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Alerting and Communicating Devices for Deaf and Hard of Hearing People

 For more than 21 million Americans, hearing loss presents many everyday challenges-some large, some small. communication may be the biggest challenge of all-getting and giving information, exchanging ideas, sharing feelings-whether in one-to-one contact, in groups, on the telephone, or through television and radio.

Sometimes there are small disruptions of daily life that result from reduced hearing. Most of us have no need to imagine these disruptions, but they make a difference for the person with a hearing loss. For example, how do you know when there is someone at the door? Or the phone is ringing? Or the baby is crying? How can you enjoy television or movies if you receive little or no information from the sound track? Ask enough of the "How do you..." and " What if..." questions, and inevitably you will get to this one: "Is there anything available that will help deaf and hard of hearing people in these and other situations? The answer is yes.

Many devices and systems are available to help deaf and hard of hearing people improve communication, adapt to their environment, and function in society more effectively.

Who uses these devices?

People with a hearing loss are the primary users. Their family members and friends may use them as well. Individuals with normal hearing may also use the technology (and the actual devices) when distance or other sound barriers impede spoken communication. In fact, some of these devices-such as wrist-worn vibrators, for example-were originally designed for people with normal hearing.

Where do people use these devices?
Just about anywhere. These devices are used at home, at work, at school, at social gatherings, at meeting, in hospitals, in church, in theaters, and some are helpful for hard of hearing listeners in cars.

Why do they use them?
The more than 21 million Americans with hearing loss are individuals who have hearing losses of different degrees and types. For each of these individuals, the experience of hearing loss is different and unique. In general, however, a hearing loss will prevent a person from receiving spoken messages (and many signal sounds) the same way someone with normal hearing receives them. Some hard of hearing people have losses so mild that speaking louder helps; other people do not respond to spoken sound at all and develop there skills in speechreading or sign language to receive messages from others. A device that simply amplifies sound may benefit one deaf or hard of hearing person may need a device that offers a visual or vibrotactile component to convey the signal.

These alternatives are available. The main point is that people with hearing loss use such devices because they work and because they offer a means of being tuned in-conveniently-to the larger society.

Telephone Aids
The telephone has proved to be a formidable challenge to people with hearing loss. It's a challenge being met daily. Some deaf and hard of hearing people make use of devices that strengthens a phone's auditory signal; others use devices that communicate in a print format.

Telecommunication Devices for Deaf People (TTY's)
TTY permits conversations in print, rather than in voice Two callers with compatible TTY's can communicate over regular phone lines. Their TTY's have typewriter keyboards, and the typed conversation appears either in a readout panel (display) or on paper. Although called telecommunication devices for deaf people, TTYs are recently used by people with varying degrees of hearing loss and also by hearing people who want direct phone contact with their deaf or hard of hearing family members, friends, colleagues, or clients.

When a deaf or hard of hearing user wants to call a hearing person who lacks a TTY, a TTY message-relay (or answering service) is required. In this third-party arrangement, the dual party operator uses two telephones-one in conjunction with a TTY-to complete the call.

The procedure is simple. Either a person with a normal hearing or a person with a hearing loss can initiate the call. Let's assume that a person with a hearing loss wants to call his doctor to make an appointment. Using his TTY, he calls the relay service. The relay service operator reads the message typed by the caller, dials the doctor's office using the second telephone, and by voice conveys the message typed by the TTY user. The conversation proceeds with the relay service operator servicing as a bridge-print to voice to communicate between the two parties. The nation wide number for the relay service in the United States is 711. Either voice or TTY user can use this number to place a call with the relay service. More information about the relay service can be obtained through this number.

Various TTY models are available, many of them portable, lightweight, and powered by household current or rechargeable battery pack. Those with computer compatibility enable owners to access special communication "mail" net-works such as DEAFNET.Computer-compatible TTY's also allow conversation between TTY users and computer users.

Under the Americans with Disabilities act (ADA), telephone companies will be required to provide dual party relay systems nationwide.

Phone in Public Places
Amplifier handsets installed in public telephones are a real convenience for individuals with a hearing loss who require amplification to complete calls successfully. The telephone access sign identifies the availability of such handsets at airports, bus and train stations, museums, and telephone kiosks on the streets. Some hotels are installing amplifier handsets in some lobby phones, but may not identify them with an access sign. While such handsets are not universally available in public places, they are becoming more common.

Pay telephone and emergency telephones are being modified for compatibility with all hearing aids having the telephone switch, thus assuring this type of telephone access for those who need it.

For TTY users who need to make a telephone call from an airport, bus station or any public telephone location, this pay telephone is now accessible with the new pay phone TTY.

