Hearing Aids
Author: Dolly Bhargava, M.Spec.Ed.
Technology such as hearing aids, cochlear implants, captioning, assistive listening devices and alerting devices can amplify sounds to help maximize the student’s communication and learning potential at school (Pratt, Heintzelman & Deming, 1993). With all of the devices described in this section it is crucial that a thorough assessment of the classroom environment is carried out before a device is chosen. A team approach should be used that consists of the classroom teacher, an assistive technology consultant, audiologist, visiting teacher for hearing, parent, speech-language pathologist, and the student. A major part of the assessment should include classroom observation to get a thorough understanding of auditory-related concerns. Based on the assessment, the best possible device to provide an appropriate educational environment for the student should be determined (Smith, Polloway, Patton and Dowdy, 1998). Also, both teacher and student need to receive appropriate in-service information and on-going follow-up support from a hearing specialist for each of the device/s to gain maximum benefit from it in the classroom.
This chapter will present technology solutions for students who have a hearing impairment. Access to information and the capacity to interact with that information in a variety of ways is fundamental to a rich curricula experience. Through provision of technology solutions that are viewed as tools, students with hearing impairment have greater opportunity to achieve access, equity and opportunity.
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Fraser (1996) states that “…a hearing aid is an instrument which collects sounds, amplifies them and then directs the louder sounds into the ear” (p. 41).
Hearing aids enable the student to use auditory perception to maximum effect. It is important to remember that hearing aids are not comparable to eyeglasses (Dugan, 2003). In other words, unlike eye glasses, which can restore vision to normal, hearing aids do not correct or restore hearing. Instead they enable the wearer to use his or her remaining hearing more effectively by amplifying sounds (Staab, 2002).
The hearing aid includes the following parts that work together to help the student listen:
- Microphone – It picks up the sound signal and converts it into electrical energy. The electrical signal is fed into the amplifier (Fraser, 1996).
- Amplifier – It progressively boosts the power of the electrical signal through various stages. The magnified electrical signal is fed into the receiver (Fraser, 1996).
- Receiver – The receiver converts the electrical signal back into sound energy, which is much louder than the original. This amplified sound is then fed into the ear canal. An incoming signal can be boosted as much as 80 dB. For example, a sound entering the microphone at 70dB can be boosted and emerge from the receiver at 150dB (Fraser, 1996).
- Battery – It is the power source of the hearing aid. Currently, there are two main types of batteries that are used: zinc-air and mercury. Zinc-air batteries are more commonly used as they last twice as long and are much more environmentally friendly than mercury batteries (Lysons, 1996).
- Ear mould – Ear moulds are designed to fit the contour of the ear. Ear moulds are the medium through which sound travels from the receiver to the student’s ear drum without leaking. Leaking causes feedback in the hearing aid, resulting in a high-pitched whistling sound (Downie, 2000).
The hearing aid is specifically tailored to meet the needs of the student with hearing impairment. Factors such as the results of the audiogram, degree of hearing loss, shape of the ear, demands on hearing, situations in which the student communicates, and expense contribute to the selection of the hearing aid (Dugan, 2003).
Most hearing aids have a volume control feature that allows the student with hearing impairment to adjust the volume manually as needed. If it’s a built-in volume control (automatic signal processing) it adjusts the volume automatically. According to Fraser (1996), hearing aids are “non selective amplifiers, which means that all sounds within the range of the microphone are amplified equally” (pg. 47). Initially the student using the hearing aid maybe disturbed or distracted by some everyday sounds, such as other students talking, coughing, sneezing, pencil dropping, paper shuffling or any other sounds in the classroom, especially if they haven’t heard these sounds before. With time and use of the hearing aid, the sounds become less disturbing (Dugan, 2003). Please refer to the chapter on Accommodations to help reduce the background noise as much as possible.
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There are several types of hearing aids. Each type offers different advantages, depending on its design, levels of amplification, and size. Selecting the right type of hearing aid is crucial so that it meets the needs of the individual. For example, the aid is tuned to boost the frequency range(s) where the student’s hearing loss is the greatest (Downie, 2000). Choosing a hearing aid should be based on a full assessment carried out by an audiologist. Some hearing aids are equipped with a T-switch (telecoil), which is a magnetic coil that allows for clearer reception of sounds from assistive listening devices such as induction loops and sound amplification systems or telephones (Downie, 2000).
