Miscellaneous

Hearing Amplification

Amplification Options

Amplification can refer to either personal amplification (e.g., hearing aids, cochlear implants) or assisted listening systems [e.g., frequency modulated (FM) systems, infrared systems] designed for group situations such as classrooms.

Hearing Aids

Hearing aids are available in a variety of styles and circuitry. Styles include hearing aids worn behind the ear, in the ear, or in the ear canal. Circuits, which are the internal electronic parts of the hearing aid, can be fitted to a child's hearing loss and also provide switches for talking on the telephone. Most often, hearing aids are fit for both ears-binaural hearing aids. This is especially true for children, since the idea is to provide them with listening opportunities that are similar to those of other children.

Although there are many options in hearing aids, they all have the following three basic parts:

Hearing aids can have remote controls, built-in volume control, computer programming, and other adjustments. The audiologist is your resource for information about how hearing aids work, those that may best meet your child's hearing needs, and for answering questions about your child's adjustment to amplification.

Care of the hearing aid is important. It is an expensive instrument that requires daily care. It should be kept dry and in the same place every day. Pets or toddlers can quickly chew or play with a hearing aid and break it. Hearing aid batteries are small and frequently of great curiosity to young children who like to put them in their mouth. Batteries can be harmful if swallowed.

Assistive Listening Systems

Some listening situations are more difficult to handle than others because of background noise or the sound source is too far away. So even when wearing hearing aids, other listening devices can be helpful. The percentage of useful information (speech) compared to the background (noise) is called signal-to-noise ratio. Assistive Listening Systems improve the signal-to-noise ratio by placing a second microphone closer to the sound source.

FM Listening Systems

To improve listening for people with hearing loss, audiologists recommend FM systems. These systems function like a radio station. The speaker's voice is picked up through a microphone (the speaker is the radio station) and transmitted to the child's hearing aids through a receiver. Cords are used to deliver the sound to the hearing aids. FM systems reduce the background noise level and help the individual hear the speaker's voice.

Cochlear Implants

When it has been determined that there is little or no benefit from the use of hearing aids or listening systems in the perception or understanding of environmental sounds and speech, a cochlear implant may be considered. This surgically implanted hearing device captures sound and transforms it into electrical impulses that are channeled directly to the auditory nerve. By stimulating this nerve, and thereby the auditory portion of the brain, the child can gain a perception of sound and learn to interpret speech sounds. The success of cochlear implants varies from no improvement, to some sound detection and awareness, to the ability to understand and develop speech. As with other assistive listening devices, intensive auditory training and an auditory-rich environment increases the probability of success with a cochlear implant. If you are under the impression, like many, that CIs are a “cure” for deafness, you are mistaken. Many people, including the author, have derived no benefit from such a device.

Every Day Aids

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.

Teletypewriters (TTY’s) -- also called Telecommunication Devices for Deaf People (TDD'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, it is necessary to contact the relay. 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.

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.

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. 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. 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.

Captioning

What is closed captioning?

Like subtitles on movies, captions are transcriptions of the spoken word into a written form that permit deaf and hard of hearing people to see what they cannot hear. Unlike subtitles, captions also provide descriptions of sounds, such as a bell ringing or a door slamming. There are two kinds of captioning-open and closed. Open captions always appear on the screen, while closed captions are carried in the television signal in hidden form and must be "opened" (electronically decoded) to be seen. Closed captioning is the process whereby captions are converted to electronic codes and inserted in the regular television signal, specifically on Line 21, a portion of the picture normally not seen. There are 525 horizontal lines in the television picture. Line 21 appears at the top of the picture and occurs just prior to the start of the lines carrying picture information.

How are closed captions accessed?

Closed captions are hidden within normal television broadcasts and on videotapes and DVD's. All you need is a television with the built-in caption decoder chip or an external decoder to make the captions visible. There's no special service to subscribe to in order to receive the captions. Rather, captioning is made free for all viewers by the television and home video industries and with the support of grants and donations.

Just look for NCI's registered trademarks, which mean a program or video has been captioned by the National Captioning Institute. Or you can look for the generic (CC) symbol that also indicates a program is captioned.

Is closed captioning of television programming required?

Congress passed The Telecommunications Act of 1996, a law requiring video program distributors (cable operators, broadcasters, and satellite distributors) to phase in closed captioning of their television programs. The law does not require captioning of VHS or DVD home video releases or video games.