The pay phone TTY is a TTY inside a metal drawer underneath the public telephone. A protective metal cabinet prevents vandals from tampering with the TDD. When the TDD is in use, the drawer is open so that the keyboard and displayed are exposed. When making a phone call, the caller simply lifts the telephone handset, inserts a coin, and dials the number just like any pay telephone call. The pay TTY listens to the telephone line for the sounds of another TTY. When the person answering begins to type the drawer contain the TTY slides out

When the conversation ends, the pay TTY automatically closes the drawer, erases the memory and returns the telephone to normal operation. Once closed, the drawer cannot be open unless another TTY call is made.

Amplification Devices for Telephone Use
The telephone handset may be specially wired with an amplification device. Such volume control handset may provide up to 30 percent additional power for the listener who has a hearing loss. They may be used with or without an individual's hearing aid.

Portable amplifiers are small devices that can be carried in a purse or briefcase and slipped over the receiver of a regular telephone handset to provide increased amplification. They can be especially useful for travelers who are unable to find a pay phone with the amplifier handset, but who cannot manage telephone calls without such amplification. Portable amplifiers do not work with all phones. They are not compatible with princess, Trimline, or Slimline models, for example, since these phones do not emit sufficient magnetic leakage. Sometimes telephone adapters resolve this incompatibility.

Telephone adapters work with the hearing aid's telephone pickup feature, which is called the telecoil, telephone switch, or T-switch. A portable device slipped over the receiver, the telephone adapter does not amplify sound; it simply generates a magnetic field on which the hearing aid T-switch depends for proper operation. This adapter is necessary for the hearing aid wearer who uses Pirncess, Trimline, or Slmline phone or non-AT&T telephones. Many newer phones do not work either with the T-switch or the portable amplifier. And telephone adapters themselves vary in the amount of magnetic leakage they emit Thus, it's mandatory to find out-before buying-whether a particular phone is compatible with a hearing aid, or a portable amplifier.

Television and Film Access
Telecaption Adapters

There are a few features available for captioning. The most recent development is the Television Decoder Circuitry Act. This law mandated that all television set with screens 13 inches or larger that are manufactured for sale in the United States after July 1, 1993 must contain a built in captioning decoding capability.

The other features available are decoders, such as the TeleCaption II Adapter, that are attached to television sets enable viewers to read captions on their television screen. The signal is carried invisibly; only when the decoder is in operation can captions be seen. More than 400 hours of television viewing are captioned each week, including all of ABC's prime time and most network movies. Cable television distributors are also arranging to caption some of their programs and movies. The National Captioning Institute also has captioned more than 700 video titles for use on videocassette recorders (VCR). Therefore persons with hearing loss, can access to the airwaves is increasing, making more attractive the consumer investment of about $200 in such devices.

Captioned Film/Video Programs
On August 7, 1997 the Federal Communications Commissions adopted order to include roles and implementation schedule for the captioning of video programs access to including video programming for a person with hearing disabilities. A service rather than a device, Captioned Film/Video program is a distribution program for feature and education films captioned for viewers who are deaf. To receive the films, deaf or hard of hearing people must form a group and apply for membership to Captioned Film/Video Program, Captioned film groups may meet in members home, schools halls, senior centers, and nursing homes for regular showing of films chosen from the captioned films catalog. The only cost to the group is the postage charge for returning the 16mm films to the Distribution office.

Alerting Devices/Systems
How does a person with a hearing loss know when there is a knock at the door? Or the baby's crying? Or the telephone is ringing? Or the alarm clock is buzzing? The various alerting and alarm systems that signal deaf and hard of hearing people include: baby-cry alarms, doorbell alerting systems, paging devices, telephone signaling systems, smoke alarm systems, security alarms, and wake up alarms. The signal may be visual (a flashing light); auditory (an increase in amplification); or vibrotactile (a vibrator). If an alarm clock is wired to a vibrator placed under the bed pillow, the user is literally shaken awake. Auditory signals are sometimes used in conjunction with either visual or vibratory signals. Sometimes a single flashing light signaling system installed in a deaf or hard of hearing person's home may be wired to alert the person to several different sounds: for example. When the light flashes how does the person know where to go? A simple code helps identify the source of the sound: three slow flashes may mean the doorbell; three quick flashes may mean the telephone; regular on-off flashes may signal the baby's cries.

Listening Devices and Systems
As a benefit of modern technology, a number of amplification systems are now available to compensate for a hearing loss. In addition to the aforementioned telephone aids, there are listening enhancement system for group and individual use. Any of these systems and devices may be incorporated into an existing facility or room.

