Designing with the ears in mind: Making user interviews accessible for people with hearing loss

Interviews via video calls are common during the pandemic

Conducting interviews and usability tests are a common practice in user experience (UX) research. Understanding what the users want and need, as well as how to apply them is at the core of user experience research. That’s why it’s even called user experience! But what happens when you are designing products for people who have different communication needs? In order to get the information you need, it is important to develop trust between you and the person you are interviewing. People are more likely to share honestly when they are comfortable and this is especially important when they have different communication needs. How are you supposed to get answers when the person cannot hear your questions? What about if the person communicates using a different language modality, such as sign language?

I want to share some tips that I have learned from my time interviewing people, both hearing and hard of hearing, as well as what I have learned from my close friends who wear hearing aids and how we communicate with each other. Though I am still new to UX and have a lot more to learn, I am confident in my knowledge of communicating with people who have hearing loss, which is what really matters for the purpose of this article. Good communication is necessary when conducting an interview, and Deaf/Hard of Hearing people deserve the same opportunities to contribute. But first, trust must be established.

The role of trust in an interview

It is a crucial first step when beginning an interview to make the interviewee feel at ease. This could look like a bit of small talk at the beginning: asking about their day, if they had any trouble connecting to the online platform, or whether they’ve done a user interview before. Part of making the user feel comfortable includes developing a sort of relationship with them. It is all too common that designers create a product based on their own conceptions of the target users rather than going off of ideas from the users themselves. This can lead to a lack of trust between the interviewer and the interviewee, as there is a sort of power dichotomy at play. Users often want to appease the designer, especially in usability testing scenarios, but also when being asked questions about things like habits. If they feel at all uncomfortable during the interview, they will be more likely to twist their answers in a way that makes them feel less likely to be judged.

Getting the information you are looking for

For example, if you are asking someone about their hearing aid wearing habits, not only do the questions need to be designed in such a way that it evokes an honest answer, but it needs to be delivered in a non-judgemental and trusting atmosphere too. You may need to also circle back and rephrase things to be more clear. I interviewed a person who told me he had no expectations before getting his hearing aids, but later in the interview, he described how he was disappointed that his hearing aids weren’t as expected. It could be possible that he misunderstood or even misheard my first question, which is why it is important to be aware that these inconsistencies may occur. It does not mean that they are not being honest, so do not be entirely dismissive if this scenario comes up. The best thing to do is to use your intuition and rely on your previous experience to filter through the information being gained in an interview. By not being dismissive of any answers, you can further foster trust in the relationship, as the person will feel more confident that they are being listened to and that their thoughts are being taken seriously. You will gain even more insights if the interviewee feels respected and can trust that their contribution is meaningful.

Challenging who you choose as your interview candidates

Consulting with people with hearing loss is key to creating a well-informed and valuable design. This may seem like an obvious design principle, but all too often these people are excluded from the design process of the very products being made for them. This results in user needs not being adequately addressed and creates friction between the users and the company. There tends to be one conception of what an ideal informant looks like, but I want you to challenge this.

What is interactional expertise?

An expert is not just a person with a Ph.D. An expert in your UX research could be an audiologist, but it can also be a person with hearing loss, their close family, work colleagues, and friends. This type of expertise can be defined as “interactional.” Interactional expertise, in this sense, does not just mean having a relationship with someone who wears hearing aids; it is someone who has enough knowledge to contribute to a discussion on the matter. They know the vocabulary around the issue and, while they may not be able to build a hearing aid, they can still effectively communicate with a “traditional” expert, such as an audiologist. They also bring lived experience, meaning they are experts in the part that really matters for designers: How they engage with the devices.

Challenge who you consider to be an expert

I would consider myself an interactional expert as well as having lived experience of communicating with people who use hearing aids. I can have conversations with my boss, an audiologist, and understand his explanations, but most of my knowledge on hearing aids comes directly from seeing my friends use them and even caring for them myself. I know how hard it is for my friend to hear in a gym because we played volleyball together and I had to tailor my own communication methods for him. I know that hearing aid cases aren’t always designed in a way that securely holds the hearing aids in place because I have held my friend’s device while he wore a helmet. It is one thing to study the theory and another to engage with it on a daily basis in multiple different scenarios. That is how I came up with a lot of the tools listed below; I have seen firsthand how challenging it can be to conduct interviews, especially online, with a person who has hearing aids.

Tools that you can use when interviewing people with hearing loss

During my time working as a user experience researcher at a hearing aid company, I had the opportunity to interview numerous people with hearing loss. As I was a newbie, my interview skills were shaky, but I still remembered the communication principles I had learned from interacting with my friends who wear hearing aids. One scenario, in particular, stands out in my mind as a case where better-tailored communication strategies could have made the interview a more comfortable experience. We were interviewing someone who had quite severe hearing loss, so he had learned American Sign Language (ASL) as a new method of communication (in addition to using his hearing aids). When we first began the video call, he immediately could not understand the interviewer, another person on my team. He found her voice too high-pitched, in a range that he simply could not hear. This issue is one that any interviewer may face when working with Deaf and Hard of Hearing communities.