In-the-Ear (ITE) Hearing Aids. All the components of ITE hearing aids – the microphone, amplifier, receiver, power source – are built into the ear mould itself, which is specifically made to fit the student’s 's ear. The ITE hearing aid is useful for students with mild to severe hearing loss. ITE aids can accommodate added technical mechanisms such as a T-switch or telecoil to improve sound transmission. ITE aids can be damaged by earwax and ear drainage, and their small size can cause adjustment problems and feedback. ITE aids are not usually recommended for young children because of the size of the ear moulds and also because they will need to be replaced as the ear grows. Also, the small size of the battery door and volume control may be difficult to adjust (Fraser, 1996; Lysons, 1996). For more information and an example of an ITE aid please visit https://www.connecthearing.com/hearing-aids/in-the-ear/
Behind-the-Ear (BTE) Hearing Aids. BTE hearing aids are the most common form of hearing aid for children (Fraser, 1996). The body of the BTE aid, which is in a small curved case, contains the microphone, amplifier, receiver and battery. The sound from the receiver in the case is fed through a clear plastic tubing to an ear mould, which fits inside the outer ear. The sound is transferred from the ear mould into the auditory canal. BTE aids are used by children of all ages with any degree of hearing loss, mild to profound. (Staab, 2002). A t-switch can be installed into the BTE aid to facilitate the use of assistive listening devices and improve sound transmission. Some models also have a tone and volume control, which is easy to adjust. Poorly fitting BTE ear moulds may cause feedback, a whistling sound caused by the fit of the ear mould or by buildup of earwax or fluid (Fraser, 1996). For more information and an example of a BTE aid please visit https://www.connecthearing.com/hearing-aids/behind-the-ear/
Body Worn Hearing Aids – The microphone, amplifier and battery are inside a case that is carried inside a pocket or attached to clothing or a specially designed harness. The amplified signal is fed along a thin cord to a receiver which is attached directly to the ear mould (Fraser, 1996). The body worn hearing aid is of a fairly large size so it is able to incorporate many signal-processing options. Yet, due to its cumbersome large size and visibility, older students do not commonly use it. Students with severe to profound hearing losses or very young students or students who cannot use other types of aids (i.e., due to manual dexterity problems) mostly use body worn aids (Esse and Thibodeau, 1995; Lysons, 1996). For more information and an example of a body worn aid please visit https://us.hearingdirect.com/blogs/guides/types-of-hearing-aids#body
In the Canal (ITC) Hearing Aid - ITC aids are contained in a tiny case that is placed inside the ear canal, with size and shape customized to fit. They are not visible, offer better acoustics and are easy to maintain. Students who have mild to moderately severe hearing losses use ITC aids (Esse and Thibodeau, 1995). However, due to their small size, ITC aids are difficult to handle, adjust and remove, and may not be able to hold additional devices, such as a telecoil. ITC aids can also be damaged by earwax and ear drainage. They are not typically recommended for young students because they needs to be replaced as the ear grows (American Academy of Otolaryngology, 2002). For more information and an example of an ITC aid please visit https://www.connecthearing.com/hearing-aids/in-the-ear/
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The benefits of hearing aids are dependent on the age of onset and the severity of the hearing loss, type of hearing aid used, student’s communication abilities and motivation to use hearing aid. Hearing aids can enhance quality of life by:
- Increasing the student’s ability to hear sounds
- Reducing speech reading effort
- Reducing communication stress/fatigue level
- Improving understanding of speech with or without visual cues
- Promoting independence (e.g. use of the telephone)
(E-Michigan Deaf and Hard of Hearing, 2002)
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- Help students develop realistic expectations of what their hearing aid can do. For example, Lysons (1996) emphasizes that “not even the best aid can wholly provide the clear discrimination, selectivity and location of sound that is obtained with normal hearing” (p. 99).
- Help students become familiar with their hearing aid. For example, they should know how to insert and remove the hearing aid, replace batteries, adjust volume, operate on-off switch, use telecoil or telephone (Lysons, 1996)
- Encourage students to take care of their hearing aid. For example, students should wipe the hearing aid regularly with a dry cloth or tissue. The hearing aid should never be put in water. Additional information on cleaning the hearing aid will be provided by their hearing aid supplier.