Communication Access Systems for Groups and Large Rooms
In a large room, a person with a hearing loss-even with a powerful hearing aid-may have difficulty understanding the voice of the speaker on the stage on the screen, at the podium, or in the pulpit. Background noise and room reverberation compete with speech sounds and exxaggerate the listening problems experience by hard of hearing people in such settings. However, a number of electronic systems can help overcome the problems by bringing the speaker closer to the ears of the listener and by eliminating much of the background noise. Each large room hearing enhancement system has two major components: 1) a transmitter that sends the signals and 2) a receiver that picks up those signals and delivers them at increased sound levels into the ears or hearing aids of people with a hearing loss-wherever they may be sitting. Among the general categories of communication access systems for groups and large rooms are audio loops systems, AM systems, FM sound systems and infrared systems.

Audio Loop Systems
The components of a "loop" system are a microphone, an amplifier, and a length of wire that loops the seating area. Some loops are connected to standard public address systems. The electric current flowing through the loop creates a magnetic field that can be picked up by a hearing aid set on the T-Switch. Portable receivers are available for hard of hearing individual without a hearing aid T-switch. To pick up the signals, listeners must sit within or near the loop.

AM Systems
Users listen to sound transmitted on the AM radio wavelength through individual AM receiver headsets or through a personal portable radio. The AM transmitter can be connected to a public address system or can operate alone, depending on the system installed. AM systems are subject to the same kind of interference from electrical apparatus or thunderstorm that affects regular AM radio transmissions.

FM (frequency modulation) Systems
FM systems, originally designed for and restricted to classroom use, are now benefiting hard of hearing users in general society. They work in this way: Sound is picked up at the source and transmitted via a FM frequency directly to a receiver worn by the individual with a hearing loss. Since transmission can occur over a 300-foot range, this system is ideal for group situations, including meetings in dining rooms and lounges, church services, and theaters. The FM system can be used in conjunction with an individual's hearing aid. To work in tandem with the FM system, the hearing aid must have a T-switch turned to the "T" position, or there must be a means for direct audio input to the hearing aid. In the first instance, a small "necklace" loop worn around the neck connects to the individually worn FM receiver. The signals are picked up by the T-switch of the hearing aid. In the case of direct audio input, the FM system is linked to the hearing aid by way of a "boot," a special attachment that slips onto the bottom of a behind-the- ear hearing aid. The "boot" is connecting to the receiver by the wire. Both "neck-lace" loops and "boot" attachments can be connected to an external microphone or amplifier.

Infrared Systems
Like FM systems, infrared systems are useful in-group situations and may be adapted for individual use as well. These large area systems require the installation of an infrared light emitter that is plugged into the existing public address system. Harmless infrared light rays transmit the sound to portable infrared receivers, which are available in "stethoscope" or headphone form. Usually the receivers for such systems are distributed and collected from a central place in the theater, auditorium, or meeting room. Any group considering a communication access system for a large area must review carefully all the alternatives before making any decisions. Among the question to ask are: How much does the system cost? Will a less expansive alternative work as well? How suitable is the system for the particular room and the intended user? Does installation require trained personnel (a thus is more expensive) or is it possible to do it yourself? What are the advantages and disadvantages of each system? "Communication Access Systems for Groups and Large Rooms," a chart published by Self-Help for Hard of Hearing People, Inc, will help. It compares the various systems, describing their components, their suitability for different settings, their cost, etc., in a simple-to-scan grid format.

Personal Listening Devices
The listening enhancement device most familiar to the public is the hearing aid. Because hearing aids are fitted only after extensive testing by trained professionals, they will not be treated as part of this general discussion of assistive devices. However, the condition of an individual's hearing aid has directed bearing on the effective use of several of the systems described here. An individual whose hearing aid or hearing aid T- switch does not function well will not notice significant benefits from loops, FM systems, or other amplification enhancements devices used in conjunction with the aid.

Situation involving a few other people (small group discussions, dinner table conversations, social gatherings) or noisy environments (auto rides, cafeteria meals, out-of-doors activities) easily qualify for the name "difficult listening." Some of the difficulty experience by people in such situations may be minimized by the use of person listening systems. Composed of a small microphone, receiver, and amplifier, these systems convey the amplified speech signal directly from the microphone to the listener's aided or unaided ear. Other sounds are thus reduced in comparison to the speech signal.

Some of these devices are hard-wired, meaning that an actual wire connects the device worn by the user to the sound source located near the person speaking. Other of these devices are wire-less and permit unimpeded motion, the possibility of use out-of-doors, and even, as with FM, the capability of hearing the speech signal outside the place which it originates.

When used with television or radio, such devices allow the person with a hearing loss to adjust the volume on a receiver or hearing aid without disturbing the listening comfort of others in the same room.

