Hear, Hear!

By David Baquis

Although people with hearing loss comprise the largest disability group, their needs are poorly understood and often not addressed, even within the disability community.

There are many ways of coping with hearing loss. Assistive technology is just one strategy. Other resources include hearing aids, hearing loss support groups, and educational publications on subjects such as stress control and personal advocacy.

Assistive technologies help people with hearing loss acquire greater confidence in their communication skills, expand their abilities to maintain independent lifestyles and reach their full potential scholastically, professionally and socially. An important challenge to overcome, however, is lack of awareness about what devices and services are out there.

Assistive technology is a broad term that encompasses devices, such as TTYs, as well as related support, such as relay services. Other services include: equipment distribution programs; assistive device demonstration centres; financial aid programs; and legal advocacy services.

Some devices, such as flashing wake-up alarms, were specifically designed to help someone with hearing loss. Other devices, such as personal computers, were originally developed for general purposes, but nevertheless afford important secondary benefits to people with hearing loss. Hearing assistance technologies can be grouped into three categories: listening devices, telecommunications, and alerting devices.

LISTENING DEVICES
An assistive listening system (ALS) is designed to amplify and clarify sound by reducing the effect of distance between the user and the sound source. Such systems can also help minimize background noise and can help compensate for poor acoustics.

There are three types of ALS technologies: inductive loop, infrared and FM. Loops transmit an electromagnetic field, infrared systems emit light waves, and FM systems send radio waves. Each works well, operates without wires, and can be used with or without hearing aids. An array of receiver attachments is available to meet varying individual needs and preferences.

People who use a hearing aid equipped with a telecoil may prefer an inductive loop, since they will not need additional receivers - they simply switch their hearing aid to the T position. Infrared systems offer the advantage of privacy because the light waves they transmit don’t pass through walls. Such systems might be a good choice for courtroom situations. FM systems are portable, making them a popular choice for classroom situations, since both the teacher and student can use battery-operated components, and the student can move around without interfering with reception.

All three systems are susceptible to interference. Loop systems are occasionally affected by electromagnetic fields, but some sources, such as computer monitors, can be turned off at times. Infrared systems can be affected by sunlight or certain fluorescent lights, but a more powerful emitter and a newer model receiver may help compensate for that. Pagers and other radio transmitting devices may affect FM systems. Changing FM frequencies may help.

One key to successful use of any ALS in a meeting situation is effective placement of microphones. For example, during a large meeting, one microphone might be used by a primary speaker, with audience members asked to use side microphones. A cordless FM microphone could also be passed around as needed. For a medium-sized meeting, the tables could be equipped with a single microphone for every two or three people. Conference microphones, which pick up the speech of several people in the vicinity, are also available.

For a small meeting (three to four people) another option would be to use a personal listening device. This involves connecting both a microphone and listening attachment to the same device, an amplifier. This offers two advantages: it is relatively inexpensive ($150-$300) and portable (the size of a deck of cards). Such a device is often used for one-to-one conversations, such as when driving a car or when speaking to a doctor. This is not wireless, so it could not transmit across a distance, although in some cases it can be used with several microphones.

TELECOMMUNICATIONS
People with hearing loss can get information by phone in one of two ways: amplification or text. There are four types of amplifiers: portable, in-line, handset and phone set. Portable amplifiers strap onto the telephone handset. They are convenient for travel but are not usually practical for regular use.

In-line and handset amplifiers are the most popular choices because they are relatively inexpensive and generally equal in effectiveness. Most amplifiers designed for hard of hearing people offer a 20-decibel gain, although devices with gains up to 40 decibels are also available. Some amplification phones offer a differential boost in volume, resulting in a reduction of "muddling" sounds for some users because the low frequencies are not amplified as much as the high ones.

Electronic incompatibility can be a problem: Some amplification handsets do not work on certain phones, as evidenced by a buzzing sound or the inability of one party to hear the other. The problem sometimes occurs at hotels that loan amplifiers to customers to use with their room phones. The cause is related to the type of handset microphone and circuitry being used. The solution may involve obtaining a universal amplifier, which is designed to work with most types of phones.

