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.
- 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.
- Live transcription during phone calls in more than 100 different languages.
- Speech-to-text app that translates voicemail messages into texts and emails. Emails and texts can be saved, searched and shared.
- 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…
- Glide: for texting and talking.
- P3 Mobile: for texting, talking and relay services. Includes ASL and clear-speech relays.
- Google Voice: for transcribing messages (speech to text).
- Sorenson Buzzcards: d/Deaf create flashcards for communication with the hearing. Flashcards can be saved.
- Speak4Me: text-to-speech
- Alarm Clock with FlashLights: alarm clock with flashing lights (and music)
- Alarmed Reminders + Timers: integrates with iPhone native Reminder app
- Loud Alarm Clock Best and Loudest Alarms 2: for people who need something REALLY loud
- Sorenson Buzzcards: create flashcards to communicate with non-ASL users
- Text to Speech!: text-to-speech
- iSpeech: text-to-speech
- Subtitles Viewer LIVE!: live speech-to-captions (caption real-time, live conversations)
- Earfy: live speech-to-captions (caption real-time, live conversations)
- Dragon Anywhere: dictation application that can be used by us deaf with hearing – have the hearing person speak and it will automatically caption what they are saying (if it is said clearly enough)