The technology of large room systems may appear in these personal listening devices. Personal FM listening systems may be adapted for use while walking, in cars and vans, and even for television and radio listening. Individual infrared systems are available for person use. It is possible to loop a living room, a section of a room, a desk in an office, or a chair inexpensively both for television and conversational listening. With components purchased from commercial electronics outlets, it is possible to put together an inexpensive hardwired listening system for personal use.

Such personal listening aids may use specially designed receivers (as in the case of infrared systems) or commercially available headsets, or they may work in conjunction with the hearing aid T-switch. An example is the "necklace" to loop described earlier that may be connected to a FM or hard-wired receiver.

Some individuals make their own neckloops. To them, a word or caution: there may be an electric shock hazard to the user when a neckloop with insufficient wire insulation is plugged into a portable AC-powered television set.

How does a person decide which of these options is best? Aside from the questions of cost, there is the question of suitability. A personal listening device that works for one person may not be an appropriate choice for another. Is the sound quality clear? Is the amplification sufficient? Is the device easy to use? The only way to get answers to these questions is to try out several such devices and compare them critically and carefully.

What is the next step?
What are the right devices for me?
Ask your audiologist to refer you to a demonstration center where these various devices are on display. If there are none in your area, ask your audiologist to help you try out various personal listening systems and alerting devices. Do not buy anything unless you can arrange for a 30 day-trail with the assurance that you can get most of your money back if you decide not to buy. Check on warranty before buying as well. During the trial period use the device in a variety of everyday situations so you will have a realistic idea of their suitability.

What will people think?
Most people are remarkable able and willing to do their part-if you tell them what they must do and how to do it. Involving others is the first step in any communication. There's an added benefit to involving friends and acquaintances in your attempts to use such devices: they will be able to share what they've learned about these devices with others and help others to the same convenience you've found.

Where can I get more information about such devices?
Various community agencies serving deaf and hard of hearing people have small centers with demonstration models of different devices. A local audiology or speech, language, and hearing center or university training center in the speech, language, and hearing sciences may have the technology or may be able to help you locate such centers in your regions. Also contact manufacturers of devices or resources near to you to get information about specific devices. The following resources provide descriptive information about various devices and their availability.

8630 Fenton Street, Suite #930 
Silver Spring, MD 20910
V (800)227-0216
TTY: (301) 608-8912
Fax: (301) 608-8958
Email: ABLEDATA@verizon.net  
Web page: http://www.abledata.com

Alexander Graham Bell Association for the Deaf, Inc.
3417 Volta Place NW
Washington, DC 20007
Voice/ TTY: (202) 337-5220
Fax: (202) 337-8314
Email: info@agbell.org  
Web Page: http://www.agbell.org

Described and Captioned Media Program
National Association of the Deaf
1447 E. Main Street
Spartanbrug, SC 29307
Voice: 864-585-1788
TTY: 864-585-2617
Fax: 864-585-2611
Toll Free:
Voice: (800) 237-6213
TTY: (800) 237-6819
Fax: (800) 538-5636
Email: info@cfv.dcmp.org  
Web Page:  http://www.dcmp.org

National Association of the Deaf
8630 Fenton Street, Suite # 820
Silver Spring, MD 20910-3819
Voice: (301) 587-1788
TTY: (301) 587-1789
Fax: (301) 587-1791 
Web Page: http://www.nad.org

National Captioning Institute
1900 Gallows Road, Suite #3000
Vienna, VA 22182
Voice/TTY: (703) 917-7600
Fax: (703) 917-9853

Hearingloss Association of America 
7910 Woodmont Ave., Suite #1200 
Bethesda, MD 20814
TTY/Voice: (301) 657-2249 
Fax: (301) 913-9413
Web Page: http://www.hearingloss.org

Telecommunication for the Deaf, Inc.
8630 Fenton Street, Suite #604
Silver Spring, MD 20910
Voice: (301) 589-3786
TTY: (301) 589-3006
Fax: (301) 598-3797
Web Page: http://www.tdi-online.org/

ASHA provides public information about communication disorders, including deafness and the role of speech and hearing professionals in rehabilitation. Informational materials and Helpline is provided for inquires about speech, language or hearing problems.

American Speech-Language Hearing Association
2200 Research Blvd. 
Rockville MD 20850-3289
HELPLINE: (800) 638-8255 (VOICE/TTY)
FAX: (301) 296-8580
Email: actioncenter@asha.org
Web Page: http://www.asha.org

Originally written by:
Loraine DiPietro, M.A.; Pettyt Williams, Ph.D.; Hariet Kaplan, Ph.D.*