- Ensure that the material used in activities in which the student is involved does not damage the hearing aid. For example, chemicals in cosmetics, after-shave, hair spray, perfume, sunscreen and mosquito repellent can damage their hearing aid. Ask them to remove their hearing aid before applying those products and allow time for the product to dry.
- Speak to the audiologist for a checklist to assist with troubleshooting for commonly occurring problems with hearing aids. Below is an example of such a checklist. Keep it in a location for access by staff.
Symptom
Possible Cause
Solution
Whistling or squealing noise while hearing aid is being worn
- Hearing aid or ear mould not inserted correctly
- Ear wax blocking the ear canal
- Earmould tubing split
- Earmould or in-the-ear hearing aid is too loose
- Re-insert hearing aid
- Have the ear canal examined
- Contact the hearing aid provider
- Contact the hearing aid provider
No sound
- Aid not turned on
- Dead battery
- Aid in ‘T’ position
- Tubing blocked with wax or moisture
- Check that the battery holder is fully closed and the aid is switched ON
- Replace battery with a new one
- Switch to ‘M’ position
- Remove wax or moisture from tubing
Weak sound
- Volume too soft
- Moisture or wax partially blocking the tubing
- Change in hearing
- Adjust volume control
- Remove wax or moisture from tubing
- Have another hearing test
Intermittent Sound
- Dirty or corroded battery contacts
- Return aid for service
Cochlear Implants
Author: Dolly Bhargava, M. Spec. Ed.
Some students with a severe to profound sensorineural hearing loss may be using appropriate hearing aids but are not receiving much benefit from them and are still having difficulty communicating. Such students may be candidates for cochlear implants. Selecting a suitable candidate for a cochlear implant involves an evaluation process that takes into consideration factors such as: the student’s age, duration of hearing impairment, speech and language abilities, results from the medical assessment, audiological assessment and psycho-social factors (Chute, 2002, Miyamoto and Kirk, 1998).
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A cochlear implant is an electronic device that is surgically implanted into the cochlea (inner ear) to compensate for the damaged or absent hair cells by directly stimulating the auditory nerve fibers. The internal cochlear implant is coupled to external components that pick up sounds from the environment (Turnbull, Turnbull, Shank and Smith, 2004). Dugan (2003) states that “a cochlear implant is not a cure nor does it restore hearing to normal” (p. 77). Rather, it taps into the retained potential of the hearing pathway, by bypassing damaged hair cells and directly stimulating the functional auditory nerve fibers in the cochlea (Dugan, 2003; Turnbull et. al, 2004).
A cochlear implant has internal and external parts. The internal implant consists of an internal receiver coil and a receiver/ stimulator, which is surgically implanted under the skin behind the ear, and electrodes that are inserted into the cochlea. The external speech processor converts sound waves into a digital code, which is transmitted via a mini radio link to the internal coil. The receiver/ stimulator then converts the code into electrical currents, which the electrode delivers to the auditory nerve. The external part consists of a microphone, a speech processor and a transmitter coil (Dugan, 2003; Turnbull et. al, 2004). The microphone is located on the student’s head, held in place by the pinna. The speech processor is either worn on the body or is positioned behind the ear. The external transmitter coil is held in place over the internal receiver coil by a magnet (Downie, 2000). The external components work together to collect, analyze, process and transmit auditory information to the internal parts to provide the student with sound (Zwolan, 2002).
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- A microphone picks up sound.
- Sound is sent from the microphone to the speech processor.
- The speech processor analyzes and digitizes the sound into coded signals.
- The speech processor is programmed to the student’s hearing needs.
- Coded signals are sent to the transmitter.
- The transmitter sends the code across the skin to the internal implant.
- The internal implant converts the code to electrical signals.
- The signals are sent to the electrodes to stimulate the remaining nerve fibres.
- The signals are recognized as sounds by the brain, producing a hearing sensation.
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For most recipients the cochlear implant is able to provide sufficient hearing to stimulate speech and language development, enabling some children to attend mainstream schools and enjoy broader education, employment and social opportunities.
Deaf children’s speaking and hearing success depends on a number of things, including how long they were deaf before receiving any auditory stimulation. Spencer and Marschark (2003) state that the earlier in life implants are provided, the better the outcome, particularly with spoken communication, literacy and mainstreaming.
