The Canadian approach seems to go along with the stat view hearing loss is an issue primarily for older people, they even call it a 'seniors' set up to hammer home the point.
They do seem to not be aware that hearing loss can start at BIRTH, and even young adults from 16yrs of age onward start suffering hearing loss, a lot caused by ignoring volume levels on music equipment etc and playing it back far too loud. Clinically at age 21 approximately, they will lose access to higher frequencies by default. It seems to mirror in part the UK's RNID set up which looks at hearing loss as a clinical issue more than a social thing.
They too promote amplification aids and auditory equipment and such. They do seem pretty vague on 'inclusion' and maintaining hearing loss to hearing peer inclusion. Obviously, technology has been vital in maintaining contact, albeit ZOOM and other platforms don't have a viable speech to text inclusion and there are costs involved for those who want it. It is suggested large groups will present issues for those with hearing loss. The plus with ZOOM is people cannot or should not talk over each other, in that respect makes it easier to follow, but we have lobbied for years that open meetings are badly run and don't insist people speak one at a time and allow backchat to occur that makes it difficult to follow even with help.
Counselling trauma is vital we would like to see this a norm in the UK but it has no system at present that works and there are still cross-communicational issues via sign language usage and lip-reading tuition, education etc that again are non-viable in the UK due to polarised approaches and views on what actually constitutes inclusion.
For those with minor to severe loss, the primary view is maintaining some sort of bridge between them and hearing people. To that end hearing aids, CI's, captioning, subtitling, amplified telephones, are the way they proceed. They also view lip-reading as some 'holy grail' and image, that will make them 'hearing' once again, despite a 90% failure rate of most pupils to attain any realistic skill at it, because of age, disposition, or lack of basic abilities to master, what is a very difficult skill to attain.
A db here or there makes your participation in a class hit and miss, as they are designed to maximise what hearing of use you still have. As classes are open to all where they exist, then the entire class set up can fail if one or two attending, just do not have enough useful hearing to proceed and need obvious one on one help.
This raises a point as to what exactly is the point of them? it isn't obviously assisting those with little useful hearing or those who believe they have more useful hearing that is actually evident to others. In actuality, this means those most in need of counselling and communication help are unlikely to benefit from or able to participate, in such class communal approaches. We are told few tutors expect any real skill to emerge, and the class point is to erect some sort of mini-social set up as an alternative, 'like with like', which will fail obviously once you leave the class.
Trauma can only be alleviated WITH effective hearing options to many, which of course is not the point of the counselling which is to assist you in coping with the fact your limited hearing makes that unviable, facing facts. Even so, no guarantees hearing won't deteriorate with time anyway. This suggests a lip-reading class merely delays the inevitable in that once hearing deteriorates to non-useful status, the pupil can be back to square one, as lip-reading relies on what you may no longer have i.e. useful hearing. Turning your hearing aid off, means the class is pointless.
There doesn't seem to be much organised about hearing loss and how to address or alleviate communication issues. Most of the awareness is over-simplistic and frankly unviable and they all seem to adopt the same mantra which isn't working and has been offset to a large degree by technology, not peer to peer inclusion which, is the whole point, or should be, in addressing hearing loss, not acquiring the latest gizmo.
People need people, and people need to bridge communications between each other face to face, not video to video which suggests isolation no longer exists. Counselling needs to be brutal in part in laying out realistic goals and addressing misconception and denial, it is not clear clinical assessments are the start point. They appear to be treating people that turn up ad hoc. Sign language isn't a magic bullet, or the user of that mode would not need help in following everyone else and demanding nation-wide support to do that, and lip-reading demands skills perhaps you don't have and lip-speakers are not an actuality in the UK as such so if you master it you cannot call on those.
What most need to be told, is reliance is NOT an inevitability of hearing loss IF appropriate tuition and support at day one is there to use, and not given 'Hobson's choice' of this mode or that mode. The reality is that a form of total communication is the best approach and not an and/or one. That enables whilst the other options tend to maintain the status quo. I wonder if counsellors tell patients which they need to acquire? or do they still sit on the fence and 'recognise' cultural views on communication, prioritise over actual need and abilities, adopting the horses for courses approaches?
They don't need to consider cultural want, their patients won't be from those areas. They will need to clarify what the reality is by patients who ask should they go to that area? If hearing is still your bag, then the answer is no, stay clear of cultural area support. As counselling is taking a clinical view of loss, then they should not be sitting on any fence but saying 'this may suit you, but that won't'. No point taking advice if you are not going to follow it.