Examining the efficacy of lipreading classes in Scotland – report published

The ALLIANCE Scottish Sensory Hub carried out a review for Scottish Government that highlights considerations for future service planning.

The ALLIANCE Scottish Sensory Hub have published a report following its review – carried out for the Scottish Government – of the efficacy of lipreading classes as an adult aural rehabilitation approach. It highlights considerations for future service planning in Scotland.

Lipreading classes are a form of aural rehabilitation for adults living with deafness. The World Health Organisation (WHO) states that healthcare systems should prioritise rehabilitation, and the Scottish Government aims to alleviate loneliness and isolation, which is particularly relevant for aural rehabilitation because unsupported deafness/poor access to inclusive communication is an established risk factor for both.

The main findings of the review are that lipreading classes are beneficial in terms of improving feelings of well-being and increasing communication confidence. The report highlights several considerations for future service planning:

1. More research to evidence lipreading as a teachable skill. Scottish Higher Education institutions have Audiology, Speech and Language and British Sign Language departments – they may be well placed to offer expertise and targeted research opportunities.
2. More research to understand the cost-effectiveness of lipreading classes/courses and sustainability of income streams for tutors/teachers. It is not clear if lipreading is part of aural rehabilitation as a health/social care pathway, or if it should reside in adult education similar to language learning – or if an alternative approach bridging the two is viable. There may also be overlap or opportunities to develop with BSL, deaf communication courses or other aspects of sensory care.
3. More research on when rehabilitation should be offered relative to receiving a deafness diagnosis. It is important to establish when rehabilitation interventions are most likely to be effective and meaningful for the person living with deafness. There is a need to understand the variance between the offer of rehabilitation being made, and the readiness of the person living with deafness to engage.
4. More research to understand attitudes towards and the demand for lipreading classes as part of, or instead of, other forms of rehabilitation or peer support. A mapping exercise of newly diagnosed people with hearing loss, as well as mapping peer support classes in Scotland, would help clarify what services currently exist with uptake/likely uptake figures.
5. More research to inform inclusive and effective rehabilitation services for people living with dual sensory loss and deafblindness to optimise the brain’s capacity for somatosensory processing.
6. More research to evaluate the cost-effectiveness of providing a one-to-one lipreading service for people living with deafness who feel discouraged from attending group learning (online or in-person), or those who experience sudden and catastrophic acquired profound hearing loss and need a range of intensive supports and inputs.
7. Development of a programme of lipreading with defined start/end points, i.e. beginner, intermediate and advanced classes, complete with learning outcomes and outcome measures, and established time-limited attendance to gain optimal and value-for-money benefit.
8. Creation of a sustainable workforce framework for lipreading tutors to ensure there are viable employment opportunities. Specific consideration may be given to registration and regulation by a governing body to promote a culture of best practice.
9. Development of a sustainable network of lipreading tutors across Scotland, to be in place before any referral pathways from Audiology or other health professions and organisations is implemented to ensure equitable access to lipreading classes. Established methods for obtaining consent for onward referral would be required here.
10. A pilot tested/test for change in a few selected areas of Scotland.
11. Development and provision of courses to include information on the human right to communication as well as the full range of assistive and augmentative tools available such as communication strategies, hearing aids, assistive listening devices (e.g. remote microphones, loop systems, FM systems, mobile technology and digital applications), Electronic Notetakers, speech to text software and knowledge of the limitations of technology.
12. Transitioning away from the historical lipreading approach in favour of designing an innovative and robust system of sensory care which bridges health, social care and education. This might include a programme of learning delivered by tutors/teachers skilled beyond the current lipreading syllabus to provide sustainable return on investment and a more inclusive learning framework suitable across the spectrum of deafness.

The report is available in Word and PDF formats at the links below.

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