According to parents, children with cochlear implants enjoy significant gains in sound awareness, especially of softer sounds, speech understanding, monitoring their own speech and understanding voices without looking at the speaker. This makes communication a great deal easier and promotes success in communication.
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- Cochlear implants will not restore hearing to “normal”. In other words the student will not immediately start understanding all the sounds that they are hearing. Once a student has been fitted with a cochlear implant he or she must undergo extensive audition based speech and language therapy to learn how to interpret the new sounds effectively (Pagliano, 2005).
- It is important to remember that each student is unique, and outcomes will differ from student to student. A variety of factors (such as degree of hearing loss, type and amount of auditory and speech intervention before and after cochlear implantation, motivational factors) will affect how much and how quickly the student will benefit from the cochlear implant.
- Please refer to the strategies discussed in the Accommodations chapter, as they are still relevant when communicating with the student who has a cochlear implant. For example, facing the student when interacting, speaking clearly and monitoring background environmental noise and light are critical for successful communication.
Assistive Listening Devices
Author: Dolly Bhargava, M. Spec. Ed.
In writing this section I consulted with and appreciated the input (both information and images) from Andrew Willis, Assistive Technology Consultant from Word of Mouth Technology www.wom.com.au; Karina Badcock , Early Childhood Trained Teacher of the Deaf (oral deaf and Auslan user), and Margaret Haenke, Manager of Deafness Resources Australia: www.deafnessresources.net.au
Lewis (1998) states that the three most common factors that affect the student’s ability to hear and understand in the classroom are background noise, reverberation and distance. Hearing aids provide maximum benefit when the environment is relatively quiet, the acoustics are good and the student with hearing impairment is interacting at a close distance to the speaker (Turnbull, Turnbull, Shank and Smith, 2004). However, in environments such as the classroom, difficulties with background noise, reverberation and distance cannot be solved by hearing aids alone. An assistive listening device (ALD) may be beneficial.
Assistive listening devices (ALDs) are specifically designed to enhance sound by minimizing the negative effects of background noise, reverberation, and distance from the speaker and thereby maximizing the student’s ability to hear and understand. ALDs are specifically designed to pick up the desired sound from as close to the sound source as possible and send it directly to the listener’s ear, which enhances hearing (Thurman, 1999).
There is a wide range of ALDs, from personal amplifiers and television listening devices to large area and stadium size systems (Thurman, 1999). In this section we will discuss three types of ALDs that are particularly useful for the classroom setting. They include frequency modulated (FM systems), induction loops and sound field amplification systems.
Smith, Polloway, Patton and Dowdy (1998) outline some suggestions for teachers to assist students with hearing impairments on the use of the assistive listening devices to their maximum potential. For example, teachers should:
- Have sufficient knowledge about the type of ALD that the student uses.
- Understand how the device works and have some ideas for troubleshooting commonly occurring problems.
- Be able to determine whether the ALD is functioning properly or not.
- Know how to take care of the ALD.
- Know whom to contact if there is a problem with the ALD.
In the following sections we will discuss FM systems, induction loops and sound field amplification systems.
FM Systems
Author: Dolly Bhargava, M. Spec. Ed.
What Is an FM System?
A frequency modulation (FM) system can be used by teachers to transmit their voice directly to the student and can be used indoors and outdoors. It consists of:
- Microphone
- Transmitter
- Receiver
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The sound (e.g. teacher’s voice) is picked up by a microphone which is connected through a line input to the transmitter. The sound signals are then picked up by the receiver that is worn by the student with hearing impairment. There are several options for getting the sound from the receiver to the ear depending on the student’s degree of hearing loss and personal preference (Downie, 2000). If the student wears hearing aids, normally there is a lead that physically connects the FM receiver to the hearing aid (called direct audio input).
An FM system can also be used with headphones that directly transmit the teacher’s voice to the student, resulting in less distraction by other noise in the room and better understanding of what the teacher is saying.
An FM system can also be used in a classroom to transmit other audio signals to the student, such as television and radio. This can be done using an audio lead that takes the audio signal from the sound source and connects it to the auxiliary input on the FM transmitter.
Systems that use an FM signal can transmit through walls, so it is important to remember to turn off the transmitter when you leave the room or wish to discuss something in private or confidentially, as otherwise the student may be able to overhear your conversation.