The Federal Communications Commission (FCC) has prescribed rules and implementation schedules for the captioning of video programming for television broadcasts. They have established an eight-year transition period starting on January 1, 1998 for the captioning of new video programming in English. At the end of the transition period, 100% of all non-exempt new programs must be captioned. Here is the schedule:

• January 1, 2002: average of 10 hours per day (50%)
• January 1, 2004: average of 15 hours per day (75%)
• January 1, 2006: average of 20 hours per day (100%)

No captioning is required between 2:00 am and 6:00 am.

For programming first exhibited before January 1, 1998 ("pre-rule programming"), the FCC has established a ten-year transition period. The FCC has ruled that at least 30% of a channel's pre-rule programming be provided with captions beginning on January 1, 2003, and that at least 75% of such programming be captioned by the end of the transition period in 2008.

Correct Terminology for Deaf & Hard of Hearing People

What term should I use to describe people who are deaf or have hearing losses? And what is wrong with the use of these terms: "Deaf-mute", "Deaf and dumb", or "Hearing-impaired"?

Deaf and hard of hearing people have the right to choose what they wish to be called, either as a group or on an individual basis. Overwhelmingly, deaf and hard of hearing people prefer to be called "deaf" or "hard of hearing".

Yet there are many people who persist in using terms other than "deaf" and "hard of hearing". The alternative terms are often seen in print, heard on radio and television, and picked up in casual conversations all over. Let's take a look at the three most-used alternative terms.

Deaf and Dumb -- A relic from the medieval English era, this is the granddaddy of all negative labels pinned on deaf and hard of hearing people. The Greek philosopher, Aristotle, pronounced us "deaf and dumb", because he felt that deaf people were incapable of being taught, of learning, and of reasoned thinking. To his way of thinking, if a person could not use his/her voice in the same way as hearing people, then there was no way that this person could develop cognitive abilities.

In later years, "dumb" came to mean "silent". This definition still persists, because that is how people see deaf people. The term is offensive to deaf and hard of hearing people for a number of reasons. One, deaf and hard of hearing people are by no means "silent" at all. They use sign language, lip-reading, vocalizations, and so on to communicate. Communication is not reserved for hearing people alone, and using one's voice is not the only way to communicate. Two, "dumb" also has a second meaning: stupid. Deaf and hard of hearing people have encountered plenty of people who subscribe to the philosophy that if you cannot use your voice well, you don't have much else "upstairs", and have nothing going for you. Obviously, this is incorrect, ill-informed, and false. Deaf and hard of hearing people have repeatedly proved that they have much to contribute to the society at large.

Deaf-Mute -- Another offensive term from the 18th-19th century, "mute" also means silent and without voice. This label is technically inaccurate, since deaf and hard of hearing people generally have functioning vocal chords. The problem lies with the fact that to successfully modulate your voice, you need to be able to hear your own voice. Again, because deaf and hard of hearing people use various methods of communication other than using their voices, they are not truly mute. True communication occurs when one's message is understood by others, and they can respond in kind.

Hearing-impaired -- A term much preferred by hearing people, largely because they view it as politically correct. In the mainstream society, to boldly state one's disability (e.g., deaf, blind, etc.) is somewhat rude and impolite. To their way of thinking, it is far better to soften the harsh reality by using the word "impaired" along with "visual", "hearing", and so on. "hearing-impaired" is a well-meaning word that is much-resented by deaf and hard of hearing people.

Deaf and hard of hearing people feel that the words "deaf" and "hard of hearing" are not negative in any way at all. Indeed, the deaf and hard of hearing community views "hearing-impaired" as negative, because the label focuses on what they can't do. With this label, a standard has been set: the "hearing" standard. To be anything other than "hearing" is not acceptable to the mainstream society, and deaf and hard of hearing people have failed to meet the "standard". To be fair, this is probably what hearing people did not intend to convey to deaf and hard of hearing people every time they use "hearing impaired" as a label. Deaf and hard of hearing people believe that there is nothing wrong with them, and that their culture, language, and community are just as fulfilling as the ones experienced by the mainstream society.

What Is The Difference Between a Deaf and a Hard of Hearing Person?

The deaf and hard of hearing community is very diverse, differing greatly on the cause and degree of hearing loss, age at the onset, educational background, communication methods, and how they feel about their hearing loss. How a person "labels" themselves in terms of their hearing loss is personal and may reflect identification with the deaf community or merely how their hearing loss affects their ability to communicate. They can either be deaf, Deaf, or hard of hearing.