There are a few ways this interview could have moved forward in order to develop a better relationship with the interviewee and ensure that he was comfortable communicating his thoughts in a way that worked best for him. For example, since he had trouble hearing the specific interviewer’s voice, we could have found someone with a lower voice to read the questions. As this is not always a reasonable change for the interviewing team, a different meeting software could have been used so that live captions were available. This would have been an even better option, as even someone with a lower voice might not have been understood perfectly. Finally, as this specific participant knew ASL, having some option for interpretation may have ensured that the participant could participate in the most comfortable method for him. That is again not always a doable change, but one that might want to be considered if you are going to be interviewing people who primarily sign as part of your target users.

I have compiled a list of tips that I have learned both from my friends and from doing interviews with people who wear hearing aids. Each person may have their own preferred method of communication that makes them feel most comfortable, so I am simply presenting some options to consider. I have broken them into various sections, as it is still important to know the communication needs of a person with hearing loss outside of the interview environment.

Specific tips for interviewing people with hearing loss

1. If you are conducting the interview online, use a platform that has captions. Check out this article which goes into great depth about the pros and cons of various platforms.
2. For in-person interviews, offer the use of live transcription services like Otter.ai (you will likely want a transcript for your own use anyways, so allowing it to be seen in real-time can act as a useful transcription service for the interviewee).
3. Have a copy of your interview questions available, in case the person needs to see the question written out — for online interviews, use the chat function to talk if there is something the interviewee is having a hard time understanding (send the questions through the chat or just write out important details such as disclaimers and such).
4. Consider language needs before the interview — what is their primary method of communication, do they know sign language, and how well can they communicate in certain situations (this is especially relevant for remote interviews because hearing through a speaker can be even more challenging when you cannot lip read as effectively).
5. Offer to use any assistive technology they may have, such as a remote mic that allows your voice to stream directly into their hearing aids. Note that not everyone has access to this technology, but do not fear these devices should it come up. My friend, who uses the Phonak Roger Pen, has encountered many people afraid to wear the pen as they believe he was trying to secretly record them. The current devices on the market are simply mics that ensure your voice goes directly into the hearing aids rather than being muddled with background sounds.
6. Organize seating for in-person interviews such that you are able to face each other and your lips are visible. Being able to face each other will ensure you are in the best position for the interviewee to see your lips and facial expressions will help them gain context during the conversation.

There are lots of things interviewers can do to make communicating with a person with hearing loss easier. [Top row] Wear a clear mask so lipreading is easier, print out the questions sheet to make it easier to understand the questions. [Bottom row] Ensure you are communicating in the most appropriate modality, use assistive devices to make your voice stream directly into the participant’s hearing aids.

An additional communication tip during the pandemic

1. For in-person interviews, ensure either appropriately distancing, having a clear barrier, or wearing a mask with a clear window to allow for lip-reading. Be aware that these masks still muffle sound, so you may need to be extra patient when communicating during these circumstances. Communicating over a larger distance may also be more challenging, so this is where something like a remote mic would be extra useful.

General tips for communicating with a person with hearing loss

1. Never dismiss the person. This is one of the most disrespectful things you can do. It may feel frustrating in the moment to have to repeat things a few times, but don’t give up. There are many different methods of communication and there will be one that allows you to get your point across.
2. If someone does not understand your question, it may be because it is too long or uses words that sound a lot like words with other meanings. Rephrasing is ok, but ensure you maintain the spirit of the question so as not to be dismissive, and if they ask you to repeat the exact question, focus on their needs first.
3. Repeat as many times as you have to. This is a part of not dismissing the person. It may seem frustrating to have to repeat things two or three times, but give the person a chance and be respectful. I’m notorious for repeating things infinitely so long as the person requests it, almost to a fault. One of my high school teachers used to tease me when I brought up hearing health in class and say “Sorry, could you repeat that?” over and over again. I always took it seriously because it really matters to me that someone understands what was said. Designers should take it just as seriously, not only when they are interviewing a person with hearing loss, but when communicating with anyone around them. It’s a simple change that shows you care about the other person’s involvement in the conversation.
4. Speak louder and clearer if they ask, but do not over-enunciate or yell. This is a common misconception, as it actually makes it harder to lip read.

Conducting interviews is a huge aspect of UX research and all different kinds of communities should be able to contribute to this work. There may be some atypical steps required to make the interview environment more conducive to someone who wears hearing aids, but all of the communication strategies I have shared are great, simple ways to improve the interview experience. This is especially important to consider during the pandemic, as virtual interviews present unique challenges for hearing aid wearers. I encourage you to follow my suggestions should you interview a client with hearing loss. Even when generally communicating with a person who has hearing loss, these tools should be used regardless, as everyone deserves to be treated with respect, and hearing loss does not only impact people during interviews. Hearing aids are not perfect devices, but as designers, you can make communicating with them a pleasant user experience.

The UX Collective donates US$1 for each article published on our platform. This story contributed to Bay Area Black Designers: a professional development community for Black people who are digital designers and researchers in the San Francisco Bay Area. By joining together in community, members share inspiration, connection, peer mentorship, professional development, resources, feedback, support, and resilience. Silence against systemic racism is not an option. Build the design community you believe in.