Depending on the FM systems being used by students, it is also possible to transmit the signal from PA systems in halls and stadiums on the school grounds directly to the student’s receiver. This is a convenient means of providing access to students with hearing impairment to schools that use a PA system. This process uses a product called a large area transmitter.
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- They can be used with students with a wide variety of hearing impairments.
- The student is able to receive high-quality sound over considerable distance (Downie, 2000).
- The FM system enables the student to hear the person speaking into the microphone clearly and without most of the background noise.
- The student can hear the speaker clearly even when the speaker is not close by or is moving around the room.
- The FM systems are portable and can be easily moved from one class to another and used in situations where other classroom amplification systems are not practical (e.g. on the playground or during field trips) (Lewis, 1998).
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- It is important to wear the transmitter.
- Inquire whether or not the student has been issued an FM system and encourage its use.
- The speaker needs to be aware of the volume of his/her voice as it is being directly broadcast to the student.
- The speaker must take care to eliminate interfering noise. For example, ensure that the microphone does not rub on clothing (Downie, 2000), the speaker’s hair does not rustle against the microphone and the speaker does not clear his/her throat or eat whilst talking.
- The speaker wearing the transmitter needs to remember to turn it off when not interacting with the student wearing the FM receiver.
- During group discussions, try to pass the microphone to each child who speaks (Trautwein, 2005) so that the student wearing the FM receiver can hear all contributions.
- If two transmitters are being used in the same classroom, e.g. in a team teaching situation, ensure that the transmitting frequency channels are as distinct as possible. Remind the student to change channels as they move from group to group (Trautwein, 2005).
- For multi-media lessons on TV, CD or DVD, place the FM transmitter microphone near the sound source, or preferably connect the TV directly to the FM transmitter via the auxiliary input jack (Trautwein, 2005).
Induction Loops
Author: Dolly Bhargava, M. Spec. Ed.
What is an Induction Loop Amplification System?
An induction loop amplification (ILA) system is comprised of:
- one or more microphones to collect the desired sound (such as a teacher’s voice, television),
- an amplifier to boost the signal, and
- a loop of wire that surrounds the perimeter of the listening area (such as the classroom or auditorium). (Lewis, 1998)
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Here is an illustration of how an induction loop works.
The sound signal is transmitted from the microphone worn by the source (e.g. speaker, TV or radio) to a loop amplifier that converts the signal into electrical energy. The electrical signal passes through the wire loop and generates an electromagnetic field. The electromagnetic energy is received by one of the following devices if it is equipped with a T switch (a telecoil that picks up messages from the magnetic field).:
- hearing aid
- cochlear implant
- loop receiver that the student can connect to using earphones or headphones (Lewis, 1998).
Induction loops are traditionally used in venues such as lecture halls, theatres, churches and public halls.
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- They can be used with students with a wide variety of hearing impairments.
- If the receiver is the built-in T coil in the hearing aid or cochlear implant, it means the student with the hearing aid always has a "receiver" with them (Palm, 2004). If the student does not have the telecoil facility, he/she can use a Loop Receiver and a headset to hear the audio signal provided by the induction loop system.
- Induction Loop Systems deliver sound directly from the source to the hearing aid, without the interference of background noise, by bridging the distance between the sound source and listener and reducing background noise.
- The sound signal received by the student matches his/her needs.
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This section describes some of the limitations associated with use of induction loop systems in classrooms, and provides tips for teachers to use them effectively.
When the hearing aids are switched on to 'T' no other sounds can be heard at all, except what is coming through the "pick up point," so the student will not be able to hear peers’ comments, class discussions, or questions. To overcome this problem, recent changes in hearing aid technology now provide more options. For example, it is possible to have the option of 'M' and 'T' combined on some hearing aids. This means that the student can access information from the loop system (‘T’) as well as information from the hearing aid microphone (‘M’).
The signal generated by the induction loop system may be affected by interference picked up from metal, electrical equipment such as fluorescent lights, dimmer switches or electric wiring, or video display terminals (Lewis, 1998). Replacing dimmer switches with good quality switches that do not emit interference, reducing the size of the loop, or rearranging the seating away from the source of the interference and reducing the speaker-to-listener distance may help overcome this problem.