TTYs allow users to read the text of their phone conversations. One option is for both parties to use a TTY. However, even when the hearing party doesn’t have a TTY, the local telecommunications relay service (such as Bell Relay, 1-800-855-0511, for Ontario and Quebec) can provide an operator to bridge the gap by typing the hearing party’s conversation into the TTY. Instead of typing, a hard of hearing person with clear speech can use a relay service option called "voice carry-over" to respond orally.

While cellular phones may be convenient, some are not hearing-aid compatible, some do not offer amplification, and some do not feature an audio jack that allows connection to attachments for listening through both ears. Vibrating ringers are only available on select models. Digital wireless phones in particular have not generally been shown to work reliably with hearing aids or TTYs at this time, although the industry is working towards a solution for both.

Other telecommunication devices which provide parity for people with hearing loss include fax machines, pagers and integrated wireless products (which may combine fax, pager, TTY and e-mail). Most pagers can vibrate and some display the text of messages. The Internet especially is a boon because it can be used for instant messaging, conference calling and e-mail.

New developments in text telecommunications include a video phone that allows you to see, hear and type to your party, if they have the same equipment. Text-based intercom systems allow office workers to communicate the arrival of a visitor or a phone call by typing a message through an intra-office system. Accessible interactive voice response systems allow TTY users to read audiotext information and use automated attendant phone systems.

Some of the optional services offered by local phone companies hold advantages for people with hearing loss. Caller identification, for example, allows consumers to see the number of a caller on a TV or display box and to return that call through a relay service. Distinctive ringing allows households with both hearing and hard of hearing members to dedicate one number for TTY use and the other for voice calls. Voicemail service allows consumers to listen to messages using amplification devices. These custom calling features require an additional monthly fee.

Like the telephone, there are two ways to know what is said on television: reading captions or listening through amplification. All TVs, 13 inches or greater, sold and manufactured in the U.S. must have closed-caption capability. Older TVs can be modified through the use of a telecaption decoder.

It is also possible to connect inexpensive assistive listening systems to the TV. These allow consumers to hear sounds more clearly without interfering with the enjoyment of other listeners. ALSs can also be used with stereo systems.

ALERTING DEVICES
Smoke alarms, the ringing of a telephone, doorbells, the crying of a baby, wake-up alarms and security systems are some of the producers of sounds that can be transmitted to a person with hearing loss through an alerting device.

The most commonly used systems employ loud ringers, flashing lights or portable vibrators and can range from relatively simple to very sophisticated. For example, a simple telephone light flasher may only cost $30, but it would only be visible at the site where it is installed. A more comprehensive system could signal a consumer to a variety of events through the placing of devices at various points in the house.

Another signalling device, a personal pager, is only about $60. It allows a user to alert someone in the vicinity (via tone or vibration) and does not require a monthly fee like telecommunications pagers.

Two types of alerting devices are available to help drivers with hearing loss. One is an emergency siren indicator that flashes a panel of small lights on the dashboard to signal the approach of an ambulance, fire engine or police car. The other is a turn-signal reminder that flashes a light or makes a progressively louder sound if the driver forgets to turn the signal switch off.

Advocacy is an important component of the effective use of assistive technology. Consumers must understand governing public policies and exercise their rights to acquire and use assistive technology. For example, under the Canadian Charter of Rights and Freedoms every Canadian is guaranteed equal access regardless of disability, and every agency across the country under government regulation is responsible for ensuring this access.

It is important for consumers to make use of resources already in place, since this is one of the best ways to support advocacy efforts to improve public accommodations. In addition, membership in consumer groups can help you learn assertiveness skills and become comfortable using assistive listening devices.

(David Baquis is Director of the Self Help for Hard of Hearing People (SHHH), Inc., National Center on Assistive Technology in Bethesda, Maryland, U.S.A. SHHH is the world’s largest consumer organization of and for people with hearing loss. Call (301) 657-2248; TTY: (301) 657-2249; fax: (301) 913-9413; e-mail: national@shhh.org; or check out the SHHH website, www.shhh.org.)