could help improve the well-being of your clients who are spending extra time at home.

Hearing loss can have serious negative consequences for the person with the hearing loss and for those around them. It is associated with social isolation, withdrawal, poor quality of life, and depression. Our role as hearing care professionals is to help adults with hearing loss to become more effective communicators and to provide them with strategies to cope better in everyday life. While we often discuss hearing better in background noise, research shows that for most of our clients the most common and important listening environment is the home. On top of this, the current COVID-19 pandemic means we are all spending a lot more time at home and with family. While talking to speakers who are familiar to us helps speech understanding, families can also sometimes have ineffective communication habits in the home, such as talking to each other from different rooms, or with distractors such as televisions or radios.

Using this time to learn effective communication habits

Now could be an ideal opportunity for hearing care professionals to offer their clients additional communication strategies and the Active Communication Education (ACE) program does just that. The ACE program is an evidence-based group communication awareness, education and training program for adults with acquired hearing loss and their significant others1. It is suitable for those who use hearing aids or not (yet). It is also an ideal stepping stone to amplification and can give great support if your client cannot be provided with hearing aids at this time. For clients who prefer an individual rather than group program, there is the I-ACE which can be self-paced or guided.

Both the group and the individual ACE programs are modular with individual modules to address communication in background noise, communication around the house, communication with difficult speakers, listening to other signals such as TV, radio or telephone, and listening in meetings and other group functions. Each module is designed to empower participants to improve their daily communication via demonstrations, practical activities, discussions, and problem-solving.

All the information required to run the ACE or I-ACE program are freely available at no cost at

Getting your clients started

If you’re not yet familiar with the ACE program, you may choose to offer one I-ACE module to individual clients. Here are some ideas to use the I-ACE Communication around the House module into your clinical practice using eAudiology and help your clients with effective communication at home:

  1. Download the I-ACE resources from the link above
  2. Find the information and exercises for Module 1 – Introduction to I-ACE and email these to your client or call/video-conference with them to do the activities together.
  3. Once your client has completed Module 1 and based on the outcome of the activities, create an individualized Communication in the Home module, using the resources found in Module 3 – Communication around the House. You may find that most clients have similar communication needs and aims and therefore the module may not need a lot of changes to suit your client.
  4. Encourage your client to incorporate the significant others in their household in the exercises – experience shows that it can lead to valuable discussions for everyone.
  5. Depending on their living arrangements and their feedback from Module 1, consider adding some elements from other modules – for example activity 2 in the Communication in Background Noise module which addresses listening in a living room with the family or activity 2 in the TV, Radio and Telephone module.
  6. Email the individualized Communication around the House Module to your client and follow-up with a telephone or video-conference appointment after one or two weeks to discuss the Module and answer any questions.

COVID-19 restrictions have meant that any group sessions cannot be conducted face-to-face but video conferencing platforms such as Zoom, Skype or Teams are ideal for small group virtual meetings. Once you have some experience with the ACE resources, you may find you have clients who are suitable for group ACE sessions. While the I-ACE is excellent in teaching communication strategies, the value in discussing hearing difficulties and solutions with others with hearing loss (and their significant others) adds another dimension of learning and support and most group participants rate those shared experiences as very beneficial.

The challenging times most of us are experiencing right now means we’ve had to pivot to delivering hearing care in different and innovative ways. Structured communication strategies like those provided in the ACE program may go a long way in helping your clients through these times and being evidence-based, will give you the knowledge that you’re providing best practice care.



1 Hickson, L., Worrall, L., & Scarinci, N. (2007). A randomized controlled trial evaluating the active communication education program for older people with hearing impairment. Ear and Hearing, 28(2), 212-230. doi:10.1097/AUD.0b013e31803126c8


We invite you to read a previous blog article by Professor Louise Hickson on the benefits of the ACE program.

To learn more about Family-Centered Care, including resources to help you implement this approach into your practice, please visit our website.

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