Walls, ceilings and floors do not block the magnetic waves from a loop, so loop signals can spill out into other rooms. According to Gilmore (1995) the spillover distance can be 50 to 100 feet. Rooms that are next to each other, and rooms directly above and below the loop, can be affected. Hearing aid users whose hearing aids are also switched to T and people using a Loop Receiver outside the room may be able to overhear sounds or conversations (RNID, n.d.). To overcome this problem it is important that the induction loop system is configured using a low spillover design. Alternatively an infrared system maybe used.
Infra-red Systems. Another alternative might be to use an Infrared system, as infrared transmissions will not pass through walls. Infrared listening devices can be supplied that work with the T-switch on the hearing aid, connect directly to the hearing aids (Direct Audio Input) or are used without hearing aids (using headphones). Infrared transmitters convert the sound source into infrared light that is transmitted to a receiver. The receiver must be in line-of-sight to the transmitter. Strong sunlight affects the infrared light, so infrared would be a classroom based solution only (i.e. not suitable for field trips or out in the playground).
What is a Sound Field Amplification System?
A sound field amplification system is used in the classrooms to improve the signal-to-noise ratio, amplifying the teacher’s voice above the ambient noise in the room. The sound field amplification system consists of:
- a microphone/transmitter
- an amplifier and
- a number of strategically placed loudspeakers in different locations around the room and ceiling (Crandell and Smaldino, 2002).
This system is useful for students with mild or fluctuating hearing impairment (e.g. caused by Otitis Media) or central auditory processing disorder.
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The teacher wears a microphone and radio transmitter that transmits their voice to speakers installed in the classroom. It provides amplification uniformly throughout the classroom. There are also portable sound field systems which can be placed on the student’s desk (Crandell and Smaldino, 2002).
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Sound field amplification systems have been demonstrated to improve the learning environment for students and teachers due to the following:
- they can be used with students with mild hearing impairments and fluctuating hearing impairment
- they improve the signal-to-noise ratio for all students in the class (Lewis, 1998)
- no receiver is required
- they enable teachers to be mobile, aid teachers with projecting their voices and thereby avoid vocal abuse (Crandell and Smaldino, 2002)
- they improve the learning environment for the student by enhancing speech perception
It is important to note that the other assistive listening devices described in this section may be more relevant for students with severe hearing impairments, because the sound field amplification system does not provide enough amplification relative to the degree of hearing loss (Lewis, 1998). Also, a sound field amplification system will not provide adequate benefits in excessively noisy or reverberant environments (Crandell and Smaldino, 2002).
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- Every classroom is different in terms of its size, shape, seating arrangements and teaching style used (Lewis, 1998). It is important to take these factors into consideration when deciding on the loudspeaker arrangements or number of loud speakers in the classroom (Crandell and Smaldino, 2002). Lewis (1994) states that inappropriate installation may result in an amplified signal that is poorer than the un-amplified signal.
- Audiologists recommend the use of sound field amplification systems (Flexer, 1997) based on an evaluation of classroom acoustics such as ambient noise level, reverberation time and signal-to-noise ratio. Based on the measurement results, audiologists then select, evaluate and customize sound field systems to fit the needs of the students, teachers and classroom.
- It is not practical to move the system from one classroom to another so its location needs to be carefully considered.
Devices for Environmental Sounds
Author: Dolly Bhargava, M.Spec.Ed.
In writing this section I consulted with and appreciated the input from Margaret Haenke, Manager of Deafness Resources Australia. www.deafnessresources.net.au
What are Devices for Environmental Sounds?
The telephone ringing, alarm clocks, smoke or fire alarms are sounds that alert people to daily life occurrences. Many devices have been designed to assist students with hearing impairments become aware of the sounds in the environment that are needed for personal safety or convenience (Meier, 1999). These devices help compensate for the student’s hearing impairment, allowing for a greater sense of confidence, independence and control of the environment. Varying in their level of sophistication and complexity, there are many alerting products available on the market today to help students with hearing impairments.
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- Vibrating alarm clock: It is a clock that has a vibrating device, which can be clipped onto the pillowcase or a section of a bed or the entire bed. At the chosen time, the clock activates the alarm signal, which in turn causes the vibrator to move the attached section, thus awakening the sleeper.
- Flashing alarm clock: It is a clock that has a bright light, which will flash when the alarm goes off.
- Combination alarm clock: It has a combination of both the vibrating and flashing light features. (Meier, 1999)
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- Vibrating alarm watch: The wristwatch vibrates when the alarm goes off. These watches are generally used as reminder tools during the daytime, as they are usually not strong enough to wake someone from sleep. Some alarm watches may have an automatic reload countdown timer, which gives reminders as often as needed.