People lose their hearing in various ways. The most common causes of hearing loss are:

• Childhood illnesses (spinal meningitis and rubella/German measles are the most common examples);
• Pregnancy-related illnesses (such as rubella/German measles or dependence on drugs/alcohol);
• Injury (a severe blow to the head can damage the hearing);
• Excessive or prolonged exposure to noise;
• Heredity (scientists involved with the mapping of the Human Genome Project have identified approximately fifty (50) "deaf" genes to date, and they are working on identifying the remaining 350 "deaf" genes)
• Aging (progressive deterioration of hearing in older people, which is a natural part of aging process)

Definition of Hard of Hearing

The term "hard of hearing" refers to those who have some hearing, are able to use it for communication purposes, and who feel reasonably comfortable doing so. A hard of hearing person, in audiological terms, may have a mild to moderate hearing loss. The terms "deaf" and "Deaf" have been described above. What about "hard of hearing"? To answer this question, we turn to Deaf Life magazine's "For Hearing People Only" article (October 1997, page

"'Hard-of-hearing' can denote a person with a mild-to-moderate hearing loss. Or it can denote a deaf person who doesn't have/want any cultural affiliation with the Deaf community. Or both. The HOH dilemma: in some ways hearing, in some ways deaf, in others, neither."

Later in that same article, the term is analyzed further:

"Can one be hard-of-hearing and ASL-Deaf? That's possible, too. Can one be hard-of-hearing and function as hearing? Of course. What about being hard-of-hearing and functioning as a member of both the hearing and Deaf communities? That's a delicate tightrope-balancing act, but it too is possible.

As for the political dimension: HOH people can be allies of the Deaf community. They can choose to join or to ignore it. They can participate in the social, cultural, political, and legal life of the community along with culturally-Deaf or live their lives completely within the parameters of the 'Hearing world.' But they may have a more difficult time establishing a satisfying cultural/social identity."

For everyone with a hearing loss, it is a matter of deciding whether to treat it as an audiological perspective or as a cultural lifestyle. It's all about choices, comfort level, mode of communication, and acceptance of hearing loss. Whatever the decision, the NAD represents all deaf and hard of hearing Americans, and advocacy work that the NAD does is of benefit to everyone, regardless of the type of hearing loss and background.

Americans With Disability Act

WHAT IS THE ADA?

The Americans with Disabilities Act (ADA) is a law that prohibits discrimination against people with disabilities, including deaf and hard of hearing people. There are four sections in the law: employment, government, public accommodations, and telecommunications. Each section of the ADA lists services that should be provided for deaf individuals. The ADA adds more protection for handicapped persons to the Rehabilitation Act of 1973.

In general, the ADA expects agencies, businesses, service providers, and employers to remove barriers that prevent a deaf person from participating. Some of the rules are being added gradually, so organizations can have time to make the changes.

The law does allow for some exceptions, when the changes that would be needed would cost too much. If an agency or business cannot make all the changes, the law says they must try to do as much as possible to become accessible for deaf and hearing impaired persons.

The law also says you need to tell agencies and businesses what you need to communicate. Notes, interpreters, and telecommunication devices for the deaf (TTYs) are all ways to communicate, but you need to let providers know what you are comfortable using.

PUBLIC ACCOMMODATIONS

Stores, Businesses, hotels, theaters, restaurants, retail stores, banks, museums, parks, libraries, and private schools should all provide auxiliary aids and services for communicating with deaf people. Sometimes, written notes are enough to communicate information. At other times, an assistive listening device, TTY, or an interpreter is needed.

Public accommodations or businesses like hotels must provide TTYs when phones are available for the general public.

Movie theaters do not have to provide captioned films, but other places that present information on film or TV should either caption the presentation or provide an interpreter. Aids for deaf and hearing impaired should be provided for presentations at conventions or performances at a hotel.

MEDICAL TREATMENT

Hospitals that receive money from the U.S. government must provide equal services to deaf persons. Hospitals must be sure deaf persons can communicate with doctors and nurses. When important communication is needed, the ADA says the hospital must provide a qualified interpreter. If you need to stay in the hospital and have a television in your room, the hospital must provide a decoding device for closed caption viewing. The hospital must also provide you with a TTY. Classes given to the general public must also be open for deaf persons to attend. Private practice doctors are also required to follow the ADA laws. Communication is just as important at the doctor's office as it is at the hospital. Ask for an interpreter or assistive listening device. The doctor's office should provide this at no charge.

EMPLOYMENT

The ADA says employers cannot discriminate in the job application process, hiring, firing, salary/pay, promotion, or any other benefit of being an employee. This means a qualified interpreter should be available for a job interview. If a verbal test is part of the job application process, the employer should provide an appropriate written test for a deaf applicant.

The deaf person should be able to do the most important parts of the job without assistance. Employers should change a job whenever possible to allow a deaf or hearing impaired person the opportunity to do the job. If answering the phone is one small part of the job and you can do the other parts of the job by yourself, your employer should assign the phone duties to someone else.

The ADA covers employers with more than 15 employees.