Don’t Forget Assistive Listening Devices: They’re Not What They Used to Be

assistive listening devices hearing loss
Paul Teie
March 1, 2021

All a person has to do to hear better is to wear hearing aids.  Slap on a pair and the world will be your oyster.  No more problems.  Easy peasy!  

Or maybe not?  Definitely not!  Hearing aids are a tool.  All too often it is the only tool offered to our patients.  In that we do our patients a disservice because there are so many other useful implements at our disposal.  

Good old-fashioned aural rehab (or as my mentor Henry Tobin used to insist on calling it – audiologic habilitation) gets way too short shrift these days.  It doesn’t pay, it’s too time-consuming and convincing patients it’s time well-spent isn’t easy.  I get it.  But still, it’s a shame.  I’m not saying we should be teaching cued speech.  But a simple list of suggested behavior adjustments would be extremely helpful to most of our patients.  I used to give out a document I called The Rules (for family and friends of hearing impaired people) that noted that hearing aids do not restore “normal” hearing and listed a few simple steps they could employ to make everyone’s lives a little more pleasant.  I recently blew the dust off an old copy and gave it to my mother-in-law who had been experiencing issues with one of her daughters’ unrealistic expectations. 

And then there are assistive listening devices.  We should be routinely talking to our patients about these extremely helpful tools. 


Assistive Listening Devices (ALDs)


ALDs enhance the effectiveness of hearing aids and help fill some of the gaps in the utility of even the most technologically advanced devices.  This is particularly true for patients with more severe hearing loss, significant signal to noise ratio loss (as quantified by QuickSIN) and poor word recognition ability. We know that hearing aids can do only so much for some of these patients.  

Patients with particularly poor understanding of speech in noisy environments are likely to receive little or no benefit from those multi-channel automatic and adaptive directional microphones we are so proud of.  To improve their performance in noise they may well require technologies like streaming remote microphones to improve signal-to-noise ratio (ain’t Bluetooth grand!). 

It used to be a heavy lift to convince our patients to invest in a $2,000 FM system when they had just paid several thousand dollars for their hearing aids. These remote mics do pretty much the same job at much lower cost. 

Other complementary assistive devices, such as the Neosensory Buzz, can also provide additional sound awareness and speech discrimination improvements for individuals with severe-to-profound hearing losses. 


Telecoils and Smartphones Apps


Even as states like New York have passed legislation to improve accessibility to t-coils, recommendation of that tried-and-true technology seems to be waning in some quarters.  The phone application may be somewhat less urgent with the decline of landline phones, the advent of Bluetooth, and the inconvenience of finding a cell phone that is compatible.  And an adhesive magnet just does not cry out “high tech.” But still, there are plenty of situations where the t-coil can be useful in looped public spaces.   

Apple’s Facetime, ubiquitous as it is, is an assistive listening device you may not have thought of.  We know how much easier it is for our patients to “hear” when they can see the speakers’ face.  Combine this with the sound being streamed via Bluetooth to both ears and even patients with the poorest WR will do better.   

There are tons of other smart phone apps that our patients may find useful.  The following list is certainly not exhaustive and may well be partially obsolete by the time I finish writing this article, but here are just a few: 

  • CaptionCall Mobile:
    • CaptionCall is a no-cost captioning service that provides captioning of calls for people with hearing loss that need captioning to use the phone effectively. It is provided under the Americans with Disabilities Act. Advanced technology and live captioning agents deliver fast and accurate captions of what a caller is saying. If you miss calls, CaptionCall saves a voice message with captioning. CaptionCall Mobile is available for both Apple and Android devices
  • Google Live Transcribe – 
    • This is a real-time transcription of speech into text.  Words spoken appear on the phone of the person who has the app.  It works for 70 different languages.
  • AVA
    • Lip reading can be more difficult in a group of people and this is one of the main reasons AVA was created.  Friends connect to the app – then the person who has hearing loss will see live transcriptions of the group conversation.  The speech is picked up using the phone’s microphone and on screen the name of the person talking is displayed in front of what that person says.
  • Rogervoice
    • Live transcription during phone calls in more than 100 different languages. 
  • Voxsci
    • Speech-to-text app that translates voicemail messages into texts and emails.  Emails and texts can be saved, searched and shared. 
  • TapSOS
    • Tap SOS won a recent  Tech4Good Digital Health Award. It offers a way for people who are deaf or hearing impaired to communicate with emergency services without needing to speak or listen.  It works by the user tapping the screen to select which options they need and stores medical history and pertinent personal information on their device, delivering them directly to the selected emergency service using GPS to pinpoint the user’s location.
  • Braci Sound Alert
    • Allows hearing impaired individual to record sounds from their environment and produces visual and vibrational alerts on their smartphone when they are recognized. 
  • Subtitles Viewer
    • Allows the user to view subtitles in various languages on iOS (Apple) devices.  Synchronizes with television or movies on your TV or at the cinema.  Similar options available for Android devices.
  • And more…


  1. This is a great article, thank you. I’ll be testing out a number of these solutions.

  2. And my favorite, the Bose Hearphones. Unfortunately, they are no longer being manufactured (why? Is Bose coming out with something even better?) But you can find them on eBay and at other re-sale places. I prefer them to my top quality hearing aids. Especially when wearing a mask.
    Apple iPhone has several built-in possibilities, including the flashing light of Accessibility, and Live Listen.

  3. I am a retired microbiologist who has been hard of hearing since 1941. Regarding assistive listening devices, many folks may not know that all TVs since 1993 over 13″ have captions. It is called Closed Caption (CC) because the TV remote button will turn the (CC) on or off as requested. Open Captions is when the captions remain permanently. Another assistive listening device is a Pocketalker Ultra as a personal listening device with a volume and tone control. There is a 12 foot TV listening kit to extend the Pocketalker microphone to use the Pocketalker Ultra for TV listening. Hearing aids are wonderful but do not give you 20/20 hearing similar to eyeglasses. Joining the Hearing Loss Association of American (HLAA) a non-profit organization for those who speak and listen but have difficulty hearing in every situation.

  4. Good news for consumers is that hearing loops are finding their way into more and more places. To find looped locations visit or But know that the benefit of telecoils is not ONLY about hearing loops. Telecoils also come in handy in those theaters that offer FM or IR assistive listening technology with neckloops – and there are thousands of places like that. The updated (in 2010) ADA law requires that these places make 25% of their assistive devices hearing aid compatible with neckloops. The other good news is that more and more hearing aids now come in the “superfecta” form (cosmetically appealing, wireless connection to iPhone and Android phones and other devices, rechargeable and including a telecoil!) Recently – an audiologist asked me why there were no hearing loops in his community yet – I told him that this was likely because he wasn’t educating his clients about the benefits of having a telecoil and offering some simple advocacy materials and demoing the loop using a portable loop or a hearing loop connected to a TV in the waiting room. Where providers educate consumers and speak up in the community about making assistive technology DIRECTLY hearing aid compatible (as opposed to compatible via neckloops) – hearing loops happen. Want to start a hearing loop initiative in your community but not sure where to start? Find information and my email at the LoopWisconsin website – I am happy to help you. Your clients will love you for it.

  5. This is a GREAT reminder of how we as professionals can help do so much more than just fit a pair of hearing aids !
    Thank you !

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