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- Schools should have a flashing light system linked to the smoke or fire alarms and other bells/sound systems to visually alert the student with hearing impairment. These systems should be visible in classrooms and in general areas where the student maybe alone, such as rest rooms or study carrels (Gloucestershire Country Council, 2004). It is important to note that if a flashing light alert system is used for both the school bell and smoke/evacuation alarms, it is critical that these flashing light alert systems be distinctly different to each other. If the smoke/evacuation alert goes off, it is crucial that the student respond immediately and that there is no danger of ignoring the flashing light thinking that it’s ‘just the school bell’.
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Telephones - Hearing the telephone ring
- Ring Enhancers: A device that allows the student with hearing impairment to set the volume of the ring to much louder levels than ordinary telephones (Meier, 1999).
- Telephone Light Flashers: A light is fitted into the telephone that flashes whenever the telephone rings. This is generally a fairly small light and the student would need to have the telephone in view for this to be effective. Alternatively, the telephone can be connected to an external system to make lights flash throughout the room or the building.
Telephones – Communicating using the telephone
- T-switch – alternatively also known as a telecoil. It is a coil of wire, which has the capacity to pick up sound directly from a magnetic field created when sound is fed into the coil. Many telephones can output a magnetic signal which hearing aids with a telecoil can "hear." If the hearing aid or cochlear implant has a T-switch, then it only responds to those sounds coming from the telephone so unwanted and distracting background noises are not picked up (SHHH, 2004).
- In-built amplifier – a telephone that has an in-built amplifier and an adjustable volume control that the student can use to make the caller’s voice louder to compensate for the hearing loss (Downie, 2000).
- Portable amplifier – a battery-powered amplifier which slips over the handset ear piece. The student can adjust the volume to suit individual needs. It is convenient if using several different phones, however, it may not work on all telephones or make the volume as loud as some students may need it to be (Dugan, 2003).
- TeleTypewriter (TTY) also known as a Textphone: If neither the T-switch nor the amplification allows the student to communicate well on the telephone, a TTY may be a better option (Dugan, 2003). A TTY unit consists of a QWERTY keyboard, visual display screen and acoustic coupler. The acoustic coupler is two upward facing rubber cups – one for the mouthpiece and one for the earpiece of the telephone handset (Downie, 2000). Some TTYs also have a ‘direct connect’ option whereby the TTY can be plugged directly into the telephone outlet, rather than using the acoustic coupling option. When a TTY calls another TTY, the users send their message by typing what they want to say and the words appear on the digital display of the other person’s TTY. Some TTYs also allow the user the option to print the conversation on a piece of paper (Meier, 1999). If someone who needs to use a TTY wishes to make a call to someone who doesn’t have a TTY (or vice versa), then the call can be made through the Telecommunication Relay Service, as known in USA, or the National Relay Service in Australia
- Telecommunication Relay Service – The Telecommunications Relay Service provides telephone access service to people who have a hearing impairment or severe speech impairment. Relay Officers, who are specially trained communication assistants, serve as intermediaries, relaying conversations between the person using the TTY and the person without a TTY. For example, students with hearing impairment use the TTY to type what they want to say to the person they are calling. The Relay Officer reads this text communication and simultaneously reads it aloud to the person at the other end of the call. The Relay officer listens to the response and types it back to the student to read and respond (Downie, 2000; Dugan, 2003).
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There are many factors which impact on a Deaf person’s or person with hearing impairment’s ability to successfully use a mobile phone, so it is important to choose carefully in terms of the following features:
- Mobile networks (e.g. CDMA or GSM). People with a hearing aid may experience an interfering noise when using a mobile phone. It can be a buzzing sound that makes speech hard to understand. In severe cases, it can make the phone unusable. Possible solutions to this problem include:
- Use a CDMA mobile phone
- If using a GSM mobile phone, use it with a T-link attachment and switch the hearing aid to the 'T’ position.
- Use an alerting system for incoming calls (e.g. flashing screen or vibrating alert)
- Use the text messaging or short messaging service (SMS) feature, although there may be restrictions on the length of the message (number of characters) that can be sent.
- These use the built-in QWERTY keyboard or can be attached to the mobile. (Downie, 2000; Dugan, 2003)
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